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The course of subsequent pregnancies after previous cesarean section. The course of pregnancies subsequent to cesarean section (CS) was studied. During the years 1970-72, 543 women were delivered by CS at Borås Central Hospital. A questionnaire was sent to all 543 during the autumn of 1976 and the spring of 1977. The questions concerned further conceptions and the outcome of all subsequent pregnancies after CS. Of the 440 (81%) women who answered the questionnaire, 244 (55.5%) became pregnant, the total number of subsequent pregnancies being 306. The incidence of spontaneous abortion, extra-uterine pregnancy and legal abortion was not significantly higher than the corresponding rate for the total material for our department during the same period. Among the 215 women who completed a new pregnancy, an elective CS was performed in 81 cases (38%). Trial of labor occurred in 143 patients, 91 of whom (68%) gave birth per vaginam , while 43 (32%) were delivered by acute CS. In nearly half of the acute CS cases the indication was a narrow pelvis not detected until labor had started. This indicates that roentgenologic pelvimetry should be considered in certain cases, when planning delivery after a previous CS.

[Lymph node staging and diagnostic imaging--status quo and future prospects]. Exact lymph node staging is crucial to tumor staging and outcome, as well as therapy planning. Due to the low specificity and sensitivity of current imaging methods, invasive, expansive and uncomfortable diagnostic procedures are still widely used, often in conjunction with imaging. This brief overview is intended to summarize current imaging strategies and to give an outlook on new experimental imaging strategies which may play an important role in lymph node staging.

Primary measures of dependence among menthol compared to non-menthol cigarette smokers in the United States. Previously published studies provide somewhat inconsistent evidence on whether menthol in cigarettes is associated with increased dependence. The National Health and Nutrition Examination Survey, National Survey on Drug Use and Health, National Health Interview Survey, and Tobacco Use Supplement to the Current Population Survey collect data on current cigarette type preference and primary measures of dependence, and thus allow examination of whether menthol smokers are more dependent than non-menthol smokers. Analyses based on combined data from multiple administrations of each of these four nationally representative surveys, using three definitions for current smokers (i.e., smoked ⩾1day, ⩾10days and daily during the past month), consistently demonstrate that menthol smokers do not report smoking more cigarettes per day than non-menthol smokers. Moreover, two of the three surveys that provide data on time to first cigarette after waking indicate no difference in urgency to smoke among menthol compared to non-menthol smokers, while the third suggests menthol smokers may experience a greater urgency to smoke; estimates from all three surveys indicate that menthol versus non-menthol smokers do not report a higher Heaviness of Smoking Index. Collectively, these findings indicate no difference in dependence among U.S. smokers who use menthol compared to non-menthol cigarettes.

Effect of nitric oxide in protective effect of melatonin against chronic constriction sciatic nerve injury induced neuropathic pain in rats. Developing a successful treatment strategy for neuropathic pain has remained a challenge among researcher and clinicians. Various animal models have been employed to understand the pathogenic mechanism of neuropathic pain in experimental animals. The present study was designed to explore the possible nitric oxide mechanism in the protective effect of melatonin against chronic constriction injury (CCI) of sciatic nerve in rats. Following chronic constriction injury, various behavioral tests (thermal hyperalgesia, cold allodynia) and biochemical parameters (lipid peroxidation, reduced glutathione, catalase, and nitrite) were assessed in sciatic nerves. Drugs were administered for 21 consecutive days from the day of surgery. CCI significantly caused thermal hyperalgesia, cold allodynia and oxidative damage. Chronic administration of melatonin (2.5 or 5 mg/kg, ip) significantly attenuated hyperalgesia, cold allodynia and oxidative damage in sciatic nerves as compared to CCI group. Further, L-NAME (5 mg/kg) pretreatment with sub-effective dose of melatonin (2.5 mg/kg, ip) significantly potentiated melatonin's protective effect which was significant as compared to their individual effect per se. However, L-arginine (100 mg/kg) pretreatment with melatonin (2.5 mg/kg, ip) significantly reversed its protective effects. Results of the present study suggest the involvement of nitric oxide pathway in the protective effect of melatonin against CCI-induced behavioral and biochemical alterations in rats.

Changes in the organization of membrane lipids during human platelet activation. Study by fluorescent and freeze-fracture cytochemistry. Modifications in the membrane lipid organization of human platelets activated with different agents (adenosine 5'-diphosphate, thrombin, collagen type I, and monosaccharides such as fucose, mannose, and galactose) were analyzed in vitro by using three lipid markers. Cholesterol was detected upon interaction with filipin, the anionic phospholipids were reacted with polymyxin B, and alterations in the degree of lipid packing were evaluated with the lipophilic fluorescent probe merocyanine 540, which reportedly inserts into bilayer domains whose lipids are more disordered. Filipin-sterol complexes and polymyxin B-anionic phospholipid complexes form characteristic membrane deformations which were examined in freeze-fracture preparations, whereas the merocyanine 540 binding to platelet membrane was recorded by fluorescent microscopy. In contrast to the resting cells, thrombin-stimulated platelets displayed an uneven distribution of filipin-sterol complexes which occurred in much higher density on the cell body than on pseudopods: on the latter, apparently cholesterol-free domains were very common. Unlike the non-stimulated cells, the platelets aggregated with the various agents employed showed characteristic polymixin B-anionic phospholipid complexes deformations of plasmalemma suggesting the appearance in uneven concentration of anionic phospholipids in the outer membrane leaflet. Incubation with merocyanine 540 did not result in staining of resting platelets when these were maintained in plasma, but a slight fluorescence was observed when platelets were kept in Tyrode buffer. However, platelets stimulated with thrombin, collagen type I, and monosaccharides bound very heavily the fluorescent dye; platelets aggregated with adenosine-5'-diphosphate bound only small amounts of merocyanine 540. The results showed that, during activation by different agents, modifications in lipid membrane organization include alterations in cholesterol and anionic phospholipid distribution, transbilayer movement of anionic phospholipids accompanied by more disordered membrane.

Transcriptome profiling of the meristem tissue of Saccharina japonica (Phaeophyceae, Laminariales) under severe stress of copper. Copper (Cu) is an essential metal involved in many physiological processes of living organisms. However, beyond a certain threshold, Cu can become highly toxic. For instance, in the summer sporeling production of the economic kelp Saccharina japonica, the excess Cu accidently released from the low-quality alloys of the refrigerating machine was deadly to the seedlings and led to the failure of hatchery operations. However, the molecular basis underlying high toxicity of Cu remains unclear. In this study, juvenile sporophytes were cultured in seawater containing different concentrations of Cu2+ (10, 100, and 200 μg L-1). Bleaching was observed in the meristem of individuals in the 100 and 200 μg L-1 treatment groups on the third day, indicating that Cu has caused severe harm at these concentrations. RNA-Seq was used to profile transcriptomic changes under different Cu2+ concentrations. Compared with the control, the number of differentially expressed genes (DEGs) was 11,350 (4944 up- and 6406 down-regulated) in the 200 μg L-1 treatment group and 2868 (1075 up- and 1793 down-regulated) in the 100 μg L-1 treatment group, whereas much fewer DEGs were detected in the 10 μg L-1 treatment group. Genes coding for glutathione-S-transferase and vanadium-dependent bromoperoxidase and iodoperoxidase were found to be remarkably regulated, especially in the 200 μg L-1 treatment group. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses showed that only down-regulated DEGs were enriched. There were 45 enriched GO terms and four enriched KEGG pathways common to the 100 and 200 μg L-1 treatment groups, which were associated with diverse essential biological processes such as photosynthesis, protein synthesis, redox activity, and metabolism and biosynthesis of functional biomolecules, among others. Suppression of these biological processes at the transcriptional level likely contributes to the observed high toxicity of Cu2+ in S. japonica.

Termination of a randomized controlled trial of two vasectomy techniques. Family Health International (FHI) and EngenderHealth conducted a multicenter, randomized controlled trial to evaluate a fascial interposition (FI) component of a vas occlusion procedure for male sterilization. A data monitoring committee (DMC) was established to provide independent review of the interim report. The DMC met to review the interim report after enrollment of 552 men. As planned, an estimate of the hazard ratio (HR) for successful vasectomy for the FI group versus the no-FI group controlling for age of the participant and level of experience of the surgeon was obtained for the interim report using Cox's proportional hazards regression. The main analysis comparing time to vasectomy success, defined as two consecutive azoospermic semen samples, was highly significant and met the prespecified level for stopping enrollment (HR=1.54, p<0.01). However, a troublesome age by vasectomy technique interaction became apparent in the analysis. FI was clearly beneficial for younger males. However, the trend for older men was not as clear. The DMC recommended continuing the trial to better study this interaction and obtain more data to clarify the effect of FI for older men. After consulting further with the DMC, the study statisticians presented the interim report to senior management at FHI. A meeting between FHI senior management and the DMC followed. After much deliberation, trial enrollment was terminated. Follow-up of participants already enrolled in the study continued as planned. This paper presents the issues involved in the decision to terminate the study.

lacP1 promoter with an extended -10 motif. Pleiotropic effects of cyclic AMP protein at different steps of transcription initiation. The cyclic AMP receptor protein (CRP), which activates transcription from the wild-type lacP1 promoter and most of its mutants, represses productive RNA synthesis from a lacP1 promoter variant that contains an extended -10 element, although CRP enhances RNA polymerase binding as well as open complex formation in both promoters. Moreover, abortive RNA synthesis, which is already higher in the extended -10 variant compared with the parent promoter, was further enhanced by CRP. These results, together with the observed decrease in productive RNA synthesis, indicate that CRP, while facilitating the earlier steps of initiation, inhibits transcription from the extended -10 lacP1 by hindering promoter clearance. We propose that CRP decreases energetic barriers to RNA polymerase binding, isomerization, and abortive RNA synthesis but stabilizes the abortive RNA initiating complex, which results in increasing the activation energy of the transition state before the elongation complex. The results demonstrate for the first time that a DNA-binding regulatory protein acts as an activator or a repressor in different steps of the transcription initiation pathway because of the energetic differences of the intermediate complex in the same promoter.

[WANG Zhizhong and his Experience on Acupuncture and Moxibustion Therapy]. WANG Zhizhong, born in the Southern Song Dynasty, was proficient in TCM theory and enjoyed summarizing proved prescriptions. During his spare time, he wrote Experience on Acupuncture and Moxibustion Therapy with scientific writing structure, wide quote of references and attached medical reports, which modified and enriched the content of acupoint therapy. This book played an important role as a link between past and future; it included a considerable number of moxibustion methods and was considered as the greatest medical achievement before Song Dynasty. In addition, this book contained the greatest number of proved prescriptions among the ancient acupuncture books, so its academic value was self-evident. However, when examining and correcting the acupoints, WANG ignored the fact that acupuncture physicians had different clinical experience and their understanding on the body structure was discrepant, so the contradictions of location and indications of acupoints appeared in the book.

Automated polysomnogram artifact compensation using the generalized singular value decomposition algorithm. Manual/visual polysomnogram (psg) analysis is a standard and commonly implemented procedure utilized in the diagnosis and treatment of sleep related human pathologies. Current technological trends in psg analysis focus upon translating manual psg analysis into automated/computerized approaches. A necessary first step in establishing efficient automated human sleep analysis systems is the development of reliable pre-processing tools to discriminate between outlier/artifact instances and data of interest. This paper investigates the application of an automated approach, using the generalized singular value decomposition algorithm, to compensate for specific psg artifacts.

Susceptibility of porin- and lipopolysaccharide-deficient strains of Escherichia coli to some antiseptics and disinfectants. The sensitivities of some outer membrane protein (Omp) and/or lipopolysaccharide (LPS)-defective mutants of Escherichia coli to chlorhexidine and some quaternary ammonium compounds (QACs) were examined. Wild-type strains, with no defect in Omp or LPS were the most resistant to QACs, whereas LPS-deficient strains were the most sensitive. As expected, QAC resistance could not be related to the presence or absence of any specific porin(s). Chlorhexidine was highly active against all strains, inhibitory concentrations lying within the narrow range of 1 and 2 mg l-1.

Obesity, emerging risk in China: trend of increasing prevalence of obesity and its association with hypertension and hypercholesterolaemia among the Chinese. 1. The aim of the present study was to investigate the trend of the prevalence of obesity in China and its association with hypertension and hypercholesterolemia. 2. A multicentre cross-sectional study was conducted in Chinese men and women aged 48-56 years between 1985 and 2000. In the report, three study periods were classified as survey 1 (1985), survey 2 (1988-1989) and survey 3 (1997-2000) in order to describe the long-term trend. 3. The results show that: (i) mean body mass index (BMI), prevalence of obesity (BMI > or = 28 kg/m2) and overweight (BMI > or = 25 and < 28 kg/m2) increased significantly from 1985 to 2000 in both sexes (P < 0.001); (ii) similar to the trend for BMI, the prevalence of hypertension and hypercholesterolaemia (total cholesterol (TC) > or = 220 mg/dL) also increased significantly from 1985 to 2000 (P < 0.001); (iii) partial correlation and multiple linear regression analyses indicated that increased BMI was significantly positively correlated with blood pressure and TC and negatively correlated with serum high-density lipoprotein-cholesterol (P < 0.01 or P < 0.001); and (iv) multiple logistics regression analysis models indicated that obese subjects had a 3.9-fold higher risk of being hypertensive (relative risk (RR) 4.9; 95% confidence interval (CI) 3.4-7.3) compared with those subjects who had a BMI less than 25 kg/m2. The corresponding RR (95% CI) of obesity for hypercholesterolaemia was 2.63 (1.57-4.40). 4. In conclusion, the results highlight the epidemic of obesity, an emerging risk in China. Great efforts must be made to alter this unwelcome trend.

Plasma CCL5 promotes EMT-medicated epirubicin-resistance in locally advanced breast cancer. Neoadjuvant chemotherapy (NCT) is the standard treatment for locally advanced breast cancer (LABC). Pathological complete response (pCR) is commonly used as a valid predictor of NCT long-term outcomes. Blood-based tumor biomarkers have the potential to predict response to NCT at early stage non-invasively. We believed plasma CCL5 could be a potential marker to predict NCT of LABC. Its efficiency and possible mechanism was studied in this work. Human Cytokine Antibody Microarray was applied to screen different cytokine concentration in plasma between low histological regression (Low-R) and high histological regression (High-R) patients. LABC patients were divided into two groups according to pathological reactivity. The concentration of plasma CCL5 in different groups was determined by ELISA analysis. CCK8 assay was performed to analyze epirubicin susceptibility of breast cancer cells. Transwell assay was performed to determine the effect of CCL5 on breast cancer cells' migration and invasion. qRT-PCR and western blot were used to verify the EMT (epithelial-mesenchymal transition) markers in CCL5-treated and epirubicin-treated breast cancer cells. The concentration of plasma CCL5 of Low-R group was higher than High-R group before NCT. The plasma levels of CCL5 were significantly reduced after NCT in the group of high histological regression (High-R). Epirubicin susceptibility decreased in the breast cancer cells treated by recombinant CCL5. Migration and invasion were significantly enhanced in breast cancer cells treated by recombinant CCL5. E-cadherin expression was decreased whereas vimentin increased significantly in CCL5-treated breast cancer cells. The phosphorylation of ezrin in Y-567 and its downstream protein cortactin increased significantly in CCL5-treated breast cancer cells. Plasma CCL5 level could be a promised candidate to predict chemotherapy response of breast cancer. Plasma CCL5 plays an important role in EMT process of breast cancer.

Interaction of terbinafine with human serum and serum proteins. The allylamine antimycotic terbinafine acts by inhibition of ergosterol biosynthesis at the level of squalene epoxidase. Using this mechanism in Candida parapsilosis cells, a functional assay was developed to investigate the effects of serum and serum proteins on the antifungal action of terbinafine and related drugs in vitro. Inhibition of ergosterol biosynthesis by terbinafine was antagonized by human serum in a dose-dependent non-saturable manner. The results were not affected by varying the period of pre-incubation of serum with the drug or with the fungal cells, or by performing the test in other species of Candida, Aspergillus and Trichophyton. Qualitatively similar effects were observed with the related allylamine compounds naftifine and SDZ 87-469, the extent of antagonism correlating with their lipophilicity. The effect appeared to be caused by non-specific binding of the drug to major serum components, including albumin and the lipoproteins (both LDL and HDL). Reduced bioavailability resulting from binding by serum may at least partly account for the low efficacy of terbinafine in experimental models of systemic infection, in contrast to its high efficacy in infections of the skin, nails and hair.

Are immigrants at a disadvantage in psychiatric in-patient care? To assess the utilization of psychiatric in-patient care among immigrants, and to compare immigrants and natives with respect to sociodemographic and clinical characteristics. Analysing a sample of 23 377 consecutive referrals to psychiatric hospitals of a catchment area in 1995-2001. Within this sample, 20% were foreign nationals. Rates of psychotic disorders were similar in immigrants and natives. Regarding other diagnoses, sociodemographic and clinical measures, there were significant differences. Most immigrant groups had higher rates of compulsory admission, were more likely to be admitted with lower illness severity and not to be readmitted, and spent significantly shorter time in hospital, compared with Swiss in-patients. Some of these differences were clearly gender-specific. Service utilization and psychiatric treatment decisions are not explained merely by illness-related aspects in immigrants. Social and cultural factors have to be recognized in order to prevent disadvantages in psychiatric care.

Coexistence of pemphigus vulgaris, malignant melanoma and low-grade lymphoma. A 53-year-old female patient with pemphigus vulgaris under continuous immunosuppressive therapy for about 2 years presented a superficial spreading malignant melanoma on a pre-existing melanocytic naevus. After surgical removal of the inguinal lymph node group, a diffuse low-grade polymorphous immunocytoma was proved both histologically and immunocytochemically. The possible induction mechanisms are discussed.

Progesterone receptor function from a behavioral perspective. Hormonal induction of sexual receptivity in ovariectomized female mice can be effectively reinstated by sequential administration of estradiol and progesterone. In this regard, mice appear to be similar to other rodents. While it is generally accepted that hypothalamic progesterone receptors function as estradiol-induced transcription factors in the induction of sexual receptivity in rats, hamsters, and guinea pigs, relatively little is known about their role in the mouse, a species which exhibits genotypic and strain differences in the responsiveness to steroid hormones. Using a transgenic mouse carrying a null mutation for the progesterone receptor by gene targeting, we examined the role of the progesterone receptor as a coordinator of key regulatory events in the induction of sexual receptivity. A concordance between hypothalamic progesterone receptor levels and behavioral responsiveness was established by comparing the homozygous mutant, heterozygous mutant, and wild-type littermates. The behavioral and biochemical findings reveal the importance of estradiol-induced progesterone receptors for the expression of sexual behavior in female mice. The behavioral response of the two parental mouse strains from which the recombinant genotype was generated was also examined. As an extension of our earlier studies on the ligand-independent activation of progesterone receptors by neurotransmitters, the behavioral effect of dopamine in the facilitation of sexual receptivity in mice was also examined. The studies provide further evidence that steroid hormone receptors function as general transcription factors to achieve the integration of neural information in the central nervous system, and they assign a more important role for progesterone receptors than hitherto envisioned.

Self-consistent chaotic transport in fluids and plasmas. Self-consistent chaotic transport is the transport of a field F by a velocity field v according to an advection-diffusion equation in which there is a dynamical constrain between the two fields, i.e., O(F,v)=0 where O is an integral or differential operator, and the Lagrangian trajectories of fluid particles exhibit sensitive dependence on initial conditions. In this paper we study self-consistent chaotic transport in two-dimensional incompressible shear flows. In this problem F is the vorticity zeta, the corresponding advection-diffusion equation is the vorticity equation, and the self-consistent constrain is the vorticity-velocity coupling z nabla xv=zeta. To study this problem we consider three self-consistent models of intermediate complexity between the simple but limited kinematic chaotic advection models and the approach based on the direct numerical simulation of the Navier-Stokes equation. The first two models, the vorticity defect model and the single wave model, are constructed by successive simplifications of the vorticity-velocity coupling. The third model is an area preserving self-consistent map obtained from a space-time discretization of the single wave model. From the dynamical systems perspective these models are useful because they provide relatively simple self-consistent Hamiltonians (streamfunctions) for the Lagrangian advection problem. Numerical simulations show that the models capture the basic phenomenology of shear flow instability, vortex formation and relaxation typically observed in direct numerical simulations of the Navier-Stokes equation. Self-consistent chaotic transport in electron plasmas in the context of kinetic theory is also discussed. In this case F is the electron distribution function in phase space, the corresponding advection equation is the Vlasov equation and the self-consistent constrain is the Poisson equation. This problem is closely related to the vorticity problem. In particular, the vorticity defect model is analogous to the Vlasov-Poisson model and the single wave model and the self-consistent map apply equally to both plasmas and fluids. Also, the single wave model is analogous to models used in the study of globally coupled oscillator systems. (c) 2000 American Institute of Physics.

Higher adherence with 3-year entecavir treatment than lamivudine or telbivudine in treatment-naïve Taiwanese patients with chronic hepatitis B. Oral nucleos(t)ide analogs (NAs) are effective in suppressing hepatitis B virus (HBV) replication in treatment naïve chronic hepatitis B (CHB) patients. However, little is known about the treatment modification and adherence on such patients with prolonged NA treatment. In this multicenter observational study, a total of 600 NA-naïve Taiwanese CHB patients aged 16 years and older were enrolled. The 600 patients were retrospectively identified by their NA treatment history from August 2008 to July 2009; this cohort was prospectively followed up over 3 years. During the 3-year period, incidence of treatment modifications, reasons for modification, and rate of adherence were evaluated. Among the 583 evaluable patients, the initial NA treatment included entecavir (ETV) in 468 patients, telbivudine (LdT) in 67, and lamivudine (LVD) in 48. During the 3-year treatment, 9.0% of ETV-treated patients, 38.8% of LdT-treated patients, and 54.2% of LVD-treated patients had treatment modification. The main reasons for treatment modification were fulfilling stopping criteria in the ETV group (40.5%) and virological breakthrough in both the LdT (61.5%) and LVD (46.2%) groups. The proportion of patients with adherence rate (> 90%) at year 3 was 90.8% in the ETV group, 83.9% in the LdT group, and 83.9% in the LVD group. Treatment-naïve CHB patients with a 3-year ETV treatment in Taiwan have the lower likelihood of treatment modification and better rate of adherence compared with those with LdT or LVD treatment.

Catathrenia and Treatment With Positive Airway Pressure in the Pediatric Population. Catathrenia, also known as sleep-related groaning, is a relatively rare sleep disorder with characteristics consistent with loud groaning on expiration during sleep. Organic causes of catathrenia are unknown and the decision of whether or not to treat is unclear. Limited research is available concerning appropriate treatment and none of the literature focuses primarily on pediatrics. We report a series of three, male pediatric cases with catathrenia that were treated with continuous positive airway pressure (CPAP) while identifying and comparing clinical symptoms, polysomnogram findings, treatment, and patient response to treatment. Catathrenia may be associated with abnormal nocturnal oxygenation and ventilation and may lead to negative clinical daytime symptoms which may warrant treatment. If catathrenia leads to sleep disruption and negative daytime symptoms, treatment with CPAP should be considered.

IgA antibody to lipid A in alcoholic liver disease. To find out whether the increased immunoglobulin A (IgA) levels commonly reported in patients with alcoholic liver disease (ALD) are part of the immune response to gut-derived endotoxin antigen, an enzyme-linked immunoabsorbent assay was used to measure serum levels of antibodies to lipid A (the shared core of various lipopolysaccharides and the biologically active component of endotoxins) in patients with various diseases and in controls. Of 41 patients with ALD, 35 had significantly raised titres of IgA anti-lipid A. Rises of antilipid A were found in the secretory fraction of IgA as well, and titres of IgG antibody were also consistently increased. IgM titres were high in only 7 of 35 ALD patients tested. Patients with other diseases did not show significantly high titres of IgA antibodies to lipid A even though many had rises in total concentration of their serum IgA.

Solvent based hydrogen bonding: impact on poly(3-hexylthiophene) nanoscale morphology and charge transport characteristics. We demonstrate that supramolecular assembly and subsequent enhancement of charge transport characteristics of conjugated polymers can be facilitated simply by adding small amounts of a more volatile poor solvent, which can hydrogen bond with the majority solvent. Addition of up to 2 vol % acetone to a precursor solution of poly(3-hexylthiophene) (P3HT) in chloroform leads to approximately a 4-fold increase in P3HT field-effect mobility. The improvement is associated with hydrogen bonding interactions between acetone and chloroform which decrease the evaporation rate of the mixed solvent. P3HT is less soluble in the binary solvent than in the more readily vaporized chloroform component, and this characteristic enables the supramolecular assembly of P3HT chains at the nanoscale. Two-dimensional molecular ordering of the polymer film was controlled by varying the quantity of poor solvent added to the precursor solution, and the correlation between field-effect mobility and molecular ordering was investigated. Hansen solubility parameters were used to systematically understand how the solvent mixture enhances the alignment and assembly of polymer chains and influences subsequent thin film properties. The value of the relative energy difference (RED) of the solvent with respect to P3HT increased from less than 1 to more than 1 during film formation, which indicates that the solvent characteristics are initially those of a good solvent but transform into those of a poor dissolution medium. A mechanistic illustration of the molecular ordering process during film formation is postulated.

[Transesophageal Doppler color echocardiography in the evaluation of patients after percutaneous mitral valvuloplasty]. To determine the value of transesophageal ultrasound in the assessment of patients after percutaneous mitral valvuloplasty, 42 patients were studied by transthoracic (TTE) and transesophageal (TEE) two-dimensional and color Doppler echocardiography. All of them were studied as out-patients and without complications. We describe the technique, planes of examination and the advantages that this new acoustic window offers in patients after balloon valvuloplasty regarding to: detection of thrombus in the left atrium (LA), visualization of spontaneous echo contrast in the LA, evaluation of mitral regurgitation (MR), detection of small atrial septal defects (ASD) and evaluation of the stage of the commissures of the mitral valve. We detected thrombus by TEE, in 5/42 vs 1/42 by TTE approach. Spontaneous echo contrast was found in 35/42 by TEE and none by TTE. Small ASDs were visualized in 10/42 patients vs 2/42 by TTE. No differences were found in the evaluation of MR and mitral valve commissures either by TEE or TTE. We conclude that transesophageal echocardiography is a well-tolerated technique in outpatients which complements and improves the information obtained by the transthoracic approach in patients after balloon mitral valvuloplasty.

Ectopic pregnancy: triage do's and don'ts. Ectopic pregnancy is on the rise and accounts for 2% of all reported pregnancies. This article introduces the reader to the complexities of the condition and explores risk factors as well as differential diagnosis and methods of treatment. The importance of early diagnosis is discussed as well as the implications of misdiagnosis. The role of the midwife/practitioner in the triage of patients with ectopic pregnancy is detailed.

Refractive error distribution and incidence among U.S. Army aviators. Spectacle incompatibility has been a major problem in the fielding of advanced Army avionic and electro-optical systems. As a result, routine contact lens wear may be instituted as an option to spectacles. Refractive error data were extracted from the Aviation Epidemiological Data Registry, a computer-accessible repository of flight physical medical information on the entire Army aviation population. Refractive error distribution patterns in the class 1 and class 2 flight physical populations were analyzed in order to provide a contact lens supply reference database, estimate the annual incidence of refractive error development, and estimate costs of possible spectacle-wearer flight-duty deselection. Contact lens wear appears to be a more cost-effective alternative than deselection.

Twenty-four-hour fluid intake and renal handling of electrolytes after various doses of ethanol. The effects of single ethanol doses on fluid and electrolyte metabolism were studied in 31 male mongrel dogs. The animals were given either 0.75 g/kg 1.50 g/kg, or 2.25 g/kg of a 25% (v/v) ethanol solution or isovolumetric quantities of water. Fluid intake, urine output, and electrolyte (Na, K, Cl, Mg) excretions were measured at 0--3, 3--8, and 8--24 hr. During the ascending portion of the plasma ethanol curve (0--3 hr) there was a diuresis and renal magnesium loss in the two highest dosage ethanol groups. During the initial portion of the descending plasma ethanol curve (3--8 hr), each ethanol group had a significant elevation in voluntary intake. At 8--24 hr, renal retention of sodium, potassium, and chloride was found in the 1.5 and 2.25 g/kg groups, and magnesium excretion was also reduced in the 2.25 g/kg group. Over the 0--24 hr, none of the ethanol groups showed fluid loss, while the 2.25 g/kg ethanol group had significant retention of water. The administration of the 2.25 g/kg ethanol dose also resulted in 24-hr retention of sodium and potassium.

Microsomal ATPase of kidney papilla: sensitivity to diuretics and other inhibitors. Microsomal ATPase isolated from rat kidney papilla was compared to that from kidney medulla. Microsomal Na, K-ATPase from papilla was more sensitive to inhibition by ouabain, Cad N-ethyl-maleimide, Hg++, Thiomerin, ethacrynic acid and Furosemide than the enzyme from the medulla. Mg-ATPase of the papilla was less sensitive than the medullary enzyme to inhibition by Ca++, Cd++, N-ethyl-maleimide, Hg++, ethacrynic acid and Furosemide. Papillary Mg-ATPase was less sensitive than papillary Na, K-ATPase to all the inhibitors mentioned. Medullary Mg-ATPase was more sensitive than medullary Na, K-ATPase to inhibition by ethacrynic acid and Furosemide but less sensitive than medullary Na, K-ATPase to all the other inhibitors. Papillary Na, K-ATPase is the most sensitive to inhibition and papillary Mg-ATPase is the most resistant to inhibition by various diuretic drugs. The possible significance of these characteristics is discussed.

Identification, characterization and HPLC quantification of formulation-related impurities of honokiol, an antitumor natural drug candidate in clinical trials. Natural products and their derivatives have historically been invaluable as a source of therapeutic agents. Honokiol, as a well-known natural product in Chinese herbal medicine Houpu, is finally being studied in a Phase I clinical trial (CTR20170822) in patients with Advanced Non-Small Cell Lung Cancer (NSCLS) in China this year. During the honokiol liposome formulation process, five major impurities were present in the range of 0.05-0.1% based on the HPLC analysis. These five major impurities were obtained from the forced degradation product of honokiol through countercurrent chromatography and prep-HPLC. The structure were elucidated with 1H NMR, 13C NMR, 2D NMR and MS spectral data. The proposed HPLC method was validated for specificity, linearity (concentration range 0.01-1.62, 0.003-0.96, 0.05-7.98, 0.04-6.52, 0.03-5.18 μg/ml for impurities I-V respectively, R2 > 0.9988), accuracy (99.11-100.67%), precision (CV < 1.6%), and sensitivity (LOD 3.3, 0.1, 16.7, 13.3, 10.0 ng/ml for impurities I-V respectively). The validated method was employed in the further study of the honokiol drug substance.

Neural correlates of delicate sadness: an fMRI study based on the neuroaesthetics of Noh masks. Although the role of the amygdala in processing facial expressions of fear is well established, its role in the processing of other emotions, such as sadness, remains unclear. We hypothesized that the amygdala would respond to a negative emotion such as sadness, when sadness was represented by a theatrical mask. In the traditional Japanese Noh theater, performers use masks to indicate many of the mental states of the characters they portray. Here, we report a functional MRI study, in which participants' brains were scanned while viewing Noh masks, whose faces appeared delicately sad. Among seventy standard Noh masks previously rated by the individual participants, we chose six top-rated sad masks and six neutral masks to study the neural correlates of such delicate sadness. Results based on a region of interest analysis indicated the activation of the right amygdala while viewing sad masks. We suggest the fact that such delicate sad masks could activate the amygdala, and it could possibly be because of an underlying similarity to emotions such as fear and disgust.

Multifunctional squalene-based prodrug nanoparticles for targeted cancer therapy. Fluorescent and biotinylated squalene-gemcitabine prodrug nanoparticles exhibiting high drug payloads have been prepared and successfully used to target different cancer cell lines, resulting in increased cell uptake and improved anticancer efficiency, which represents the first targeted system derived from the squalenoylation approach.

Parathyroid imaging: the importance of dual-radiopharmaceutical simultaneous acquisition with 99mTc-sestamibi and 123I. Our objective was to compare the accuracy of 3 imaging protocols for the detection of parathyroid adenomas: single-tracer, dual-phase imaging with (99m)Tc-sestamibi; dual-tracer, single-phase imaging with simultaneous acquisition of (99m)Tc-sestamibi and (123)I images; and dual-tracer, dual-phase imaging with simultaneous acquisition of (99m)Tc-sestamibi and (123)I images. Thirty-seven patients with surgical proof of parathyroid adenomas were evaluated. Three different protocols were derived from a single study in each patient, resulting in an intrapatient intrastudy comparison. The first derived protocol was the conventional dual-phase protocol with (99m)Tc-sestamibi consisting of anterior and anterior-oblique pinhole images of the neck at 15 min and 3 h plus parallel-hole images of the neck and upper chest at both imaging times. The second derived protocol was a dual-tracer, single-phase protocol consisting of administration of (123)I followed 2 h later by (99m)Tc-sestamibi. Fifteen minutes later, anterior and anterior oblique pinhole images of the (99m)Tc-sestamibi and (123)I were acquired simultaneously, allowing generation of perfectly coregistered subtraction images. Parallel-hole images of the neck and upper chest were also obtained. The third protocol was the same as the second except that the same imaging protocol was repeated at 3 h. Two experienced nuclear medicine physicians indicated the location of any identified lesion and graded the certainty of diagnosis on a 3-point scale. Thirty-seven patients had 41 parathyroid adenomas. For the 2 observers combined, the localization success rate was 66% for the single-tracer, dual-phase protocol; 94% for the dual-tracer, single-phase protocol; and 90% for the dual-phase, dual-tracer protocol. Both dual-tracer protocols were significantly more accurate than the single-tracer protocol (P < 0.01); there was no significant difference between the 2 dual-tracer protocols. In addition, the degree of certainty of localization was greater with the 2 dual-tracer protocols than the single-tracer protocol (P < 0.001). A dual-tracer, single-phase parathyroid imaging protocol consisting of simultaneous acquisition of (99m)Tc-sestamibi and (123)I images with pinhole collimation at 15 min and perfectly coregistered subtraction results in a higher degree of accuracy and a greater degree of diagnostic certainty than the commonly used single-tracer, dual-phase protocol of imaging (99m)Tc-sestamibi alone at 15 min and 3 h. The addition of delayed imaging to the dual-tracer protocol did not improve results.

Stress proteins are used by the immune system for cognate interactions with anti-inflammatory regulatory T cells. Since the initial discovery of the protective role of heat shock protein (HSP) 60 in arthritis, T cell recognition of endogenous HSP was found to be one of the possible underlying mechanisms. Recently we have uncovered potent disease-suppressive Tregs (anti-inflammatory immunosuppressive T cells) recognizing HSP70 self-antigens, and enabling selective targeting of such Tregs to inflamed tissues. HSP70 is a major contributor to the major histocompatibility complex (MHC) Class II ligandome and we have shown that a conserved HSP70-epitope (B29) is abundantly present in murine MHC Class II. Upon transfer, B29-induced CD4+CD25+Foxp3+T cells suppressed established proteoglycan-induced arthritis (PGIA) in mice. These self-antigen specific Tregs were activated in vivo and as little as 4.000 cells sufficed to fully inhibit arthritis. Furthermore, in vivo depletion of transferred Tregs abrogated disease suppression. Given that B29 can be presented by most human MHC class II molecules and that B29 inhibited arthritis in HLA-DQ8 (human MHC) transgenic mice, we feel that therapeutic vaccination with selected HSP peptides can be an effective route for induction of anti-inflammatory Tregs as a novel intervention in chronic inflammatory diseases.

Outcome and medical management in dogs with lower motor neuron disease undergoing mechanical ventilation: 14 cases (2003-2009). To describe the application of intermittent positive pressure ventilation (IIPV) in dogs with lower motor neuron disease (LMND). Multi-institutional, retrospective study (2003-2009). Intensive care units at multiple university teaching hospitals. Fourteen dogs with LMND that underwent IIPV. None. The ventilatory logs of 4 teaching hospitals were searched for dogs undergoing IIPV in association with a diagnosis of acute LMND. The medical records were evaluated for signalment, specific LMND, ventilatory management and duration, complications associated with ventilation, duration of hospitalization, and outcome. Descriptive statistics were used as indicated. Fifteen records were evaluated, 1 dog was excluded since it experienced cardiopulmonary arrest (CPA) before commencement of IIPV. The median age was 7.0 years (range 10 mo to 12 y). There were 5 Labrador retrievers, 4 mixed breeds, and 5 other breeds were each represented once. Five dogs were diagnosed with myasthenia gravis, 4 dogs with polyradiculoneuritis, and 5 dogs had an undetermined LMND. Clinical signs of weakness before ventilation were present for a median of 36 hours (range 6 h to 14 d). Dogs were ventilated for a median of 109 hours (range 5-261 h). Nine dogs had temporary tracheostomies performed, and 8 dogs received nutritional support. Five dogs developed ventilator associated pneumonia. Six dogs were successfully weaned from the ventilator with a median ventilatory time of 49 hours (range 25-192 h). Three dogs survived to discharge. No single LMND was associated with a better outcome. High euthanasia rates and iatrogenic complications limit the ability to accurately prognosticate for affected dogs in this retrospective study, but in dogs with LMND that is severe enough to require IIPV, support may be required days to weeks.

[Spectral analysis of chromatin and its components in the vacuum ultraviolet region of the spectrum]. Electronic absorption spectra of thin films of chromatin and chromatin components in ultraviolet (140-280 nm) were investigated. The absorption coefficients mu (lambda) of chromatin, nucleosomes with and without histone H1, total histones (TH), DNA were compared. The spectra of nucleosomes and chromatin differ from summary spectra of DNA + TH. The lack of additivity of absorption coefficients at different wavelengths may be explained by different conformational changes of free DNA, TH and DNA, TH in nucleosomes and chromatin during the process of drying aqueous solutions for the preparations of thin films. The obtained mu (lambda) values are necessary for the estimation of the DNA and TH parts of absorption in chromatin and nucleosomes in the investigations of UV and VUV irradiation damages.

[Career wishes and career worries of medical students--results of focus group interviews]. In addition to a prospective longitudinal study of career determinants in young physicians the aim of the present qualitative study was to gather information on 1. experiences by medical students during their clinical year, 2. their understanding of career, 3. their career desires and worries regarding the compatibility of profession and family, and 4. their wishes of career promotion. Twenty-two subjects from the initial sample of 377 students from the three medical schools in the German-speaking part of Switzerland in their senior year agreed to participate in focus groups. The interviews were structured by an interview guideline, the material was tape-recorded, transcribed, paraphrased, and categorised. 1. The experiences during the clinical year mainly brought a gain of practical skills. Female students were disillusioned by the daily routine at the hospital. 2. Career was associated with a poor quality of life. 3. Regarding career wishes male students showed more optimistic attitudes, while female students suppressed their career wishes in prospect of a spouse and/or family. Female and male students had rather traditional ideas about the compatibility of their profession and family. The only acceptable models were the so-called life cycle model (professional work - family phase - return to work for women) or a reduced professional engagement of the woman during the family phase. 4. The majority of the participants wanted some sort of career promotion, female students at the beginning, males rather in a later stage of their career. The results of the longitudinal study will show whether the assessments of the subjects in the focus groups will be confirmed during their further career.

Recommendations for reporting the results of studies of instrument and scale development and testing. Scales and instruments play an important role in health research and practice. It is important that studies that report on their psychometric properties do so in a way such that readers can understand what was done and what was found. This paper is a guide to writing articles about the development and assessment of these tools. It covers what should be in the abstract and how key words should be chosen. The article then discusses what should be in the main parts of the paper: the introduction, methods, results and discussion. In each of these parts, it suggests the statistical tests that should be used and how to report them. The emphasis throughout the paper is that reliability and validity are not fixed properties of a scale, but depend on an interaction among it, the population being evaluated and the circumstances under which the instrument is administered.

Health care costs of heart failure: results from a randomised study of patient education. Heart failure is a serious syndrome with a bad prognosis. Hospitalisation is common and readmittance rate is high; factors which influence the cost of care and treatment. Only scarce data on detailed patient materials regarding health care costs are known. To describe in detail the health care costs for heart failure patients. Costs for patients (n=108) who completed a randomised education trial were studied for 6 months after hospital discharge. Costs for hospital stay, out-patient visits, diagnostic tests and procedures, laboratory analyses and drug treatment were calculated. Official unit prices list used to reimburse providers of cross-boundary health services and prices for drugs in the Swedish Drug Compendium were employed. The total cost for a heart failure patient was approximately 20000 SEK (2564 US$, 7.80 SEK=1 US$) for 6 months. There was a 27-fold variation between patients. There was no relation between age or sex and cost. In decreasing order cost for hospitalisation was followed by costs for out-patient visits, diagnostic tests and procedures, laboratory analyses and drugs. Hospitalisation was the largest part of the total cost and there was a large inter-individual variation. Efforts to reduce the economic burden should be focused on hospitalisation. Due to skewed distribution, individual data must be considered in the analysis of the efforts.

Identification of important abiotic and biotic factors in the biodegradation of poly(l-lactic acid). The biodegradation of four poly(l-lactic acid) (PLA) samples with molecular weights (MW) ranging from approximately 34 to 160kgmol(-1) was investigated under composting conditions. The biodegradation rate decreased, and initial retardation was discernible in parallel with the increasing MW of the polymer. Furthermore, the specific surface area of the polymer sample was identified as the important factor accelerating biodegradation. Microbial community compositions and dynamics during the biodegradation of different PLA were monitored by temperature gradient gel electrophoresis, and were found to be virtually identical for all PLA materials and independent of MW. A specific PLA degrading bacteria was isolated and tentatively designated Thermopolyspora flexuosa FTPLA. The addition of a limited amount of low MW PLA did not accelerate the biodegradation of high MW PLA, suggesting that the process is not limited to the number of specific degraders and/or the induction of specific enzymes. In parallel, abiotic hydrolysis was investigated for the same set of samples and their courses found to be quasi-identical with the biodegradation of all four PLA samples investigated. This suggests that the abiotic hydrolysis represented a rate limiting step in the biodegradation process and the organisms present were not able to accelerate depolymerization significantly by the action of their enzymes.

Barriers to Effective Deliberation in Clinical Research Oversight. Ethical oversight of clinical research is one of the primary means of ensuring that human subjects are protected from the natural bias of researchers and research institutions in favor of experimentation. At a minimum, effective oversight should ensure that risks are minimized and reasonable in relation to anticipated benefits, protect vulnerable subjects from potential coercion or undue influence, ensure full and informed consent, and promote the equitable distribution of the risks and benefits of research. Because these assessments often involve value judgments for which there are no agreed-upon objective standards, we rely on deliberative procedures thought to have the greatest likelihood of producing the right or best outcomes. Concerns about the potential for improperly functioning IRBs to waste scarce human and institutional resources and impede biomedical progress have motivated a surge in empirical research assessing their procedures and outcomes. Yet within this literature, there has been minimal attention paid to the social scientific evidence regarding how individuals and deliberating groups make decisions, nor how those data might inform IRB practice. This essay seeks to fill that gap, locating recent empirical data on IRB composition and process within the context of data regarding what I call "deliberative pathologies," or instances when deliberation fails to live up to one or more aspect of the deliberative ideal because of systematic biases in the ways participants interact. The paper goes on to make evidence-based recommendations to reduce the vulnerability of IRB deliberations to the kinds of pathologies discussed and indicate directions for future research.

Factors associated with survival in pediatric extracorporeal membrane oxygenation--a single-center experience. We aimed to examine outcomes of extracorporeal membrane oxygenation (ECMO) therapy in the pediatric population and identify pre-ECMO and on-ECMO characteristics that are associated with survival. We retrospectively reviewed the ECMO records at our institution between 1999 and 2008 and selected pediatric patients who were cannulated for respiratory failure or hemodynamic instability resistant to conventional interventions. We recorded details of pre-ECMO clinical characteristics, including blood gas variables and mechanical ventilatory support, and details of ECMO therapy including survival off ECMO and to hospital discharge. Predictors of survival were analyzed using logistic regression modeling and a prediction algorithm was developed. Of the 445 ECMO runs, data from 58 consecutive patients were analyzed: 57% were successfully decannulated, and 48% survived to discharge from the hospital. The cohort included 32 (55%) female patients, 22 postoperative patients (38%), and 15 (26%) with an immunosuppressive condition, with a median age of 5 years and weight 19.5 kg, The mean duration of pre-ECMO respiratory support was 3 days, in the form of high-frequency oscillatory ventilation (n = 28, 48%) and conventional mechanical ventilation (n = 13, 22%). The median duration (interquartile range) of ECMO support was 142 hours (60, 321) or 5.9 days. Pre-ECMO pH above 7.2 (P < .001) and oxygenation index below 35 (P = .021) were associated with the highest survival rates. Pre-ECMO PaCO(2) and duration of mechanical ventilation were not associated with survival. Based on our results, ECMO therapy should be considered early in children with oxygenation index greater than 35 with worsening metabolic status. The restriction of ECMO based on ventilator days alone needs to be revisited in this era of lung protective ventilation.

Spectrum of cutaneous hyperalgesias/allodynias in neuropathic pain patients. The aim of this study was to discern the pathophysio-logical bases for neuropathic hyperalgesias. In this study, neurological and neurophysiological evaluation of 132 consecutive hyperalgesia patients using rigorous clinical and laboratory protocols were carried out. Two discrete semeiologic entities emerged: classic neurological vs atypical, fulfilling taxonomically complex regional pain syndrome (CRPS) II and I, respectively. The classic group (34.9%) exhibited sensorimotor patterns restricted to nerve distribution and documented nerve fiber dysfunction. Among them four (3.03%) had sensitization of C-nociceptors, seven (5.3%) had central release of nociceptive input, and 35 (26.52%) probable ectopic nerve impulse generation. The atypical group (65.1%) displayed weakness with interrupted effort; non-anatomical hypoesthesia and hyperalgesia; hypoesthesia or paresis reversed by placebo, or atypical abnormal movements, and physiological normality of motor and sensory pathways. Spatiotemporal features of neuropathic hyperalgesia constitute key criteria for differential diagnosis between CRPS II and I and, together with other behavioral sensorimotor features, signal psychogenic pseudoneurological dysfunction vs structural neuropathology. 'Neuropathic' hyperalgesias may reflect neuropathological or psychopathological disorders.

[Conscious ability following hanging--a triple attempt]. Report of a case of suicidal hanging which was fatal on the third attempt. In spite of the fact that the first two ligatures tore but remained throttling around the neck, a possibility of action was apparently existent over a longer period, allowing a third and fatal strangulation attempt.

Transition-Metal-Free N-Arylation of Amines by Triarylsulfonium Triflates. A simple and efficient method for transition-metal-free N-arylation of various amines by triarylsulfonium triflates is described. Both aliphatic and aromatic amines were smoothly converted at 80 °C in the presence of tBuOK or KOH to give the corresponding mono N-arylated products in good to high yields. The molar ratios of the reactants and the choice of bases had a big effect on the reaction. When a large excess of [Ph3 S][OTf] and tBuOK were employed for primary amines under the standard conditions, the bis(N-phenyl) products were predominantly formed. This method was also applicable to the synthesis of bioactive N-phenyl amino acid derivatives. The control experiments, the deuterium labelling study, and the presence of regioisomers of N-arylated products when using 4-substituted triarylsulfonium triflates suggested that the reaction might proceed through an aryne intermediate. The present protocol demonstrated that triarylsulfonium salts are versatile arylation reagents in the construction of CAr -N bonds.

Plastic bullet injury: a case report. Plastic bullets have been introduced into Northern Ireland for use by the Security Forces in riot control. They are alleged to be more accurate in flight than the rubber bullet and are cheaper to produce. The injuries to a patient caused by a plastic bullet are described.

A novel method for determination of patulin in apple juices by GC-MS. A reliable gas chromatography-mass spectrometry with a QuEChERS procedure has been developed and validated for detection and determination of patulin in apple juice. This procedure includes initial extraction step with acetonitrile, partitioning step by addition of magnesium sulphate, sodium carbonate and sodium chloride, and clean-up step using dispersive solid-phase extraction by addition of a mixture of magnesium sulphate and primary secondary amine sorbent. In order to increase GC adoptability of patulin, derivatisation step was performed using N,O-bis-trimethylsilyl trifluoroacetamide. Method recoveries of patulin from apple juice samples ranged from 79.9% to 87.9%. Limit of detection (LOD) and quantification (LOQ) were 0.4 and 1.3 μg/L, respectively. Relative standard deviations were lower than 9.5%. The developed method has been successfully applied to the analysis of patulin in apple juice samples.

Nitrous oxide and epinephrine-induced arrhythmias. We asked whether the sympathomimetic effect of nitrous oxide (N2O) predisposed patients receiving N2O to arrhythmias in response to epinephrine administration. We also asked whether aging contributed to the development of arrhythmias, with or without N2O. One hundred patients having transsphenoidal hypophysectomy were randomly assigned to receive anesthesia including (n = 49) or excluding (n = 51) N2O. All patients were given an injection of epinephrine 1:200,000, with 0.5% lidocaine to produce hemostasis. Using intermittent 12-lead and continuous lead II electrocardiography, we determined the incidence of premature ventricular contraction, isorhythmic atrioventricular (AV) dissociation, and changes in T-wave morphology. Patients given N2O had a significantly higher incidence of isorhythmic AV dissociation (61.2% vs 41.2%). A trend toward a higher incidence of multiple premature ventricular contractions (16.3% vs 7.8%) was not statistically significant. Both anesthetic groups had a high incidence of postoperative changes in T-wave morphology (46.9% in the N2O group vs 50.9% in the group not given N2O). Aging alone did not affect the incidence of ventricular ectopic beats, isorhythmic AV dissociation, or changes in electrocardiographic morphology, but correlated with the development of ventricular ectopy during N2O anesthesia. We conclude that the use of N2O correlated with a higher incidence of isorhythmic AV dissociation in response to injection of epinephrine with lidocaine.

Epstein-Barr virus infection and immunity in bone marrow transplant recipients. Studies on patients for up to one year following allogeneic, HLA-matched bone marrow transplants have shown no increased incidence of salivary Epstein-Barr (EB) virus secretion and no significant rise in EB-virus-specific antibody titers. EB-virus-specific cytotoxic T cells could be detected in the peripheral blood of all patients by six months posttransplant. For up to one year posttransplantation in vitro EB virus infection of peripheral blood B lymphocytes from the majority of patients leads to an abortive infection followed by cell death, and without the establishment of continuously growing cell lines. This abnormality appeared to be due to patients' monocytes, which formed a defective feeder cell layer in culture, and it could be circumvented by culturing the EB-virus-infected B cells from patients on a feeder layer of x-irradiated adherent cells from normal peripheral blood. These findings may explain the relative lack of EB-virus-associated lymphoma seen in bone marrow transplant recipients when compared with other groups of transplant patients.

Changes in phospholipid composition and calcium flux in LLC-PK cells cultured at low magnesium concentrations. Monolayers of porcine kidney cells (LLC-PK) were grown in a series of Nu-Serum-supplemented media containing different Mg(2+) concentrations (480, 250, 25, 6.3 or 2.6 microM) to study the effect of Mg(2+) depletion on cellular phospholipid changes and the consequent effect on the membrane permeability to Ca(2+). Cells grown on 6.3 or 2.6 microM Mg(2+) showed a decrease in PE, PS, Sph, PI and an increase of PC. These changes were attributed mainly to the decreased rate of Sph synthesis through the transfer of phosphocholine from PC to ceramide, or due to the increase of PE N-methylation as found in Mg(2+)-deficient cells. The (45)Ca uptake was increased in cells grown on 25.0 microM Mg(2+), while it was decreased in cells grown on 6.3 or 2.6 microM Mg(2+). These changes in Ca(2+) uptake were related to changes of cellular phospholipids and fatty acids which affect adenylate cyclase activity in the membrane, as well as the membrane fluidity.

Sitosterolemia presenting with severe hypercholesterolemia and intertriginous xanthomas in a breastfed infant: case report and brief review. Sitosterolemia is an autosomal recessive disorder characterized by increased intestinal absorption of plant sterols. It is caused by mutations in genes encoding ATP-binding cassette, subfamily G5 (ABCG5) or G8 (ABCG8), and clinical features include elevated plant sterol levels, xanthomas, and accelerated atherosclerosis. Although it was originally reported in patients with normolipemic xanthomas, patients with sitosterolemia also hyperabsorb cholesterol, and serum cholesterol levels tend to be elevated. We report an infant with sitosterolemia who presented with severe hypercholesterolemia and intertriginous xanthomas. A 15-month-old Korean girl presented with yellow dermal plaques over flexural areas including the wrist, neck, and gluteal folds, which were consistent with intertriginous xanthomas. The lesions were first noticed at 3 months of age when she was being exclusively breastfed. Her total cholesterol and low-density lipoprotein-cholesterol levels were 675 and 540 mg/dL, respectively. A low-fat/low-cholesterol diet and cholestyramine therapy were introduced. Unexpectedly, her serum cholesterol level decreased dramatically and normalized in 2 months. Cholestyramine was tapered off. The xanthomas also regressed and disappeared by 3 years of age. Gas chromatography-mass spectrometric analysis was performed with serum drawn at 3 years of age when her low-density lipoprotein-cholesterol was 118 mg/dL, which revealed striking elevation of her sitosterol level at 19.36 mg/dL. Direct sequencing for ABCG5 revealed compound heterozygous null mutations c.904+1G>A (p.Met302Asnfs*82) and c.1336C>T(p.Arg446*). Our case suggests that sitosterolemia can present with severe hypercholesterolemia and intertriginous xanthomas. Sitosterolemia should be suspected when a patient with hypercholesterolemia shows unexpectedly good response to dietary modification or bile acid sequestrant therapy.

Quantum dot based fluorometric detection of cancer TF-antigen. Cancer is a major global health challenge that would benefit from advances in screening methods for early detection that are rapid and low cost. TF-antigen is a tumor-associated antigen displayed on cell surface proteins of a high percentage of human carcinomas. Here we present a fluorometric bioassay for TF-antigen (galactose-β-(1→3)-N-acetyl-d-galactosamine) that utilizes quantum dot (QD) technology coupled with magnetic beads for rapid detection of TF-antigen at high sensitivity (10(-7) M range). In the competitive bioassay, 4-aminophenyl β-d-galactopyranoside (4-APG) conjugated to QDs competes with TF-antigen for binding sites on peanut agglutinin (PNA) that is immobilized on magnetic beads. The bioassay is specific and ultrasensitive in the environment of complex protein mixtures, demonstrating its potential applicability for the screening of clinical samples.

Characterization of the interleukin 1 receptor-associated kinase 4 (IRAK4)-encoding gene in salmonid fish: the functional copy is rearranged in Oncorhynchus mykiss and that factor can impair TLR signaling in mammalian cells. The interleukin 1 receptor-associated kinase 4 (IRAK4) is an essential factor for TLR-mediated activation of the host's immune functions subsequent to pathogen contact. We have characterized the respective cDNA and gene sequences from three salmonid species, salmon, rainbow trout and maraena whitefish. The gene from salmon is structured into eleven exons, as is the mammalian homologue, while exons have been fused in the genes from the two other salmonid species. Rainbow trout expresses also a pseudogene at low levels. Its basic structure resembles more closely the primordial gene than the functional copy does. The N-terminal death domain and the C-terminal protein kinase domain of the factors are better conserved throughout evolution than the linker domain. The deduced amino acid sequences of the factors from all three species group together in an evolutionary tree of IRAK4 factors. Scrutinizing expression and function of IRAK4 from rainbow trout, we found its highest expression in head kidney and spleen and lowest expression in muscle tissue. Infecting fish with Aeromonas salmonicida did not modulate its expression during 72 h of observation. Expression of a GFP-tagged trout IRAK4 revealed, expectedly, its cytoplasmic localization in human HEK-293 cells. However, this factor significantly quenched in a dose-dependent fashion not only the pathogen-induced stimulation of NF-κB factors in the HEK-293 reconstitution system of TLR2 signaling, but also the basal NF-κB levels in unstimulated control cells. Our data unexpectedly imply that IRAK4 is involved in establishing threshold levels of active NF-κB in resting cells.

Atypical onset of symptoms in Huntington disease: severe cognitive decline preceding chorea or other motor manifestations. To describe the onset of Huntington disease (HD) in a patient with atypical progression of symptoms. The authors report the case of a 39-year-old man with severe cognitive impairment and diffuse cortical atrophy before the onset of motor manifestations or symptoms of an extrapyramidal movement disorder. Clinical examinations, neuropsychologic assessments, magnetic resonance imaging, electroencephalogram, and genetic testing were conducted. Although HD was eventually confirmed through genetic testing, chorea was not part of the clinical picture until well after the patient had developed a frank dementia, with a decline in global intellectual functioning, memory deficits, slowed information processing speed, and executive dysfunction. This case indicates HD may present with atypical clinical features in the early course of the disease, and warrants diagnostic consideration in patients with early dementia of unknown etiology.

Precursor RNAs harboring nonsense codons accumulate near the site of transcription. Messenger RNAs containing premature termination codons (PTCs) are selectively eliminated by nonsense-mediated mRNA decay (NMD). Paradoxically, although cytoplasmic ribosomes are the only known species capable of PTC recognition, in mammals many PTC-containing mRNAs are apparently eliminated prior to release from the nucleus. To determine whether PTCs can influence events within the nucleus proper, we studied the immunoglobulin (Ig)-mu and T cell receptor (TCR)-beta genes using fluorescent in situ hybridization (FISH). Alleles containing PTCs, but not those containing a missense mutation or a frameshift followed by frame-correcting mutations, exhibited elevated levels of pre-mRNA, which accumulated at or near the site of transcription. Our data indicate that mRNA reading frame can influence events at or near the site of gene transcription.

The surgical correction of varicocele: multidisciplinary study on semen evaluation and prognostic factors for fertility. The seminal pattern was studied in a group of 52 patients before and six months after sclerotherapy of varicocele. In this series, we studied the differences in clinical and seminal characteristics between the group that succeeded in obtaining a pregnancy and the group that remained infertile after 1 year follow-up. The difference in pregnancy rate is discussed between the operated group and a control group of pz, who refused any form of surgery, after 1 year follow-up.

Work-related musculoskeletal conditions: evidence from the THOR reporting system 2002-2005. Musculoskeletal disorders (MSDs) are commonly encountered in current occupational health practice and comprise up to 45% of the workload for occupational physicians (OPs). To compare the reported incidence of work-related (WR) MSDs by specialist OPs and specialist rheumatologists and to relate it to self-reported and general practitioners-reported WR MSDs. Analysis of data reported to surveillance schemes within The Health and Occupation Reporting network and comparison to denominator data derived from the Labour Force Survey and occupational/work activity classifications. There are significant differences between the patterns of WR MSDs seen by the different specialist groups. Thus OPs report three times as many back and lower limb conditions. However, both specialist groups report similar numbers of cases of hand-arm vibration syndrome (12/9%) and 'vague and ill-defined' upper limb conditions (16/14%). The absolute risk of physician reported that WR MSDs increases 5-fold between ages 15-24 and 45-64. The specialist reporting schemes give an indication of current practice and are useful both to update and to strategically inform planning. The data are amenable, with appropriate statistical analysis, for comparison with self-reporting and to the characterization of risk in broad categories of occupation and work activity.

"Atypical" posteroseptal accessory pathway in Wolff-Parkinson-White syndrome. The posteroseptal accessory pathway in the Wolff-Parkinson-White syndrome is associated with a delta wave that is negative in the inferior electrocardiographic (ECG) leads and the occurrence of the earliest retrograde atrial activation near the orifice of the coronary sinus during atrioventricular (AV) reentrant tachycardia. Seventy-two patients with a posteroseptal accessory pathway underwent epicardial mapping before operative ablation. The earliest epicardial activation occurred at the posterosuperior process of the left ventricle in all patients. Dissection of the posteroseptal region (right atrial-left ventricular sulcus) resulted in permanent loss of preexcitation in 69 patients and failure to abolish preexcitation permanently in 3. At reoperation in two patients, preexcitation was abolished by discrete cryoablation of the left side of the interatrial septum near the AV node approached through the atrial septum in the normothermic beating heart. At reoperation, one patient had extensive AV node dissection. All patients have had permanent loss of preexcitation. The vast majority of posteroseptal accessory pathways ("typical") are epicardial and ablated by dissection of the posteroseptal region. Rarely, posteroseptal accessory pathways are "atypical" in that they are intraseptally located near the AV node on the left atrial endocardial surface.

Morphology of subcortical brain nuclei is associated with autonomic function in healthy humans. The autonomic nervous system (ANS) is a brain body interface which serves to maintain homeostasis by influencing a plethora of physiological processes, including metabolism, cardiorespiratory regulation and nociception. Accumulating evidence suggests that ANS function is disturbed in numerous prevalent clinical disorders, including irritable bowel syndrome and fibromyalgia. While the brain is a central hub for regulating autonomic function, the association between resting autonomic activity and subcortical morphology has not been comprehensively studied and thus was our aim. In 27 healthy subjects [14 male and 13 female; mean age 30 years (range 22-53 years)], we quantified resting ANS function using validated indices of cardiac sympathetic index (CSI) and parasympathetic cardiac vagal tone (CVT). High resolution structural magnetic resonance imaging scans were acquired, and differences in subcortical nuclei shape, that is, 'deformation', contingent on resting ANS activity were investigated. CSI positively correlated with outward deformation of the brainstem, right nucleus accumbens, right amygdala and bilateral pallidum (all thresholded to corrected P < 0.05). In contrast, parasympathetic CVT negatively correlated with inward deformation of the right amygdala and pallidum (all thresholded to corrected P < 0.05). Left and right putamen volume positively correlated with CVT (r = 0.62, P = 0.0047 and r = 0.59, P = 0.008, respectively), as did the brainstem (r = 0.46, P = 0.049). These data provide novel evidence that resting autonomic state is associated with differences in the shape and volume of subcortical nuclei. Thus, subcortical morphological brain differences in various disorders may partly be attributable to perturbation in autonomic function. Further work is warranted to investigate these findings in clinical populations. Hum Brain Mapp 39:381-392, 2018. © 2017 Wiley Periodicals, Inc.

A computerized national Blood Donor Deferral Register. With blood given exclusively by volunteer donors, the American National Red Cross (ANRC) Blood Program aims to supply patients needing transfusion with blood products of the highest quality. The use of blood from volunteers, with its established greater safety, combined with laboratory testing to detect carriers of hepatitis B surface antigen (HB-SAg) and modern computer technology, creates an effective system to reduce the risk of post-transfusion hepatitis. The ANRC has devised a national Donor Deferral System, which is designed to minimize the transmission of hepatitis by blood and blood products.

Innovative approaches to the use of polyamines for DNA nanoparticle preparation for gene therapy. Advances in genomic technologies, such as next generation sequencing and disease specific gene targeting through anti-sense, anti-gene, siRNA and microRNA approaches require the transport of nucleic acid drugs through the cell membrane. Membrane transport of DNA/RNA drugs is an inefficient process, and the mechanism(s) by which this process occurs is not clear. A pre-requisite for effective transport of DNA and RNA in cells is their condensation to nanoparticles of ~100 nm size. Although viral vectors are effective in gene therapy, the immune response elicited by viral proteins poses a major challenge. Multivalent cations, such as natural polyamines are excellent promoters of DNA/RNA condensation to nanoparticles. During the past 20 years, our laboratory has synthesized and tested several analogs of the natural polyamine, spermine, for their efficacy to provoke DNA condensation to nanoparticles. We determined the thermodynamics of polyamine-mediated DNA condensation, measured the structural specificity effects of polyamine analogs in facilitating the cellular uptake of oligonucleotides, and evaluated the gene silencing activity of DNA nanoparticles in breast cancer cells. Polyamine-complexed oligonucleotides showed a synergistic effect on target gene inhibition at the mRNA level compared to the use of polyamines and oligonucleotides as single agents. Ionic and structural specificity effects were evident in DNA condensation and cellular transportation effects of polyamines. In condensed DNA structures, correlation exists between the attractive and repulsive forces with structurally different polyamines and cobalt hexamine, indicating the existence of a common force in stabilizing the condensed structures. Future studies aimed at defining the mechanism(s) of DNA compaction and structural features of DNA nanoparticles might aid in the development of novel gene delivery vehicles.

Isolation and biological activity of frankiamide. An antibiotic produced by the symbiotic actinomycete Frankia strain AiPs1 was isolated from culture broth using optimized thin-layer chromatography and high-performance liquid chromatography (HPLC) methods. The novel compound that was isolated, dubbed frankiamide, displayed antimicrobial activity against all 14 Gram-positive bacterial strains and six pathogenic fungal strains tested. The pathogenic actinomycete Clavibacter michiganensis and the oomycete Phytophthora were especially susceptible. In addition to displaying antimicrobial activity, frankiamide also strongly inhibited 45Ca(2+) fluxes in clonal rat pituitary GH4C1 tumor cells and was comparable to a frequently used calcium antagonist, verapamil hydrochloride. The results of HPLC analysis, supported by both nuclear magnetic resonance and mass spectroscopy studies, showed that frankiamide has a high affinity for Na(+) ions.

Factors Affecting Enrolment in the Community Based Health Insurance Scheme of Chandranigahapur Hospital of Rautahat District. Low income countries face considerable challenges in financing health care for their populations. As its consequences, poor people don't have access to desired health services, drugs and medicine.To address the financial barriers to health services, Government of Nepal introduced Community Based Health Insurance scheme at selected health facilities. However, enrolment in the schemeis very low. This study aims to identify the associated factors affecting enrolment in the insurance scheme. A community based case-control study was conducted within the coverage area of CBHI scheme of Chandranigahapur Hospital. CBHI Scheme of Chandranigahapur Hospital was selected purposively. Altogether 416 households were interviewed using a structured questionnaire. The required number of sample size from the enrolled households as cases and equal number of non-enrolled households as controls were selected randomly in 1:1 ratio. The odds of enrolment in the CBHI scheme among male-headed households were found lower than female-headed households (AOR 0.251, 95% CI 0.097 to 0.652). Similarly household head belonging to upper caste/ethnic groups (AOR 3.981, 95% CI 2.027 to 7.816) as well aseducated household head(AOR 6.184, 95% CI 3.137 to 12.188)were more likely to enrol in the CBHI scheme. Households having >60 years elderly were found significantly associated with enrolment in CBHI scheme(AOR 3.996, 95% CI 2.130 to 7.497). Time to reach health facility as well as affordability of premium of the insurance scheme was also found significantly associated with enrolment in the CBHI scheme. The enrolment in the CBHI scheme is determined by combination of householdhead, household and health service related factors.These determinants should be addressed to enhance the enrolment in the insurance scheme.

Changes in the gonads, reproduction and generations of white rats under the effect of some pesticides. The problems of the gonadotropic effect of pesticides, together with changes in reproduction and in the offspring are of great interest and have drawn the attention of scientists during recent years. Assessment of these aspects should be made on the basis of integrated toxicological tests (weight, behaviour, mortality, fertility, etc.). They should be completed by some biochemical studies on homogenates of the testes (determination of RNA and DNA, as well as of enzyme systems which might relative to the metabolic processes in the sex tissue, according to the chemical nature of the examined noxa). These studies should be carried out in the parent generation (F0), directly exposed to chemical agents. The following generations, (F1-F3), not exposed to the agent, are submitted to the same analyses. with regard to the full assessment of the offspring some evaluation of the functional state of given organs (liver, brain, testes) might be performed.

Room-temperature synthesis of MnO2.3H2O ultrathin nanostructures and their morphological transformation to well-dispersed nanorods. MnO(2).3H(2)O ultrathin nanostructures with sizes of approximately 2-3 nm were synthesized at room temperature and transformation to well-dispersed nanorods was achieved after hydrothermal treatments.

Respective and interactive effects of doubled CO2 and O3 concentration on membrane lipid peroxidation and antioxidative ability of soybean. Effects of doubled CO2 and O3 concentration on Soybean were studied in open-top chambers (OTC). Under doubled CO2 concentration, grain yield and biomass increased, the SOD activity, vitamin C (Vc) and carotenoid (Car) content also increased; Superoxide (O2-*) generating rate decreased, relative conductivity and malondialdehyde (MDA) content significantly declined. But under doubled O3 concentration, the SOD activity, Vc and Car contents declined, resulting in imbalance of activated-oxygen production, enhanced O2-* generating rate and accelerated process of lipid peroxidation and increase in MDA content and ion leakage of leaves. The final result was decreased grain yield and plant biomass. Interactive effects of doubled CO2 and O3 concentrations on soybean were mostly counteractive. However, the beneficial effects of concentration-doubled CO2 more than compensate the negative effects imposed by doubled O3, and the latter in its turn partly counteracted the positive effects of the former.

Two new alcohol glycosides from the roots of Paeonia intermedia C. A. Meyer. Two new alcohol glycosides, 1-O-β-d-glucopyranosyl-deoxypaeonisuffrone (1) and 9-O-β-d-apiofuranoyl-(1→6)-β-d-glucopyranosyl-xanthoarnol (2), together with eight known compounds (3-10), have been isolated from the dried roots of Paeonia intermedia C. A. Meyer. Their structures were mainly elucidated on the basis of ESIMS, one- and two-dimensional NMR techniques. Antibacterial activities of compounds 1-10 were evaluated, and compounds 9 and 10 showed antibacterial activities against Staphylococcus argenteus CMCC26003 and Escherichia coli CMCC44103.

The singlet oxygen oxidation of chlorpromazine and some phenothiazine derivatives. Products and reaction mechanisms. A kinetic and product study of the reactions of chlorpromazine 1, N-methylphenothiazine 2, and N-ethylphenothiazine 3 with singlet oxygen was carried out in MeOH and MeCN. 1 undergoes exclusive side-chain cleavage, whereas the reactions of 2 and 3, in MeOH, afforded only the corresponding sulfoxides. A mechanism for the reaction of 1 is proposed where the first step involves an interaction between singlet oxygen and the side-chain dimethylamino nitrogen. This explains why no side-chain cleavage is observed for 2 and 3.

High prevalence of deep vein thrombosis in elderly hip fracture patients with delayed hospital admission. Deep vein thrombosis (DVT) is a common complication in hip fracture patients, associated with significant morbidity and mortality. Research has focused on postoperative DVT, with scant reports on preoperative prevalence. The aim of this study was to describe the prevalence of preoperative DVT in patients accessing medical care ≥ 48 h after a hip fracture. We included elderly patients admitted ≥ 48 h after sustaining a hip fracture, between September 2015 and October 2017. Patients with a previous episode of DVT, undergoing anticoagulation therapy, with pathologic fractures or undergoing cancer treatment were excluded. Of 273 patients, 59 were admitted at least 48 h after the fracture. DVT screening by Doppler ultrasound of both lower extremities was carried upon hospital admission. We recorded age, sex, Charlson comorbidity index and ASA score, fracture type, time since injury, time from admission to surgery and total length of hospital stay. We studied 41 patients, 79 (± 10.34) years old. The delay from injury to admission was 120 h (48-696 h). Seven patients (17.1%) had a DVT upon admission. There were no significant differences between patients with and without DVT, regarding time from admission to surgery or the total length of the hospital stay. The prevalence of DVT in patients admitted ≥ 48 h after a hip fracture was 17.1%. The diagnosis and management of DVT did not increase time to surgery or hospital stay. Our results suggest routine screening for DVT in patients consulting emergency services ≥ 48 h after injury.

Quantitative real-time PCR based on single copy gene sequence for detection of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. To establish a method for quantification of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis from subgingival plaque by real-time polymerase chain reaction (PCR) technique. Bacterial cells from both species were obtained from type culture and counted microscopically. Cellular suspension in sterile distilled water was used for DNA extraction by boiling for 20 min, with a mineral oil cover. Primers for PCR were selected from sequences of LktC gene (A. actinomycetemcomitans) and Arg-gingipain (P. gingivalis) to yield amplicons below 100 bp. SYBR Green I based real-time PCR was adjusted to quantify separately both species. A good sensitivity and specificity were obtained for both species, although the yield was better for A. actinomycetemcomitans. A good repeatability of cycle threshold (CT) was encountered, so coefficient of variation was below 6% at every initial copy number. A new method of quantification of A. actinomycetemcomitans and P. gingivalis based on SYBR Green real-time PCR is presented. Its good sensibility and repeatability will allow its application to analysis of subgingival plaque samples.

In vitro attachment of bovine hatched blastocysts on fibronectin is mediated by integrin in a RGD dependent manner. We investigated the effect of extracellular matrix protein on in vitro attachment and outgrowth of bovine hatched blastocysts. In vitro produced bovine hatched blastocysts were cultured on a fibronectin- or laminin-coated Petri dishes. Hatched blastocysts adhered and outgrew on the fibronectin-coated dish whereas no attachment was observed on the laminin-coated dish. The attachment and outgrowth on fibronectin were significantly inhibited in the presence of synthetic peptides containing the Arg-Gly-Asp (RGD) sequence, which interacts with the fibronectin receptor (integrin alpha5beta1), but were not inhibited by the control peptides containing the Arg-Gly-Glu (RGE) sequence. Addition of anti-fibronectin receptor (integrin alpha5beta1) antibody to the culture medium also inhibited the attachment and outgrowth on fibronectin-coated Petri dishes. Subsequently we examined mRNA expression and protein expression of alpha5 and beta1 integrin subunit in the hatched blastocyst by reverse transcription-polymerase chain reaction (RT-PCR) and immunostaining, respectively. Expression of both mRNA and protein were detected in blastocysts. These results indicate that trophectoderm cells of bovine hatched blastocysts have already acquired the ability to adhere and outgrow on fibronectin in vitro by an integrin- mediated manner.

[In vitro organogenesis in Dalbergia retusa (Papilonaceae)]. Plants were obtained via organogenesis from hypocotyl explants of Dalbergia retusa from in vitro germinated seedlings. Adventitious bud induction was achieved on Murashige and Skoog medium containing five BA (benzyladenine) concentrations. The best BA concentration for budding induction and budding development was 8.8 microM. Shoot rooting was obtained on half-strength modified MS basal medium, supplemented with 20 g x l(-1) of sucrose and five concentrations of indole-3-butyric acid (IBA). The highest number of shoot rooting was obtained with 19.7 microM IBA but the highest average number of roots for plantlet was achieved with 24.6 microM IBA. Plants were transferred to greenhouse conditions.

Long-term effect of Boston brace treatment on renal function in patients with idiopathic scoliosis. The long-term effects of Boston brace treatment on renal function were studied in 20 patients with idiopathic scoliosis. Renal function was tested by clearances of inulin and para-aminohippurate sodium (PAH) when the brace was first applied as well as after four and 12 months of brace treatment. Each function test was performed without and with the brace. The glomerular filtration rate decreased when the brace was first applied, was unchanged after four months, and increased after 12 months. Renal plasma flow decreased when the brace was first applied but was unchanged after four and 12 months. Urinary sodium excretion decreased to values lower than those of control subjects when the brace was first applied, but an adaptive increase was noted after four and 12 months of brace treatment. The acute effects of brace application were observed even after four and 12 months of treatment; an increase in urinary sodium excretion was found when the brace was removed.

Regulation of Jumonji-domain-containing histone demethylases by hypoxia-inducible factor (HIF)-1alpha. The transcription factor HIF (hypoxia-inducible factor) mediates a highly pleiotrophic response to hypoxia. Many recent studies have focused on defining the extent of this transcriptional response. In the present study we have analysed regulation by hypoxia among transcripts encoding human Fe(II)- and 2-oxoglutarate-dependent oxygenases. Our results show that many of these genes are regulated by hypoxia and define two groups of histone demethylases as new classes of hypoxia-regulated genes. Patterns of induction were consistent across a range of cell lines with JMJD1A (where JMJD is Jumonji-domain containing) and JMJD2B demonstrating robust, and JMJD2C more modest, up-regulation by hypoxia. Functional genetic and chromatin immunoprecipitation studies demonstrated the importance of HIF-1alpha in mediating these responses. Given the importance of histone methylation status in defining patterns of gene expression under different physiological and pathophysiological conditions, these findings predict a role for the HIF system in epigenetic regulation.

[Management of severe Budd-Chiari syndrome by spleen-internal jugular venous shunt]. To study the operative method for severe Budd-Chiari syndrome. 17 patients with severe Budd-Chiari syndrome were treated with splenectomy and spleen-internal jugular venous shunt. Follow up for 3 to 20 months 11 patients showed excellent results, 5 good results and 1 died. Spleen-internal jugular shunt is effective for the patients with severe Budd-Chiari syndrome.

[Leveling the hyperlipidemic effect of beta-adrenoblockers by means of antiatherogenic vegetarian diet]. The purpose of the study was to examine the capacities of correction of impaired lipid metabolism in patients with CHD receiving selective beta-adrenoblockers (beta-AB) by using an antiatherogenic milk-and-vegetable diet. According to the type of antiatherogenic diet, 67 patients were divided into 2 groups: 1) 42 patients were on an antiatherogenic vegetarian diet (a vegetarian group--VG) and 2) 25 patients received routine mixed diet No. 10c (a control group--CG). At the same time all the patients received similar antianginal drug therapy including the selective beta-AB atenolol in a dose of 50 mg/day. The vegetarian diet without special hypolipidemic therapy had a marked normalizing effect on the serum lipid spectrum in patients with CHD. Thus, in VG, by the end of treatment, the level of total cholesterol significantly decreased by 16% while in the controls it increased by 13%. High-density lipoprotein cholesterol increased in VG and decreased in CG, therefore the atherogenicity coefficient considerably rose. These were true for triglycerides and very low-density lipoprotein cholesterol. These parameters significantly decreased in VG (by more than 30%) and increased in CG (by 16%). Among the clinical symptoms, a more pronounced decrease in blood pressure in the patients on vegetarian diet and a more significant increase in their exercise tolerance. Balanced antiatherogenic milk-and-vegetable diet in patients with coronary heart disease prevents the hyperlipidemic effect caused by the selective beta-AB atenolol and it is an agent for preventing its negative effect on lipid metabolism.

Is a Medical Mistake an Error or a Crime? The case of a Tennessee nurse has rekindled an old debate.

Direct visuomotor mapping for fast visually-evoked arm movements. In contrast to conventional reaction time (RT) tasks, saccadic RT's to visual targets are very fast and unaffected by the number of possible targets. This can be explained by the sub-cortical circuitry underlying eye movements, which involves direct mapping between retinal input and motor output in the superior colliculus. Here we asked if the choice-invariance established for the eyes also applies to a special class of fast visuomotor responses of the upper limb. Using a target-pointing paradigm we observed very fast reaction times (<150 ms) which were completely unaffected as the number of possible target choices was increased from 1 to 4. When we introduced a condition of altered stimulus-response mapping, RT went up and a cost of choice was observed. These results can be explained by direct mapping between visual input and motor output, compatible with a sub-cortical pathway for visual control of the upper limb.

Indications and results of pleuropulmonary decortications in the university hospital of Kinshasa. In a retrospective and prospective study the authors assess factors influencing postoperative results in patients operated on for pachypleuritis with late referral to the hospital. There were 78 cases in the retrospective (1970-1984) and 28 cases in the prospective (1985-1992) parts of the study. The total number of treated cases is 106 (75 males and 31 females). There were 32 children (> 15 years of age) and 74 adults (< or = 15 years). General condition was good in 45 patients (11 children and 34 adults) and poor in 61 patients (21 children and 40 adults). Ninety percent of the patients were operated on at least one month after the appearance of their symptoms. Eighty-one patients (75.4%) had an empyema secondary to bronchopulmonary infection (34 tuberculous). Other etiologies were: thoracic trauma: 23 cases (19 open and 4 internal); miscellaneous: 2 cases. The commonest isolated organisms were S. aureus, (21.4%), Klebsiella (21.4%) Pseudomonas (13%), Proteus mirabilis, P. vulgaris, P. aeruginosa (11.9%), E. coli (8.4%) and Pyocyaneus (5.9%). In all cases, a total decortication was performed. Good result was achieved in 55/106 (51.8%). There were 39/106 (36.9%) poor results and 12 operative deaths (11.3%). No correlation could be found between results and age, sex or etiology. A significant correlation appeared between duration of symptoms and postoperative results. The longer the delay; the worse the results.

Somatosensory-evoked potentials in term neonates with postasphyxial encephalopathy. This article reviews the use of median nerve somatosensory-evoked potentials in full-term neonates with postasphyxial encephalopathy. The predictive value of this technique with regard to neurodevelopmental outcome is compared with that of clinical assessment and cranial ultrasonography.

Inhibitory role of the serotonergic system on estrogen receptor α expression in the female rat hypothalamus. The role of the serotonergic system in regulating the expression of estrogen receptor (ER) α in the hypothalamus was investigated in ovariectomized rats by injecting a serotonin synthesis inhibitor, parachlorophenylalanine (PCPA), or by destroying the dorsal raphe nucleus (DR). The number of ERα-immunoreactive (ir) cells was counted in the anteroventral periventricular nucleus in the preoptic area (AVPV), ventrolateral ventromedial hypothalamic nucleus (vlVMN), and arcuate nucleus (ARCN). Seven days after ovariectomy, 100mg/kg PCPA or saline was injected daily for 4 days. Alternatively, radiofrequency lesioning of the DR (DRL) or sham lesions were made on the same time of ovariectomy. One-day after the last injection of PCPA or 7 days after brain surgery, the brain was fixed for immunostaining of ERα and the number of ERα-ir cell were counted in the nuclei of interest. The mean number of ERα-ir cells/mm(3) (density) in the AVPV of the PCPA or DRL groups was statistically higher than that in the saline or sham group. In the vlVMN and ARCN of the PCPA or DRL groups, the mean density of ERα-ir cells was comparable to the saline or sham groups. These results suggest that the serotonergic system of the DR plays an inhibitory role on the expression of ERα in the AVPV, but not in the vlVMN and ARCN.

ABO blood groups and age groups in surgical venous thromboembolism. In a series of cases of surgical thromboembolism there were significant age differences in the ratio of cases of blood group A to those of blood group O, the ratio being highest in the youngest age groups.

Photodegradation of acetone over V-Gd-O composite catalysts under visible light. A series of visible light active catalysts, V-Gd-O composites, were prepared by the impregnation method. In the photodegradation of acetone, the highest acetone conversion was obtained on V(1)Gd(1)O(x) catalyst under visible light. The physical and photophysical properties of the composite catalyst have been characterized by XRD, FT-IR, Raman, BET surface area, UV-vis diffuse reflectance spectra, and photoluminescence (PL) spectra. The characterization indicates the V-Gd-O photocatalyst exhibits three phases: Gd(2)O(3), GdVO(4) and V(2)O(5). On the basis of the calculated energy band positions and PL spectra, the high activity of the V-Gd-O catalysts could be attributed to the coupling effect between GdVO(4) and V(2)O(5) in retarding the recombination of electron-hole pairs.

[Severe reactions to iodinated contrast agents: is anaphylaxis responsible?]. The etiology of severe reactions following injection of iodinated contrast agents is the subject of controversy. No consensus has been established regarding the management of patients at risk, risk factors and premedication because in most cases published no diagnostic exploration has been carried out on patients who have experienced a severe reaction. and Methods. Diagnosis of drug anaphylaxis is based on clinical history, proof of mediator release and drug-specific IgE antibodies (when the technique is available) or cutaneous tests (when direct technique is not available). This approach has been adopted for etiologic diagnosis of 5 clinical cases of severe anaphylactoid reactions (including one death) following the injection of ionic and non ionic contrast agents. Clinical symptoms, biology and cutaneous tests are consistent with anaphylaxis. Any patient who has had a severe anaphylactoid reaction following injection of a contrast agent should undergo an allergological assessment to confirm the diagnosis and identify the culprit contrast agent. Indeed, no premedication has proved efficient for the prevention of subsequent allergic reactions.

Selective tissue distribution of tibolone metabolites in mature ovariectomized female cynomolgus monkeys after multiple doses of tibolone. Tibolone is a selective tissue estrogenic activity regulator (STEAR). In postmenopausal women, it acts as an estrogen on brain, vagina, and bone, but not on endometrium and breast. Despite ample supporting in vitro data for tissue-selective actions, confirmative tissue levels of tibolone metabolites are not available. Therefore, we analyzed tibolone and metabolites in plasma and tissues from six ovariectomized cynomolgus monkeys that received tibolone (0.5 mg/kg/day by gavage) for 36 days and were necropsied at 1, 1.25, 2.25, 4, 6, and 24 h after the final dose. The plasma and tissue levels of active, nonsulfated (tibolone, 3alpha-hydroxytibolone, 3beta-hydroxytibolone, and Delta(4)-tibolone), monosulfated (3alpha-sulfate,17beta-hydroxytibolone and 3beta-sulfate,17beta-hydroxytibolone), and disulfated (3alpha,17beta-disulfated-tibolone and 3beta,17betaS-disulfated-tibolone) metabolites were measured by validated gas chromatography with mass spectrometry and liquid chromatography with tandem mass spectrometry. Detection limits were 0.1 to 0.5 ng/ml (plasma) and 0.5 to 2 ng/g (tissues). In brain tissues, estrogenic 3alpha-hydroxytibolone was predominant with 3 to 8 times higher levels than in plasma; levels of sulfated metabolites were low. In vaginal tissues, major nonsulfated metabolites were 3alpha-hydroxytibolone and the androgenic/progestagenic Delta(4)-tibolone; disulfated metabolites were predominant. Remarkably high levels of monosulfated metabolites were found in the proximal vagina. In endometrium, myometrium, and mammary glands, levels of 3-hydroxymetabolites were low and those of sulfated metabolites were high (about 98% disulfated). Delta(4)-Tibolone/3-hydroxytibolone ratios were 2 to 3 in endometrium, about equal in breast and proximal vagina, and 0.1 in plasma and brain. It is concluded that tibolone metabolites show a unique tissue-specific distribution pattern explaining the tissue effects in monkeys and the clinical effects in postmenopausal women.

Valorization of crude glycerol and eggshell biowaste as media components for hydrogen production: A scale-up study using co-culture system. The properties of eggshells (EGS) as neutralizing and immobilizing agent were investigated for hydrogen (H2) production using crude glycerol (CG) by co-culture system. Eggshells of different sizes and concentrations were used during batch and repeated-batch fermentation. For batch and repeated-batch fermentation, the maximum H2 production (36.53±0.53 and 41.16±0.95mmol/L, respectively) was obtained with the EGS size of 33μm<x5<75μm. Hydrogen production increased with the decreasing size of EGS. Eggshells maintained the fermentation pH (6.00-6.30) and provided immobilization support as confirmed by scanning electron microscopy. As media components, the EGS concentration of 0.25% (w/v) was found to be optimum for maximum H2 production (31.66±0.55mmol/L) and the production profile was comparable to H2 production (32.07±0.92mmol/L) obtained with all media components. In scale-up study with semi-continuous bioreactor (7.5L), almost 1.5-fold increase (in comparison to mono-culture) i.e. 312.12mmol-H2/L-of medium with 86.65% glycerol utilization was obtained.

Activation of AMP-activated protein kinase stimulates proopiomelanocortin gene transcription in AtT20 corticotroph cells. Starvation is known to activate the hypothalamo-pituitary-adrenal (HPA) axis, a representative antistress system in the living organism. In this study, we investigated in vitro whether activation of the AMP-activated protein kinase (AMPK), which is known to occur in intracellular energy depletion, influences the expression of POMC gene that encodes adrenocorticotropin. We first confirmed that each subunit of AMPK was expressed in the AtT20 corticotroph cell line. We then found that AICAR, a cell-permeable AMP analog and an activator of AMPK, potently stimulated the 5'-promoter activity of POMC gene in a dose-dependent manner. The effects were promoter specific because AICAR enhanced the AP1-mediated POMC promoter activities but did not influence other transcription factor-induced transcription. The effect of AICAR on POMC gene transcription was completely eliminated by specific AMPK inhibitor compound C or by dominant negative AMPK, whereas overexpression of constitutively active AMPK mimicked the effect of AICAR. Finally, experiments using specific kinase inhibitors suggested that the PI 3-kinase-mediated signaling pathway is at least partly involved in the effect. Our results suggest that intracellular energy depletion with the resultant activation of AMPK directly stimulates the HPA axis at the pituitary level by increasing the expression of POMC gene.

Treatment of early-stage gastric lymphoma. The treatment of early-stage gastric lymphoma is controversial. This retrospective analysis reports on the outcome of 24 patients treated in our institution during the past 25 years. Fourteen patients had stage IEA, one patient had IEB, six patients IIEA1, and three patients had stage IIEA2 non-Hodgkin's lymphoma (NHL). Diffuse large cell intermediate-grade NHL was diagnosed in 17 patients, diffuse small cleaved cell in three patients, and diffuse mixed large and small cell lymphosarcoma, low-grade B-cell lymphoma, and unclassified lymphoma in one patient each. Fourteen patients underwent surgery, 21 had radiation therapy (XRT), and 10 patients received chemotherapy. Surgery + XRT were given to 7 patients, surgery + XRT + chemo and XRT alone were delivered to five patients each, and XRT + chemotherapy were employed in four patients. Surgery alone was the initial treatment in two patients and chemotherapy alone was given to one patient. Following treatment 22/24 achieved a complete response. During a mean follow-up period of 77.6 months (range 1-285), five patients relapsed. At 10 years, the actuarial survival of the 15 patients with stage I disease was 57.4% and for stage II it was 51.9% (Gehan P-value 0.33). Freedom from relapse (FFR) was 60.7% and 58.3%, respectively (P-value 0.56). No significant statistical differences in terms of survival and FFR were noted in patients treated with surgery, chemotherapy, or XRT. The outcome of patients treated with triple-modality therapy was similar to those treated with double-modality therapy and to patients treated with XRT alone. Gender, age, presenting symptoms, depth of tumor through the gastric wall, and stage were not statistically significant for prediction of either survival or FFR. Both surgery + XRT and chemotherapy + XRT are effective in the treatment of early-stage gastric disease. XRT alone is equally effective as two or three modality treatments in the subset of patients with early-stage gastric lymphoma. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion. Until prospective randomized studies are initiated, management programs should be individually tailored.

Perceptrons with Hebbian learning based on wave ensembles in spatially patterned potentials. A general scheme to realize a perceptron for hardware neural networks is presented, where multiple interconnections are achieved by a superposition of Schrödinger waves. Spatially patterned potentials process information by coupling different points of reciprocal space. The necessary potential shape is obtained from the Hebbian learning rule, either through exact calculation or construction from a superposition of known optical inputs. This allows implementation in a wide range of compact optical systems, including (1) any nonlinear optical system, (2) optical systems patterned by optical lithography, and (3) exciton-polariton systems with phonon or nuclear spin interactions.

Primary and secondary lysosomes in megakaryocytes and platelets from cattle with the Chediak-Higashi syndrome. The ultrastructure of lysosomes from megakaryocytes (MK) and platelets of cattle with the Chediak-Higashi syndrome (CHS) was characterized using acid phosphatase histochemistry with beta-glycerophosphate as substrate and cerium as a capturing agent. Acid phosphatase was localized in the trans aspect of the Golgi complex and/or granules in MK at all stages of maturation. Morphometric analysis of the diameter of each lysosome was performed on MK from CHS cattle and compared to MK from normal cattle. Lysosomes in CHS MK were neither enlarged nor different with respect to classification as secondary lysosomes, which composed 35% of the lysosomes in CHS MK. Lysosomes were demonstrated in 22% of the CHS platelet sections and appeared similar to those from normal cattle, 56% of them being classified as secondary lysosomes. Why lysosomes are not enlarged in bovine CHS MK and platelets, whereas they are enlarged in most other cell types, remains unknown.

Self-similar renormalization approach to barrier crossing processes. An algebraic self-similar renormalization method developed recently for summation of divergent field-theoretical series is applied to the thermally activated escape of a Brownian particle over an arbitrarily shaped barrier. Based on the Mel'nikov-Meshkov result for the underdamped Brownian motion and the inverse friction expansion of the underlying Fokker-Planck equation for strong friction, an overall rate formula is constructed. This formula agrees in the weak friction regime with the rate obtained from a diffusion equation in energy variables and, in the limiting case of strong friction with the rate following from a Smoluchowski equation. Its validity is tested for Brownian motion in bistable potentials with parabolic, cusped, and quartic barriers of different heights. The proposed formula is found to give a reasonable description of activated rate processes even though the barrier is quite low. Our comparison also includes results from various different crossover theories. In most of the cases considered the present formula is in considerably better agreement with exact numerical rates than the other interpolation formulas.

Dexamethasone enhances mallory body formation in drug-primed mouse liver. In a clinical study in which patients with alcoholic hepatitis were treated with prednisone for 1 month, posttreatment liver biopsies showed diminished inflammation, but Mallory bodies were not diminished. This suggested that steroid treatment may reduce inflammation by inhibiting NFkappaB activation. Sparing of Mallory bodies suggests that NFkappaB activation may not be involved mechanistically in Mallory body formation. To test this idea, we induced Mallory body formation in drug-primed mice with or without dexamethasone treatment. As predicted, dexamethasone decreased NFkappaB activation; however, Mallory body formation was increased. Surprisingly, TNFalpha and iNOS, which normally increase as a result of NFkappaB activation, were upregulated by the dexamethasone treatment. It was concluded that NFkappaB activation is not involved in Mallory body formation. Despite this, induced increases in TNFalpha, iNOS, c-jun/API and c-myc expression indicate that oxidative stress is likely involved in Mallory body formation.

Surviving the housing crisis: Social violence and the production of evictions among women who use drugs in Vancouver, Canada. Single room accommodation (SRA) housing is among the only forms of accessible housing to marginalized women who use illicit drugs in many urban settings. However, SRA housing environments may create specific health and drug risks for women. Little research has examined the gendered mechanisms contributing to housing vulnerability for women who use drugs and the subsequent ways they aim to mitigate harm. This study examines the gendered vulnerabilities to, and harms stemming from, evictions from SRAs in Vancouver, Canada. Qualitative interviews were conducted with 56 people who use drugs who were recently evicted (past 60 days) from SRAs in Vancouver's Downtown Eastside neighbourhood, 19 of whom identified as women which informed this analysis. Participants were recruited by Peer Researcher Assistants for baseline and follow-up interviews three to six months later. Interview transcripts were analyzed thematically and interpreted by drawing on concepts of social violence. Findings underscore how gendered violence and forms of social control operationalized within SRAs normalized violence against women and restricted their agency. Surveillance mechanisms increased women's experiences of violence as they sought to evade such interventions. Post-eviction, women faced pronounced vulnerability to harm which reinforced their social and spatial marginality within a drug scene. Collectively, women's experiences within SRAs highlight how the hybrid forms of disciplinary mechanisms used within these housing environments significantly impacted women's experiences of harm. Greater attention to the impacts of housing and building policies on women who use drugs is needed to better address the morbidity and mortality of this population.

Iridium(III) complexes with polypyridine ligands coordinated as N-heterocyclic carbenes. Synthesis, structure and photophysical properties. Unsaturated [Tp(Me2)Ir(III)] fragments, readily generated from compounds [Tp(Me2)Ir(C(6)H(5))(2)(N(2))], (1a) and [Tp(Me2)Ir(η(4)-CH(2)=C(Me)C(Me)=CH(2)] (1b) (Tp(Me2) = hydrotris(3,5-dimethylpyrazolyl)borate), induce the isomerisation of the polypyridines, 2,2'-bipyridine, 1,10-phenanthroline and 2,2':6'2''-terpyridine, to form complexes that contain the carbene tautomer of these ligands. For terpy, a binuclear compound has also been isolated, in which this molecule bridges two Ir(III) centres, thanks to its coordination as a bidentate N-heterocyclic carbene. The new compounds have been structurally authenticated by X-ray crystallography and their photophysical properties have been investigated.

Measuring end-of-life care outcomes retrospectively. Fundamental to measuring both the processes and outcomes of end-of-life care is that one understand the context and distinct differences of that care. Measurement plays an important role in clinical assessment, research, quality improvement, and public accountability. Some of the unique challenges that confront investigators using prospective research designs to assess quality of end-of-life care can be addressed with retrospective approaches or follow-back designs. Retrospective research avoids reliance on the difficult task of prospectively identifying the terminally ill, avoids burdening very sick participants, minimizes missing data because of poor functional status, creates a clear time frame for the purpose of comparing settings of care, and is a cost-effective way to collect population-based data about individuals who have died. This paper reviews research using a retrospective design and analyzes the reliability and validity issues associated with a follow-back design. Although methodological challenges beset both prospective and retrospective data collection, use of both methods in combination or in sequence provides a clearer understanding of the complex, multidimensional issues involved in providing care to dying individuals.

Oral health care and status of elderly care home residents in Glasgow. To investigate variations in reported oral health care provision and unmet dental need within a sample of care homes for the elderly in Glasgow. Two-phase study of a 50% random sample of 120 care homes (n = 60). Phase 1: telephone interviews with care home managers. Phase 2: oral examinations of residents and face-to-face interviews with care staff, in a sub-sample of 10 homes. Care homes in Greater Glasgow. Residents and staff. Phase 1: data were collected from 58 of 60 care home managers approached (response rate: 97%). Oral assessment of residents on admission was reported for 78% of nursing homes and 24% of residential homes, and annual screening by a dentist for 85% and 76% respectively. Only 58% of nursing homes and 8% of residential homes had a formal mouth care policy. Staff training in mouth care was not universal and often carried out "in-house". All managers believed dental support was available when required. Phase 2: 288 oral examinations and 22 staff interviews took place within 10 homes selected. Examinations revealed high levels of oral disease. When interviewed, staff accepted that mouth care was within their remit but failed to document it within patient care plans. Further training on oral health and disease was requested from all levels of staff. Oral disease is common among elderly care home residents in Glasgow. Increased emphasis on implementation of standard oral care protocols and improved education of staff is essential if the oral health of elderly institutionalised residents is to improve.

[The grading of cellular and structural atypia in cancer and related lesions using multivariate analysis]. In morphologically diagnosing cancer, pathologists' attention is focussed on the presence or absence of atypia, i.e., the form of cells and tissues deviated from the norm, and if it is present, on its grade. However, due to retarded development of techniques for the objective evaluation of its grade, separation of cancer from premalignant lesions still meets great ambiguity. Particularly, the boundaries of "dysplasia" with cancer and noncancerous lesions are not defined in clear morphological terms and are susceptible to a strong between-observers fluctuation. In this paper we outlined our recent efforts to establish in various organs a statistically most adequate, and therefore reproducible, classification of atypical lesions, resorting to morphometry and multivariate analysis. Two examples were given: atypia of the pancreatic duct epithelia as an object for the study of purely cellular abnormalities, and hepatocellular carcinoma, which required also to quantify the atypia of tissue structures, The classifications thus established proved to be the most adequate, in that, they closely reflected the grade of malignancy in a clinical as well as biological sense, as shown by the clear between-categorier differences in oncogene mutation, DNA ploidy pattern, the patients' prognoses, and so on.

[Variability in the rate of episiotomies and its relation to severe perineal tears and neonatal morbility]. To determine the variability in the use of episiotomy among midwives and its relation to third and fourth-degree tears, and the impact on neonatal morbidity. A study was conducted on historical groups from a total of 2,366 eutocic births with a single live fetus greater than or equal to 37 weeks gestation and 18 midwives over a three year period (2009, 2010 and 2011) in "Mancha-Centro" Hospital (Alcázar de San Juan).The outcomes variables for this analysis were the incidence of episiotomy, perineal lacerations, and neonatal morbidity. The variability in the use of episiotomy ranged from 19.5% to 50.1% among the 18 midwives in the study, with an average rate of 34.9% (824). Grouped at intervals, 22.1% (524) had a rate of ≤25%, 26.1% (621) between 26-35%, 38% (898) between 36-44%, and 13.7% (323) a rate of ≥45%, with homogeneity between the groups for all the confounding factors. There was no statistical association between higher rates of episotomy and pH of umbilical artery<7.10, Apgar score after 5 min<7, and the level of neonatal resuscitation type iii and iv. There was also no relationship between the rate of episiotomy with perineal integrity and third and fourth-degree tears. The variability in the rate of episiotomy is high, and it is not related to the increased presence of third and fourth-degree tears or increased neonatal morbidity. Episiotomy rates should not be greater than 25%, in order to prevent perineal trauma or loss of fetal well-being.

Identification of sulphur-organic compounds obtained by thermal treatment of the meat broths in the presence of alkyl-mercaptopropanol. By means of GLC-analysis on columns with different polarity phases the composition of the sulphur-containing volatiles obtained by the thermal treatment of the industrial broths and alkyl-mercaptopropanol was studied using flame-photometric detector specific for sulphur. The identification of the sulphur-containing compounds was realized using both retention indices and GLC-MS. The comparison of the composition of sulphur-containing flavour components of the industrial broth with that of its product with alkyl-mercaptopropanol was carried out.

[Progressive decrease of the causes that maintain ventricular fibrillation after experimental coronary occlusion]. Progressive diminution of the causes that maintain ventricular fibrillation after coronary occlusion. Extracorporeal circulation was performed on a group of normal dogs in which a ligature was placed on the left anterior descending coronary artery, immediately beneath the bifurcation of the left coronary artery. The incidence of ventricular fibrillation was of 15 dogs out of 20 (table 1). In a control group without extracorporeal circulation ventricular fibrillation appeared in 24 dogs out of 30 (table 2). These results demonstrate that extracorporeal circulation performed with the idea of improving coronary circulation does not prevent ventricular fibrillation in coronary occlusion. In those dogs with the cross circulation, attempts to defibrillate the ventricles with an electric a.c. defibrillator (three electrical shocks applied directly on the myocardium every 4 or 5 minutes) were uniformly unsuccessful until a period ranging from 12 to 80 minutes elapsed after the onset of ventricular fibrillation. After these periods all fibrillating dogs were defibrillated and recovered either normal or idioventricular rhythm. It is assumed that a "fibrillator substance" liberated by the injury in the initial state of infarction is washed out of the myocardium, or a zone of increased excitability and conduction disturbance is progressively eliminated so that the chances of originating circus movements are diminished.

The effect of Piétrain sire on the performance of the progeny of two commercial dam breeds: a pig intervention study. Genetic evaluation of Piétrain sires in Flanders occurs under standardized conditions, on test stations with fixed dam breeds, standardized diets and uniform management practices. As environmental conditions vary on commercial farms and differ from the test stations, this study aimed at understanding to what extent the sire, the dam breed and the interaction between both affects the translation of breeding values to practice. Dams of two commercial breeds were inseminated with semen from one of five different sires selected for contrasting breeding values (daily gain, feed conversion ratio and carcass quality). For each sire by dam breed combination, six pen replicates (with three gilts and three barrows per pen) were evaluated for growth performance from 9 weeks of age (20 kg) to slaughter (110 kg), and for carcass and meat quality. In our experimental setup, both sire and dam breed affected growth, carcass and meat quality traits. No significant sire×dam breed interactions on performance could be detected. Though a tendency for interaction on average daily feed intake between 20 and 110 kg (P=0.087), and on pork colour (lightness) (P=0.093) was present. In general, offspring of all tested sires behaved similarly in both dam breeds, indicating that estimated breeding values for Piétrain sires determined in one dam breed are representative in other dam breeds as well.

The Emerging Challenge of Diagnosing Drug-resistant Tubercular Uveitis: Experience of 110 Eyes from North India. Background: Rapid and timely diagnosis of tubercular uveitis (TBU) is of paramount importance to save these eyes from blindness. The present study was, therefore, undertaken to carry out a comparative evaluation of Gene Xpert MTB/RIF (Xpert), MTBDRplus and Multiplex PCR (MPCR) for the diagnosis of TBU. These tests were performed on vitreous fluid of 110 patients with presumed TBU and 90 controls. rpoB gene sequencing confirmed Rifampicin resistance. Results: Xpert, MTBDRplus and MPCR were positive in 19(17.2%),38 (34.5%) and 79 (71.8 %) patients, respectively. All tests were negative in all controls. Rif resistance was detected in 3 by Xpert and 7 by MTBDRplus. MPCR followed by rpoB gene sequencing detected Rif resistance in 6 cases. One case of false Rif resistance was reported each by MTBDRplus and Xpert. Conclusion: MPCR followed by rpoB sequencing is a robust technique for the diagnosis of paucibacilliary condition like TBU and reliable detection of drug resistance.