[A Case of Pathologically Complete Response in Ruptured Hepatocellular Carcinoma Treated with Transcatheter Arterial Embolization].
We report a case of pathologicallycomplete response in ruptured hepatocellular carcinoma(HCC)treated with transcatheter arterial embolization(TAE). A 56-year-old man presented to our hospital with a hepatic tumor. Enhanced computed tomography(CT)revealed a tumor 65mm in diameter at S7/8 of the liver and the presence of abdominal fluid collection around the tumor. We diagnosed rupture of HCC and selective TAE was subsequentlyperformed. After TAE, the elevated PIVKA- / Ⅱ tumor marker level(1,008mAU/mL)decreased to the normal level. Three weeks after TAE, we performed right hepatectomy. The resected specimen revealed that the tumor consisted of necrotic tissue. Viable tumor cells were absent in this tumor. The pathological diagnosis was therefore HCC in which complete response was obtained with TAE.


European Stroke Organisation (ESO) - European Society for Minimally Invasive Neurological Therapy (ESMINT) Guidelines on Mechanical Thrombectomy in Acute Ischemic Stroke.
Mechanical thrombectomy (MT) has become the cornerstone of acute ischemic stroke management in patients with large vessel occlusion (LVO). To assist physicians in their clinical decisions with regard toMT. These guidelines were developed based on the standard operating procedure of the European Stroke Organisation and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. An interdisciplinary working group identified 15 relevant questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence, and wrote evidence-based recommendations. Expert opinion was provided if not enough evidence was available to provide recommendations based on the GRADE approach. We found high-quality evidence to recommend MT plus best medical management (BMM, including intravenous thrombolysis whenever indicated) to improve functional outcome in patients with LVO-related acute ischemic stroke within 6 hours after symptom onset. We found moderate quality of evidence to recommend MT plus BMM in the 6-24h time window in patients meeting the eligibility criteria of published randomized trials. These guidelinesdetails aspects of prehospital management, patient selection based on clinical and imaging characteristics, and treatment modalities. MT is the standard of care in patients with LVO-related acute stroke. Appropriate patient selection and timely reperfusion are crucial. Further randomized trials are needed to inform clinical decision-making with regard tothe mothership and drip-and-ship approaches, anesthaesia modalities during MT, and to determine whether MT is beneficial in patients with low stroke severity or large infarct volume.


Novel solid dispersions of benznidazole: preparation, dissolution profile and biological evaluation as alternative antichagasic drug delivery system.
Solid dispersions (SD) of benznidazole (BNZ) in sodium deoxycholate (NaDC) or low-substituted hydroxypropylcellulose (L-HPC) were developed by freeze-drying process to improve the solubility of this low water-soluble drug and consequently, its trypanocidal activity. Although the dissolution studies showed a progressive decrease in the release rate of BNZ when formulated in the presence of NaDC, the increase in the surfactant concentration resulted in a better trypanocidal profile on epimastigotes, as well as in an enhancement of the unspecific cytotoxicity. However, such an effect was not so evident on amastigotes and in vivo (blood-trypomastigotes), where high concentrations of surfactant (BNZ:NaDC ≥ 1:6) experimented a loss of activity, correlating this fact with the minor cession of BNZ these formulations accomplished in acidic locations (i.e., dissolution test medium). According to the in vitro results, we reformulated the promising SD-1:3 (IC₅₀ epimastigotes = 33.92 ± 6.41 µM, IC₅₀ amastigotes = 0.40 ± 0.05 µM and LC₅₀ = 183.87 ± 12.30 µM) replacing NaDC by L-HPC, which achieved the fastest dissolution profile. This fact, together with the safety this carrier ensures (LC₅₀ > 256 µM), prompted us to evaluate the cellulose SD in vivo, improving the effectiveness of its NaDC equivalent (%AUPC = 96.65% and 91.93%, respectively). The results compiled in the present work suggest these solid dispersions as alternative drug delivery systems to improve the limited chemotherapy of Chagas disease.


[Webbed neck associated with other developmental defects].
In patients with a combination of congenital webbed deformity of the neck with the Klippel-Weil syndrome, muscular hyperplasia of lateral masses of the neck and latent cerebrospinal hernias favorable cosmetic results could be obtained by an operative dissection of excessive soft tissues including the muscular and cyst ectopic cerebrospinal membrane tissues.


[Isolated fractures of the zygomatic arch].
Out of 245 cases of zygomatic complex fractures which have been treated during 1978-1987, 20 were isolated zygomatic arch fractures. The analysis of the cases showed that the causing factors had been direct violence due to fight, sport and traffic accidents. It had been proved that these fractures are not very rare. Evaluation and treatment must be in time. Reduction of the fracture with the Ginestet hook and the Gillies method offer the most promising therapeutic results as it has been showed through this study.


Histological effect on the adipocutaneous flap in rats after preconditioning with 2-chloro-N(6) -cyclopentyladenosine.
2-chloro-N(6) -cyclopentyladenosine (CCPA) was proven to be a protective factor in ischemic reperfusion injury. The purpose of this study was to determine how CCPA would affect the single tissue layers of the adipocutaneous flap. Seventy male Wistar rats were divided into 5 experimental groups. Samples were taken of the area of flap necrosis and the wound margin after classical or pharmacological preconditioning on the fifth postoperative day. All samples were fixed in formaldehyde, embedded in paraplast, and analyzed in 3- to 4-μm sections (hemalaun-eosin stain and light microscopy). In general, wound healing was alike and remained unaffected by the experimental design. The most sensitive part of the flap during preconditioning is the subcutis. The number of neutrophils and of plasma cells is reduced significantly (p < .05). CCPA has an effect on each tissue layer of the flap. Subcutis became apparent as the most sensitive layer. CCPA influences complement pathway and neutrophils directly and indirectly.


Compliance with recommendations and opportunities for vaccination at ages 11 to 12 years: evaluation of the 2009 national immunization survey-teen.
To determine vaccination coverage at selected ages and by birth cohort and to assess whether all indicated vaccines were administered during vaccination visits. Population-based cross-sectional study. National Immunization Survey-Teen 2009 telephone interview. United States adolescents aged 13 to 17 years with provider-reported vaccination histories (N = 20 066). Among all adolescents and by birth cohort: coverage estimates for 3 childhood vaccines (measles-containing, hepatitis B, and varicella) and 3 adolescent vaccines (tetanus-diphtheria and/or tetanus-diphtheria-acellular pertussis, meningococcal-containing, and human papillomavirus for girls) at selected ages. By age 11 years, most adolescents had obtained the childhood vaccines. Receipt of a tetanus-diphtheria and/or tetanus-diphtheria-acellular pertussis vaccine at ages 11 to 12 years increased significantly from the 1991 to 1996 birth cohort (33.8% vs 68.2%, P < .001); receipt of meningococcal-containing vaccine at ages 11 to 12 years increased significantly from the 1993 to 1996 birth cohort (8.4% vs 50.0%, P < .001). Among girls, receipt of human papillomavirus vaccine at ages 11 to 12 years increased significantly from the 1994 to 1996 birth cohort (11.1% vs 30.5%, P < .001). Overall, 54.9% of adolescents received at least 1 vaccination visit at ages 11 to 12 years. Among adolescents who made a vaccination visit at ages 11 to 12 years and were eligible for vaccination, 19.5% did not receive tetanus-diphtheria and/or tetanus-diphtheria-acellular pertussis, 60.9% did not receive meningococcal-containing, and 62.4% did not receive human papillomavirus vaccines. Receipt of vaccines at the recommended ages of 11 to 12 years appears to be increasing; however, providers often do not administer all indicated vaccines during a vaccination visit.


Taylor's cortical dysplasia: a confocal and ultrastructural immunohistochemical study.
In the present report we describe the neuropathological characteristics of tissue surgically resected from three patients affected by intractable epilepsy secondary to cortical dysplasia. Common features, suggestive of a focal cortical dysplasia of Taylor, were observed in all specimens. Immunocytochemical procedures were performed using neuronal and glial markers and the sections were observed at light traditional and confocal microscopes. This part of the investigation pointed out: 1. cortical laminar disruption; 2. very large neurons displaying a pyramidal or round shape; 3. ballooned cells; 4. decrease of calcium binding proteins immunoreactivity; 5. abnormal nets of parvalbumin- and glutamic acid decarboxylase-positive puncta around giant neurons but not around ballooned cells. Ultrastructural investigation on the same material provided evidence of a high concentration of neurofilaments in giant neurons and of glial intermediate filaments in ballooned cells. In addition, immunolabeled GABAergic terminals clustered around giant neurons were not found to establish synapses on their cell bodies. The present data, derived from a limited sample of patients but showing very consistent features, suggest that in Taylor's type of cortical dysplasia a disturbance of migratory events could be paralleled by a disruption of cell differentiation and maturation and by an impairment of synaptogenesis. This latter mechanism seemed to affect especially the inhibitory elements, and could account for the hyperexcitability of this tissue and thus for the high epileptogenicity of Taylor's dysplasia.


Data on the pathophysiology and clinical aspects of the mechanical obstruction of the small intestine.
A brief overview is given of the relevant physiology of the small intestine, and the pathomechanism of the clinical picture, based on a material of 423 patients with mechanical obstruction of the small intestine. The various forms of the mechanical obstruction of the small intestine are reviewed, with special regard to strangulation and adhesive obstruction. The possible forms of treatment are dealt with, with an emphasis on the importance of an early surgical intervention and of a careful after-treatment with a view to reducing the still high morbidity rate.


Specific molecular markers in hepatocellular carcinoma.
The carcinogenesis of hepatocellular carcinoma (HCC) is a multi-factorial, multistep and complex process. Its prognosis is poor, and early diagnosis and monitoring metastasis of HCC is of the utmost importance. Circulating diagnostic and prognostic biomarkers could be used in proper postoperative treatment of patients at an early stage of HCC development. This review summarizes recent studies of the specific biomarkers in diagnosis and monitoring metastasis or postoperative recurrence of HCC. An English-language literature search was conducted using MEDLINE (June 1998 to September 2006) on researches of some valuable specific biomarkers in diagnosis and monitoring metastasis or postoperative recurrence of HCC. Hepatoma tissues can synthesize various tumor-related proteins, polypeptides, and isoenzymes, such as alpha-fetoprotein (AFP), hepatoma-specific gamma-glutamyl transpeptidase (HS-GGT), etc, and then secrete into blood. The valuable early diagnostic and prognostic biomarkers could predict the development and metastases of HCC. Recent researches have confirmed that circulating hepatoma-specific AFP subfraction, transforming growth factor (TGF)-beta1, HS-GGT, and free insulin-like growth factor (IGF)-II may be more specific markers than total AFP level for early diagnosis for HCC. The circulating genetic markers such as AFP-mRNA, TGF-beta1-mRNA, IGF-II-mRNA, etc from peripheral blood mononuclear cells of HCC patients have been most extensively used in monitoring distal metastasis or postoperative recurrence of HCC. Hepatoma tissues synthesize and secrete valuable molecular markers into blood. The analyses of circulating hepatoma-specific biomarkers are useful to early diagnosis of HCC or monitoring metastasis or postoperative recurrence of HCC.


Neuroprotective effects of Aceglutamide on motor function in a rat model of cerebral ischemia and reperfusion.
To investigate the effect and underlying mechanism of Aceglutamide on motor dysfunction in rats after cerebral ischemia-reperfusion. Adult male Sprague-Dawley rats were subjected to 2 h transient middle cerebral artery occlusion (MCAO). Aceglutamide or vehicle was intraperitoneally given to rats at 24 h after reperfusion and lasted for 14 days. Subsequently functional recovery was assessed and number of tyrosine hydroxylase (TH)-positive neurons in substantia nigra (SN) was analyzed. Tumor necrosis factor receptor-associated factor 1(TRAF1), P-Akt and Bcl-2/Bax were determined in mesencephalic tissue by Western blot method. PC12 cells and primary cultured mesencephalic neurons were employed to further investigate the mechanism of Aceglutamide. Aceglutamide treatment improved behavioral functions, reduced the infarction volume, and elevated the number of TH-positive neurons in the SN. Moreover, Aceglutamide significantly attenuated neuronal apoptosis in the SN. Meanwhile Aceglutamide treatment significantly inhibited the expression of TRAF1 and up-regulated the expression of P-Akt and Bcl-2/Bax ratio both in vitro and in vivo. Aceglutamide ameliorated motor dysfunction and delayed neuronal death in the SN after ischemia, which involved the inhibition of pro-apoptotic factor TRAF1 and activation of Akt/Bcl-2 signaling pathway. These data provided experimental information for applying Aceglutamide to ischemic stroke treatment.


[5-Fluorouracil-induced colitis--a review based upon consideration of 6 cases].
At increasing use of high-dose 5-fluorouracil-based chemotherapy for metastatic colorectal and gastric cancer complicated drug-induced colitis is observed more frequently. From May 1998 to November 2000 we observed 6 cases of 5-fluorouracil-induced colitis, in which we looked for involvement of small intestine. We report summing up on the 6 cases including both endoscopic and histological findings in both sites of the gut. In 2 men and 4 women (age 49-78 years) with advanced colon (n = 2), gastric (n = 3 ) and gallbladder (n = 1) cancer a palliative weekly high-dose infusional 5-fluorouracil (2,6 g/m(2)/24 h) and folinic acid (500 mg/m(2)/2 h) chemotherapy was performed. Few days after 1-5 chemotherapy courses the patients were admitted to our hospital with abdominal pain and partly severe watery diarrhea (up to 20 times evacuations/per day). The stool cultures were negative and there were no proof both of clostridium difficile and his toxin A and B. In 4 patients colonoscopy showed different grades of colitis up to diffuse erythema and microlesions, 2 patients had no visible lesions. In 4 patients endoscopy of the upper GI-tract showed a severe inflammation (n = 1) and a fibrinopurulent exsudate, severe edema and isolated ulcerations (n = 3) of jejunum after gastrectomy or duodenum with intact stomach. In the histological assessment different grades of 5-FU-induced colitis without (n = 2) or with (n = 4) involvement of the upper small intestine destruction of the superficial mucosa and crypts (epitheliumapoptosis) were found. 5 patients were treated by antibiotics (vancomycin n = 2, metronidazole n = 3), glucocorticoids (n = 5) and Saccaromyces cerevisiae (n = 3). After 8-10 days the patients were complete free of symptoms. One patient died due to the enterocolitis. The present cases demonstrate that high-dose 5-fluorouracil-based chemotherapy not only induces a colitis but also may involve the upper small intestine tract. Consequently, it represents an increasing and serious adverse event of high-dose chemotherapy. The etiology of the enterocolitis (drug- or bacterial-induced) needs further investigations in order to find a causal therapy and/or prophylaxis.


The haematological profile of female bronze turkeys (<i>Meleagris gallopavo</i>) vaccinated with various commercial strains of Newcastle disease.
The effects of vaccination on avian blood parameters are poorly understood. The present study was designed to evaluate whether different strains (Ulster 2C, B1, live LaSota and inactivated LaSota) of Newcastle disease vaccines had an effect on the haematological profile of female turkeys. Seventy-five female turkeys were allocated to treatment groups according to vaccination strain. All the birds, except those in the control group, were vaccinated at 32 weeks of age and revaccinated at 40 and 48 weeks of age. Blood samples were obtained for haematological analyses and serum samples for the haemagglutination inhibition test. Haemoglobin concentration was significantly lower (p < 0.05) in vaccinated female turkeys than in the control birds 28 days after vaccination. Monocytes were significantly higher (p < 0.05) in 44-week-old female turkeys vaccinated with inactivated LaSota strain compared with the other groups. Turkeys vaccinated with the B1 strain showed significantly higher (p < 0.05) total white blood cell counts compared with the other groups vaccinated with various commercial strains of the Newcastle disease virus. In conclusion, female turkeys showed significant differences in haemoglobin concentrations, monocytes and white blood cell counts when vaccinated against Newcastle disease.


Possible involvement of a lipocortin in the initiation of DNA synthesis by human endothelial cells.
This work focused on three themes. First, evidence was obtained for the presence of proteins of 34, 35, 32, and 69 kDa immunologically related to lipocortins I, II, V, and VI, respectively, in human umbilical vein endothelial (HUVE) cells. The 69-kDa protein (p69), but not proteins related to lipocortins I, II, and V, exhibited an increased phosphorylation after exposure of cells to basic fibroblast growth factor (bFGF) and phorbol ester PMA. Second, treatment of HUVE cell particulate fractions with EGTA and hydrophobic affinity chromatography in combination with conventional techniques provided extracts rich in p69 and purified p69. p69 from control cells and extracts from control, bFGF-treated, and PMA-treated cells were found to possess anti-phospholipase A2 (PLA2) activity of lipocortin. In contrast, a striking reverse effect occurred when extracts were obtained from cells exposed to bFGF plus PMA. Third, the combination of bFGF and PMA induced a stimulated PLA2-catalyzed release of arachidonic acid in HUVE cells. This arachidonate production was shown to be involved in the decision of cells to enter into DNA synthesis. Taken together, the present results suggest that phosphorylation of p69 is causally involved in the control of commitment to growth in HUVE cells by acting as a coupling mechanism between surface stimuli and arachidonate pathways.


Energetics of fasting heterothermia in TRPV1-KO and wild type mice.
To learn the possible role of TRPV1 in the changes of temperature regulation induced by short-term energy lack, TRPV1-KO and wild type mice were exposed to complete fasting for 2 or 3 days while their core temperature and locomotor activity were recorded using a biotelemetry method. In both types of mice, fasting led to progressive daytime hypothermia with night-time core temperature being maintained at normothermia (collectively called heterothermia). During fasting rises of locomotor activity were observed parallel to night-time normothermia with occasional increases of both parameters recorded every 2 to 3 hours (ultradian rhythms). The daytime fall of core temperature was significantly greater in wild type than in TRPV1-KO mice, in the former an advance of the temperature/activity rhythm having been observed in spite of the presence of a 12/12 hour light/darkness schedule. Re-feeding applied at the beginning of the light-period led to rapid reappearance of normothermia in both types of mice without a large increase in locomotor activity. It is concluded that the TRPV1-gene may have a role in the development of adaptive daytime hypothermia (and hence saving some energy) in mice during complete fasting but still allowing normothermia maintained at night, a strategy probably serving survival under natural conditions in small size rodents such as the mouse. The possible role of muscle thermogenesis either with or without gross bodily movement during fasting or on re-feeding, respectively, may be based on different mechanisms yet to be clarified.


Networks of tau distribution in Alzheimer's disease.
See Whitwell (doi:10.1093/brain/awy001) for a scientific commentary on this article.A stereotypical anatomical propagation of tau pathology has been described in Alzheimer's disease. According to recent concepts (network degeneration hypothesis), this propagation is thought to be indicative of misfolded tau proteins possibly spreading along functional networks. If true, tau pathology accumulation should correlate in functionally connected brain regions. Therefore, we examined whether independent components could be identified in the distribution pattern of in vivo tau pathology and whether these components correspond with specific functional connectivity networks. Twenty-two 18F-AV-1451 PET scans of patients with amnestic Alzheimer's disease (mean age = 66.00 ± 7.22 years, 14 males/eight females) were spatially normalized, intensity standardized to the cerebellum, and z-transformed using the mean and deviation image of a healthy control sample to assess Alzheimer's disease-related tau pathology. First, to detect distinct tau pathology networks, the deviation maps were subjected to an independent component analysis. Second, to investigate if regions of high tau burden are associated with functional connectivity networks, we extracted the region with the maximum z-value in each of the generated tau pathology networks and used them as seeds in a subsequent resting-state functional MRI analysis, conducted in a group of healthy adults (n = 26) who were part of the 1000 Functional Connectomes Project. Third, to examine if tau pathology co-localizes with functional connectivity networks, we quantified the spatial overlap between the seed-based networks and the corresponding tau pathology network by calculating the Dice similarity coefficient. Additionally, we assessed if the tau-dependent seed-based networks correspond with known functional resting-state networks. Finally, we examined the relevance of the identified components in regard to the neuropathological Braak stages. We identified 10 independently coherent tau pathology networks with the majority showing a symmetrical bi-hemispheric expansion and coinciding with highly functionally connected brain regions such as the precuneus and cingulate cortex. A fair-to-moderate overlap was observed between the tau pathology networks and corresponding seed-based networks (Dice range: 0.13-0.57), which in turn resembled known resting-state networks, particularly the default mode network (Dice range: 0.42-0.56). Moreover, greater tau burden in the tau pathology networks was associated with more advanced Braak stages. Using the data-driven approach of an independent component analysis, we observed a set of independently coherent tau pathology networks in Alzheimer's disease, which were associated with disease progression and coincided with functional networks previously reported to be impaired in Alzheimer's disease. Together, our results provide novel information regarding the impact of tau pathology networks on the mechanistic pathway of Alzheimer's disease.


Trap-door technique in the background for holding stay sutures in the microvascular anastomosis.
A useful device for holding the stay sutures in microvascular anastomosis is reported, which helps to reduce the anastomotic time and frustration and bring about flawless anastomosis.


Rotating hinge prosthesis in revision total knee arthroplasty: indications and results.
Reconstruction of the knee joint with an appropriate prosthetic component that accomplishes the alleviation of pain and the restoration of joint function represents the goal of primary and revision TKA. Revision TKA procedures present a variety of complicating factors not found in primary TKA cases.


A synthetic wheat with 56 chromosomes derived from Triticum turgidum and Aegilops tauschii.
By colchicine treatment of hybrids between Triticum turgidum and Aegilops tauschii (as seedlings), a fertile wheat plant (SHW-L2) carrying 56 chromosomes was artificially synthesized. At metaphase I of 50 pollen mother cells, the 56 chromosomes of the new wheat SHW-L2 showed a mean pairing configuration of 2.82 univalents, 6.18 rod bivalents, 19.39 ring bivalents, 0.5 trivalents, and 0.14 quadrivalents. Cytological analyses suggested that SHW-L2 had additional 7 pairs of chromosomes from the A and D genome besides the 42 chromosomes of common wheat. The special chromosome constitution of SHW-L2 may be derived from the chromosome doubling by the colchicine treatment of seedlings and then spontaneous doubling of gametes.


Viral labyrinthitis -- an experimental study.
Summary--An attempt was made to produce viral labyrinthitis in the rhesus monkey. Rhesus monkeys are susceptible to the mumps virus. Nine animals were used. After removal of the stapes, the left oval windows were plugged with Gelfoam soaked in a culture of live mumps virus; right oval windows were plugged with Gelfoam soaked in killed cultures. Animals were sacrificed at different time intervals, postinfection. In eight of the nine animals there was seroconversion from negative to positive; however, none of the animals developed the histologic changes of viral labyrinthitis.


Quality Improvement Initiative to Improve Human Papillomavirus Vaccine Initiation at 9 Years of Age.
Adolescent human papillomavirus (HPV) vaccine rates remain low. Early vaccination may improve the efficacy of the vaccine and immunization rates; however, clinicians have not routinely made a strong recommendation for younger adolescents. This study assessed the feasibility of routine vaccination at 9 years of age. Three sequential quality improvement (QI) interventions were implemented to shift the initiation of the HPV vaccine to 9 years of age in a primary care network in low-income neighborhoods in Columbus, Ohio. The first intervention changed the electronic medical record alert for the HPV vaccine from 11 to 9 years of age and focused on cancer prevention when discussing the vaccine with families. The second intervention was formation of an HPV QI team. The third intervention was a clinic incentive for HPV captured opportunity rates. Immunization rates were monitored using statistical process control charts to compare the HPV immunization rate in a sample of 9- and 10-year-old children with a sample of 11- and 12-year-old children. The percentage of patients receiving an HPV vaccine before 11 years increased from 4.6% to 35.7% during the 6 months after the QI initiative began and to 60.8% 18 months after the project began. In comparison, the HPV vaccination rate in the sample of 11- and 12-year-olds increased from 78.7% to 82.8% 18 months later. This QI project used multiple interventions to increase HPV vaccination at 9 years of age in a large primary care network serving a diverse low-income population.


Human acoustic neurinomas: nervous system specific biochemical parameters.
A series of 24 human acoustic neurinomas from 24 patients has been assayed for several biochemical parameters characteristic of the nervous system. S 100 protein, 2', 3'-cyclic nucleotide 3'-phosphohydrolase activity, and the myelin lipids galactosylceramide and sulfogalactosylceramide (sulfatide). Myelin basic protein was not detected. These finding further support the neuroectodermal origin of the human acoustic neurinoma, and provide additional biochemical markers for further study.


Benign endobronchial mesenchymal tumors: their relationship to parenchymal pulmonary hamartomas.
The clinical and pathological data were reviewed on 17 patients with benign endobronchial mesenchymal tumors seen at the New England Deaconess Hospital between 1942 and 1981. The tumors were compared histologically to 147 intraparenchymal hamartomas studied during the same period. Thirteen tumors involved central bronchi and four occupied small, peripheral airways. These 17 lesions displayed overlapping histological features and ranged from predominantly cartilaginous to lipomatous growths. Mixtures of cartilage and other mesenchymal elements characterized 14 tumors, and adipose tissue was the principal component of three nonchondromatous growths. Both endobronchial and parenchymal tumors occurred predominantly during the fifth and sixth decades. Tumors of both groups contained similar mesenchymal constituents; however, the endobronchial lesions had fewer epithelial clefts, a decreased proportion of cartilage, and a correspondingly increased adipose tissue component. The centrally located intralumenal growths caused symptoms due to bronchial obstruction, while the four tumors within peripheral airways were usually symptomless, incidental findings. The histological similarity between the to groups and the presence of some endobronchial tumors within small, peripheral airways support the theory that endobronchial and parenchymal "hamartomas" are similar mesenchymal neoplasms of bronchial and bronchiolar walls occurring at different loci within the bronchial tree.


Divided or kissing nevus of the penis: A new case with dermoscopic findings.
We report on a child with a divided or kissing nevus of the penis with benign symmetric globular pattern on dermoscopic examination that evolved into a globular-reticular pattern after 1 year of follow-up. Divided nevus of the penis is exceedingly rare, with only four cases with dermoscopic findings reported to date. Dermoscopy seems to be useful when deciding on the most appropriate management of these cases.


A stochastic model for predicting dextrose equivalent and saccharide composition during hydrolysis of starch by alpha-amylase.
A stochastic model was developed that was used to describe the formation and breakdown of all saccharides involved during alpha-amylolytic starch hydrolysis in time. This model is based on the subsite maps found in literature for Bacillus amyloliquefaciens alpha-amylase (BAA) and Bacillus licheniformis alpha-amylase (BLA). Carbohydrate substrates were modeled in a relatively simple two-dimensional matrix. The predicted weight fractions of carbohydrates ranging from glucose to heptasaccharides and the predicted dextrose equivalent showed the same trend and order of magnitude as the corresponding experimental values. However, the absolute values were not the same. In case a well-defined substrate such as maltohexaose was used, comparable differences between the experimental and simulated data were observed indicating that the substrate model for starch does not cause these deviations. After changing the subsite map of BLA and the ratio between the time required for a productive and a non-productive attack for BAA, a better agreement between the model data and the experimental data was observed. Although the model input should be improved for more accurate predictions, the model can already be used to gain knowledge about the concentrations of all carbohydrates during hydrolysis with an alpha-amylase. In addition, this model also seems to be applicable to other depolymerase-based systems.


Computer assisted optimization of a flow-injection method for the assay of promethazine, chlorpromazine and trimeprazine in drug formulations.
A simple, accurate and fast method for the determination of promethazine, chlorpromazine and trimeprazine neuroleptics in drug formulations by flow injection spectrophotometric detection was developed. The method was based on the oxidation of the drug with potassium dichromate in sulphuric acid media. Optimum conditions were obtained by using the modified simplex computer programme. A 110-mul sample volume was taken as reasonable for all the compounds. The optimum conditions reached were 76-cm coil length, 6.00 ml/min flow rate, 3.10M sulphuric acid and 0.00167M dichromate for promethazine; 94-cm coil length, 5.00 ml/min flow rate, 1.48M sulphuric acid and 0.00185M dichromate for chlorpromethazine and 80-cm coil length, 6.00 ml/min flow rate, 3.44M sulphuric acid and 0.000500M dichromate for trimeprazine. High sample throughput of at least 200 samples per hour was obtained for all compounds. Acceptable relative standard deviations in the range +/-0.4-0.9%, and good accuracy in the range 99.5-99.9% were attained when the method was statistically compared with the BP method and when applied to proprietary drugs, without suffering interferences.


Effect of protein deficiency on the lysosomal enzyme activities of the spleen and thymus of weanling rats.
The effect of a low protein (4%) diet on the activity of the hydrolytic enzymes ribonuclease, deoxyribonuclease, acid and alkaline phosphatases, beta-glucuronidase and lysozyme has been studied in the spleen and thymus of weanling Wistar rats. Experimentation was carried out over 20 and 30 days, and comparisons were made with well-nourished (12% protein) controls. Body weight decreased during the terminal period in protein-deficient animals (P less than 0.001). Spleen and thymus absolute net weights also dropped significantly (P less than 0.001). In terms of organ weight relative to body weight, there was a clear decrease in thymus compared with controls (P less than 0.001). Enzyme activities expressed per total organ fell significantly. Thus, in spleen at 20 days the decrease was maximum in ribonuclease activity (91.15%) and minimum in acid phosphatase activity (44.09%). Thymus decreases ranged from 83.60% activity in beta-glucuronidase and 93.56% in ribonuclease. At 30 days decreases were accentuated; the maximum value in spleen was 92.34% lysozyme and, in thymus, 97.09% acid phosphatase. A large increase in hydrolytic activity expressed per milligram of protein was registered, especially at 30 days. This increase reached a maximum of 78.08% beta-glucuronidase in thymus and a minimum of 56.1% alkaline phosphatase; acid phosphatase and ribonuclease activities were not modified. In spleen, however, acid phosphatase (34.00%), alkaline phosphatase (62.50%), deoxyribonuclease (39.25%), and beta-glucuronidase (36.01%) increased, but lysozyme and ribonuclease enzymes decreased. We concluded that a low protein diet increases catabolism in spleen and thymus through an enhancement of lysosomal hydrolase activities.


Oculoplethysmography and supraorbital Doppler evaluation of carotid disease. A reappraisal.
A variety of noninvasive tests are available for the evaluation of patients with suspected extracranial cerebrovascular disease. Recent emphasis on more sophisticated techniques has raised questions concerning the current utility of older methods, e.g., pulse delay oculoplethysmography (OPG) and supraorbital Doppler (SOD) examination. The results of OPG and SOD examination were compared with the findings of carotid arteriography in 75 consecutive patients. This analysis revealed a sensitivity of 78 per cent, specificity of 92 per cent, false-positive rate of 12.5 per cent, false-negative rate of 15.8 per cent, and overall diagnostic accuracy of 85 per cent for OPG. Although the specificity of SOD was superior (94.3%), the sensitivity (41%) false-positive rate (16.6%), false-negative rate (30.5%), and overall diagnostic accuracy of 71.6 per cent of SOD revealed it to be an inferior test of significant carotid stenosis. Based on its ease of performance, minimum of time required, and high level of diagnostic accuracy, OPG currently remains a valuable screening procedure for carotid disease, particularly in the asymptomatic bruit population.


Improved microscopy diagnosis of pulmonary tuberculosis using sodium hypochlorite concentration technique in Tanga, Tanzania.
Pulmonary tuberculosis diagnosis commonly relies on the bacteriological examination of sputum. A cross-sectional hospital-based study was carried out to compare on "on the spot" sputum staining using sodium hypochlorite (bleach method) and routine Ziel-Neelsen (ZN) staining technique. Study candidates included individual patients presenting with cough <3 weeks (Group I) and > or =3 weeks (Group II). Sensitivity and specificity of the bleach method was calculated and compared at 100% using the ZN staining technique as the standard. A total of 171 patients (94 males, 77 females) with mean age 34.9 years (SD +/- 12.9) were recruited. Fifty-eight patients had coughed for <3 weeks while 113 had coughed for 23 weeks. Smear-positive TB in Group I was 13.8% (95% CI = 5-23) while in Group II was 25.7% (95% CI = 21-29). Using the bleach method, the prevalence of smear-positive TB in Group II was 28.3% (CI 95% = 20-36). This was an increase in smear-positivity rate of 15.6% as compared to the ZN technique. These results suggest that the use of bleach technique "on the spot" improve the sensitivity of tuberculosis diagnosis among patients with a history of coughing of over three weeks. However, further studies in different settings are recommended to validate the technique.


Redefining the World Health Organization algorithm for diagnosis of pneumonia with simple additional markers.
WHO to examine the value of additional markers like history of previous respiratory distress and response to bronchodilator (BD) to redefine these guidelines. Fifty (50) patients were analysed for presence of fever. Those who were febrile were put on antipyretic to look for resolution of tachypnea. Those who showed persistent tachypnea and those who were afebrile were analyzed for history of previous respiratory distress. Those who gave a positive history were challenged with BD. The association of persistent tachypnea and pulmonary infiltrates was recorded. Persistence of tachypnea after BD therapy was associated with pulmonary infiltrate in 7/8 (87.5%) whereas tachypnea persisted in 9/30 (30%) of those without infiltrates (p < 0.001). The proposed algorithm brings down the overuse of antibiotics from 78.9% to 26.3% (p <0.001) and also brings down the underuse of bronchodilators from 78.9% to 21.1 %(p<0.001). Adding simple markers like history of previous respiratory distress and response to BD therapy to the existing WHO guidelines it is possible to reliably differentiate pneumonia from acute exacerbation of asthma.


Twenty-four-hour melatonin and core body temperature rhythms: their adaptation in night workers.
To determine whether the melatonin (MT) rhythm is adapted to a permanent nocturnal schedule, 11 night workers were studied during their usual 24-h cycle, and 8 day-active subjects during two 24-h cycles, once with night sleep and once after an acute shift of their sleep period to daytime. Rectal temperature (Tre) was continuously recorded. In day-active subjects, the MT rhythm was not affected by the acute shift in the sleep period, whereas the Tre rhythm was split in a biphasic pattern with the circadian descending phase during the night of sleep deprivation and a second descending trend during day sleep. Night workers showed a great variability in their MT profiles, with the onset of the MT release varying between 2145 and 0505. In contrast, the Tre rhythm was homogeneously entrained to their usual sleep-wake cycle, with the onset of the descending trend initiated before sleep onset so that the large decrease was found, in some subjects, to be uncoupled with their MT increase. The night-active schedule did not induce any amplitude modification of the Tre and the rhythms compared with day-active subjects sleeping at night. No relationship between work-dependent factors and the extent of the MT shift could be found. These results show the great variability in the timing of MT secretion among night workers, in contrast to the homogeneity of their Tre rhythm. The exact mechanisms by which night workers adapt their circadian systems have not yet been identified.


Effects of long-term exposure of the red swamp crawfish Procambarus clarkii to a mixture of two herbicides, 2,4-dichlorophenoxyacetic acid and monosodium methanearsonate, and associated human health risks.
2,4-dichlorophenoxyacetic acid and monosodium methanearsonate are often sold in commercial mixtures. Bioconcentration studies have been performed for each of these herbicides individually, but little information exists concerning long-term exposure to a mixture of these herbicides. The following study examined the uptake of arsenic in crawfish after long-term exposure to this mixture, and the health risks associated with consumption of these crawfish. Bioconcentration and depuration experiments using a 50:50 by concentration mixture of the two herbicides, with and without surfactant, were performed to quantify how much arsenic is concentrated in the edible tissue of the crawfish. Of the three tissues (muscle, gill, and hepatopancreas) sampled hepatopancreas bioconcentrated the highest amount of arsenic. Surfactant significantly reduced this uptake but did not affect bioconcentration of arsenic into other tissues. Surfactant had no effect on depuration of arsenic from any of the tissues. Cooking lowered hepatopancreatic arsenic content, possibly as a result of structural changes in the hepatopancreas. Assessment of the human health risk associated with consuming these crawfish showed an exposure dose at the high end of consumption that was approximately twice the reference dose for arsenic. Cancer risks were averaged at approximately 7 extra tumors in a population of 10,000 and 6 extra tumors in a population of 10,000 resulting from a lifetime consumption of crawfish exposed to the herbicide mixture without and with surfactant, respectively.


Legume seed exudates and Physcomitrella patens extracts influence swarming behavior in Rhizobium leguminosarum.
Plants are known to secrete chemical compounds that can change the behavior of rhizosphere-inhabiting bacteria. We investigated the effects of extracts from legume host plants on the swarming behavior of Rhizobium leguminosarum bv. viciae. We also investigated the effects on swarming when Rhizobium is exposed to extracts from an ancestor to vascular plants, the model bryophyte Physcomitrella patens. Lentil and faba bean seed exudates enhanced and inhibited swarming motility, respectively, whereas pea seed exudates had no observable effect on swarming. Swarming was also enhanced by the moss extracts. Exposure to lentil seed exudates and the moss extract increased flaA expression 2-fold, while faba bean seed exudates exposure decreased expression 3-fold, suggesting that the swarming effect could, in part, be due to regulation of flagellin gene expression. However, the exudates and extracts did not significantly affect flaA gene expression in planktonic motile cells, indicating that the response to flagellar regulation is specific to a physiology unique to the swarming cell. Transmission electron microscopy demonstrated that addition of the lentil seed exudate and the moss extract results in earlier differentiation into swarmer cells, which could contribute to the development of a larger swarming surface area. To gain further mechanistic insight into the effect of the moss extract on swarming, a moss strigolactone-deficient mutant (Ppccd8Δ) was tested. A reduction in the promotive effect was observed, suggesting that the plant hormone strigolactone may be a signalling molecule activating swarming motility in R. leguminosarum.


Effects of self-talk: a systematic review.
This article presents a systematic review of the literature examining the relationship between self-talk and performance. "Second-generation questions" regarding potential mediators and moderators of the self-talk-performance relationship were also examined. A total of 47 studies were analyzed. Results indicated beneficial effects of positive, instructional, and motivational self-talk for performance. Somewhat surprisingly, two evidence-based challenges to popular current viewpoints on self-talk emerged. First, negative self-talk did not impede performance. Second, there was inconsistent evidence for the differential effects of instructional and motivational self-talk based on task characteristics. Results from the mediation-based analysis indicate that cognitive and behavioral factors had the most consistent relationships with self-talk. The findings are discussed in the context of recent theoretical advances, and the article includes recommendations for future research (e.g., the use of designs allowing the testing of meditational hypotheses) and for current applied practice (e.g., avoiding the use of thought-stopping techniques).


Synthesis of some new 1,2,4-triazoles, their Mannich and Schiff bases and evaluation of their antimicrobial activities.
4-Phenyl-5-pyridin-4-yl-4H-1,2,4-triazole-3-thiol (3) was obtained in basic media via the formation of 2-isonicotinoyl-N-phenylhydrazinecarbothioamide (2), and converted to some alkylated derivatives (4a,b) and Mannich base derivatives (5a-c). 2-[(4-Phenyl-5-pyridin-4-yl-4H-1,2,4-triazol-3-yl)thio]acetohydrazide (7) that was obtained by using compound 3 as precursor in two steps was converted to thiosemicarbazide derivative (8), Schiff base derivatives (9) and 5-{[(4-phenyl-5-pyridin-4-yl-4H-1,2,4-triazol-3-yl)thio]methyl}-1,3,4-oxadiazole-2-thiol (10). Moreover, 5-{[(4-phenyl-5-pyridin-4-yl-4H-1,2,4-triazol-3-yl)thio]methyl}-3-{[(2-morpholin-4-ylethyl)amino]methyl}-1,3,4-oxadiazole-2(3H)-thione (11) was synthesized via reaction of compound 10 with 2-(4-morpholino)ethylamine. The treatment of compound 8 with NaOH gave 4-(4-methylphenyl)-5-{[(4-phenyl-5-pyridine-4-yl-4H-1,2,4-triazol-3-yl)thio]methyl}-4H-1,2,4-triazole-3-thiol (12), while the acidic treatment of compound 8 afforded 5-{[(4-phenyl-5-pyridin-4-yl-4H-1,2,4-triazol-3-yl)thio]methyl}-2(4-methylphenyl)-amino-1,3,4-thiadiazole (14). N-Methyl derivative of compound 14 and a Mannich base derivative of compound 12 were synthesized from the reactions of these precursors with methyl iodide and methyl piperazine, respectively. All newly synthesized compounds were screened for their antimicrobial activities. The antimicrobial activity study revealed that all the compounds screened showed good or moderate activity except compounds 3, 5c, 7, 9c, 9e, 9g, 9h, 11, and 13.


Consistent chemical form of Cd in liver and kidney tissues in rats dosed with a range of Cd treatments: XAS of intact tissues.
X-ray absorption spectroscopy of frozen intact tissues shows that in rats exposed to a range of treatments involving cadmium, alone or in combination with other metal ions, the coordination environment of cadmium is consistent in both the liver and kidney. Comparison of the spectra from the rat tissues to biologically relevant model compounds indicates that the vast majority of the cadmium is bound to metallothionein in these tissues.


Photo-configurable embossed liquid crystal alignment layer with high azimuthal anchoring strength.
Herein we describe a photo-alignment layer of improved azimuthal anchoring energy comparable to conventional rubbing method. In order to address the inherent low anchoring stability of photo-alignment layer, we applied embossing technique to conventional photosensitive polymer film, based on the cinnamoyl photoreactive groups, to introduce physical micro-groove effect for additional anchoring energy. From this, 2.5 × 10⁻⁴ J/m² of azimuthal anchoring energy was achieved, which is considered as synergistic effect from both photoinduced chemical interaction and physical microgroove alignment. In this study, we conducted systematic study on change in anchoring energy as a function of both aspect ratio of embossed pattern and UV exposure dose. We also demonstrated fabrication of sophisticated multi-domain structure of LC cells and discussed theoretical interpretation through LC simulation.


Exploring the role of mast cells in eosinophilic esophagitis.
The mast cell plays a critical role in allergic responses in the gastrointestinal tract and other sites. Emerging evidence indicates that mast cells also participate in the pathogenesis of eosinophilic esophagitis, although their precise role has not been defined. This article reviews the biology of mast cells and examines the potential involvement of the cell as an effector of the inflammatory response and tissue remodeling, and as a cell that has the potential to function as an immunomodulator and limit inflammation.


Ligand inhibition of the platelet glycoprotein IIb-IIIa complex function as a calcium channel in liposomes.
Platelet glycoproteins IIb and IIIa function as a fibrinogen receptor on the activated platelet. We have shown that these glycoproteins can be incorporated onto the surface of phosphatidylcholine vesicles with retention of fibrinogen and antibody binding properties and can permit Ca2+ transit across the phospholipid bilayer. In the current study we demonstrate that this apparent Ca2+ channel function is specifically inhibited by the synthetic analogue of the fibrinogen gamma COOH-terminal peptide, His-His-Leu-Gly-Gly-Ala-Lys-Gln-Ala-Gly-Asp-Val (His-12-Val), but not by the adhesive protein sequence Arg-Gly-Asp-Ser (RGDS). Prior incubation of IIb-IIIa liposomes with RGDS prevented Ca2+ transit inhibition by 25 microM His-12-Val, analogous to RGDS inhibition of His-12-Val binding to platelets. His-12-Val inhibited a minor component of transmembrane Ca2+ influx into ADP and thrombin-activated human platelets but had no effect on steady-state platelet 45Ca flux. These data indicate that ligand binding may exert a regulatory influence on transmembrane Ca2+ influx into activated platelets. The difference in inhibitory potency of the peptides studied may be related to differences in conformational changes in the glycoprotein IIb-IIIa complex induced by His-12-Val and RGDS, steric considerations, or differences in interactions with glycoprotein IIb Ca2+ binding domains.


[Sugar cane burning in Brazil: respiratory health effects].
The article aimed to update scientific literature information about respiratory health effects caused by sugarcane burning, considering the expansion of sugarcane plantations in Brazil and in the state of São Paulo. Articles published between 1996 and 2006, which deal with the health effects of sugarcane burning and/or air pollutants originating from this burning, were discussed. These studies suggest that part of the population--especially the elderly, children and asthmatics--suffers health effects of sugarcane burning. As a result, these people require health care, thus affecting health services and their families.


Pinhole single-photon emission computed tomography for myocardial perfusion imaging of mice.
Although transgenic mice have emerged as powerful experimental models of cardiovascular disease, methods for in vivo phenotypic assessment and characterization remain limited, motivating the development of new instruments for biologic measurement. We have developed a single-photon emission computed tomography system with a pinhole collimator (pinhole SPECT) for high-resolution cardiovascular imaging of mice. In this study, we describe a protocol for myocardial perfusion imaging of mice using technetium-99m ((99m)Tc)-sestamibi and demonstrate the feasibility for measurement of perfusion defect size from pinhole SPECT images. Mice were anesthetized and injected with 370 MBq (10 mCi) of (99m)Tc-sestamibi. Tomographic projection images were acquired by rotating each mouse in a vertical axis in front of a stationary clinical scintillation camera equipped with a pinhole collimator. BALB/c mice (n = 15) were imaged after the permanent ligation of the left anterior descending coronary artery. The resulting defect size was measured from circumferential profiles of short-axis images. After imaging, the hearts were excised and sectioned to obtain ultra-high resolution digital autoradiographs of (99m)Tc-sestamibi, from which the actual infarct size was determined. Reconstructed image quality was equivalent to that obtained for clinical myocardial perfusion imaging. Linear regression analysis produced a correlation coefficient of 0.83 (p < 0.001) between the measured and actual values of the defect size. These results demonstrate that myocardial perfusion can be characterized qualitatively and quantitatively in mice using pinhole SPECT.


Intra-day variation of in vivo prostaglandin F2alpha formation in healthy subjects.
Prostaglandin F(2alpha) (PGF(2alpha)) is a major stable prostaglandin formed in vivo in physiological and pathophysiological situations and has mainly potent vasoconstrictive and pro-inflammatory properties. PGF(2alpha) is now used as an indicator of acute and chronic inflammation in human clinical settings but the extent of daily variation of PGF(2alpha)in vivo in healthy humans is unknown. We quantified levels of the PGF(2alpha) metabolite 15-keto-dihydro-PGF(2alpha) in 10 healthy males and females in spot urine samples during the day (including morning urine sample) and in 24-h urine during the same day. The intra-day coefficient of variation was 20.9%. However, the total mean value of 15-keto-dihydro-PGF(2alpha) in urine collected in the morning did not significantly differ from the mean level of 15-keto-dihydro-PGF(2alpha) in the 24-h urine samples in the 10 subjects. 15-Keto-dihydro-PGF(2alpha) levels in morning urine showed a positive linear correlation with levels of 15-keto-dihydro-PGF(2alpha) in 24-h urine (R=0.72, P<0.05). In conclusion, formation of PGF(2alpha) shows a biological variation within the day in healthy humans which should not be overlooked when planning a clinical study. Single morning urine samples can be used as an alternative to 24-h urine collections for quantification of PGF(2alpha) formation to simplify the sampling regime in larger clinical studies.


Conditional regulation of a ROCK-estrogen receptor fusion protein.
The Rho-associated kinases ROCK I and ROCK II are serine/threonine kinases that play central and critical roles in regulating the actin cytoskeleton. Activation of ROCK proteins contributes positively to the phosphorylation of myosin II light chains (MLC), myosin ATPase activity, stabilization of filamentous actin, and coupling of the actin-myosin filaments to the plasma membrane, thereby leading to the increased actin-myosin force generation and contractility. We have constructed a conditionally-activated form of ROCK II (called ROCK:ER) by fusing the ROCK II kinase domain to the estrogen receptor hormone-binding domain. In this chapter, we describe the construction and characterization of this regulatable ROCK:ER fusion protein.


No correlation between primary mandibular anterior crowding and vertical craniofacial configuration or lower incisor inclination.
The aim of the present study was to evaluate the correlation between primary mandibular anterior crowding and vertical craniofacial configuration or sagittal lower incisor inclination. The collective comprised 100 consecutive patients (50 males, 50 females) subject to 4 selection criteria: mandibular anterior crowding > or = 1.0 mm, no previous orthodontic therapy, completely preserved deciduous canines and molars, and lateral cephalograms of good diagnostic quality before initiation of orthodontic treatment. Study casts of all patients were used to measure the mesiodistal width of the incisors and deciduous canines as well as the anterior arch circumference. The difference between the 2 represented the amount of crowding. On all cephalograms 16 parameters of vertical craniofacial configuration and 9 parameters of lower incisor inclination were measured. For error evaluation all measurements were repeated independently on 10 randomly selected study casts and cephalograms. This error amounted for the combined tooth width to 0.51% +/- 0.81, for arch circumference to 0.03% +/- 0.68, and for all cephalometric parameters to 0.38% +/- 4.81. For all parameters, arithmetic means, standard deviations and ranges were calculated. Further, correlation coefficients were calculated between anterior crowding and all 25 cephalometric parameters. The arithmetic mean of crowding was m = 2.0 +/- 1.3 mm with a range of 1.0 to 6.6 mm. The values of all cephalometric parameters were close to well accepted norms in the literature. The correlation coefficients between crowding and all cephalometric parameters varied from r = 0.0 to 0.3. According to this study there is no correlation between primary mandibular anterior crowding and vertical craniofacial configuration or sagittal lower incisor inclination.


Effects of renal denervation on renin release induced by intracerebroventricular administration of biological active peptides in conscious rats.
Experiments were performed to determine whether the renal nerve mediates the renin release induced by intracerebroventricular administration of angiotensin II (ANG II), bradykinin (BK), leucine-enkephalin (Leu-ENK) and neurotensin (NT). In sham-operated rats, both ANG II and NT suppressed plasma renin activity (PRA), BK did not affect PRA, and Leu-ENK increased PRA. Renal denervation abolished the increase in PRA by Leu-ENK. Suppression of PRA by ANG II was attenuated in denervated rats. Renal denervation did not influence the renin release by BK or NT. These results suggest that the renal nerve plays an important role in elevating PRA after central stimulation by Leu-ENK. Although suppression of PRA is mainly mediated by mechanisms other than the renal nerve, the renal nerve partially participates in suppression of PRA by ANG II.


Early versus late enteral nutritional support in adults with burn injury: a systematic review.
Burn injury increases the body's metabolic demands, and therefore nutritional requirements. Provision of an adequate supply of nutrients is believed to lower the incidence of metabolic abnormalities, thus reducing septic morbidity, and improving survival rates. Enteral nutrition support is the best feeding method in a patient who is unable to achieve an adequate oral intake, but optimal timing of its introduction after burn injury (i.e. early versus late) needs to be established. The purpose of this review is to examine evidence for the effectiveness and safety of early versus late enteral nutrition support in adults with burn injury. An examination of randomized and controlled clinical trials using various medical databases such as The Cochrane Library (Issue 3, 2006), MEDLINE (from 1950), CINHAL (from 1982) and EMBASE (from 1980). The trial evidence about the benefit of early enteral nutritional support on standardized clinical outcomes such as length of hospital stay and mortality remained inconclusive. Similarly, the question of whether early enteral feeding influenced or decreased metabolic rate, reduced septic and other complications remained uncertain. Promising results suggest early enteral nutrition support may blunt the hypermetabolic response to thermal injury, but it is insufficient to provide clear guidelines for practice. Further research incorporating larger sample sizes and rigorous methodology that utilizes valid and reliable outcome measures is essential.


Pulmonary tissue and cigarette smoke. 2. Parenchymal response.
Cigarette smoke and hydrocortisone acetate (HCA) induce marked abnormalities in lungs of C57BL/6J male mice. In many pulmonary regions of smoke-exposed, HCA-treated animals, alveoli were highly congested with surfactant and flocculent material. In addition, prominent alveolar collapse and septal hypertrophy were common. These conditions resembled pulmonary alveolar proteinosis described in humans. Administration of HCA to sham-treated animals also produced lung abnormalities, however, considerably milder in severity, while stress (resulting from sham treatment) or HCA injections of mice alone failed to induce any pulmonary tissue disorder. Data reported indicate that the genesis of abnormal conditions which resemble pulmonary alveolar proteinosis is potentiated by cumulative effects of different treatments (i.e., smoke, HCA, and stress), most significant being the interaction between cigarette smoke and the steroid.


[The gonotrophic cycle and the daily rhythm of bites of Anopheles gambiae (Giles) 1902 and Anopheles nili (Theobald), 1904].
The authors have elaborated a formula to calculate the average number of times an anopheline parous female bites in one day ("L") according to its gonotrophic cycle and more specially to its behaviour before and after oviposition (parameters "alpha" and "A". The formula was applied to Anopheles gambiae observed at Djoumouna village (L = 0.40) and to Anopheles nili observed at M'Pola village (L = 0.30). The value obtained has then to be multiplied by the anthropophilic index to obtain the "a" parameter of MacDonald (1957) when studying malaria transmission in a village. On the other hand such a formula allowed a better evaluation of biting frequency of a vector, thus of risks of transmission of diseases, according to the respective situation of human houses and water storages. An important point which ahs to be born in mind when planning artificial permanent reservoirs.


Herbal medicines for treatment of irritable bowel syndrome.
Traditional herbal therapies have been used for a long time to treat gastrointestinal disorders including irritable bowel syndrome, and their effectiveness from clinical research evidence needs to be systematically reviewed. To assess the effectiveness and safety of herbal medicines in patients with irritable bowel syndrome. We searched the following electronic databases till July 2004: The Cochrane Library (CENTRAL), MEDLINE, EMBASE, AMED, LILACS, the Chinese Biomedical Database, combined with hand searches of Chinese journals and conference proceedings till end of 2003. No language restriction was used. Randomised controlled trials of herbal medicines compared with no treatment, placebo, pharmacological interventions were included. Data were extracted independently by two authors. The methodological quality of trials was evaluated using the components of randomisation, allocation concealment, double blinding, and inclusion of randomised participants. Seventy-five randomised trials, involving 7957 participants with irritable bowel syndrome, met the inclusion criteria. The methodological quality of three double-blind, placebo-controlled trials was high, but the quality of remaining trials was generally low. Seventy-one different herbal medicines were tested in the included trials, in which herbal medicines were compared with placebo or conventional pharmacologic therapy. Herbal medicines were also combined with conventional therapy and compared to conventional therapy alone.Compared with placebo, a Standard Chinese herbal formula, individualised Chinese herbal medicine, STW 5 and STW 5-II, Tibetan herbal medicine Padma Lax, traditional Chinese formula Tongxie Yaofang, and Ayurvedic preparation showed significantly improvement of global symptoms. Compared with conventional therapy in 65 trials testing 51 different herbal medicines, 22 herbal medicines demonstrated a statistically significant benefit for symptom improvement, and 29 herbal medicines were not significantly different than conventional therapy. In nine trials that evaluated herbal medicine combined with conventional therapy, six tested herbal preparations showed additional benefit from the combination therapy compared with conventional monotherapy. No serious adverse events from the herbal medicines were reported. Some herbal medicines may improve the symptoms of irritable bowel syndrome. However, positive findings from less rigorous trials should be interpreted with caution due to inadequate methodology, small sample sizes, and lack of confirming data. Some herbal medicines deserve further examination in high-quality trials.


Refolding of lysozyme by quasistatic and direct dilution reaction paths: a first-order-like state transition.
A first-order-like state transition model is considered to be a global reaction mechanism to directly folded proteins from an unfolded state to its native form. In order to verify the general applicability of this mechanism, we used lysozyme as a model protein. It was fully unfolded by 4.5 M urea, 0.1 M dithiothreitol (DTT) in pH 3 and refolded to its native form by way of an overcritical reaction path (a quasistatic process) or directly crossing transition boundary path (a directly dilution process). In addition to the two states coexisting in the direct folding path, lysozyme might be trapped in a glassy state. However, it can escape from the glassy state by concentration twice. This indicates the existence of a state transition line or boundary in the direct folding reaction. However, lysozyme can continuously fold from unfolded to native by an overcritical reaction path. During the overcritical path, four stable folding intermediates and native lysozyme were obtained. The secondary structures, particle size distributions, thermal stabilities, and oxidation state of disulfide bonds of folding intermediates were analyzed by circular dichroism spectra, dynamic light scattering, differential scanning calorimetry, and Raman spectra, respectively. According to the data, the intermediates of both the overcritical reaction and the direct crossing transition boundary paths can be described by a common concept pertaining to a model that undergoes collapse, sequential, and first-order-like state transition. This indicated that protein folding by way of different reaction paths might follow a similar folding mechanism-i.e., a mechanism of overcritical folding of intermediates. A protein folding reaction diagram is postulated and discussed. In spite of a global interaction mechanism the alpha -helix is formed prior to the beta -sheet, which may indicate that protein folding is initiated by local interactions.


Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report.
The Lichtenstein technique for inguinal hernia repair is easy to learn and associated with few complications. However, recent studies have suggested that this technique is inferior to some 'sutureless' repair systems in terms of perceived difficulty, operating time, surgeon satisfaction, etc. We employed a sutureless Lichtenstein technique in 80 consecutive patients with primary unilateral inguinal hernia, to assess patient and trainee surgeon outcomes. Human fibrin glue was used in place of conventional sutures. The mean operating time was 36 min and all patients were discharged 5-6 h after the operation. On a 100-point visual analogue scale, the surgeons rated the difficulty of the operation as low (mean score, 31), and perceived satisfaction as high (mean score, 84). No complications were observed at 12-month follow-up. This study confirms the efficacy of mesh fixation with human fibrin glue, and supports the viability of a sutureless Lichtenstein procedure.


[A comparative morphological description of the gingival and buccal epithelium in females in various phases of the menstrual cycle].
Computer morphometry was used to analyze morphologically and histochemically the smears of the gingival and buccal epithelium obtained from women at the secretion and proliferation phases of the menstrual cycle. A variety of reliably statistic differences conditioned by a menstrual-cycle phase was found to be typical of the gingival epithelium. A high percentage of epitheliocytes of differentiation terminal stages as well as signs of enhanced protein-synthesizing processes were typical of the cells ratio in the gingival epithelium at the secretion phase. The number of differences in the buccal epithelium conditioned by a menstrual cycle was by far less, which denotes a lesser dependence of this epithelium on hormones, whose concentration at the proliferation phase essentially differs from that observed at the secretion phase.


Marked plasmacytosis and immunoglobulin abnormalities following infusion of streptokinase.
Marked plasmacytosis is an uncommon clinical finding associated with plasma cell dyscrasias and certain reactive states, particularly serum sickness. Moreover, serum sickness-like reactions are a well-recognized complication of therapy with streptokinase. In this report, the authors describe a patient who developed a transient, but striking, plasmacytosis and an unexplained fever following streptokinase treatment for a pulmonary embolus. An evaluation for multiple myeloma was completely negative except for the occurrence of serum monoclonal-like proteins which largely disappeared over an eight month period.


Low-dose aspirin in a short regimen as standard treatment in in vitro fertilization: a randomized, prospective study.
To determine if treatment with low-dose aspirin in a short regimen improves the outcome in a nonselected IVF population as compared with no treatment. Prospective, randomized study where IVF patients were given aspirin or received no treatment. IVF clinic. The study included 1380 consecutive IVF cycles. Women undergoing IVF were randomly assigned to treatment with aspirin 75 mg daily from the day of embryo transfer (ET) until pregnancy test or no treatment in an open study. Birth rate per ET. Background characteristics were similar in the two groups studied except for a minor difference in number of embryos transferred (2.1 vs. 2.0). Birth rate was 27.2% in the aspirin group as compared with 23.2% in the nontreated group, giving an odds ratio, adjusted for number of embryos transferred, of 1.2 (95% confidence interval, 1.0-1.6). The increased birth rate with aspirin compared with no treatment was significant. Given the importance of every birth in IVF, especially when taking into account the limited number of IVF cycles that are normally performed in an individual woman, any treatment to improve birth rate is important.


LRG is a novel inflammatory marker clinically useful for the evaluation of disease activity in rheumatoid arthritis and inflammatory bowel disease.
By proteomic screening of sera obtained from patients with rheumatoid arthritis (RA), we previously identified leucine rich α2 glycoprotein (LRG) as a possible marker for inflammation. Unlike C-reactive protein (CRP), a biomarker widely used to evaluate inflammation, LRG is induced not only by IL-6 but also by other proinflammatory cytokines. In addition, LRG is upregulated not only in liver but also in local inflammatory sites. Therefore, serum LRG is a novel inflammatory marker applicable to evaluate inflammation in many diseases including ulcerative colitis in which serum CRP often fails to reflect disease activity and RA to which IL-6-blocking biologic agents such as tocilizumab are given as a first line therapy. Interestingly, evidence indicates that LRG is functionally involved in pathogenesis of inflammation, by promoting cellular proliferation, differentiation and angiogenesis via modulating TGF-β signaling.


Time trends in population-based breast cancer survival in Estonia: analysis by age and stage.
Survival from breast cancer (BC) in Estonia has been consistently among the lowest in Europe. The aim of this study was to examine most recent trends in BC survival in Estonia by age and stage. The trends in overall BC incidence and mortality are also shown in the paper. Estonian Cancer Registry data on all cases of BC, diagnosed in women in Estonia during 1995-2007 (n = 7424) and followed up for vital status through 2009, were used to estimate relative survival ratios (RSR). Period hybrid approach was used to obtain the most recent estimates (2005-2009). Stage was classified as localized, local/regional spread or distant. BC incidence continued to rise throughout the study period, but mortality has been in steady decline since 2000. The distribution of patients shifted towards older age and earlier stage at diagnosis. Overall age-standardized five-year RSR increased from 63% in 1995-1999 to 74% in 2005-2009. Younger age groups experienced a more rapid improvement compared to women over 60. Significant survival increase was observed for both localized and locally/regionally spread BC with five-year RSRs reaching 96% and 70% in 2005-2009, respectively; the latest five-year RSR for distant BC was 11%. Survival for T4 tumors was poor and large age difference was seen for locally/regionally spread BC. Considerable improvement in BC survival was observed over the study period. Women under 60 benefited most from both earlier diagnosis and treatment advances of locally/regionally spread cancers. However, the survival gap with more developed countries persists. Further increase in survival, but also decline in BC mortality in Estonia could be achieved by facilitating early diagnosis in all age groups, but particularly among women over 60. Investigations should continue to clarify the underlying mechanisms of the stage-specific survival deficit in Estonia.


Evaluation of cognitive technologies in geriatric rehabilitation: a case study pilot project.
The aim of this study was to develop and evaluate low-cost technology for cognitive rehabilitation in older individuals with dementia and document changes stemming from a clinical case study using these tools. An activity board, a calendar, a routine organizer and a software program were used and evaluated by specialists (n = 7). A pre-post-case study with an elderly male with dementia was undertaken for four months. All rehabilitation resources were classified as appropriate by the specialists. Post-intervention scores demonstrated improvement in cognitive functioning and daily activities at home. There is a need for further research to assess the therapeutic effects in patients with dementia applying equipment and software to improve cognitive function.


Intravaginal misoprostol versus dinoprostone as cervical ripening and labor-inducing agents.
To compare dinoprostone (prostaglandin E2) and misoprostol (prostaglandin E1) for ripening the cervix and inducing labor at term. Sixty-three women were randomized to receive 100 micrograms misoprostol or 3 mg dinoprostone, both as intravaginal tablets. There was no statistical difference between the groups for pre-induction status. The mean Bishop scores before drug insertion were almost identical. Twelve hours after insertion, the mean change in the Bishop score was significantly higher in those receiving misoprostol (5.0 versus 3.3) (P = .008). However, there were no significant differences in induction-to-delivery interval, spontaneous labor rates, type of delivery, fetal outcome, or maternal complications. Misoprostol is as effective as dinoprostone for inducing labor at term.


VirB2 and VirB5 proteins: specialized adhesins in bacterial type-IV secretion systems?
Many type-IV secretion systems (T4SSs) of plant and human pathogens assemble a pilus used to inject virulence molecules (effectors) into host target cells. The T4SS of Agrobacterium tumefaciens consists of VirB1-VirB11 and VirD4 proteins. Whether targeting of T4SSs to the host requires a T4SS-adhesin that specifically engages host receptors for delivery of effectors has, until recently, remained unclear. Recent data of Agrobacterium and Helicobacter indicate that two classes of T4SS components, VirB2 and VirB5, might function as adhesins that mediate host-cell targeting through binding to specific host receptors. Here, we discuss this important issue and recent progress in the field.


Primary liver carcinoma and liver cirrhosis in atomic bomb survivors, Hiroshima and Nagasaki, 1961-75, with special reference to hepatitis B surface antigen.
During 1961-75, 128 cases of primary liver carcinoma (PLC) in the Radiation Effects Research Foundation life-span study extended sample and 301 cases of liver cirrhosis in the pathology study sample were observed. The presence of hepatitis B surface antigen (HBsAg) was assessed in all of the cases with the use of orcein and aldehyde fuchsin stains and was confirmed by the immunofluorescence technique. The incidence of PLC was two times higher in Nagasaki than in Hiroshima, which was statistically significant, but little difference was noted in the prevalence of cirrhosis in the two cities. Findings that might possibly explain the higher PLC incidence in Nagasaki were 1) the 2.3 times higher presence in Nagasaki than in Hiroshima of HBsAg in the livers of subjects without liver disease and 2) the two times higher prevalence in Nagasaki than in Hiroshima of cirrhosis with PLC. We believe that the higher incidence of PLC in Nagasaki is attributable to hepatitis B virus infection, although other factors (e.g., immunologic competence affected by radiation) cannot be excluded. In both cities, a suggestive relationship of radiation dose to cirrhosis prevalence, but not to PCL prevalence, was noted. To clarify possible radiation effects on cirrhosis prevalence, further follow-up of the populations of these two cities is necessary.


[Methods of assessing the state of the digestive system in mass examinations of rural population].
On the basis of physician's logic a questionnaire has been elaborated for identifying the most common diseases of digestive system during mass medical check-ups of rural population. 98 combinations of signs were considered in the diagnostic algorithm for making conclusions regarding 11 diseases. The programme elaborated envisages recommendations on the volume of examinations necessary for verification of diagnoses. The questionnaire and rules governing it were verified for 152 patients. By means of mathematical statistics methods the informativeness of the signs used have been assessed. The analysis showed a great diagnostic value of choosing signs on the basis of physician's logic taking into account their pathogenetic correlation. The efficiency of questionnaires have been demonstrated and sufficient under conditions of automated examinations sensitivity (on the average for diseases 78.1%) and specificity (on the average for diseases 70.0%).


Antitumor activity of chemical modified natural compounds.
Search of new activity substances starting from chemotherapeutic agents, continuously appears in international literature. Perhaps this search has been done more frequently in the field of antitumor chemotherapy on account of the unsuccess in saving advanced stage patients. The new point in this matter during the last decade was computer aid in planning more rational drugs. In near future "the accessibility of super computers and emergence of computer net systems, will open new avenues to rational drug design" (Portoghese, P. S., J. Med. Chem. 1989, 32, 1). Unknown pharmacological active compounds synthetized by plants can be found even without this electronic devices, as traditional medicine has pointed out in many countries, and give rise to a new drug. These compounds used as found in nature or after chemical modifications have produced successful experimental medicaments as FAA, "flavone acetic acid" with good results as inhibitors of slow growing animal tumors currently in preclinical evaluation for human treatment. In this lecture some international contributions in the field of chemical modified compounds as antineoplastic drugs will be examined, particularly those done by Brazilian researches.


Postsurgical muscle protein turnover in perfused hindquarters of the rat.
Skeletal muscle protein synthesis and degradation were measured simultaneously in perfused hindquarters of adult female rats 0, 2, and 4 days after surgical trauma. In order to explore the role of decreased postoperative nutrient intake on muscle protein turnover, a group of rats were pair-fed to the level of food consumed by surgical traumatized animals. Protein synthesis was measured by the incorporation of 3H-L-phenylalanine into the myofibrillar (contractile) and sarcoplasmic (soluble) proteins of gastrocnemius muscle. Protein degradation rates were calculated from the release of myofibrillar 3-methyl histidine (3MH) during the perfusion. Surgical trauma significantly depressed myofibrillar and sarcoplasmic protein synthetic rates by 33 and 29%, respectively. Protein degradation, as assessed by 3MH release into perfusate, increased 25% on the second postoperative day but returned to control levels by the 4th day after surgery. Food restriction of the pair-fed control rats did not alter protein synthesis, however, protein degradation decreased significantly. In conclusion, the effect of trauma on protein turnover appears not to be due to decreased nutrient consumption.


Compliance with safe handling guidelines of antineoplastic drugs in Jordanian hospitals.
To evaluate the compliance of healthcare workers with standard safety guidelines during the preparation and administrations of antineoplastic medications. A cross-sectional survey study. All hospitals in Jordan where healthcare workers are involved in preparation and administration of antineoplastic medications. All healthcare workers who are involved in preparation and administration of antineoplastic medications in Jordanian hospitals. A questionnaire that covered information about work place, healthcare workers, and use of personal protective equipments during handling of antineoplastic medications was self-filled by each participant. Compliance rates with workplace requirements, healthcare workers, and use of personnel protective equipments. Majority of participants (74.2%), representing nine out of 15 (60%) hospitals, reported full compliance of workplace with all requirements of the guidelines. Items with full compliance in all hospitals were availability of policies and procedures for safe handling of antineoplastic agents, availability of reporting system, and availability of sharp containers. Concerning healthcare workers' guidelines, worker with full compliance were 46.4% of participants. Items with least compliance rate were working inside biological safety cabinet (65.1%) and having training program on handling chemotherapy medications (66.7%). Finally, concerning items-related personal protective equipments, only 10.7% of participants reported full compliance. Items with least compliance rates were wearing goggles (eye protection), shoe cover, and hair cover. Results of this study showed the levels of compliance with guidelines pertaining to work place and workers who prepare and administer antineoplastic medications. Among other points, compliance with guidelines pertaining to wearing personnel protective equipments was limited and required further improvement.


Synthesis, structure, and olefin polymerization with nickel(II) N-heterocyclic carbene enolates.
Two novel N-heterocylic carbene enolate nickel complexes have been prepared and shown to be active for ethylene and propylene polymerization to yield linear polymers.


Measurement and description of three-dimensional shoulder range of motion with degrees of freedom interactions.
The shoulder is the most mobile joint of the human body due to bony constraint scarcity and soft tissue function unlocking several degrees of freedom (DOF). Clinical evaluation of the shoulder range of motion (RoM) is often limited to a few monoplanar measurements where each DOF varies independently. The main objective of this study was to provide a method and its experimental approach to assess shoulder 3D RoM with DOF interactions. Sixteen participants performed four series of active arm movements with maximal amplitude consisting in (1) elevations with fixed arm axial rotations (elevation series), (2) axial rotations at different elevations (rotation series), both in five planes of elevation, (3) free arm movements with the instruction to fill the largest volume in space while varying hand orientation (random series), and (4) a combination of elevation and rotation series (overall series). A motion analysis system combined with an upper limb kinematic model was used to estimate the 3D joint kinematics. Thoracohumeral Euler angles with correction were chosen to represent rotations. The angle-time-histories were treated altogether to analyze their 3D interaction. Then, all 3D angular poses were included into a nonconvex hull representing the RoM space accounting for DOF interactions. The effect of series of movements (n = 4) on RoM volumes was tested with a one-way repeated-measures ANOVA followed by Bonferroni posthoc analysis. A normalized 3D RoM space was defined by including 3D poses common to a maximal number of participants into a hull of average volume. A significant effect of the series of movements (p < 0.001) on the volumes of thoracohumeral RoM was found. The overall series measured the largest RoM with an average volume of 3.46 ± 0.89 million cubic degrees. The main difference between the series of movements was due to axial rotation. A normalized RoM hull with average volume was found by encompassing arm poses common to more than 50% of the participants. In general, the results confirmed and characterized the complex 3D interaction of shoulder RoM between the DOF. The combination of elevation and rotation series (overall series) is recommended to fully evaluate shoulder RoM. The normalized 3D RoM hull is expected to provide a reliable reference to evaluate shoulder function in clinical research and for defining physiologic continuous limits in 3D shoulder computer simulation models.


The role of surgery in the treatment of thyroid anaplastic carcinoma in the elderly.
Anaplastic thyroid carcinoma (ATC) is characterized by local invasiveness, risk of recurrence and very poor prognosis. We retrospectively analysed the multimodality treatment of ATC in 79 patients considering the impact of surgery on survival. Patients were divided in two age groups A and B (cut-off 75 years) and in two size subgroups (cut-off 5 cm). Surgery was performed in 78.5% patients of group A and 32.4% of B (p < 0.05). Radiation respectively in 73.8% and 43.2% (p < 0.05). Tracheostomy and endoprosthesis were used in 45.2% and 16.6% in group A and in 43.2% and 35.1% in group B. The use of tracheostomy was significantly higher (p < 0.05) in larger tumours. In group B comparing operated and not operated patients significant difference in survival was observed for larger tumours (p = 0.043). In Kaplan Meir analysis significant difference in survival was observed comparing surgical and no surgical patients of all four subgroups. Surgery plus radiotherapy offered a significant better outcome in smaller tumours (p = 0.017). Considering the effect of the single treatment, compared to no treatment at all, survival is significantly improved by surgery for smaller and larger tumours respectively with 4.42 (p = 0.001) and with 3.5 months (p = 0.0001) and by radiotherapy respectively with 3.44 and with 3.28 months (p = 0.047 and p = 0.0001). In elderly patients with ATC, although poor prognosis, surgery is still fundamental in the multimodality treatment with significant advantage in selected patients. Nevertheless most of elderly patients with large tumours are suitable only for palliative management.


Minimally Invasive Management of Complicated Diverticular Disease: Current Status and Review of Literature.
Diverticulitis is a common condition which carries significant morbidity and socioeconomic burden (McGillicuddy et al in Arch Surg 144:1157-1162, 2009). The surgical management of diverticulitis has undergone significant changes in recent years. This article reviews the role of minimally invasive approach in management of complicated diverticulitis, with a focus on recent concepts and advances. A literature review of past 10 years (January 2004 to September 2014) was performed using the electronic database MEDLINE from PubMed which included articles only in English. We identified total of 139 articles, out of which 50 were excluded resulting in 89 full-text articles for review 16 retrospective studies, 7 prospective cohorts, 1 case-control series and 1 systematic review were included. These suggest that urgent surgery is performed for those with sepsis and diffuse peritonitis or those who fail to improve despite medical therapy and/or percutaneous drainage. In addition, 3 randomized control trials: DILALA, LapLAND and the Scandinavian Diverticulitis trial are working towards evaluating whether laparoscopic lavage is safe in management of complicated diverticular diseases. Growing trend toward conservative or minimally invasive treatment modality even in severe acute diverticulitis was noticed. Laparoscopic peritoneal lavage has evolved as a good alternative to invasive surgery, yet clear indications for its role in the management of complicated diverticulitis need to be established. Recent evidence suggests that existing guidelines for optimal management of complicated diverticulitis should be updated. Non-resectional radiographic techniques are likely to play a prominent role in the initial treatment of complicated diverticulitis in the near future.


Development of an equation for estimating appendicular skeletal muscle mass in Japanese older adults using bioelectrical impedance analysis.
Bioelectrical impedance analysis has been reported to have high reliability and accuracy in assessing body composition. However, equations for estimating appendicular skeletal muscle mass are population-specific, and few have been developed for older Japanese adults. Thus, the purpose of the present study was to develop and validate an estimate equation for appendicular skeletal muscle mass using bioelectrical impedance analysis. A total of 250 older adults aged 65 years and older participated in this study. Appendicular skeletal muscle mass was measured using dual-energy X-ray absorptiometry, and bioelectrical resistance was measured using a multifrequency bioelectrical impedance analyzer. Multiple regression analysis was applied to derive sex-specific estimation formulae using bioelectrical impedance analysis, and a Bland-Altman analysis was used to test agreement. The cross-validation results showed that the slopes and intercepts of the regression lines were approximately one and zero, respectively, and the coefficients of determination and standard errors of the estimate of the newly developed equations were similar between the two groups. Thus, the single sex-specific equations were developed using all participants as follows. Men: appendicular skeletal muscle mass=0.197 × (impedance index) +0.179 × (weight) -0.019 (R(2) =0.87, standard error of the estimate=0.98 kg). Women: appendicular skeletal muscle mass=0.221 × (impedance index) +0.117 × (weight) +0.881 (R(2) =0.89, standard error of the estimate=0.81 kg). These new equations offer a valid option for assessing appendicular skeletal muscle mass in older Japanese adults.


Exome sequencing in Thai patients with familial obesity.
Obesity is a major worldwide health issue, with increasing prevalence in adults and children from developed and developing countries. Obesity causes several chronic diseases, including cardiovascular and respiratory diseases, osteoarthritis, hypertension, stroke, type II diabetes, obstructive sleep apnea, and several types of cancer. Previous genome-wide association studies have identified several genes associated with obesity, including LEP, LEPR, POMC, PCSK1, FTO, MC3R, MC4R, GNPDA2, TMEM18, QPCTL/GIPR, BDNF, ETV5, MAP2K5/SKOR1, SEC16B, SIM1, and TNKS/MSRA. However, most of these variants are found in the intronic or intergenic regions, making it difficult to elucidate the underlying mechanisms. Therefore, in this study, we performed a whole exome sequencing of the protein-coding regions in the total genome (exome) of two obese and one normal subject belonging to the same Thai family to identify the genes responsible for obesity. We identified 709 functional variants that were differentially expressed between obese and normal subjects; of these, 65 were predicted to be deleterious to protein structure or function. The minor allele frequency of 14 of these genes (ALOX5AP, COL9A2, DEFB126, GDPD4, HCRTR1, MLL3, OPLAH, OR4C45, PRIM2, RXFP2, TIGD6, TRPM8, USP49, and ZNF596) was low, indicating causal variants that could be associated with complex traits or diseases. Genotyping revealed HCRTR1, COL9A2, and TRPM8 to be associated with the regulation of feeding behavior and energy expenditure. These genes constituted a network of pathways, including lipid metabolism, signaling transduction, immune, membrane transport, and gene regulation pathways, and seemed to play important roles in obesity.


Pattern of antibodies in toxoplasmosis of pregnant women and their children in Thailand.
The latex agglutination test for toxoplasmosis was performed on 690 blood samples collected from the Veterans and Bang Bua Thong Hospitals in Bangkok. Blood samples were collected in the first- and the third-trimester from pregnant women and from the cord blood. The seroprevalence of toxoplasmosis in the first trimester was 13.14%, 13.60%; in the third trimester was 12.21%, 9.43% and in the cord blood 7.18% and 13.04% for the Veterans Hospital and Bang Bua Thong Hospital, respectively. There was no significant difference between the prevalence of toxoplasmosis for each type of blood from both hospitals. The average prevalence of toxoplasmosis for Thai pregnant women in the first- and third-trimester was 13.38% and 11.41%, respectively, and that for the cord blood was 9.01%. Congenital toxoplasmosis occurred in children of untreated mothers who were seropositive or seronegative in the third-trimester, the infection rates of the fetus being 46.67% and 8.13% respectively.


Infrared observations of the saturnian system from voyager 1.
During the passage of Voyager 1 through the Saturn system, the infrared instrument acquired spectral and radiometric data on Saturn, the rings, and Titan and other satellites. Infrared spectra of Saturn indicate the presence of H(2), CH(4), NH(3), PH(3), C(2)H(2), C(2)H(6), and possibly C(3)H(4) and C(3)H(8). A hydrogen mole fraction of 0.94 is inferred with an uncertainty of a few percent, implying a depletion of helium in the atmosphere of Saturn relative to that of Jupiter. The atmospheric thermal structure of Saturn shows hemisphere asymmetries that are consistent with a response to the seasonally varying insolation. Extensive small-scale latitudinal structure is also observed. On Titan, positive identifications of infrared spectral features are made for CH(4), C(2)H(2), C(2)H(4), C(2)H(6), and HCN; tentative identifications are made for C(3)H(4) and C(3)H(8). The infrared continuum opacity on Titan appears to be quite small between 500 and 600 cm(-1), implying that the solid surface is a major contributor to the observed emission over this spectral range; between 500 and 200 cm(-1) theopacity increases with decreasing wave number, attaining an optical thickness in excess of 2 at 200 cm(-1). Temperatures near the 1-millibar level are independent of longitude and local time but show a decrease of approximately 20 K between the equator and north pole, which suggests a seasonally dependent cyclostrophic zonal flow in the stratosphere of approximately 100 meters per second. Measurements of the C ring of Saturn yield a temperature of 85 +/- 1 K and an infrared optical depth of 0.09 +/- 0.01. Radiometer observations of sunlight transmitted through the ring system indicate an optical depth of 10(-1.3 +/-0.3) for the Cassini division. A phase integral of 1.02 +/- 0.06 is inferred for Rhea, which agrees with values for other icy bodies in the solar system. Rhea eclipse observations indicate the presence of surface materials with both high and low thermal inertias, the former most likely a blocky component and the latter a frost.


Stress, the adrenergic hypothalamovagal pathway, and the aetiology of chronic duodenal ulceration.
In the rat, stress activates the hypothalamus causing central adrenergic discharge with delivery of an alpha-adrenergic stimulus by the adrenergic hypothalamovagal pathway to the stomach. This stimulus controls intragastric blood flow and 5-HT release. In rats stressed pharmacologically by administration of intraperitoneal reserpine (0.1 mg/kg), the stimulated pathway releases gastric 5-HT which in turn significantly increases gastric acid secretion. Administration of intramuscular reserpine (0.1 mg/kg) every 24 hr for six weeks significantly (p less than 0.001 by Wilcoxon matched pairs signed-rank test) increased the basal acid output of the rat stomach (12 mumol/h +/- 0.5 vs 38.1 mumol/h +/- 2.4, mean +/- SEM) and produced duodenal ulceration in 83.3% of animals. Vagotomy completely protected the rat stomach against these effects. The data show that prolonged stress in the rat stimulates gastric acid secretion and produces duodenal ulceration.


[Interaction of connective tissue structural glycoprotein with proteoglycans and glycosaminoglycans].
It was shown that structural glycoprotein (SGP) of connective tissue isolated from be cattle heart valves and nasal septum cartilage formed water-soluble complexes with protein-chondroitin-4-sulphate and different heparin fractions. SGP formed no mentioned complexes with hyaluronic acid. Probably this plays an important role in the formation of collagen and elastin fibers.


Rapid estimation of spoilage bacterial load in aerobically stored meat by a quantitative polymerase chain reaction.
We report a quantitative PCR which utilizes primers from a conserved 23S rDNA sequence identified in nine different spoilage bacteria commonly present in meat. The PCR detected the spoilage bacteria by amplifying a specific 207 bp sequence from their chromosomal DNA. Quantification of PCR product by electrochemiluminescence revealed that the concentration of the amplified product was dependent on cycle number and the initial number of bacteria present in the sample. Statistical analysis of the results indicated a correlation coefficient of 0.94 (P < 0.001) between aerobic plate count and QPCR luminosity units.