Phylogenetic relationships of amphibian families inferred from DNA sequences of mitochondrial 12S and 16S ribosomal RNA genes.
Nucleotide sequence comparisons were used to investigate ordinal and familial relationships within the class Amphibia. Approximately 850 base pairs of the mitochondrial 16S ribosomal RNA (rRNA) gene from representatives of 28 of the 40 families of extant amphibians were sequenced. Phylogenetic analyses of these data together with published data of the 12S rRNA gene for the same families and both genes for three more taxa (approximately 1,300 base pairs total for 35 taxa) support the monophyly of each of the three amphibian orders: Anura (confidence value with the interior-branch test: P(c) = 99%), Caudata (P(c) = 100%), and Gymnophiona (P(c) = 99%). An analysis using the four-cluster method cannot discriminate significantly between all three possible unrooted trees involving the three orders of amphibians and an outgroup. Within the Anura, there is support for the monophyly of the two suborders: Neobatrachia (P(c) = 100%) and Archaeobatrachia (P(c) = 97%); the latter was believed to be paraphyletic on the basis of morphology. Within the Archaeobatrachia, the following pairs of taxa cluster: Pelobatidae + Pelodytidae (P(c) = 99%), Pipidae + Rhinophrynidae (P(c) = 99%), Ascaphus + Leiopelmatidae (P(c) = 89%), and Bombina + Discoglossidae (P(c) = 99%). The latter six taxa cluster (P(c) = 94%) such that Pelobatidae + Pelodytidae forms a basal lineage within the Archaeobatrachia. Three major lineages are distinguished within the Neobatrachia: the superfamily Bufonoidea sensu Duellman (P(c) = 86%), the superfamily Ranoidea sensu Lynch (P(c) = 99%), and the Sooglossidae. Basal within the Bufonoidea, Myobatrachidae + Heleophrynidae cluster at P(c) = 96%. The enigmatic Dendrobatidae clusters with the bufonoid families (P(c) = 92%) and is excluded from the ranoid families (P(c) = 99%). (ABSTRACT TRUNCATED AT 250 WORDS)


BDNF protection of basal forebrain cholinergic neurons after axotomy: complete protection of p75NGFR-positive cells.
To elucidate the role of brain derived neurotrophic factor (BDNF) in the protection of cholinergic neurons in the basal forebrain, recombinant human BDNF and as a positive control, human recombinant nerve growth factor (NGF), were infused for 20 days into the lateral ventricle of adult rats with fimbrial transections. BDNF and NGF administration protected cholinergic basal forebrain cells from degenerative changes after axotomy, as assessed with immunohistochemical analysis of the two cholinergic marker proteins ChAT and p75NGFR. Both BDNF and NGF treatment completely prevent the lesion induced loss of p75NGFR-positive cells in the septal area of animals with fimbrial transections. This finding contrasts with the result obtained with ChAT immunohistochemistry, where BDNF treatment protects only part of the population of neurons which disappear following the transections. These findings are compatible with the view that there is a cascade of events induced in cholinergic neurons by the transections, so that ChAT expression is lost before p75NGFR expression, and that BDNF reduces degenerative events in the entire population of cholinergic neurons, maintaining some of them as p75NGFR-positive but ChAT-negative cells.


The C-terminal appended domain of human cytosolic leucyl-tRNA synthetase is indispensable in its interaction with arginyl-tRNA synthetase in the multi-tRNA synthetase complex.
Human cytosolic leucyl-tRNA synthetase is one component of a macromolecular aminoacyl-tRNA synthetase complex. This is unlike prokaryotic and lower eukaryotic LeuRSs that exist as free soluble enzymes. There is little known about it, since the purified enzyme has been unavailable. Herein, human cytosolic leucyl-tRNA synthetase was heterologously expressed in a baculovirus system and purified to homogeneity. The molecular mass (135 kDa) of the enzyme is close to the theoretical value derived from its cDNA. The kinetic constants of the enzyme for ATP, leucine, and tRNA(Leu) in the ATP-PP(i) exchange and tRNA leucylation reactions were determined, and the results showed that it is quite active as a free enzyme. Human cytosolic leucyl-tRNA synthetase expressed in human 293 T cells localizes predominantly to the cytosol. Additionally, it is found to have a long C-terminal extension that is absent from bacterial and yeast LeuRSs. A C-terminal 89-amino acid truncated human cytosolic leucyl-tRNA synthetase was constructed and purified, and the catalytic activities, thermal stability, and subcellular location were found to be almost identical to native enzyme. In vivo and in vitro experiments, however, show that the C-terminal extension of human cytosolic leucyl-tRNA synthetase is indispensable for its interaction with the N-terminal of human cytosolic arginyl-tRNA synthetase in the macromolecular complex. Our results also indicate that the two molecules interact with each other only through their appended domains.


Treatment of Taenia saginata infection with mixture of areca nuts and pumpkin seeds.
In January and February 1974, 32 adults (20 males and 12 females) and a 13-year-old girl with taeniasis saginata were treated with the mixture of boiled areca nuts and pumpkin seeds at Mastoban, Jen-ai District, Nantou County, Taiwan. A total of 48 worms including 42 scolices were recovered from 29 cases. Side-effects were observed in 4 cases including 3 with complaints of dizziness, tinnitus, nausea and vomiting, and one with coma and abdominal pain. Mixtures of 75-150 g areca nuts and 50-100 g pumpkin seeds were judged effective and safe.


Multifocal versus monofocal intraocular lenses after cataract extraction.
Good unaided distance visual acuity is now a realistic expectation following cataract surgery and intraocular lens (IOL) implantation. Near vision, however, still requires additional refractive power, usually in the form of reading glasses. Multiple optic (multifocal) IOLs are available which claim to allow good vision at a range of distances. It is unclear whether this benefit outweighs the optical compromises inherent in multifocal IOLs. The objective of this review was to assess the effects of multifocal IOLs, including effects on visual acuity, subjective visual satisfaction, spectacle dependence, glare and contrast sensitivity, compared to standard monofocal lenses in people undergoing cataract surgery. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 2), MEDLINE (January 1946 to March 2012), EMBASE (January 1980 to March 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 6 March 2012. We searched the reference lists of relevant articles and contacted investigators of included studies and manufacturers of multifocal IOLs for information about additional published and unpublished studies. All randomised controlled trials comparing a multifocal IOL of any type with a monofocal IOL as control were included. Both unilateral and bilateral implantation trials were included. Two authors collected data and assessed trial quality. Where possible, we pooled data from the individual studies using a random-effects model, otherwise we tabulated data. Sixteen completed trials (1608 participants) and two ongoing trials were identified. All included trials compared multifocal and monofocal lenses but there was considerable variety in the make and model of lenses implanted. Overall we considered the trials at risk of performance and detection bias because it was difficult to mask patients and outcome assessors. It was also difficult to assess the role of reporting bias. There was moderate quality evidence that similar distance acuity is achieved with both types of lenses (pooled risk ratio (RR) for unaided visual acuity worse than 6/6: 0.98, 95% confidence interval (CI) 0.91 to 1.05). There was also evidence that people with multifocal lenses had better near vision but methodological and statistical heterogeneity meant that we did not calculate a pooled estimate for effect on near vision. Total freedom from use of glasses was achieved more frequently with multifocal than monofocal IOLs. Adverse subjective visual phenomena, particularly haloes, or rings around lights, were more prevalent and more troublesome in participants with the multifocal IOL and there was evidence of reduced contrast sensitivity with the multifocal lenses. Multifocal IOLs are effective at improving near vision relative to monofocal IOLs. Whether that improvement outweighs the adverse effects of multifocal IOLs will vary between patients. Motivation to achieve spectacle independence is likely to be the deciding factor.


Neuroendocrine studies in dementia patients: responses of plasma GH and PRL following bromocriptine administration.
Bromocriptine stimulates growth hormone (GH) secretion at the hypothalamus and suppresses prolactin (PRL) secretion at the pituitary level. We administered bromocriptine to 30 patients with dementia of the Alzheimer type (DAT), 30 patients with multi-infarct dementia (MID) and 22 age matched healthy controls, and compared response patterns of GH and PRL. Incomplete PRL suppressive responses (suppression rate < 50%) were seen in 36.7% of DAT patients and in 30.0% of MID patients, indicating that both groups had the same degree of pituitary dysfunctions. Blunted GH responses (< 5 ng/ml) were seen in 93.3% of DAT patients, in 63.3% of MID patients and in 31.8% of the controls. The results indicate that neuroendocrine regulation of GH is more selectively and severely damaged in DAT patients than in MID patients at the hypothalamus.


In vitro sequence-dependent synergism between paclitaxel and gefitinib in human lung cancer cell lines.
In clinical trials, the epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) administered concomitantly with first-line cytotoxicity chemotherapy failed to confer a survival benefit to patients with non-small-cell lung cancer (NSCLC). The aim of this study was to test whether paclitaxel followed by gefitinib is superior to other treatment schedules of NSCLC cell lines and to clarify the underlying mechanisms. Human lung cancer cell lines with wild-type and mutant-type EGFR genes were used as in vitro models to define the differential effects of various schedules of paclitaxel with gefitinib treatment on cell growth, signaling pathway, and cell cycle distribution. Sequence-dependent antiproliferative effects differed between EGFR-TKI-resistant and EGFR-TKI-sensitive lung cancer cell lines. Exposure to paclitaxel resulted in an increased pEGFR level. This increase in phosphorylation was inhibited by subsequent exposure to gefitinib, whereas during the reverse sequence, the inhibition effect was reduced. After paclitaxel exposure, a higher level of pEGFR was observed in mitotic than in interphase cells. The sequence of paclitaxel followed by gefitinib resulted in greater anti-VEGF activity than did the reverse sequence. We confirmed that gefitinib arrested cells in G1, and paclitaxel arrested them in S phase. The sequence of paclitaxel followed by gefitinib arrested cells in G1, whereas the reverse sequence arrested cells in S and G2 phases. These findings suggest that the sequence of paclitaxel followed by gefitinib may be superior to other sequences in treating NSCLC cell lines. Our results also provide molecular evidence to support clinical treatment strategies for patients with lung cancer.


Nontuberculous Mycobacterial Infection in the Uterine Cervix Mimics Invasive Cervical Cancer in Immunocompetent Woman.
Nontuberculous mycobacterial (NTM) infection is increasing across the world. Although the most common clinical manifestation of NTM disease is lung disease, a rare form of disseminated NTM disease has also been documented. Disseminated NTM usually develops in severely immunocompromised individuals, especially those with advanced AIDS. This manifestation is rare in non-HIV-infected hosts and is associated with immunosuppressed conditions. However, recent reports have suggested that disseminated NTM disease in immunocompetent patients without HIV infection has been increasing. Dissemination may involve any organ system, but a case in the female genital tract has never been reported. We report a case in a 67-yr-old previously healthy woman who presented with a disseminated NTM infection in the uterine cervix. The primary presentation was general fatigue and body weight loss. The patient also presented with a mass formation that mimicked cervical cancer on magnetic resonance imaging. In addition to the cervical mass, the patient presented with a mass formation in the omentum; wall thickening of the vagina, bladder, and ureter; and retention of pleural/peritoneal fluid. Vaginal cytology was negative. A diagnosis was made only after detecting acid-fast bacilli in a biopsy specimen of cervical mass, which was conducted under suspicion of cervical malignancy. Then, Mycobacterium avium was confirmed in a polymerase chain reaction test of cervical tissue. After administration of antimycobacterial therapy, the mass and other findings on magnetic resonance imaging disappeared. Infection in multiple organs leads to the diagnosis of disseminated NTM. This case indicates that, for prompt and accurate diagnosis, efforts to detect specific lesions by an imaging study and to confirm diagnosis pathologically are equally important, especially when local cytology is not convincing. The clinical course of this case may serve as a useful reference in the diagnosis and treatment of NTM.


Generating Ambiguous Figure-Ground Images.
Ambiguous figure-ground images, mostly represented as binary images, are fascinating as they present viewers a visual phenomena of perceiving multiple interpretations from a single image. In one possible interpretation, the white region is seen as a foreground figure while the black region is treated as shapeless background. Such perception can reverse instantly at any moment. In this paper, we investigate the theory behind this ambiguous perception and present an automatic algorithm to generate such images. We model the problem as a binary image composition using two object contours and approach it through a three-stage pipeline. The algorithm first performs a partial shape matching to find a good partial contour matching between objects. This matching is based on a content-aware shape matching metric, which captures features of ambiguous figure-ground images. Then we combine matched contours into a compound contour using an adaptive contour deformation, followed by computing an optimal cropping window and image binarization for the compound contour that maximize the completeness of object contours in the final composition. We have tested our system using a wide range of input objects and generated a large number of convincing examples with or without user guidance. The efficiency of our system and quality of results are verified through an extensive experimental study.


Role of fecal calprotectin in the assessment of intestinal inflammation in children with familial Mediterranean fever.
Familial Mediterranean fever (FMF) is the most common auto-inflammatory disease with recurrent fever and serositis episodes. In recent years, some cases with FMF were reported with gastrointestinal involvement without amyloidosis, vasculitis and inflammatory bowel disease (IBD). It is not yet known whether gastrointestinal involvement is a part of the disease or not. The aim of this study is to investigate the frequency of intestinal inflammation by using a noninvasive method, fecal calprotectin measurement, in pediatric FMF patients. Sixty-five FMF patients, 30 healthy controls and 11 patients with acute ulcerative colitis were included in the study. A standard survey inquiring gastrointestinal and other clinical symptoms was completed. The medications, MEFV mutations, whole blood count and C-reactive protein levels were recorded. Fecal calprotectin was studied with the enzyme-linked immunosorbent assay method from the feces samples of the all subjects. None of the FMF patients had clinical signs of IBD. Fecal calprotectin levels of the FMF patients were found to be significantly higher than the healthy controls (174.8 ± 150.8 vs 52.9 ± 36.5, p < 0.001). Fecal calprotectin levels of the ulcerative colitis patients were significantly higher than the FMF patients (523.5 ± 183 vs 174.8 ± 150.8, p = 0.001). There was a correlation between fecal calprotectin levels and neutrophil/lymphocyte ratio (r = 0.324, p = 0.009). Our results supported subclinical intestinal inflammation in pediatric FMF patients. Further studies are needed to clarify the reason for intestinal inflammation in FMF patients.


Seasonal variations of weather conditions on acute myocardial infarction onset: Oita AMI Registry.
The onset of acute myocardial infarction (AMI) has been reportedly related to weather conditions. The aim of this study was to investigate the impact of weather conditions on AMI onset. Our study population consisted of 274 patients enrolled in the Oita AMI Registry who were admitted with AMI between June 2012 and May 2013. We divided the 365 days of the year into the four seasons: spring (March, April, May), summer (June, July, August), autumn (September, October, November), and winter (December, January, February). We classified each day as a day of onset of AMI (onset day) or a day of non-onset of AMI (non-onset day). Information on maximum temperature, minimum temperature, mean humidity, and mean atmospheric pressure was obtained from the Japan Meteorological Agency. In summer, the temperatures and intraday temperature differences were significantly lower on onset days than on non-onset days. Receiver operating characteristic analysis for predicting AMI onset in each season showed that the maximum temperature 2 days before AMI onset in summer had the largest area under the curve (AUC = 0.72, p = 0.0005). Our analysis demonstrated that there exist specific weather conditions that influence AMI onset in each season in Oita prefecture. AMI onset in summer was particularly associated with the maximum temperature 2 days before AMI onset.


Organochlorines and breast cancer: the uses of scientific evidence in claimsmaking.
This paper explores the role and utilization of scientific evidence concerning one of the potential adverse health impacts (breast cancer) of the use of chlorine through examining the aims of an environmental group, Greenpeace, and its opponents. Specifically, the paper identifies the claims of Greenpeace and the scientific evidence used to justify those claims in its (Thornton, 1993) report Chlorine, Human Health and the Environment: The Breast Cancer Warning. A media analysis was conducted over a ten year period to assess what counter-claims were generated. The claimsmaking activities of breast cancer advocacy groups, scientists, pro-chlorine groups, and environmentalists were monitored. To counter the Greenpeace claims, pro-chlorine supporters argued for the responsible use of science, and redefined the chlorine issue as one of public health and economic security. The counter-claims between the supporters and the opponents of the chlorine issue stemmed from differences in their agendas, values, and solutions proffered in the environmental health policy domain.


The dysmorphic cervical spine in Klippel-Feil syndrome: interpretations from developmental biology.
The authors conducted a study to identify radiological patterns of Klippel-Feil syndrome (KFS), and they present a new interpretation of the origin of these patterns based on recent advances in understanding of embryonic development of the spine and its molecular genetic control. The authors studied radiographs and computerized tomography (CT) scans as well as magnetic resonance images or CT myelograms obtained in 30 patients with KFS who were referred for treatment between 1982 and 1996; the patients had complained of various neuroorthopedic complications. Homeotic transformation due to mutations or disturbed expression of Hox genes is a possible mechanism responsible for C-1 assimilation, which was found to have occurred in 19 cases (63%). Notochordal defects and/or signaling problems, which result in reduced or impaired Pax-1 gene expression, may underlie vertebral fusions. This, together with asymmetrical distribution of paraxial mesoderm cells and a possible lack of communication across the embryonic midline, could cause asymmetrical fusion patterns, which were present in 17 cases (57%). The wide and flattened shape of the fused vertebral bodies and their resemblance to the embryonic cartilaginous vertebrae as well as the process of progressive bone fusion with age suggest that the fusions occur before or, at the latest, during chondrification of vertebrae. The authors suggest that the aforementioned mechanisms are likely to be, at least in part, responsible for the observed patterns in KFS that affect the craniovertebral junction and the cervical spine.


Carotid artery shortening: a safe adjunct to carotid endarterectomy.
Kinks and coils of the extracranial carotid artery system have been described in conjunction with atherosclerotic disease of the internal carotid artery. The purpose of this study was to determine whether adding a carotid artery shortening procedure to carotid endarterectomy affected perioperative mortality and stroke-morbidity rates or late restenosis. A retrospective chart review of all patients who concurrently underwent carotid endarterectomy and ipsilateral carotid artery shortening between 1983 and 1992 was performed. Long-term follow-up was obtained by contacting the primary physician or patient, and carotid artery duplex scans were obtained. One hundred seven patients were found to have undergone concurrent carotid endarterectomy and carotid artery shortening. The age range was 47 to 89 years, with 53 female and 54 male patients. Indications for surgery in this group were transient ischemic attacks in 28%, stroke in 18%, amaurosis fugax in 7%, and high-grade asymptomatic stenosis in 47%. Shortening procedures were performed by use of a variety of techniques at the completion of endarterectomy. The combined 30-day mortality and stroke morbidity rate was 2.7%, with two postoperative deaths and one stroke. In this same period, a total of 1072 carotid endarterectomies were performed, and the combined 30-day mortality and stroke morbidity rate was 4.0%. During late follow-up there were no ipsilateral strokes, recurrent symptoms, or significant restenoses. This experience suggests that the addition of a shortening procedure to carotid endarterectomy can be performed without increased morbidity and mortality rates and, when deemed appropriate, is a procedure with which the vascular surgeon should be familiar.


[Sub-coraco-clavicular approach of the axillary vein].
This prospective study aimed to assess the value of the infraclavicular route for axillary vein catheterization in intensive care patients. Forty-six patients, 26 to 90 years old, were assigned to one of two groups according to their body mass index: obese (W/H2 < 30) and non obese (W/H2 < 30). The three operators were not previously trained for this particular technique, but were familiar with others. There were 55 attempts. Overall success rate was 47%; 8% in obese and 58% in non obese patients respectively. Perceiving axillary artery beats beneath the coracoid process increased significantly the success rate in non obese patients (94%; p < 0.01). There was one major complication (pneumothorax), due to a non respect of the technique. In conclusion, this technique requires a previous training period, and is not to be recommended in the obese. However, it is a convenient technique for non obese patients, in whom axillary artery beats can be detected.


[Traumatically-induced dermatofibrosarcoma protuberans of the breast].
Dermatofibrosarcoma protuberans is a rare, cutaneous-subcutaneous low grade malignancy. Despite the locally aggressive behaviour, metastases seldom occur. Evidence exists that trauma may be a predisposing factor. Treatment by wide tridimensional excision is recommended. One case of trauma-induced dermatofibrosarcoma protuberans in a 71-year old woman is reported.


Quantitative Characterization of Protein-Lipid Interactions by Free Energy Simulation between Binary Bilayers.
Using a recently developed binary bilayer system (BBS) consisting of two patches of laterally contacting bilayers, umbrella sampling molecular dynamics (MD) simulations were performed for quantitative characterization of protein-lipid interactions. The BBS is composed of 1,2-dilauroyl-sn-glycero-3-phosphocholine (DLPC) and 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) with an embedded model membrane protein, a gramicidin A (gA) channel. The calculated free energy difference for the transfer of a gA channel from DLPC (hydrophobic thickness ≈ 21.5 Å) to DMPC (hydrophobic thickness ≈ 25.5 Å) bilayers, ΔG(DLPC → DMPC), is -2.2 ± 0.7 kcal/mol. This value appears at odds with the traditional view that the hydrophobic length of the gA channel is ∼22 Å. To understand this discrepancy, we first note that recent MD simulations by different groups have shown that lipid bilayer thickness profiles in the vicinity of a gA channel differ qualitatively from the deformation profile predicted from continuum elastic bilayer models. Our MD simulations at low and high gA:lipid molar ratios and different membrane compositions indicate that the gA channel's effective hydrophobic length is ∼26 Å. Using this effective hydrophobic length, ΔG(DLPC → DMPC) determined here is in excellent agreement with predictions based on continuum elastic models (-3.0 to -2.2 kcal/mol) where the bilayer deformation energy is approximated as a harmonic function of the mismatch between the channel's effective hydrophobic length and the hydrophobic thickness of the bilayer. The free energy profile for gA in the BBS includes a barrier at the interface between the two bilayers which can be attributed to the line tension at the interface between two bilayers with different hydrophobic thicknesses. This observation implies that translation of a peptide between two different regions of a cell membrane (such as between the liquid ordered and disordered phases) may include effects of a barrier at the interface in addition to the relative free energies of the species far from the interface. The BBS allows for direct transfer free energy calculations between bilayers without a need of a reference medium, such as bulk water, and thus provides an efficient simulation protocol for the quantitative characterization of protein-lipid interactions at all-atom resolution.


55 degrees posterior oblique tomography of the pulmonary hilum in the evaluation of lung tumors.
Findings at 55 degrees posterior oblique tomography and chest films were compared to those at thoracotomy in 53 patients with malignant lung tumor. A correct evaluation of presence of lymph node metastases was made by tomography in 44 of the patients. Lack of tissue diagnosis at tomography makes mediastinoscopy better as a staging procedure. Oblique hilotomography is mainly indicated as a method for accurate evaluation of the questionably large hilum.


Long live the health care system in Japan.
In Japan, a cost-containment policy has been implemented with health care system reform. Increasing medical expenses are inevitable due to aging of the population, health transitions, and expanded and advanced medical services. Policies such as the introduction of regressive reimbursement for inpatient services as part of social insurance, the reduction in the number of hospital beds, fewer medical examinations, and curtailed usage of medical tests have jeopardized the accessibility and quality of medical services, especially for the elderly. Compared to other developed countries, both the proportion of the government's payment of health expenses and the proportion of health expenses in proportion to GDP are lower in Japan. To confront the challenges of an aging society in terms of finances and the health care system, policymakers from the Ministry of Health should take a comprehensive approach instead of a mere cost-containment policy.


Protein misfolding and disease; protein refolding and therapy.
Diverse human disorders, including several neurodegenerative diseases and systemic amyloidosis, are thought to arise from the misfolding and aggregation of an underlying protein. Recent findings strongly support this hypothesis and have increased our understanding of the molecular mechanism of protein conformational disorders. Many questions are still pending, but the data overall suggest that correction of protein misfolding constitutes a viable therapeutic strategy for conformational diseases.


Frequency of subclinical herpes zoster in pediatric hematology-oncology patients receiving chemotherapy: A retrospective cohort analysis.
Varicella-zoster virus (VZV) reactivation from enteric nervous system can cause ileus (Ogilvie's syndrome) in adult patients. Since no pediatric cases have been described, we sought to retrospectively analyze VZV reactivation in pediatric hematology-oncology patients to determine whether VZV infection including subclinical VZV reactivation can induce gastrointestinal complications such as Ogilvie's syndrome. Thirty-five patients who received chemotherapy at our institution between September 2013 and June 2018 were included. Serum samples were collected weekly during hospitalization and every 3 months during outpatient maintenance chemotherapy. A real-time polymerase chain reaction assay was used to measure VZV DNA load in serum. The clinical features of patients with VZV infection were retrospectively analyzed. Of 1,165 serum samples, 7 (0.6%) were positive for VZV DNA. VZV DNA was detected in 3 of 35 patients. In Patient A, VZV DNA was detected during 2 episodes. The first episode involved varicella-like eruptions caused by the Oka VZV vaccine strain. The second episode involved herpes zoster (HZ) caused by the same strain. Patients B and C had a clinical course that was typical for HZ caused by wild-type VZV. No gastrointestinal symptoms were observed at the time of VZV infection in these 3 patients. VZV DNA was not detected in any other samples. No pediatric cases with Ogilvie's syndrome caused by VZV reactivation was demonstrated in this cohort. Additionally, no subclinical VZV reactivation was found in this cohort. Further study is needed to elucidate the precise incidence of pediatric Ogilvie's syndrome caused by VZV reactivation. This article is protected by copyright. All rights reserved.


Helminth parasitisms among intermingling insular populations of white-tailed deer, feral cattle, and feral swine.
Helminth infections among free-ranging, intermingling populations of white-tailed deer (Odocoileus virginianus), cattle (Bos taurus), and swine (Sus scrofa) on an island off the Georgia coast were studied. Of 39 species of helminths collected, 19 were found in deer, 17 in cattle, and 13 in swine. Of 28 species of helminths recovered from ruminants, 8, viz, Capillaria bovis, Cooperia punctata, Dictyocaulus viviparus, Gongylonema pulchrum, G verrucosum, Haemonchus contortus, Moniezia benedeni, and Trichostrongylus axei, occurred in both deer and cattle. Common liver flukes (Fasciola hepatica) infected cattle and swine but not deer. Only 1 helminth, G pulchrum, infected deer, cattle, and swine. The findings suggested that helminths harbored by the host species are distinct, with little exchange occurring.


Toxic Methemoglobinemia Complicating Transesophageal Echocardiography.
We describe the case of a patient with acute methemoglobinemia after topical oropharyngeal anesthesia with benzocaine spray.


Study on the antibacterial activity of ceftazidime in an in vitro pharmacokinetic model.
A kinetic model was used to evaluate the activity of ceftazidime against recently isolated bacterial strains. The microorganisms were subjected in vitro to drug concentrations simulating the serum kinetics of ceftazidime after i.v. administration of 1 g of the drug. In these conditions ceftazidime showed a bactericidal effect lasting up to 12 h, even at concentrations below the MICs for some strains. In no case did resistant populations develop after exposure to the drug.


Transcriptional regulation of dimethyl sulfoxide respiration in a haloarchaeon, Haloferax volcanii.
The halophilic euryarchaeon Haloferax volcanii can grow anaerobically by DMSO respiration. DMSO reductase was induced by DMSO respiration not only under anaerobic growth conditions but also in denitrifying cells of H. volcanii. Deletion of the dmsR gene, encoding a putative regulator for the DMSO reductase, resulted in the loss of anaerobic growth by DMSO respiration. Reporter experiments revealed that only the anaerobic condition was essential for transcription of the dmsEABCD genes encoding DMSO reductase and that transcription was enhanced threefold by supplementation of DMSO. In the ∆dmsR mutant, transcription of the dmsEABCD genes induced by the anaerobic condition was not enhanced by DMSO, suggesting that DmsR is a DMSO-responsive regulator. Transcriptions of the dmsR and mgd genes for Mo-bisMGD biosynthesis were regulated in the same manner as the dmsEABCD genes. These results suggest that the genetic regulation of DMSO respiration in H. volcanii is controlled by at least two systems: one is the DMSO-responsive DmsR, and the other is an unknown anaerobic regulator.


Heritability of macular pigment: a twin study.
Several studies have reported higher levels of macular pigment (MP) in association with reduced risk for age-related macular degeneration (ARMD), a disease to which there is a genetic predisposition. A classic twin study was performed to determine the heritability of MP in the healthy eye. One hundred fifty twin pairs (76 monozygotic [MZ] and 74 dizygotic [DZ]), aged 18 to 50 years, participated. MP optical density was measured psychophysically with heterochromatic flicker photometry (HFP) and also with an imaging method involving fundus autofluorescence (AF). The covariance of MP within MZ and DZ twin pairs was compared, and genetic modeling techniques were used to determine the relative contributions of genes and environment to the variation in MP. The mean MP optical density, measured using HFP, was 0.43 +/- 0.21. Using AF, the mean MP optical density, measured at 1 degrees eccentricity, was 0.28 +/- 0.11. MP optical densities correlated more highly in MZ twins than in DZ twins, according to both HFP (MZ: 0.65; DZ: 0.24) and AF (MZ: 0.83; DZ: 0.50). A model combining additive genetic and unique environmental effects provided the best fit and resulted in MP heritability estimates of 0.67 (95% CI, 0.52-0.77) and 0.85 (95% CI, 0.78-0.90) for HFP and AF readings, respectively. This classic twin study demonstrates that genetic background is an important determinant of MP optical density, reflected in heritability estimates of 0.67 and 0.85 for HFP and AF measures, respectively.


[Serum ferritin in donors with regular plateletpheresis].
This study was aimed to evaluate the impact of regular donating platelets on serum ferritin (SF) of donors. A total of 93 male blood donors including 24 initial plateletpheresis donors and 69 regular plateletpheresis donors were selected randomly. Their SF level was measured by ELISA. The results showed that the SF level of initial plateletpheresis donors and regular plateletpheresis donors were 91.08 ± 23.38 µg/L and 57.16 ± 35.48 µg/L respectively, and all were in normal levels, but there was significant difference between the 2 groups (p < 0.05). The SF level decreased when the donation frequency increased, there were no significant differences between the groups with different donation frequency. Correlation with lifetime donations of platelets was not found. It is concluded that regular plateletpheresis donors may have lower SF level.


Role of angiotensin II in the remodeling induced by a chronic increase in flow in rat mesenteric resistance arteries.
Angiotensin II is a potent growth factor involved in arterial wall homeostasis. In resistance arteries, chronic increases in blood flow induce a rise in diameter associated with arterial wall hypertrophy. Nevertheless, the role of angiotensin II in this remodeling is unknown. We investigated the effect of blocking angiotensin II production or receptor activation on flow-induced remodeling of mesenteric resistance arteries. Arteries were ligated in vivo to generate high-flow arteries compared with normal flow (control) vessels located at a distance. Arteries were isolated after 1 week for in vitro analysis. Arterial diameter, media surface, endothelial NO synthase expression, superoxide production, and extracellular signal-regulated kinase 1/2 phosphorylation were higher in high-flow than in control arteries. Angiotensin-converting enzyme inhibition (perindopril) and angiotensin II type 1 receptor blockade (candesartan) prevented arterial wall hypertrophy without affecting diameter enlargement. The nonselective vasodilator hydralazine had no effect on remodeling. Although perindopril and candesartan increased endothelial NO synthase expression in high-flow arteries, hypertrophy remained in rats treated with N(G)-nitro-l-arginine methyl ester and mice lacking endothelial NO synthase. Perindopril and candesartan reduced oxidative stress in high-flow arteries, but superoxide scavenging did not prevent hypertrophy. Both Tempol and the absence of endothelial NO synthase prevented the rise in diameter in high-flow vessels. Extracellular signal-regulated kinase 1/2 activation in high-flow arteries was prevented by perindopril and candesartan and not by hydralazine. Extracellular signal-regulated kinase 1/2 inhibition in vivo (U0126) prevented hypertrophy in high-flow arteries. Thus, a chronic rise in blood flow in resistance arteries induces a diameter enlargement involving NO and superoxide, whereas hypertrophy was associated with extracellular signal-regulated kinase 1/2 activation by angiotensin II.


Repeat renal biopsy in children with IgA nephropathy.
Serial renal biopsy findings in 61 children with IgA nephropathy were correlated with their clinical course. At the time of the second biopsy, 23 patients showed clinical remission defined as complete disappearance of proteinuria and hematuria with normal renal function while 38 had persistent urinary abnormalities with normal renal function at the second biopsy. There were no differences between the two groups with regard to initial clinical findings and pathologic findings of the initial renal biopsy. The second biopsy of patients with clinical remission showed improvement of the glomerular changes on light microscopy, disappearance or diminution of IgA deposits in the mesangium and decrease of electron-dense deposits, whereas the second biopsy of patients with persistent urinary abnormalities showed progression of glomerular changes on light microscopy, persistence of mesangial IgA deposits and persistence of electron-dense deposits. Our study results show the importance of repeat renal biopsy in children with IgA nephropathy with persistent urinary abnormalities, as a progression of glomerular changes is common in these patients. These observations suggest that the deposition of IgA in the mesangium may be responsible for the glomerular damage in children with IgA nephropathy.


Limited infant exposure to benznidazole through breast milk during maternal treatment for Chagas disease.
Benznidazole (BNZ) is safe and effective for the treatment of paediatric Chagas disease. Treatment of adults is also effective in many cases, but discouraged in breastfeeding women because no information on BNZ transfer into breast milk is available. We aimed to evaluate the degree of BNZ transfer into breast milk in lactating women with Chagas disease. Prospective cohort study of lactating women with Chagas disease treated with BNZ administered for 30 days. Patients and their breastfed infants were evaluated at admission, the 7th and 30th day of treatment (and monthly thereafter, for 6 months). BNZ was measured in plasma and milk by high performance liquid chromatography. The protocol was registered in ClinicalTrials.gov (#NCT01547533). 12 lactating women with chronic Chagas disease were enrolled (median age 28.5 years, range 20-34). Median BNZ dose was 5.65 mg/kg/day twice daily. Five mothers had adverse drug events (45%), but no adverse drug reactions or any untoward outcomes were observed in the breastfed infants. Median milk BNZ concentration was 3.8 mg/L (range 0.3-5.9) and 6.26 mg/L (range 0.3-12.6) in plasma. Median BNZ milk to plasma ratio was 0.52 (range 0.3-2.79). Median relative BNZ dose received by the infant (assuming a daily breast milk intake of 150 mL/kg/day) was 12.3% of the maternal dose per kg (range 5.5%-17%). The limited transference of BNZ into breast milk and the reassuring normal clinical evaluation of the breastfed babies suggest that maternal BNZ treatment for Chagas disease during breast feeding is unlikely to present a risk for the breastfed infant. ClinicalTrials.gov NCT01547533.


[Euthanasia--attempt at an ethical approach].
A categorical refusal of active euthanasia, as presently being reflected by the Austrian euthanasia debate, has, by a closer examination, proved ethically unfounded. As to all moral judgement in matters of practised euthanasia, the most important question here certainly is whether the aid for dying has been granted on request or not, or even without the ill person's consent--rather than whether that person granting euthanasia is doing this is an active, passive or possibly indirect way. However, the possibility of a moral justification for the so-called killing on request will not consequently permit the legalization of its practice due to practical reasons speaking against such a step.


Swirling flow can suppress monocyte adhesion in the flow disturbance zones of the endovascular stent.
Adhesion of monocytes (U-937 cells) along a silicone tube deployed with circular ring stents was studied to test the hypothesis that by intentionally inducing swirling flow in an endovascular stent, the adhesion of monocytes would be suppressed. The results revealed that under a normal flow condition, the flow disturbance created by the circular ring stents enhanced the adhesion of U-937 cells in the silicone tube. By inducing a swirling flow in the silicone tube, the average wall shear stress (WSS) in the tube with the circular ring stents was elevated and significantly suppressed the adhesion density of U-937 cells to the surface in the disturbed flow zones to a level equal to that when no stents were deployed in the tube. The results also showed that, due to the attenuation of the swirling flow along the tube, the adhesion density of U-937 cells increased monotonically along the tube, indicating that the adhesion density was negatively correlated with the strength of the swirling flow. Thus, the present study suggests that intentionally introducing swirling flow in an artery deployed with stents may be a solution to solve the problem of stent restenosis by restraining the adhesion of monocytes.


[Gene therapy with interleukin 10 in Crohn's disease: too early yet].
An improved understanding of the pathogenesis of inflammatory bowel disease (IBD) has led to the development of new drugs such as infliximab and insights into the modes of action of commonly used drugs such as azathioprine and methotrexate. These drugs act, at least in part, by inducing apoptosis of activated T-cells, which are an important phenomenon in the aberrant mucosal immune response in Crohn's disease. Gene therapy directed towards delivering anti-inflammatory proteins such as interleukin 10 (IL-10) to the inflamed mucosa is another new means of correcting the balance between the proinflammatory and anti-inflammatory cytokines in IBD. Gene-therapeutic manipulation of T-cells or bacteria to make them selectively deliver IL-10 to the gut mucosa has been successfully described in experimental models of IBD. Although interleukin-10-based gene therapy for Crohn's disease is an attractive option, safety aspects concerning the gene transfection method and questions about the efficacy of interleukin-10 in Crohn's disease in particular, prevent its application in the near future.


Recollections of positive early caregiving relate to sympathetic nervous system activation and chronic inflammation in subsequent generations.
To understand links between early experience and biomarkers of peripheral physiology in adulthood, this study examined associations between quality of early caregiving and markers of sympathetic activation and chronic inflammation in a sample of 52 low-income mothers and their preschool-aged children. Mothers reported on levels of positive caregiving experienced during childhood using the Structural Analysis of Social Behavior-Intrex. Mother and child sympathetic activation was indexed via pre-ejection period (PEP) at rest, during a dyadic social engagement task, and for children, while interacting with an unfamiliar adult. C-reactive protein (CRP) was collected using whole blood spots to assess levels of low-grade chronic inflammation. Results showed that mothers who reported experiencing more warm guidance and support for autonomy in early childhood displayed lower resting sympathetic nervous system activation (i.e., longer PEP) and lower chronic inflammation (i.e., CRP levels). Further, lower maternal chronic inflammation levels were associated with lower sympathetic activation (i.e., longer PEP) in their children at rest, and during social interactions with mother and a female stranger.


Pre-ovulatory plasma levels of 17beta-oestradiol (E2) and conception in patients treated with gonadotrophins.
Twenty-six patients seeking advice for sterility were given courses of treatment with HMG-HCG. Ovarian maturation was followed by daily evaluation of plasma 17beta-oestradiol concentrations. HCG was administered as soon as 17beta-oestradiol levels reached 250 pg/ml. In a first group of 7 amenorrheic patients with lack of oestrogen activity, a pregnancy rate of 71.4% and an ovulation rate of 91.7% were achieved. In a second group of 5 amenorrheic patients showing evidence of oestrogen activity, a pregnancy rate of 80.0% and an ovulation rate of 100% were obtained. In a third group of 14 oligomenorrheic patients, the pregnancy rate attained 71.4% and the ovulation rate 96.9%. The overall pregnancy rate was 73.0%. With this procedure of monitoring HMG-HCG treatment by means of plasma 17beta-oestradiol levels, the multiple pregnancy rate reached only 11.7% and only one case of mild ovarian hyperstimulation was observed. Pre-ovulatory and pre-conceptional 17beta-oestradiol concentration were identical with those observed in spontaneous ovulatory cycles with or without conception.


Low density lipoprotein receptor activity in human leukemic cells--relation to chromosome aberrations.
Chromosome analysis and low density lipoprotein (LDL) receptor activity of leukemic cells from 38 patients with acute non-lymphocytic leukemia were correlated. Clonal chromosome aberrations were found in 22 patients, and an extra chromosome 8 was found in 7 of them. LDL receptor activity was significantly higher in patients with an extra chromosome 8 than in patients with other abnormalities or a normal karyotype. Chromosome 8 may harbor genes of importance for the expression of the LDL receptor.


Variation in medical students' approaches to diagnosis: a basis for initiating conceptual change among teachers and students.
This study examines Finnish medical students' approaches to diagnosis and investigates further how medical teachers can use information about variation in their students' approaches to diagnosis to foster teaching in medical school. The medical students responded to the Conceptions and Experiences of Diagnosis Inventory (CEDI). Faculty of Medicine, University of Helsinki. Ninety medical students in their clinical years and eight clinical teachers from the same Faculty of Medicine. The 11 subscales of the CEDI formed two contrasting factors: the first reflecting variation in 'non-virtuously' labelled, and the second in 'virtuously' labelled, aspects of diagnosis. Cluster analyses revealed subgroup characteristics of students' diagnostic processes that are of potential benefit to both students and teachers. Teacher interviews indicated that, for students, the CEDI may act as a self-assessment tool to help develop their diagnostic and metacognitive skills. For teachers, the CEDI was seen to offer important information about their students' conceptions of diagnosis and diagnostic skills.


The probiotic Escherichia coli strain Nissle 1917 interferes with invasion of human intestinal epithelial cells by different enteroinvasive bacterial pathogens.
The probiotic Escherichia coli strain Nissle 1917 (Mutaflor) of serotype O6:K5:H1 was reported to protect gnotobiotic piglets from infection with Salmonella enterica serovar Typhimurium. An important virulence property of Salmonella is invasion of host epithelial cells. Therefore, we tested for interference of E. coli strain Nissle 1917 with Salmonella invasion of INT407 cells. Simultaneous administration of E. coli strain Nissle 1917 and Salmonella resulted in up to 70% reduction of Salmonella invasion efficiency. Furthermore, invasion of Yersinia enterocolitica, Shigella flexneri, Legionella pneumophila and even of Listeria monocytogenes were inhibited by the probiotic E. coli strain Nissle 1917 without affecting the viability of the invasive bacteria. The observed inhibition of invasion was not due to the production of microcins by the Nissle 1917 strain because its isogenic microcin-negative mutant SK22D was as effective as the parent strain. Reduced invasion rates were also achieved if strain Nissle 1917 was separated from the invasive bacteria as well as from the INT407 monolayer by a membrane non-permeable for bacteria. We conclude E. coli Nissle 1917 to interfere with bacterial invasion of INT407 cells via a secreted component and not relying on direct physical contact with either the invasive bacteria or the epithelial cells.


Broad expression of Toll-like receptors in the human central nervous system.
The family of Toll-like receptors (TLRs) plays a key role in controlling innate immune responses to a wide variety of pathogen-associated molecules. In this study we investigated expression of TLRs in vitro by purified human microglia, astrocytes, and oligodendrocytes, and in vivo by immunohistochemical examination of brain and spinal cord sections. Cultured primary microglia were found to express mRNA encoding a wide range of different TLR family members while astrocytes and oligodendrocytes primarily express TLR2 and TLR3. Comparisons between microglia derived from a series of control subjects and neurodegenerative cases indicate distinct differences in levels of mRNA encoding the different TLRs indifferent microglia samples. Interestingly, expression of TLR proteins in cultured microglia as revealed by immunocytochemistry was restricted to intracellular vesicles, whereas in astrocytes they were exclusively localized on the cell surface. Finally, in vivo expression of TLR3 and TLR4 was examined by immunohistochemical analysis of brain and spinal cord sections from both control and multiple sclerosis brains, revealing enhanced expression of either TLR in inflamed CNS tissues. Together, our data reveal broad and regulated expression of TLRs both in vitro and in vivo by human glia cells.


Effects of compounds that interfere with the endocannabinoid system on behaviors predictive of anxiolytic and panicolytic activities in the elevated T-maze.
An extensive literature has implicated the endocannabinoid system in the modulation anxiety-related responses. Nonetheless, it remains uncertain what would be the effects of endocannabinoid-related compounds against responses related to specific subtypes of anxiety disorders, particularly generalized anxiety and panic. In this context, the elevated T maze (ETM) has been developed to evaluate two distinct tasks in the same rat, inhibitory avoidance and escape response from an open arm, predictive of anxiolytic and panicolytic effects, respectively. Thus, the present study tested the hypothesis that drugs that facilitate endocannabinoid-signaling would inhibit both types of aversive responses in this model. As positive controls, diazepam attenuated only inhibitory avoidance (anxiolytic-like effect), whereas alprazolam was effective against both avoidance and escape (anxiolytic- and panicolytic like effects). The synthetic cannabinoid WIN55,212-2 (1.0 mg/kg) promoted an anxiolytic-like effect, which was prevented by pre-treatment with the CB1 receptor antagonist, AM 251 (1.0 mg/kg). At the higher dose (3.0 mg/kg), this antagonist promoted an anxiogenic-like effect. None of these drugs interfered with the escape task. The endocannabinoid (anandamide) hydrolysis inhibitor, URB 597 at doses of 0.3 and 1.0 mg/kg, induced, respectively, panicolytic- and anxiolytic-like effects, which were reversed by pretreatment with AM 251. These results suggest that drugs that act on the endocannabinoid system have different effects on the behaviors assessed in the ETM.


Phenotypic and PCR-based characterization of the microflora in Norvegia cheese during ripening.
Microbiological sampling of Norvegia cheese from three cheese factories was done during ripening. The evolution of aerobic mesophilic bacteria, lactococci, lactobacilli, enterococci, presumptive leuconostoc and pediococci was investigated after 30, 90, 180 and 270 days of ripening. Isolates (135) of non-starter lactic acid bacteria (NSLAB) from nine Norvegia cheeses after 90, 180 and 270 days of ripening were examined. The isolates were tested by physiological and biochemical assays, species-specific PCR and 16S rDNA sequencing. After 90 days of ripening Leuconostoc spp., most probably from the starter, and the NSLAB specie Lactobacillus paracasei dominated among the isolates, however, after longer ripening Lb. paracasei dominated. The development and evolution of the microflora in Norvegia varied according to dairy and ripening time.


Occurrence of a 16SrIV Group Phytoplasma not Previously Associated with Palm Species in Yucatan, Mexico.
The occurrence of 16SrIV group phytoplasmas in palm species Sabal mexicana and Pseudophoenix sargentii is reported here for the first time. Palm trees showed leaf decay and leaf yellowing syndromes, respectively. An amplification product (1.4 kb) was obtained in symptomatic S. mexicana (18 of 21) and symptomatic P. sargentii (1 of 1) palm trees sampled in different locations in Yucatan State, Mexico; five of the positive S. mexicana and the positive P. sargentii trees died. The identity of the phytoplasmas from these species was determined by restriction fragment length polymorphism profiling with restriction enzymes AluI and HinfI, showing there could be two phytoplasma strains of the 16SrIV group. In one S. mexicana palm, the profile was the same as observed with these enzymes for phytoplasmas of 16SrIV-A subgroup, previously associated with Cocos nucifera palm trees and, in the rest of the trees, including the P. sargentii palm, the profile was for phytoplasmas of the 16SrIV-D subgroup. These identities were supported by analyses of the amplicons obtained by nested polymerase chain reaction by nucleotide-nucleotide BLAST analysis. Geographical distribution of the association S. mexicana/16SrIV group phytoplasmas was found widely dispersed in Yucatan State. A potential role of S. mexicana palm trees as a permanent source of phytoplasma inoculum is suggested. In addition to P. sargentii, other palm species (Thrinax radiata and C. nucifera) coexisting with S. mexicana trees were also sampled and analyzed.


Dietary nitrate increases gastric mucosal blood flow and mucosal defense.
Salivary nitrate from dietary or endogenous sources is reduced to nitrite by oral bacteria. In the acidic stomach, nitrite is further reduced to bioactive nitrogen oxides, including nitric oxide (NO). In this study, we investigated the gastroprotective role of nitrate intake and of luminally applied nitrite against provocation with diclofenac and taurocholate. Mucosal permeability ((51)Cr-EDTA clearance) and gastric mucosal blood flow (laser-Doppler flowmetry) were measured in anesthetized rats, either pretreated with nitrate in the drinking water or given acidified nitrite luminally. Diclofenac was given intravenously and taurocholate luminally to challenge the gastric mucosa. Luminal NO content and nitrite content in the gastric mucus were determined by chemiluminescence. The effect of luminal administration of acidified nitrite on the mucosal blood flow was also investigated in endothelial nitric oxide synthase-deficient mice. Rats pretreated with nitrate or given nitrite luminally had higher gastric mucosal blood flow than controls. Permeability increased more during the provocation in the controls than in the nitrate- and nitrite-treated animals. Dietary nitrate increased luminal NO levels 50 times compared with controls. Nitrate intake also resulted in nitrite accumulation in the loosely adherent mucous layer; after removal of this mucous layer, blood flow was reduced. Nitrite administrated luminally in endothelial nitric oxide synthase-deficient mice increased mucosal blood flow. We conclude that dietary nitrate and direct luminal application of acidified nitrite decrease diclofenac- and taurocholate-induced mucosal damage. The gastroprotective effect likely involves a higher mucosal blood flow caused by nonenzymatic NO production. These data suggest an important physiological role of nitrate in the diet.


Technical Note: Investigation of the dosimetric impact of stray radiation on the Common Control Unit of the IBA Blue Phantom2.
This technical note aims to investigate the dosimetric impact of stray radiation on the Common Control Unit (CCU) of the IBA Blue Phantom2 and the measured beam data. Three CCUs of the same model were used for the study. The primary test CCU was placed at five distances from the radiation beam central axis. At each distance, a set of depth dose and beam profiles for two open and two wedge fields were measured. The field sizes were 10 × 10 cm2 and 30 × 30 cm2 for the open fields, and 30 × 30 cm2 and 15 × 15 cm2 for the 30° and 60° wedges, respectively. The other two CCUs were used to cross check the data of the primary CCU. Assuming the effect of stray radiation on the data measured at the farthest reachable distance 4.5 m is negligible, the dosimetric impact of stray radiation on the CCU and consequently on the measured data can be extracted for analysis by comparing it with those measured at shorter distances. The results of three CCUs were consistent. The dosimetric impact of stray radiation was greater for lower energies at larger field sizes. For open fields, the data variation was up to 4.5% for depth dose curves and 7.1% for beam profiles. For wedge fields, the data variation was up to 9.3% for depth dose curves and 10.6% for beam profiles. Moreover, for wedge field profiles in the wedge direction, they became flatter as the CCU was placed closer to the primary radiation beam, manifesting smaller wedge angles. The stray radiation added a uniform background noise on all measured data. The magnitude of the noise is inversely proportional to the square of the distance of the CCU to the primary radiation beam, approximately following the inverse square law.


[Neuro anatomical and neurological elements associated with the brain over the course of time].
This article gives a sequential vision of neuro anatomical concepts which have been considered to be relevant in the past, associating them with contemporary neurofunctional and neurological viewpoints. We start with the most ancient written records, concerning the brain at the time of the pharaohs, followed by the classical view of the Greek physicians and subsequent writers, through the phrenological period during which the relation between bony hypertrophy and cerebral function was emphasized as being suitable for the study of cerebral function at that time. Subsequent advances directed study of the nervous system towards recognition of the cells of the cerebral parenchyma, firstly through use of the optical microscope and later the electronic microscope, to make direct observations of the synapses with the vesicles of neurotransmitters. Thus reaching the present day and considering certain aspects of contemporary investigation in neuroscience, which bring structural and physiological aspects closer together. As a multi disciplinary science diverse elements have been combined so as to investigate and understand, using various tools and methods, the basic concepts described in relation to the structure and function of the nervous system, especially the brain.


[Dose-response curves for the action of 6 MeV mean-energy neutrons on a human lymphocyte culture at different stages of the mitotic cycle].
A linear component was predominant in the dose-response curve characterizing the radiosensitivity of human lymphocyte chromosomes after exposure to fast neutrons (E = 6 MeV) at different mitotic cycle stages. This was indicative of a single-hit mechanism of the formation of chromosome aberrations after the effect of 6 MeV neutrons. It is suggested that the plateau of the dose-response curve at the S-stage may be considered as an indication of repair of damages induced by neutrons at this stage.


Sex differentials in health and mortality.
It is common knowledge that females tend to live longer than males. In the United States and most other countries, female death rates are lower than male rates for all age groups and most important causes of death. But while they are alive, females' health seems to be worse than males'. Health surveys repeatedly show that females have higher rates of illness, disability days, and health services use. In this article, sex differentials in mortality are presented first, followed by sex differentials in health. Possible explanations for these sex differentials are discussed, and the apparent contradiction--why there is excess female morbidity but excess male mortality--is considered.


Malignant mixed tumor (carcinosarcoma) of parotid gland diagnosed by fine-needle aspiration biopsy.
True malignant mixed tumor (carcinosarcoma) of salivary gland is a very rare neoplasm. Only one brief account of the Fine-Needle Aspiration Biopsy (FNAB) cytologic findings of this tumor was found in the literature. The authors report a case of malignant mixed tumor (chondrosarcoma and epidermoid carcinoma) arising from the left parotid gland in an 84-yr-old man, which was definitely diagnosed by FNAB. The cytologic findings and differential diagnosis are discussed.


Effect of Clostridium perfringens alpha toxin on contraction of isolated guinea-pig diaphragm.
The effect of Clostridium perfringens alpha toxin on contraction induced by electric stimulation of isolated guinea-pig diaphragm was investigated. The toxin inhibited electrically stimulated contraction of the tissue in a dose- and incubation time-dependent manner. Tetrodotoxin resulted in no effect of the action of the toxin. Nifedipine dose-dependently delayed the action of the toxin, but verapamil and diltiazem did not. On the other hand, treatment of the toxin with N-acetylimidazole caused significant reduction of the inhibitory activity of the toxin on contraction, but did not cause significant loss of phospholipase C activity (PN activity) as measured by hydrolysis of p-nitrophenylphosphorylcholine. The data showed that the toxin impairs contraction of isolated guinea-pig diaphragm.


Cerebral blood flow decreases with time whereas cerebral oxygen consumption remains stable during hypothermic cardiopulmonary bypass in humans.
Recent investigations demonstrate that cerebral blood flow (CBF) progressively declines during hypothermic, nonpulsatile cardiopulmonary bypass (CPB). If CBF declines because of brain cooling, the cerebral metabolic rate for oxygen (CMRO2) should decline in parallel with the reduction in CBF. Therefore we studied the response of CBF, the cerebral arteriovenous oxygen content difference (A-VDcereO2) and CMRO2 as a function of the duration of CPB in humans. To do this, we compared the cerebrovascular response to changes in the PaCO2. Because sequential CBF measurements using xenon 133 (133Xe) clearance must be separated by 15-25 min, we hypothesized that a time-dependent decline in CBF would accentuate the CBF reduction caused by a decrease in PaCO2, but would blunt the CBF increase associated with a rise in PaCO2. We measured CBF in 25 patients and calculated the cerebral arteriovenous oxygen content difference using radial arterial and jugular venous bulb blood samples. Patients were randomly assigned to management within either a lower (32-48 mm Hg) or higher (50-71 mm Hg) range of PaCO2 uncorrected for temperature. Each patient underwent two randomly ordered sets of measurements, one at a lower PaCO2 and the other at a higher PaCO2 within the respective ranges. Cerebrovascular responsiveness to changes in PaCO2 was calculated as specific reactivity (SR), the change in CBF divided by the change in PaCO2, expressed in mL.100 g-1.min-1.mm Hg-1.(ABSTRACT TRUNCATED AT 250 WORDS)


Invasive group B streptococcus (GBS) disease in Norway 1996-2006.
The aim of this study was to survey the occurrence of invasive group B streptococcus (GBS) disease in Norway and detect possible trends in characteristics of invasive GBS strains from 1996 to 2006. Data from national monitoring systems for infectious diseases in Norway were analysed. Of 638,452 live births in the period, 434 cases of invasive GBS disease in infants were reported. In adults and children older than 1 year of age, 969 cases were reported. The incidence of invasive GBS disease increased significantly in the elderly, while the incidence of neonatal early-onset disease was stable with 0.46 cases per 1,000 live births. The incidence of late-onset disease increased in 2005 and 2006. The lethality of GBS in infants increased from an average of 6.5% in 1996-2005 to 20% in 2006. Serotypes III and V were predominant in 839 invasive GBS strains characterized-type III in infants and type V in the elderly. The distribution of serotypes did not change throughout the period. The distribution of detected surface proteins was stable from 1996 to 2005, but the detection rates in types III and V were low. Molecular methods for GBS typing introduced in 2006 made characterization of nearly all strains possible and appear more applicable to epidemiological studies of GBS than conventional methods. Resistance to erythromycin and clindamycin increased significantly in 2006. The increased incidence in the elderly, the increased lethality in infants in 2006, and the increased resistance to erythromycin and clindamycin the same year might indicate changing characteristics of invasive GBS strains.


DDAVP therapy controls bleeding in Ehlers-Danlos syndrome.
Patients with Ehlers-Danlos syndrome (EDS), especially types IV, VI, and VIII, are at increased risk of bleeding, and most do not have specific hemostatic deficiencies that would be amenable to replacement therapy. We have investigated the ability of DDAVP (desmopressin acetate) to control bleeding in EDS. Two children with EDS, types VIII and VI, presented with hemorrhagic symptoms and scheduled surgical procedures. Ivy bleeding times (BTs) were measured before and after intravenous (i.v.) DDAVP challenge, and i.v. DDAVP was used prophylactically for their procedures. Laboratory testing was performed to rule out other hemostatic disorders. Both patients had prolonged BTs that corrected following i.v. DDAVP therapy; all other laboratory values were normal. Both patients had excellent clinical hemostasis with surgery, and one has continued to use intranasal DDAVP to control epistaxis and gingival bleeding. The bleeding time in both patients was corrected with DDAVP, and the patients did not have any postoperative bleeding. DDAVP should be considered in other patients who have EDS with bleeding tendencies.


Research on the segmentation of MRI image based on multi-classification support vector machine.
In head MRI image, the boundary of each encephalic tissue is highly complicated and irregular. It is a real challenge to traditional segmentation algorithms. As a new kind of machine learning, Support Vector Machine (SVM) based on Statistical Learning Theory (SLT) has high generalization ability, especially for dataset with small number of samples in high dimensional space. SVM was originally developed for two-class classification. It is extended to solve multi-class classification problem. In this paper, 57 dimensional feature vectors for MRI image are selected as input for SVM. The segmentation of MRI image based on the Multi-Classification SVM (MCSVM) is investigated. As our experiment demonstrates, the boundaries of 7 kinds of encephalic tissues are extracted successfully, and it can reach satisfactory generalization accuracy. Thus, SVM exhibits its great potential in image segmentation.


Cyclic tungstoselenites based on {Se2W12} units.
The reaction of Na2WO4 and SeO2 under moderately acidic conditions yielded a novel 39-tungsto-6-selenite, [(Se2W12O46(WO(H2O))3](24-) (1), isolated as Na24[H6Se6W39O144]·74H2O. The macrocyclic polyanion consists of three {Se2W12} fragments connected via three trans-{WO(H2O)}(4+) groups. The same {Se2W12} building block is present in the structure of [(Se2W12O46)2{Mn2Cl(H2O)2}{Mn(H2O)2}2(SeO)2](13-) (2), which was obtained from the same reagents in the presence of MnCl2. The compounds were characterized by single-crystal X-ray diffraction, (77)Se NMR, Fourier transform infrared, and Raman spectroscopy.


The colon single-stripe sign and its relationship to ischemic colitis.
Endoscopic findings may assist in the clinical diagnosis of ischemic colitis but have not been systematically characterized. We noted that a single linear colonic ulcer could on occasion be found endoscopically after hypotension and proceeded to investigate its relationship to ischemic colitis. Twenty-six patients (19 female and seven male, mean age 71 yr) with endoscopic evidence of a single linear ulcer running along the longitudinal axis of the colon (colon single-stripe sign (CSSS) were retrospectively studied. Colitis etiologies were determined in the CSSS patients and in 58 consecutive patients without a stripe forming a colitis comparison group; clinical course and outcome in CSSS patients subsequently were compared with those in 22 patients with circumferentially involved ischemic colitis. The CSSS was >/=5 cm in length in all instances and isolated to a segment of the left colon in 89%. Evidence of a preceding ischemic event was noted significantly more often in the CSSS (62%) patients than in the colitis comparison group (7%) (p < 0.0001). On blinded histopathological examination, 75% of CSSS cases had microscopic evidence of ischemic injury compared with 13% in the colitis comparison group (p < 0.0001). None of the CSSS patients required surgical intervention, whereas six (27%) patients from the circumferential ischemic colitis group underwent exploration (p < 0.05). Nine patients (41%) in the circumferential ischemic colitis group died, whereas there was one death in the CSSS group (4%) (p < 0.05). Ischemia can manifest endoscopically as the CSSS. This sign seems to characterize milder disease in the clinical spectrum of ischemic colitis.


Induction of hairy roots by agrobacterium rhizogenes and growth of hairy roots in vitro.
The bacterial genus Agrobucterium includes two species of considerable interest to plant physiologists and pathologists alike. Infection by virulent strains of A. tumefaciens induces the formation of tumors and infection by A. rhizogenes the proliferation of roots in a wide range of dicotyledenous plants: crown-gall and hairy root diseases are not naturally recorded in monocotyledenous plants (1). Invasion of plant tissues by these free-living soil bacteria usually occurs at a wound site-possibly caused by insect or mechanical damage; nonvirulent strains of the bacteria may invade the plant, but only virulent strains give rise to symptoms of disease.


An alternative and fast method for determination of glyphosate and aminomethylphosphonic acid (AMPA) residues in soybean using liquid chromatography coupled with tandem mass spectrometry.
A simple and specific method using reversed-phase liquid chromatography coupled with electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) was investigated, which allowed the determination of residues of glyphosate and its metabolite, aminomethylphosphonic acid (AMPA), in soybean samples. An aqueous extraction with liquid-liquid partition followed by protein precipitation was performed before the LC/MS/MS determination. The quantitation of glyphosate and AMPA was performed in positive and negative ESI mode, respectively, using the multiple reaction monitoring (MRM) mode with three transitions for each analyte to enhance the specificity of the method and avoid false positives. The methodology reported in this work is capable of detecting residues of glyphosate and AMPA in soybean samples with limits of quantification of 0.30 and 0.34 mg kg(-1), respectively. This alternative method has throughput advantages such as simpler sample preparation and faster chromatographic analysis.


Co-Planting Cd Contaminated Field Using Hyperaccumulator Solanum Nigrum L. Through Interplant with Low Accumulation Welsh Onion.
Monoculture and intercrop of hyperaccumulator Solanum nigrum L. with low accumulation Welsh onion Renbentieganchongwang were conducted. The results showed that the remove ratio of S. nigrum to Cd was about 7% in intercrop plot when top soil (0-20 cm) Cd concentration was 0.45-0.62 mg kg(-1), which did not significantly impact the yield of low accumulation Welsh onion compared to the monoculture. The consistency of remove ratio in practice and theory indicated the remediation of S. nigrum to Cd was significant. The Cd concentration and yield of Welsh onion were not affected by the growth of S. nigrum either in intercrop plot. The Cd concentration in edible parts of Welsh onion was available either. In short, inter-planting hyperaccumulator with low accumulation crop could normally remediate contaminated soil and produce crop (obtain economic benefit), which may be one practical pathway of phytoremediating heavy metal contaminated soil in the future.


Molecular characterization of the Drosophila trp locus: a putative integral membrane protein required for phototransduction.
Recent studies suggest that the fly uses the inositol lipid signaling system for visual excitation and that the Drosophila transient receptor potential (trp) mutation disrupts this process subsequent to the production of IP3. In this paper, we show that trp encodes a novel 1275 amino acid protein with eight putative transmembrane segments. Immunolocalization indicates that the trp protein is expressed predominantly in the rhabdomeric membranes of the photoreceptor cells.


Idiopathic intracranial hypertension as a significant cause of intractable headache in patients with systemic lupus erythematosus: a 15-year experience.
To evaluate the occurrence of idiopathic intracranial hypertension (IIH) in patients with systemic lupus erythematosus (SLE) and to describe the manifestations, treatments and outcomes in these patients. We reviewed the medical records of 1084 patients with SLE followed up from January 1997 to June 2011 in our unit. We identified patients with IIH and analyzed the demographic, clinical and laboratory characteristics of these patients. Among the 1084 SLE patients, 47 underwent cerebrospinal fluid studies because of their intractable headache and eight (17%) of these were diagnosed as IIH. All were females aged 14 to 32 years. Nobody belonged to the obesity group. Headache, nausea, vomiting and blurred vision were the most common presenting symptoms. All patients had active SLE at the time of admission (SLE disease activity index ≥6). Five patients had lupus nephritis. In eight patients, there were two with antiphospholipid antibodies, two with anti-ribosomal P antibodies and six with anti-Ro antibodies. All subjects recovered without any complication after high dose steroid therapy. IIH accounts for a considerable part of the causes of intractable headache in SLE patients and steroids should be considered as a first-line treatment.


[The electrocardiogram during physical stress and Holter monitoring in the detection of asymptomatic myocardial infarct].
In patients with myocardial infarction acute myocardial ischaemia could be manifested by characteristic ischaemic symptoms or noncharacteristic symptoms such as cardiac insufficiency or heart rhythm disturbances. Sometimes myocardial ischaemia is not followed by any symptom. This condition is known as asymptomatic myocardial ischaemia. Asymptomatic myocardial ischaemia usually could be detected by treadmill exercise tolerance test or 24-hour Holter ECG monitoring. We analyzed a group of 58 patients suffering from myocardial infarction with ST segment depression during the treadmill exercise tolerance test. All patients were on Holter 24-hour ECG monitoring. As a criterion of myocardial ischaemia during Holter monitoring ST segment depression of 1 mm and more, lasting 1 minute and more, and 0.08" of J point was accepted. During the treadmill exercise tolerance test segment depression was not followed by any symptom in 18 (31%) patients. There were no differences in the number of patients with hypertension in the group with symptoms and the group without symptoms. Diabetes mellitus was more frequent in the group with asymptomatic myocardial ischaemia. The average values of maximum ST segment depression and heart rates during treadmill tests were not statistically significant in both groups (with and without symptoms). During daily activities myocardial ischaemia was found in 30 (51%) patients by a 24-hour Holter ECG monitoring. We observed 198 episodes of myocardial ischaemia of which 138 (69.1%) were asymtomatic. The amplitude of ST segment depression and duration of these changes were significantly greater in the group with symptomatic episodes than in the group with asymptomatic episodes of myocardial ischaemia. Asymptomatic myocardial ischaemia is an often appearance in patients with myocardial ischaemia. Almost in 25% of persons in whom sudden death occurred obstructive changes in coronary arteries during the autopsy were found. Asymptomatic myocardial ischaemia could be found even an a "completely healthy person" without any complaints. Asymptomatic myocardial ischaemia is usually detected in a "completely healthy person" by casual diagnosis, in patients with stable and non stable angina pectoris, in patients with stenosis of the coronary arteries proved by angiography, and in patients after myocardial infarction. Some authors considered that treadmill exercise tolerance testing is less reliable to discover asymptomatic myocardial ischaemia comparing to the continuous 24-hour Holter ECG monitoring. It is know that in patients with diabetes mellitus neuropathy precedes the onset of symptomatic myocardial ischaemia. Asymptomatic myocardial ischaemia has the same predictive value for prognosis of the disease as symptomatic myocardial ischaemia. In some patients "anginal alarm system" is defective, and perception and conduction of pain sensations are disturbed. 1. In 31% of patients who suffered from myocardial infarction with ST segment depression during the treadmill testing asymptomatic myocardial ischaemia was found. 2. By Holter monitoring ischaemia ST segment depression during the exertion is observed in 52% of patients. Most of ischaemic episodes were asymptomatic. 3. The amplitude of ST segment depression is significantly greater and duration of depression is significantly longer in symptomatic episodes of myocardial ischaemia comparing to asymptomatic myocardial ischaemia obtained by Holter ECG monitoring.


Kribbella soli sp. nov., isolated from soil.
A novel actinobacterial strain, designated FMN22T, was isolated from soil and characterised using a polyphasic approach. Strain FMN22T showed high 16S rRNA gene sequence similarity to Kribbella karoonensis Q41T (99.3%), Kribbella shirazensis UTMC 693T (99.0%), Kribbella aluminosa HKI 0478T (98.9%) and Kribbella hippodromi S1.4T (98.6%). Phylogenetic analysis using the 16S rRNA and concatenated gene (gyrB, rpoB, relA, recA and atpD) sequences showed that strain FMN22T is closely related to the type strains of K. karoonensis DSM 17344T, K. shirazensis UTMC 693T, K. aluminosa HKI 0478T, K. hippodromi S1.4T, Kribbella jejuensis HD9T and Kribbella solani DSA1T. Based on concatenated gene genetic distances analysis, strain FMN22T is distinct from all Kribbella type strains. DNA-DNA hybridization experiments with closely related type strains, were found to be 59.2 ± 2.4, 54.8 ± 2.1, 16.4 ± 2.3 and 38.6 ± 2.5%, relatedness to K. karoonensis DSM 17344T, K. shirazensis DSM 45490T, K. aluminosa DSM 18824T and K. jejuensis DSM 17305T, respectively. The cell wall peptidoglycan contained LL-diaminopimelic acid, and whole cell sugars were glucose, mannose and ribose. The predominant menaquinone was MK-9(H4). The major phospholipids are diphosphatidylglycerol, phosphatidylglycerol, phosphatidylcholine and phosphatidylinositol. Major fatty acids are anteiso-C15:0 and iso-C16:0. These chemotaxonomic traits are in good agreement with those known for representatives of the genus Kribbella. A combination of DNA-DNA hybridization results and phenotypic properties demonstrated that strain FMN22T can be clearly distinguished from all close phylogenetic relatives. Therefore, strain FMN22T (=DSM 27132T = KCTC 29219T) is considered to be the type strain of a novel species of the genus Kribbella, for which the name Kribbella soli is proposed.


The porcine brucellosis--evidence of the role of Yersinia enterocolitica O:9 in occurrence of false positive serological reactions.
Forty four pigs with typical characteristics for false positive serolpgical reactions (FPSR) were examined for the presence of Yersinia enterocolitica O:9. The positive reactions were observed in rose bengal test (RBT, N = 23 sera), serum agglutination test (SAT, N = 16), complement fixation test (CFT, N = 9), indirect ELISA (i-ELISA, N= 11) in first, and in RBT (N = 14), SAT (N = 8), CFT (N = 7) and i-ELISA (N = 18) in second examination, respectively. In bacteriological examination Y enterocolitica was confirmed in 12 cases. Six of these isolates were identified with PCR as Y enterocolitica 0:9.


Towards the analysis of protein species: an overview about strategies and methods.
The deciphering of the relationship between function and exact chemical composition of a defined protein species in the context of the proteome is one of the major challenges in proteomics and molecular cell physiology. In the Special Issue of Amino Acids about the analysis of protein species current approaches are reviewed and new methods described focusing on the investigation of protein species. On the basis of the articles in this Special Issue it can be summarized that first important and promising steps towards the comprehensive analysis of protein species have been done. It is already possible to obtain full (100%) sequence coverage of proteins by mass spectrometry, if the amount of proteins available for their analysis allows their proteolytic degradation by more than one protease and the subsequent mass spectrometric analysis of the resulting peptides. Employing affinity chromatography helps to analyse proteins with defined post-translational modifications thus opening a targeted view on e.g. the phosphoproteome. In the future the aim to identify the exact chemical composition including not one but every posttranslational modification and complete sequence coverage on the protein species level should be achievable with further progress in sample preparation techniques, especially concerning separation techniques on the protein level, mass spectrometry and algorithms for mass spectrometric data processing. For determining the function of defined protein species a closer cooperation between cell biologists and proteomics experts is desirable.


Organometallic frustrated Lewis pair chemistry.
Frustrated Lewis pairs are playing an increasingly important role in organometallic chemistry. Examples are presented and discussed where organometallic systems themselves serve as the Lewis base or Lewis acid components in frustrated Lewis pair chemistry, mostly through their attached functional groups. Activation of dihydrogen takes place easily in many of these systems. This may lead to the generation of novel catalyst systems but also in many cases to the occurrence of specific reactions at the periphery of the organometallic frameworks. Increasingly, FLP reactions are used to carry out functional group conversions in organometallic systems under mild reaction conditions. The limits of typical FLP reactivity are explored with selected organometallic examples, a discussion that points toward new developments, such as the discovery of facile new 1,1-carboboration reactions. Learning more and more about the broad spectrum of frustrated Lewis pair chemistry helps us to find novel reactions and applications.


Swallowing Problem in Patients with Stroke: Multi-Center Study in Thailand.
Swallowing problems are a common symptom in patients suffering from stroke. The severity of swallowing problems associate with age, stroke types, and brain lesion. Early recognition of the problem can prevent complications such as aspiration pneumonia, and malnutrition. To report the prevalence and the long-term outcome of dysphagia in patients with stroke. Data of patients with stroke admitted at nine rehabilitation wards/centers in Thailand were extracted from the Thai Stroke Rehabilitation Registry (TSRR) I and II (1-year follow-up). Of 327 stroke patients [mean age 62 (SD 12) years and male: female = 193:134], 49 (15%) had swallowing dysfunction at admission. Dysphagic patients had significantly more cognitive impairment (TMSE score <24) than non-dysphagic group (p = 0.01). There was no significant difference in age, gender, onset-admission interval, type of stroke, and modified Barthel Index score (mBI) between the two groups. Moreover, there was no relationship between dysphagia and poor functional outcome (mBI ≤12). One year after discharge, only 214 (65.4%) patients returned for follow-up and seven patients (3.27%) had swallowing problem. After a stroke attack, about 15% of patients had swallowing dysfunction. Those with cognitive impairment at admission were more prone to swallowing functions impairment.


An audit of forceps delivery in Trinidad.
An audit of 247 consecutive forceps deliveries during a 6-year period was undertaken in order to establish trends in recourse to this instrument, maternal complications and fetal outcome. The chief indications were prolonged second stage of labour and poor maternal effort. Our overall forceps rate of 0.81% betrays a marked divergence from the practice in metropolitan countries. Although birth injuries were a major drawback, assistance with forceps still appears to be a safer alternative than caesarean section when a problem exists which impedes spontaneous delivery in the second stage. In choosing between obstetric options, we voluntarily take one course which we dislike because the alternative is more objectionable still; the unpleasantness of the choice does not destroy its reality.


TP53 mutations in high grade serous ovarian cancer and impact on clinical outcomes: a comparison of next generation sequencing and bioinformatics analyses.
Mutations in TP53 are found in the majority of high grade serous ovarian cancers, leading to gain of function or loss of function of its protein product, p53, involved in oncogenesis. There have been conflicting reports as to the impact of the type of these on prognosis. We aim to further elucidate this relationship in our cohort of patients. 229 patients with high grade serous ovarian cancer underwent tumor profiling through an institutional molecular screening program with targeted next generation sequencing. TP53 mutations were classified using methods previously described in the literature. Immunohistochemistry on formalin-fixed paraffin embedded tissue was used to assess for TP53 mutation. Using divisive hierarchal clustering, we generated patient clusters with similar clinicopathologic characteristics to investigate differences in outcomes. Six different classification schemes of TP53 mutations were studied. These did not show an association with first platinum-free interval or overall survival. Next generation sequencing reliably predicted mutation in 80% of cases, similar to the proportion detected by immunohistochemistry. Divisive hierarchical clustering generated four main clusters, with cluster 3 having a significantly worse prognosis (p<0.0001; log-rank test). This cluster had a higher concentration of gain of function mutations and these patients were less likely to have undergone optimal debulking surgery. Different classifications of TP53 mutations did not show an impact on outcomes in this study. Immunohistochemistry was a good predictor for TP53 mutation. Cluster analysis showed that a subgroup of patients with gain of function mutations (cluster 3) had a worse prognosis.


Apparent caspase independence of programmed cell death in Dictyostelium.
During normal development, cell elimination [1,2] occurs by programmed cell death (PCD) [3], of which apoptosis [4] is the best known morphological type. Activation of cysteine proteases termed caspases [5] is required in many instances of animal PCD [6-9], but its role outside the animal kingdom is as yet unknown. PCD occurs during developmental stages in the slime mold Dictyostelium discoideum [10,11]. Under favorable conditions, Dictyostelium multiplies as a unicellular organism. Upon starvation, a pathway involving aggregation, differentiation and morphogenesis induces the formation of a multicellular fungus-like structure called a sorocarp [12], consisting mainly of spores and stalk cells, the latter being a result of cell death. Dictyostelium cell death is similar to classical apoptosis in that some cytoplasmic and chromatin condensation occurs but differs from apoptosis because it involves massive vacuolisation and, interestingly, lacks DNA fragmentation [11]. We examined whether caspase activity is required for Dictyostelium cell death. We found that caspase inhibitors did not affect cell death, although some caspase inhibitors that did not inhibit cell death impaired other stages in development and could block affinity-labelling of soluble extracts of Dictyostelium cells with an activated caspase-specific reagent. The simplest interpretation of these results is that in Dictyostelium, whether or not caspase-like molecules exist and are required for some developmental steps, caspase activation is not required for cell death itself.


[Clinical study of congenital middle ear malformations].
To search into the diagnosis and treatment of congenital malformation of middle ear. Nine patients were involved in our study, exploratory tympanotomy was undergone in all patients (eleven ears) and eight ears were reconstructed the ossicular chain. Exploratory tympanotomy showed a variety of abnomalities of the middle ear which were difficult to identify preoperatively, despite the modern imaging techniques. Stapedectomy using a wire prosthesis with an oval window tissue graft to prevent a perilymphatic leak was carried out in four ears, fenestration of vestibule with stapes prosthesis in two ears, removing the fibrotic strand around the incudostapedial joint in one ear, TORP (Total replacement prosthesis) were used in one ear, gain in hearing thresholds was obtained without severe complications occurrence. Exploratory tympanotomy is essential to identify congenital conductive hearing loss and wire prosthesis may provide a potential way for reconstruction of ossicular chain.


Photobiomodulation Therapy on Physiological and Performance Parameters During Running Tests: Dose-Response Effects.
Dellagrana, RA, Rossato, M, Sakugawa, RL, Baroni, BM, and Diefenthaeler, F. Photobiomodulation therapy on physiological and performance parameters during running tests: Dose-response effects. J Strength Cond Res 32(10): 2807-2815, 2018-This study was aimed at verifying effects of photobiomodulation therapy (PBMT) with different energy doses (15, 30, and 60 J per site) on physiological and performance parameters during running tests. Fifteen male recreational runners participated in a crossover, randomized, double-blind, and placebo-controlled trial. They performed testing protocol in 5 sessions with different treatments: control, placebo, and PBMT with 15, 30, or 60 J per site (14 sites in each lower limb). Physiological and performance variables were assessed during submaximal (at 8 and 9 km·h) and maximal running tests. Photobiomodulation therapy with 30 J significantly improved running economy (RE) at 8 and 9 km·h (3.01%, p=0.008 and 3.03%, p=0.009, respectively), rate of perceived exertion (RPE) at 8 km/h21 (7.86%, p=0.033), velocity at V[Combining Dot Above]O2max (3.07%, p= 0.029), peak of velocity (PV) (1.49%, p=0.035), and total time to exhaustion (TTE) (3.41%, p=0.036) compared with placebo. Photobiomodulation therapy with 15 J improved running economy at 9 km/h21 (2.98%, p=0.025), rate of perceived exertion at 8 km/h21 (4.80%, p=0.010), PV (1.33%, p=0.008), total time to exhaustion (3.06%, p=0.008), and total distance (4.01%, p=0.011) compared with the placebo; whereas PBMT with 60 J only increased RE at 9 km/h21 (3.87%, p=0.024) compared with placebo. All PBMT doses positively affected physiological and/or performance parameters; however, magnitude-based inference reported that PBMT applied with 30 J led to more beneficial effects than 15 and 60 J.


Different hemodynamic effects of atrial natriuretic factor and nitroglycerin in rats with congestive heart failure.
Atrial natriuretic factor (ANF) decreases cardiac filling pressure, suggesting that diminished venous return is an important mechanism for the associated reduction in cardiac output. To determine whether ANF reduces cardiac preload through venodilation in congestive heart failure (CHF), we compared the hemodynamic effects of ANF-(99-126) with those of the venodilator nitroglycerin in conscious rats with CHF induced by coronary artery ligation previously. Depending on the extent of myocardial infarction, rats were subdivided into two groups: 1) mild or 2) severe CHF. Incremental intravenous infusions of ANF (0.1, 0.25, 0.5 micrograms.kg-1.min-1) or nitroglycerin (2, 5, 10 micrograms.kg-1.min-1) were administered for 20 min at each dose. Both agents reduced cardiac filling pressures. There was no change in cardiac output or arterial pressure at any dose of ANF in rats with severe CHF, but cardiac output decreased at higher ANF doses in rats with mild CHF. In contrast, nitroglycerin produced no change in cardiac output at any dose in either CHF group, although it decreased arterial pressure at the higher doses in rats with severe CHF. ANF increased whereas nitroglycerin decreased hematocrit in both CHF groups. The ANF-induced hematocrit increase also occurred in those rats with vesicovenous shunts designed to prevent volume contraction induced by diuresis. These data suggest that ANF and nitroglycerin decreased cardiac filling pressure through different hemodynamic mechanisms. The known venodilator action of nitroglycerin was associated with decreased hematocrit, suggesting enhanced transcapillary fluid migration. However, ANF produced an opposite effect on fluid migration as demonstrated by an increased hematocrit, suggesting a mechanism other than venodilation must be operative in reducing cardiac filling pressure.(ABSTRACT TRUNCATED AT 250 WORDS)


Use of the extracranial-intracranial arterial bypass in the management of refractory vasospasm: a case report.
Cerebral arterial vasospasm after aneurysmal subarachnoid hemorrhage remains one of the major causes of morbidity and mortality in patients surviving the initial hemorrhage. Once established, no known method has been shown to reverse this process in humans. Although intravascular volume expansion and induced arterial hypertension have been shown to be effective in the reversal of neurological deficits secondary to vasospasm, a large proportion of patients remain refractory to these methods. We report one such case successfully managed by the establishment of an extracranial-intracranial anastomosis in an attempt to augment collateral flow.


The surface enhanced Raman scattering effects of composite nanocrystals of Ag-TiO2.
The composite particles of Ag-TiO2 both in a nanocrystal form was prepared by photoreduction of AgNO3 in the rutile colloidal solution. The surface plasmon absorption (SPA) band of the silver clusters supported on the TiO2 nanocrystal was red shift, and a strong surface enhanced Raman scattering (SERS) effect for the composite particles of Ag-nanocrystalline TiO2 was observed. The SERS effect is relating to the red shift phenomenon of SPA band, which could be explained by induced-resonance effect.