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Cytocompatibility of albuminated polyester fabrics. An alternative to the usual technique of preclotting porous textile vascular prostheses prior to surgical implantation is to render them impermeable to blood by impregnation with a cross-linked albumin filler matrix. This material subsequently becomes the foundation for cellular development. The compatibility of such impregnated fabrics with newly formed endothelial cells has been evaluated by an in vitro organotypic culture method. This technique enables the characterization and numeration of cells that develop on blood contact surfaces and enables determination of their rate of development. Woven, knitted, and velour fabrics were evaluated following coating with albumin and either storage in Tyrode solution or 40% ethanol or desiccation by critical point drying. Preclotted cardiovascular repair fabrics prepared according to conventional surgical protocol served as controls. The identification of the newly formed cells was confirmed histologically. The most extensive and rapid cellular development was observed on the woven fabric and is believed may have resulted from the smoother surface topography of this substrate. Good cellular development was noted particularly on fabrics which had been stored in Tyrode solution. Ethanol had a deleterious effect on the apparent compatibility.

Development of a slide ELISA for canine leishmaniasis and comparison with four serological tests. A slide ELISA for canine leishmaniasis was developed by using promastigotes of Leishmania infantum, and compared with microimmunodiffusion, immunoelectrophoresis, direct agglutination and indirect immunofluorescence assays. The sensitivity of all the tests was 100 per cent. The specificity of the direct agglutination test was 95 per cent but it was 100 per cent for the three other tests. There was also a positive correlation and a high level of concordance between the titres measured by the different tests.

n-3, n-6, and n-9 polyunsaturated fatty acids--which composition in parenteral nutrition decreases severity of acute hemorrhagic necrotizing pancreatitis in rats? Acute pancreatitis often requires parenteral nutrition. Thus, we analyzed, using a randomized trial, whether different fatty acids in parenteral nutrition influence lipidperoxidation and histopathology in acute pancreatitis in rats. Seventy-five male Sprague-Dawley rats were randomized into five groups (gr.) (n=15). Gr. 1 underwent a laparotomy followed by saline infusion, gr. 2-5 received intraductal glycodeoxycholic acid (GDOC) followed by intravenous cerulein. Six hours after induction of pancreatitis (IOP), gr. 2 received saline infusion, while gr. 3 was infused with standard lipovenous (rich in [n-6] polyunsaturated fatty acids (PUFA)), gr. 4 received ClinOleic (rich in [n-9] PUFA), while gr. 5 was infused with Omegaven (rich in [n-3] PUFA) for 18 h. After 24 h, all animals were sacrificed and the pancreas was determined histopathologically according to the severity of pancreatitis. Furthermore, pancreatic lipidperoxidation (TBARS) and activity of lipid production protective enzymes superoxide dismutase (SOD) and gluthationperoxidase (GSHPx) were analyzed. Omegaven infusion reduced the severity of histopathologic changes in acute pancreatitis and decreased lipidperoxidation (TBARS) in pancreatic tissue samples. Furthermore, pancreatic activity of SOD was increased. However, standard PUFA and ClinOleic infusion did not influence the severity of pancreatitis and lipidperoxidation. Parenteral nutrition high in n-3 PUFA seems to be superior to compositions of n-6 or n-9 PUFA in the treatment of acute hemorrhagic pancreatitis in rats.

Prolonged induction of hepatic ornithine decarboxylase and its relation to cyclic adenosine 3':5'-monophosphate-dependent protein kinase activation after a single administration of diethylnitrosamine. After a single injection of diethylnitrosamine (200 mg/kg), there was a rapid increase in the activity ratio of hepatic cyclic adenosine 3':5'-monophosphate (cyclic AMP)-dependent protein kinase (within 1 hr) followed by the induction of ornithine decarboxylase which was detectable by 3 hr. Both the cyclic AMP-dependent protein kinase activity ratio and the activity of ornithine decarboxylase were significantly elevated above controls for 7 days following the administration of diethylnitrosamine. A single noncarcinogenic dose of diethylnitrosamine (25 mg/kg) did not increase the cyclic AMP-dependent protein kinase activity ratio or induce ornithine decarboxylase activity at 24 hr postadministration. However, serial administration of diethylnitrosamine (25 mg/kg) for 4 or 7 days resulted in an increased activity ratio of cyclic AMP-dependent protein kinase and increased ornithine decarboxylase activity. This is the first report of a prolonged increase in both the activity ratio of hepatic cyclic AMP-dependent protein kinase and the activity of ornithine decarboxylase in response to a single carcinogenic dose of diethylnitrosamine.

Sixteen-year single-surgeon experience with coil embolization for ruptured intracranial aneurysms: recurrence rates and incidence of late rebleeding. Clinical article. Over a 16-year period, 570 patients presenting with acute aneurysmal subarachnoid hemorrhage were successfully treated using endosaccular coil embolization within 30 days of hemorrhage by a single surgeon. Patients were followed to assess the stability of aneurysm occlusion and its longer-term efficacy in protecting against rebleeding. Patients were followed for 6 to 191 months (mean 73.7 months, median 67 months) by clinical review, angiography performed at 6 and 24 months posttreatment, and questionnaires sent via the postal service every 5 years. Late rebleeding was defined as > 30 days after treatment. Stable angiographic occlusion was evident in 74.5% of small, 72.2% of large, and 60% of giant aneurysms. Recurrent filling was found in 119 (26.3%) of 452 aneurysms. Rebleeding was diagnosed in 9 patients (6 treated aneurysms) and occurred between 2 and 114 months posttreatment. It was due to aneurysm recurrence in 6 patients, rupture of a coincidental untreated aneurysm in 2 patients, and rupture of a de novo aneurysm in 1 patient. Rebleeding occurred in 3 (2.5%) of 119 unstable aneurysms and in 3 (0.9%) of 333 stable aneurysms, as seen on initial follow-up angiography studies. Annual rebleeding rates ranged from 0.2% to 0.6% for all causes and from 0.2% to 0.4% for rebleeding of treated aneurysms. No rebleeding was recorded after the first decade, with 138 patients having more than 10 years of follow-up. Periodic follow-up with angiographic studies after coil embolization is recommended to identify aneurysm recurrence and patients at a high risk of late rebleeding in the medium term. More frequent follow-up is recommended for patients harboring coincidental unruptured aneurysms.

Seldinger technique for nasal intubation: a case series. Nasotracheal intubation can be both challenging and traumatic, especially in cases of atypical anatomy. We present a series of 3 such cases in which an endotracheal tube introducer (bougie) was used to facilitate successful, atraumatic, nasotracheal intubation via Seldinger technique. The technique described can guide a nasotracheal tube through narrow nasal passages, small pharyngeal spaces, and past acute laryngeal approach angles, all without transoral manipulation of the tube. The technique is easy to perform, uses a routine skill set, and can be advantageous in numerous clinical scenarios.

Beneficial hemodynamic and renal effects of adrenomedullin in an ovine model of heart failure. Adrenomedullin is a recently discovered endogenous peptide with hypotensive and natriuretic actions in normal animals. Circulating and ventricular adrenomedullin are elevated in congestive heart failure, suggesting a possible role in the pathophysiology of this disease. No studies have previously examined the effects of adrenomedullin in heart failure. Eight sheep with pacing-induced heart failure received human adrenomedullin(1-52) at 10 and 100 ng x kg(-1) x min(-1) I.V. for 90 minutes each. Compared with vehicle control data, adrenomedullin increased plasma cAMP (high dose, P<.05) in association with dose-dependent falls in calculated peripheral resistance (13 mm Hg x L(-1) x min(-1), P<.001), mean arterial pressure (9 mm Hg, P<.001), and left atrial pressure (5 mm Hg, P<.001) and increases in cardiac output (0.5 L/min, P<.001). Adrenomedullin increased urine sodium (threefold, P<.05), creatinine (P<.05) and cAMP excretion (P<.01), creatinine clearance (P<.05), and renal production of cAMP (P<.05), whereas urine output was maintained during infusion and raised after infusion (P<.05). Adrenomedullin reduced plasma aldosterone levels (P<.05), whereas plasma atrial and brain natriuretic peptide concentrations were unchanged during infusion and rose after infusion (P<.01 and P<.05, respectively). Plasma catecholamine, cortisol, renin, calcium, and glucose concentrations were not significantly altered. Adrenomedullin reduced ventricular preload and afterload and improved cardiac output in sheep with congestive heart failure. Despite the clear fall in arterial pressure, adrenomedullin increased creatinine clearance and sodium excretion and maintained urine output. These results imply an important pathophysiological role for adrenomedullin in the regulation of pressure and volume in heart failure and raise the possibility of a new therapeutic approach to this disease.

Isolation of Salmonella from chickens reacting in the pullorum-typhoid agglutination test. Over a 3-year period, 134,171 serum samples were screened by the pullorum-typhoid tube agglutination test. Of the 680 (0.5%) reactors, Salmonella organisms were isolated from 226 of the chickens. Thirteen serotypes of Salmonella were isolated. The predominant serotypes were heidelberg, pullorum, kentucky, saintpaul, and enteritidis, and they were isolated from 60%, 18%, 5%, 4%, and 3% of the chickens, respectively. Salmonella were isolated from the ceca of 161 chickens, the cecal tonsils of 148 chickens, the organ pool of 150 chickens, and the ovary-oviduct pool of 110 chickens. Delayed secondary enrichment was required to isolate Salmonella from 36 (15%) of the 226 Salmonella-positive chickens and to detect 20% of the total isolations.

Characterizing the functional similarity of enzymes with high co-citation in interaction networks. New methods for reliable quantitative analysis of biological network data are in high demand in today's bioinformatics and systems biology. Here we demonstrate the applicability of the co-citation, developed earlier for the analysis of scientific literature for finding functionally similar nodes in protein-protein interaction networks in several model organisms. We prove the power of our approach in a novel way: the predicted closely related enzymes are compared to the closeness of their enzyme commission (EC) numbers, therefore we can numerically evaluate our prediction method. We have found clear correspondence between related enzymatic functions and high co-citation of proteins in interaction networks.

Simultaneous bilateral breast carcinoma: Histopathological characteristics and CD44/catenin-cadherin profile. Family history of breast carcinoma, multicentric tumor foci in one breast, and in situ lobular carcinoma increase the risk of bilateral breast cancer (BBC), synchronous or metachronous. Synchronous tumors are designated as simultaneous breast carcinoma if they appear at the same time. The CD44 family and cadherin/catenin immunophenotype of this group of BBCs has not yet been evaluated. The aim of this study was to compare clinicopathological characteristics and immunohistochemical profiles of simultaneous BBC and corresponding lymph node metastases in eight patients. In toto 15 primary and 9 metastatic tumors were evaluated. The expression of CD44 variant isoforms, beta-catenin, E, P and N-cadherin were evaluated by immunohistochemistry. Rare types of breast carcinoma were frequent in this group of patients. There were 6 pleomorphic lobular, 5 invasive ductal of usual type, 3 atypical medullary carcinomas, 2 mucinous and one invasive micropapillary carcinoma. The expression CD44v6 was most frequent, followed by CD44v3-10, CD44v5, and CD44v3. CD44v4 was generally not expressed. E-cadherin was expressed in 80% primary tumors, 40% expressed N-cadherin, and 66% expressed P-cadherin. Generally, simultaneous carcinomas had different morphology and different immunophenotype. Each primary tumor was more similar to its corresponding metastatic tumor than to the contralateral primary tumor.

Multitasking as a choice: a perspective. Performance decrements in multitasking have been explained by limitations in cognitive capacity, either modelled as static structural bottlenecks or as the scarcity of overall cognitive resources that prevent humans, or at least restrict them, from processing two tasks at the same time. However, recent research has shown that individual differences, flexible resource allocation, and prioritization of tasks cannot be fully explained by these accounts. We argue that understanding human multitasking as a choice and examining multitasking performance from the perspective of judgment and decision-making (JDM), may complement current dual-task theories. We outline two prominent theories from the area of JDM, namely Simple Heuristics and the Decision Field Theory, and adapt these theories to multitasking research. Here, we explain how computational modelling techniques and decision-making parameters used in JDM may provide a benefit to understanding multitasking costs and argue that these techniques and parameters have the potential to predict multitasking behavior in general, and also individual differences in behavior. Finally, we present the one-reason choice metaphor to explain a flexible use of limited capacity as well as changes in serial and parallel task processing. Based on this newly combined approach, we outline a concrete interdisciplinary future research program that we think will help to further develop multitasking research.

Endometrial effects of selective estrogen receptor modulators (SERMs) on estradiol-responsive gene expression are gene and cell-specific. Three selective estrogen receptor modulator (SERM) drugs which included 4-OH-tamoxifen (Tam), EM-800 (EM) and GW 5638 (GW) were investigated to determine their ability to inhibit estradiol-responsive gene expression in sheep endometrium. The uteri of ovariectomized ewes (10 ewes per SERM group) were infused with 10(-7)M SERMs for 24h prior to hysterectomy. Five ewes from each group received 50 microg 17beta-estradiol (E2) and the remaining five ewes received vehicle 18 h prior to hysterectomy. Northern blot analyses and in situ hybridization demonstrated that E2 treatment increased estrogen receptor (ER), progesterone receptor (PR), glyceraldehyde 3-phosphate dehydrogenase (GAPDH), and cyclophilin (CYC) mRNA levels in most endometrial cells examined. Tam and GW exhibited characteristics similar to E2 by increasing ER gene expression, but they antagonized the E2-induced increases in PR and CYC mRNA levels. EM acted as an E2-agonist of GAPDH gene expression, but antagonized the E2 up-regulation of ER, PR and CYC gene expression in most endometrial cells. Immunohistochemistry determined that EM decreased ER protein levels in the glandular epithelium, and the SERMs investigated antagonized increases in PR protein levels in endometrium. In conclusion, GW and EM exhibit fewer agonist effects than Tam on endometrial gene expression. EM demonstrated the greatest antagonism of E2-enhanced levels of ER, PR and CYC, likely due to the inhibition of ER gene expression at both mRNA and protein levels.

Chemical-responsive control of lower critical solution temperature behavior by pillar[10]arene-based host-guest interactions. A new water-soluble thermoresponsive pillar[10]arene with tri(ethylene oxide) groups was synthesized and its cloud point could be reversibly controlled based on a chemical-responsive host-guest system.

Major vascular injury during gynecologic laparoscopy. Report of a case and review of published cases. Serious complications following gynecologic laparoscopy are rare. We report a case of a 24-year-old woman who had a common iliac artery and vein injured by the trocar, resulting in deep shock. The arterial lesion was repaired with an allograft and the vein sutured. The patient recovered with light sequelae. The literature was reviewed and we found 15 cases described in varying detail. In most cases the injury was caused by the pneumoperitoneum-needle and in only 2 by the trocar. Characteristically the terminal aorta and its major branches were injured. All the patients had a large retroperitoneal hematoma and only minimal free blood in the peritoneum. Signs of bleeding were nearly always acute. Most lesions could be treated by simple suture. Recovery is the rule, but 2 of the 15 died. Examiner's experience and correct technique are important to prevent this potentially lethal complication which is also probably underreported.

High-performance liquid chromatography with dual-wavelength ultraviolet detection for measurement of hinokitiol in personal care products. Hinokitiol is found in the heartwood of several cupressaceous plants and is frequently added to cosmetic products such as hair restorers, skin lotions, and body soaps because of its potent and broad-spectrum antibacterial activity. In this study, we established a simple method of hinokitiol determination by high-performance liquid chromatography (HPLC) with dual-wavelength ultraviolet detection at 240 and 345 nm, using a reversed-phase C4 column (RP-4). The retention time of hinokitiol was 7.1 min at both wavelengths. The value of the symmetry coefficient of the hinokitiol peak was close to 1 when the RP-4 column, not an RP-8 or RP-18 column, was used. With the RP-4 column, the regression equation for hinokitiol showed good linearity in the range of 0.05-5 microg/ml, with a detection limit (signal-to-noise ratio of 3) of 0.005 microg/ml at 240 nm and 0.01 microg/ml at 345 nm. The coefficients of variation at 240 and 345 nm were less than 8.2% and 8.7%, respectively, and the recovery was good. The proposed method was used for the determination of hinokitiol in commercial hair restorers, skin lotions, and body soaps.

Use of fluorescence genomic in situ hybridization (GISH) to detect the presence of alien chromatin in wheat lines differing in nuclear DNA content. Many times small differences in genome size are reported between or within plant species in which no cytologic confirmation is made. Attempts to repeat these studies have met with limited success. The controversy then becomes whether or not these small differences that were not confirmed cytologically are real. The present study was undertaken to determine if the approximately 1% nuclear variation seen by flow cytometry among wheat lines selected for aluminum response was due to actual chromatin differences. The three parental wheat cultivars used in the aluminum selection along with the isolines resulting from the selection were analyzed. One parental line had previously been reported to have alien chromatin substituted for the corresponding wheat homologous chromatin. Genomic in situ hybridization was used to determine the presence or absence of rye chromatin in three cultivars and six near-isolines of wheat. Upon observing metaphase chromosomes of the Century parent and its isolines, two of the chromosomes were observed to be one-half yellow-orange, indicating rye chromatin with the remaining portion of the chromosomes and the other 40 wheat chromosomes having no label indicating wheat chromatin. In the Chisholm parent and its isolines, none of the chromosomes were labeled, indicating the absence of rye chromatin. In addition, none of the third parents' chromosomes had the rye yellow-orange signal. The wheat lines with the larger DNA contents were observed to have alien DNA present. DNA differences between the normal wheat chromosomes and the substituting alien chromatin were calculated based on total chromosome length. The increase in genome size of the wheat lines containing the alien chromatin appears to be the result of the alien chromatin having approximately 43% more DNA than the wheat chromatin it is replacing. Thus, the small DNA difference previously reported by flow cytometry was demonstrated to be a real DNA variation due to the presence of small fragments of alien chromosomes added to the wheat genome.

Rostroventral medulla-mediated biphasic modulation of the rat cardiosomatic motor reflex. The purpose of the present study was to examine whether the rostroventral portion of the medulla oblongata (RVM) exerts descending modulation on the cardiosomatic motor reflex (CMR) in rats. Capsaicin (1 μg/ml, 0.2 ml) was injected into the pericardial sac as an algesic substance to induce the CMR, which was monitored via electromyogram (EMG) responses of dorsal spinotrapezius muscle to the noxious cardiac stimulus. Descending modulation of the CMR was observed by electrical or chemical stimulation of RVM. Specifically, electrical stimulation of RVM produced facilitatory, inhibitory or biphasic effects on the CMR evoked by noxious cardiac stimulation, depending on stimulation intensity. In addition, glutamate receptor activation in RVM replicated the effects of electrical stimulation. Lidocaine interruption of the ventrolateral funiculus/ventral funiculus (VLF/VF) or transection of the dorsolateral funiculus (DLF) revealed that the descending facilitatory and inhibitory influences from RVM were conveyed via the VLF/VF and DLF, respectively. Furthermore, intrathecal administration of naloxone or yohimbine partly reversed the inhibitory effect of RVM electrical stimulation, suggesting that opioid and noradrenergic systems are involved in descending RVM modulation of the CMR.

Percutaneous laryngeal collagen augmentation for treatment of parkinsonian hypophonia. Our goal was to determine whether percutaneous laryngeal collagen augmentation improves hypophonia in parkinsonian patients. A retrospective review of 18 patients was performed. Patients and/or caretakers were called on the telephone and asked about their response to the procedure, if any. Videostroboscopic examinations for all patients were reviewed. Of 18 patients, 11 (61%) reported improvement in their hypophonia for a period of at least 2 months. Five of 7 patients without improvement were relatively aphonic both before and after the procedure. Five of 7 patients without improvement had severe dysphagia, which in 3 necessitated gastrostomy tube placement. Four of 7 patients without improvement were not ambulatory at the time of the procedure. Percutaneous laryngeal collagen augmentation is an effective treatment for parkinsonian hypophonia in a majority of patients. Patients with advanced neurologic disease with aphonia, difficulty with speech initiation, dysphagia, or ambulatory difficulty are less likely to respond to this procedure and should be so informed.

Effect of intraluminal thrombus on abdominal aortic aneurysm wall stress. Abdominal aortic aneurysms (AAAs) rupture when the wall stress exceeds the strength of the vascular tissue. Intraluminal thrombus may absorb tension and reduce AAA wall stress. This study was performed to test the hypothesis that intraluminal thrombus can significantly reduce AAA wall stress. AAA wall stresses were determined by axisymmetric finite element analysis. Model AAAs had external diameters ranging from 2.0 to 4.0 cm. Model parameters included: AAA length, 6 cm; wall thickness, 1.5 mm; Poisson's ratio, 0.49; Young's modulus, 1.0 MPa; and luminal pressure, 1.6 x 10(5) dyne/cm2. Stresses were calculated for each model without thrombus, and then were recalculated with thrombus filling 10% of the AAA cavity. Calculations were repeated as thrombus size was increased in 10% increments and as thrombus elastic modulus increased from 0.01 MPa to 1.0 MPa. Maximum wall stresses were compared between models that had intraluminal thrombus and the unmodified models. Stress reduction greater than 25% was considered significant. The maximum stress reduction of 51% occurred when thrombus with elastic modulus of 1.0 MPa filled the entire AAA cavity. Stresses were reduced by only 25% as modulus decreased to 0.2 MPa. Similarly, decreasing thrombus size by 70% resulted in stress reduction of only 28%. Large AAAs experienced greater stress reduction than small AAAs (48% vs 11%). Intraluminal thrombus can significantly reduce AAA wall stress.

Infant Weight and Length Growth Trajectories Modeled Using Superimposition by Translation and Rotation Are Differentially Associated with Body Composition Components at 3 and 7 Years of Age. To evaluate how infant weigh and length growth trajectories associate with body composition at 3 and 7 years because previous studies have noted that rapid infant weight gain increases risk for high body mass index (BMI) in children. There were 322 children enrolled at 3 years of age with dual x-ray absorptiometry body composition data and pediatrician growth data for 0-2 years of age who were included in analysis. Superimposition by translation and rotation modeling was used to characterize infant weight and length trajectories in terms of size, tempo and velocity measures. Associations of these measures with fat mass, lean mass, percent body fat, bone mineral content, BMI z-score, and overweight prevalence at 3 and 7 years of age were determined. Infant growth trajectories differed by sex, race, and breastfeeding status. Higher overall weight size and weight velocity from 0 to 2 years of age were associated positively with all age 3 body composition and anthropometry outcomes. However, longer length size from 0 to 2 years of age was associated independently with higher bone mineral content and lean mass, but lower percent body fat, BMI z-score, and a lower odds of overweight at 3 years of age. By 7 years of age, later than average infant weight tempo was also associated with lower fat mass, lean mass, and BMI z-score. Greater average weight size and greater weight velocity in infancy are markers for greater overall body size at 3 and 7 years of age. However, longer average lengths and later weight gain tempo between 0 and 2 years of age may help to establish a leaner body composition by 3 and 7 years of age.

Intracranial pheochromocytoma--a case of noradrenaline-secreting glomus jugulare tumor. A 43-year-old female was admitted for a labile hypertension and depression. High levels of plasma and urinary noradrenaline strongly suggested a pheochromocytoma. However, clinical investigations revealed a normal adrenal gland and thoraco-abdominal region. Venous samples from multiple sites indicated and increase in noradrenaline in the left jugular vein. Using computed tomography and Gadolinium DTPA (diethylene triamine pentaacetic acid)-enhanced dynamic MR (magnetic resonance) imaging, a tumor was discovered in the cerebello-pontine angle. Carotid angiography showed the feeder arteries clearly. Therefore, the tumor was classified as a noradrenaline-secreting glomus jugulare tumor fed by the carotid artery. After embolization and subsequent medical therapy, blood pressure was well controlled. Twenty cases of intracranial pheochromocytoma have been reported to date. This is the second such case in Japan.

Structure and juvenile hormone-mediated regulation of the HMG-CoA reductase gene from the Jeffrey pine beetle, Dendroctonus jeffreyi. In several pine bark beetle species, juvenile hormone (JH) III regulated 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-R) gene expression has an important role in monoterpenoid pheromone production in males. We investigated the structure and regulated expression of the HMG-R gene (HMG-R) in the Jeffrey pine beetle, Dendroctonus jeffreyi. cDNA and genomic sequences were recovered using a combination of library screening and PCR. The transcribed portion of the gene spans 9.8 kb and is interrupted by 13 introns. When compared to vertebrate HMG-Rs, the distribution of intron sites suggests a functional role for those in the 5' untranslated region and membrane anchor domains. Northern blots show that topically applied JH III stimulates HMG-R expression up to 30-fold in male D. jeffreyi, compared to untreated insects, in both a dose- and time-dependent manner. There was no increase in expression levels in similarly treated female insects. The expression pattern is consistent with the production of monoterpenoid pheromone components in male D. jeffreyi, and suggests the utility of the system as a new tool for studying the mechanism of JH action.

Drug-induced psychotic symptoms in Parkinson's disease. Problems, management and dilemma. Psychotic symptoms develop in 20-30% of patients with Parkinson's disease (PD) receiving chronic anti-PD medications, and visual hallucinations with or without delirium and paranoid delusions are the most frequent symptoms. Psychotic symptoms disturb ADL and QOL of PD patients and tax caregivers far more than the motor disabilities do, and good management of drug-induced psychotic symptoms is potentially important. Withdrawal of anti-PD drugs relieves the patients from psychotic side effects, but worsens the parkinsonian motor symptoms. The first step of treatment is to eliminate triggering factors other than anti-PD drugs, such as infections, metabolic disorders, subdural hematoma, and hallucinogenic drugs. The second step is to eliminate anti-PD drugs in the following order; first anticholinergics, amantadine and selegiline, second dopamine agonists, and finally levodopa/carbidopa. Anti-PD medications should be reduced to the point of improving psychotic side effects without drastically worsening parkinsonian motor symptoms. When the above adjustments fail to sufficiently alleviate psychotic side effects, the third step is consideration of antipsychotic drugs although they have potential capacity to antagonize dopamine D2 receptors and worsen parkinsonism. Atypical antipsychotics such as clozapine and olanzapine are recommended, though the former is not available in Japan.

The LD50 for uniform low LET irradiation of man. Previously published estimates of the whole-body radiation dose expected to kill 50% of a normal human population, the LD50, have rarely been based explicitly on evidence. The difference which might result from medical treatment seems to have been markedly over-valued. The available and relevant evidence about severe haematopoietic damage in man uncomplicated by tissue necrosis is indeed very scanty. It comes from 20 cases of therapeutic whole-body exposure to gamma rays and from two criticality accidents involving nine subjects, one of whom died, and when exposure was to neutrons as well as gamma rays. The observations suggest a judgment that 4.5 Gy (450 rad) absorbed dose in the bone marrow for energetic and therefore penetrating gamma rays giving reasonably uniform irradiation of the marrow could be regarded as the LD50 in circumstances where those irradiated were protected from thermal radiation and blast damage and from neutrons and beta rays. Examination of all the available experimental data on acute lethality following whole-body exposure to low LET radiation shows a remarkably similar co-efficient of variation of the LD50 in five species of large animal. If the same value is adopted for the human species, a quantitative estimate of the human LD50 can be inferred from the human evidence discussed. This reinforces the judgement that it is about 4.5 Gy. The use of observations after criticality accidents is examined in detail in an Appendix. The Vinca accident does not clearly meet the criteria for relevancy but there is no other instance of death in man from an uncomplicated brief whole-body exposure to ionising radiation where the bone-marrow dose can be estimated, and a possible judgment made of the value for the LD50.

Lysozyme extraction from egg white using reverse micelles in a Graesser contactor: mass transfer characterization. The gentle mixing characteristics of a Graesser contactor can help to avoid the formation of stable emulsions, which is one advantage of this type of contactor when used with reversed micellar extraction. In this study, the performance of the Graesser contactor in lysozyme extraction from hen egg white is investigated. The concentration profile of lysozyme in the aqueous and organic phases indicated that, while substantial axial mixing occurred in the contactor, the extraction yield was in the range of 97% to 99%. The number of mass transfer units (N(ox)) was determined using a diffusion model, and the influence of aqueous-to-organic phase flow ratio, rotor speed, and total throughput on contactor performance was studied. It was found that the diffusion model could describe quite well the extraction of lysozyme from hen egg white using reversed micelles. The optimal conditions for the extraction at steady state were found to be a rotor speed of 5 rpm, an aqueous-to-organic phase flow ratio of 60:20 mL/min, and a total throughput of 80 mL/min. In addition, back-extraction was also performed using the conventional method (1.5 M KBr at pH 11.5) in the contactor. It was found that this mass transfer was not well described by a diffusion model, although 85% of the lysozyme could be recovered with the operating conditions used: a rotor speed of 10 rpm, and an aqueous-to-organic flow rate of 10:10 mL/min.

Long-term follow-up of zidovudine therapy in asymptomatic HIV infection: results of a multicenter cohort study. The Italian Zidovudine Evaluation Group. In 1990 the results of a placebo-controlled study conducted within the AIDS Clinical Trials Group (ACTG 019) showed that in the short term, zidovudine was effective in slowing progression to advanced disease in HIV-infected asymptomatic patients with low CD4 cell counts. More recently, the preliminary results of the Concorde Trial suggested that while the data at 1 year agreed with those of ACTG 019, no sustained clinical benefit was detectable at 3 years for early versus deferred therapy. Therefore, the length of the clinical usefulness of zidovudine in this population is still to be determined. We evaluated the 2-year outcome of zidovudine therapy in asymptomatic patients through the prospective follow-up of a cohort of 936 subjects with low CD4+ (< 500/mm3) counts who strictly satisfied, at enrollment, the inclusion and exclusion criteria of the ACTG 019 trial. The clinical end point of the analysis was the development of AIDS. The majority (72.2%) of the individuals in the cohort acquired HIV infection through intravenous drug use; 26.6% were women. The median baseline CD4 cell count was 308/mm3. At 55 weeks of mean follow-up, the progression rate to AIDS (3.2 events per hundred person-years) appears to be comparable to that already reported at the same mean follow-up time for the ACTG 019 zidovudine-treated asymptomatic patients. After 124 weeks of mean follow-up, the overall rate of progression to AIDS was 5.2 per hundred person-years.(ABSTRACT TRUNCATED AT 250 WORDS)

Association between obstructive sleep apnea severity and glucose control in patients with untreated versus treated diabetes. The purpose of this study was to determine whether the association between obstructive sleep apnea severity and glucose control differs between patients with newly diagnosed and untreated type 2 diabetes, and patients with known and treated type 2 diabetes. This multicentre cross-sectional study included 762 patients investigated by sleep recording for suspected obstructive sleep apnea, 497 of whom were previously diagnosed and treated for type 2 diabetes (treated diabetic patients), while 265 had no medical history of diabetes but had fasting blood glucose ≥126 mg dL(-1) and/or glycated haemoglobin (HbA1c ) ≥6.5% consistent with newly diagnosed type 2 diabetes (untreated diabetic patients). Multivariate regression analyses were performed to evaluate the independent association between HbA1c and obstructive sleep apnea severity in treated and untreated patients with diabetes. In untreated diabetic patients, HbA1c was positively associated with apnea-hypopnea index (P = 0.0007) and 3% oxygen desaturation index (P = 0.0016) after adjustment for age, gender, body mass index, alcohol habits, metabolic dyslipidaemia, hypertension, statin use and study site. The adjusted mean value of HbA1c increased from 6.68% in the lowest quartile of the apnea-hypopnea index (<17) to 7.20% in the highest quartile of the apnea-hypopnea index (>61; P = 0.033 for linear trend). In treated patients with diabetes, HbA1c was associated with non-sleep variables, including age, metabolic dyslipidaemia and insulin use, but not with obstructive sleep apnea severity. Obstructive sleep apnea may adversely affect glucose control in patients with newly diagnosed and untreated type 2 diabetes, but may have a limited impact in patients with overt type 2 diabetes receiving anti-diabetic medications.

Pharmacological interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood. Between 4% and 25% of school-age children complain of recurrent abdominal pain (RAP) of sufficient severity to interfere with daily activities. For the majority no organic cause for their pain can be found on physical examination or investigation and although most children are likely managed by reassurance and simple measures, a large range of interventions have been recommended. To determine the effectiveness of medication for recurrent abdominal pain in school-age children. The Cochrane Library (CENTRAL) 2006 (Issue 4), MEDLINE (1966 to Dec 2006), EMBASE (1980 to Dec 2006), CINAHL (1982 to Dec 2007), ERIC (1966 to Dec 2006), PsycINFO (1872 to Dec 2006), LILACS (1982 to Dec 2006), SIGLE (1980 to March 2005), and JICST (1985 to 06/2000) were searched with appropriate filters Studies on school age children with RAP (Apley or the Rome II criteria for gastrointestinal diseases) allocated by random or quasi-random methods to a drug treatment vs. placebo/ no treatment were included. References identified by the searches were screened against the inclusion criteria by two independent reviewers. Data was extracted and analysed using RevMan 4.2.10. Three trials met the inclusion criteria. Symon et al report a cross-over trial comparing pizotifen and placebo in 16 children with "abdominal migraine". Data before cross-over was not available. Results for 14 children showed Mean fewer days in pain of 8.21 (95% CI 2.93, 13.48) while taking the active drug. Kline et al compared peppermint oil capsules with placebo in a randomised trial in 50 children with RAP and IBS. 42 children completed the study. OR for improvement was 3.33 (95% CI 0.93-12.1)See et al compared famotidine with placebo in a randomised cross-over trial in 25 children with RAP and dyspepsia. OR for improvement before cross-over was 11 (95%CI 1.6, 75.5). This review provides weak evidence of benefit on medication in children with RAP. The lack of clear evidence of effectiveness for any of the recommended drugs suggests that there is little reason for their use outside of clinical trials. Clinicians may choose to prescribe drugs in children with severe symptoms that have not responded to simple management. However, if using drugs as a "therapeutic trial", clinicians should be aware that, RAP is a fluctuating condition and any "response" may reflect the natural history of the condition or a placebo effect rather than drug efficacy.

A support vector machine classifier for recognizing mitotic subphases using high-content screening data. High-content screening studies of mitotic checkpoints are important for identifying cancer targets and developing novel cancer-specific therapies. A crucial step in such a study is to determine the stage of cell cycle. Due to the overwhelming number of cells assayed in a high-content screening experiment and the multiple factors that need to be taken into consideration for accurate determination of mitotic subphases, an automated classifier is necessary. In this article, the authors describe in detail a support vector machine (SVM) classifier that they have implemented to recognize various mitotic subphases. In contrast to previous studies to recognize subcellular patterns, they used only low-resolution cell images and a few parameters that can be calculated inexpensively with off-the-shelf image-processing software. The performance of the SVM was evaluated with a cross-validation method and was shown to be comparable to that of a human expert.

Alleviation of immunosuppression in vitro by recombinant platelet factor 4. To elucidate the mechanism by which platelet factor 4 (PF4), a secreted platelet protein, and its C-terminal peptides alleviate suppression of the antibody response in vivo, their immunoregulatory activity was studied in vitro, using cultured spleen cells from BALB/c mice primed with sheep red blood cells (SRBC). When addition of 48 h cultured concanavalin A (Con A) blasts at 5 x 10(5)/ml significantly suppressed the anti-SRBC plaque-forming cell response, suppression was alleviated in 25 of 29 experiments by 0.2 micrograms/ml recombinant (r)PF4 (6.4 nM if rPF4 is a tetramer). The effect of Con A blasts was abolished by cimetidine, a histamine type 2 (H2) antagonist. Dimaprit, an H2 agonist, at 1-2 x 10(-4) M, or splenic T cells that had been incubated for 1 h with dimaprit and washed, also caused significant suppression that was alleviated by 0.2 micrograms/ml rPF4 (n = 8), and by 0.02 micrograms/ml in six of these tests. The C-terminal 13 amino acid peptide of PF4 was active at 0.02-0.2 micrograms/ml (0.01-0.11 microM), but peptides from the middle or N-terminal end of the molecule, or IL-8, which shares structural homology with PF4, were inactive. IL-1 and IL-2 raised control responses without affecting suppression or its alleviation by rPF4. Neutralizing antibody to transforming growth factor beta 1 (TGF-beta 1) did not affect Con A blast-induced suppression and suppression induced by exogenous TGF-beta 1 (0.5 ng/ml) was not counteracted by rPF4. Blocking prostaglandin production with 0.2 or 2 microM indomethacin did not affect suppression significantly but reduced rPF4 activity; prostaglandin D2 restored the effect of rPF4.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of different diagnostic thresholds on dental caries calibration - a 12 month evaluation. To analyze the reproducibility of a calibration trial, at different diagnostic thresholds of dental caries, in a 12-month evaluation. A group of dental examiners (n = 11), who had previous experience in epidemiological surveys, participated in the study. An initial training phase (theoretical and clinical) and five calibration exercises (baseline, 3, 6, 9 and 12 months) were arranged. World Health Organization (WHO) criteria, including the active initial lesions (IL) were used. Six- to 7-year-old children took part in the study. They were selected according to past history and dental caries activity. The data were analyzed at WHO and WHO + IL diagnostic thresholds in accordance with tooth and dental surfaces. Excellent mean intra- and inter-examiner Kappa values were obtained for both diagnostic thresholds, in accordance with tooth and surface, during the calibration phases. However, the most relevant errors were related to the decayed component and to IL diagnosis. It was possible to use the methodology proposed in this study in epidemiological surveys when examining the mixed dentition, although new strategies to improve training in IL diagnosis and calibration are necessary.

The antidepressant-like effect of Hypericum caprifoliatum Cham & Schlecht (Guttiferae) on forced swimming test results from an inhibition of neuronal monoamine uptake. A crude (ECH) and a purified cyclohexane extract (HCP) of Hypericum caprifoliatum and their main phloroglucinol derivative (HC1) were evaluated regarding their action on monoaminergic systems, more precisely on dopamine. In rats and mice forced swimming test, ECH and HCP dose-dependently reduced the immobility time. The effect of the highest dose was prevented by a prior administration of either sulpiride or SCH 23390 (D(2) and D(1) dopamine receptor antagonist, respectively). HCP (360 mg/kg) decreased the locomotor activity of mice. ECH (90 mg/kg) caused hypothermia and potentiated apomorphine-induced (16 mg/kg) hypothermia in mice. HCP and HC1 inhibited, in a concentration-dependent and monophasic manner, the [(3)H]-DA, [(3)H]-NA and [(3)H]-5HT synaptosomal uptakes, but did not prevent the binding of specific ligands to the monoamine transporters. Moreover, when tested at the concentrations corresponding to its IC(50) on [(3)H]-DA uptake, HC1 did not induce a significant [(3)H]-DA release, while at a higher concentration (200 ng/ml) it enhanced significantly (by 12%) the synaptosomal DA release. These data suggest that the antidepressant-like effect of H. caprifoliatum on the forced swimming test is due to an increase in monoaminergic transmission, resulting from monoamine uptake inhibition, more potently of dopamine, which may be related to their phloroglucinol contents.

In vitro wear rates of materials under different loads and varying pH. Despite the need for information about the wear characteristics of restorative materials, there have been few systemic studies of the factors that influence the rate of material wear. This study compared the wear rates of enamel and 3 tooth-colored restorative materials under different loads (0, 3.2, 6.7, and 9.95 kg) and pH levels (1.2, 3.3, and 7.0). An electromechanical tooth wear machine was used so that standard restorations representing 3 materials could be worn by opposing enamel under controlled conditions. The wear rates of enamel, composite (Z100), a conventional glass ionomer cement (Fuji IX), and a resin-modified glass ionomer cement (Fuji II LC) were compared at a range of loads (0 to 9.95 kg) and pH levels (1.2 to 7.0) and also at different sites across each restoration. Ten specimens were randomly assigned to each experimental group. Wear assessment was performed with a modified light microscope to quantify the height changes at defined points across wear facets. Four-way analysis of variance was used to compare wear rates among materials, pH levels, loads, and sites. Post-hoc t tests identified significant differences between specific pairs of experimental conditions (P<.05). The wear rates of enamel and the other test materials varied significantly with pH (P<.0001), load (P<.0001), and type of material (P<.0001). Enamel wear was influenced most by varied pH, whereas the composite was least affected by acid. The conventional glass ionomer cement was more susceptible than the composite to the effects of varied pH; the acid susceptibility of the resin-modified glass ionomer cement was generally between that of the composite and conventional glass ionomer cement. Enamel and the conventional glass ionomer cement were affected similarly by load. The composite was more resistant than the conventional glass ionomer cement to wear at higher loads; the resin-modified glass ionomer cement exhibited intermediate load resistance. Within the limitations of this study, the 3 test materials were more resistant than enamel to acid, with the composite demonstrating the lowest susceptibility to acid. The acid- and load-resistance of the resin-modified glass ionomer cement was consistently less than that of the composite and greater than that of the conventional glass ionomer cement.

Secretory ranalexin produced in recombinant Pichia pastoris exhibits additive or synergistic bactericidal activity when used in combination with polymyxin B or linezolid against multi-drug resistant bacteria. Ranalexin, a cationic peptide from frogs, is a potent therapeutic antimicrobial peptide (AMP). Its limited availability is an obstacle for a wider application. A high-level production of AMPs via bioengineering is possible but remains a challenging task. In the current study, we investigated the potential antibacterial properties of recombinant ranalexin, expressed in the yeast Pichia pastoris. A 78-bp DNA fragment encoding the mature ranalexin peptide with a 6-His tag on its C-terminus was designed using the preferred codon usage of P. pastoris. The gene was inserted into pPICZaA and transformed into competent cells of P. pastoris strain KM71. The yield of secretory ranalexin reached up to ~6 mg/L culture. Time-kill curve analysis of ranalexin against both Escherichia coli and methicillin-resistant Staphylococcus aureus (MRSA) demonstrated a concentration- dependent rapid bactericidal activity. In checkerboard assays, the combinations of ranalexin with the established antibiotics polymyxin B or linezolid reduced the MIC additively in most tested bacteria. Time-kill assays indicated a significant synergism in E. coli and MRSA when ranalexin was used in combination with antibiotics, even at concentrations of 1/4 MIC or 1/2 MIC of ranalexin, respectively. Thus we propose that secretory ranalexin produced in P. pastoris could be a useful tool to unravel ranalexin’s biological function and for use in future in vivo studies against multi- resistant bacterial infections.

Frequency and distribution of mitomycin C-induced structural chromosome aberrations in lymphocytes from non-Hodgkin lymphoma patients. Lymphocytes from 15 untreated patients with non-Hodgkin lymphoma (NHL) and 15 controls were exposed to 0.08 micrograms/ml mitomycin C, and the frequency and distribution of structural chromosome aberrations (chromatid and chromosome gaps, breaks, and exchanges) were analyzed in 100 mitoses per subject. The mean frequencies of aberrant cells, and gap, break, and gap + break events were 8.7, 0.9, 9.7, and 10.6 in the NHL group and 11.6, 1.1, 12.7, and 13.8 in the control group. None of the differences between the two groups was significant (P greater than 0.05). The distribution of breakpoints was nonrandom (P less than 0.001) in both groups, with a particularly marked excess of breaks in 9q11. The other breakage-prone bands were 1q11 and 1q21 in the NHL group and 1p11, 1q11, 2q31, and 16q11 in the control group. None of these hot spots coincided with any of the 60 bands known to be involved in primary chromosome abnormalities in NHL.

Analysis of the full-length genome sequence of papaya lethal yellowing virus (PLYV), determined by deep sequencing, confirms its classification in the genus Sobemovirus. Papaya lethal yellowing virus (PLYV) causes an economically important disease in papayas in northeastern Brazil. Based on biological and molecular properties, PLYV has been tentatively assigned to the genus Sobemovirus. We report the sequence of the full-length genome of a PLYV isolate from Brazil, determined by deep sequencing. The PLYV genome is 4,145 nt long and contains four ORFs, with an arrangement identical to that of sobemoviruses. The polyprotein and CP display significant sequence identity with the corresponding proteins of other sobemoviruses. Pairwise comparisons and phylogenetic analysis based on complete nucleotide sequences confirm the classification of PLYV in the genus Sobemovirus.

Role of perceptual and conceptual similarity in category matching at age two years. Perceptual and categorical similarity were varied independently in a concept-matching task administered to 26-month-old children (N = 25). 44 test sets were assembled. Each set included a 3-dimensional standard and an array of 4 pictures, one of which was a member of the same basic or superordinate category as the standard. On each trial, placing the standard on the matching picture resulted in activation of 1 of 12 mechanical displays. The test sets varied in the perceptual and categorical resemblance of the standard to the match and to the nonmatches, as determined by adults' ratings. Perceptual similarity proved to be the primary determinant of difficulty level. When perceptual resemblance of the standard and the match were equated, superordinate and basic matches were equally difficult. When perceptual resemblance was minimal, most children were unable to recognize matches at either the basic or superordinate level.

Hypertension and the cardiometabolic syndrome--is it the blood pressure lowering or the blood pressure medication that is important? Elevated blood pressure and the cardiometabolic syndrome are often difficult clinical challenges specifically related to fusing appropriate lifestyle modifications and antihypertensive agents. This case illustrates some of the factors clinicians have utilized in approaching patients with this common but challenging clinical situation.

Efficient algorithms for generating interpolated (zoomed) MR images. This paper discusses the two-dimensional implementation of a number of modified fast Fourier transform (FFT) algorithms that efficiently interpolate (zoom) magnetic resonance (MR) images. If the original image was sampled at a rate satisfying the Nyquist criterion, these algorithms would effectively increase the sampling rate, permitting image details to be more easily discerned. The Skinner interpolating fast Fourier transform (SIFFT) avoids many of the computationally unnecessary complex multiplications that occur when interpolating using the normal fast Fourier transform algorithm. The novel interpolating fast Fourier transform (NIFFT) offers further savings when a subimage is required. Theoretical and experimental timings that compare the use of the normal FFT, SIFFT, and NIFFT algorithms for interpolation are given using magnetic resonance image reconstruction examples. Time savings of a factor of 2 to 4 are possible in typical experimental situations. Time savings of factors of 5 to 20 are possible when zooming images using two-dimensional band selectable digital filtering (2D-BSDF) in combination with decimation and the SIFFT algorithm. In 2D-BSDF, the original MRI data set is reduced in size to retain only those frequency components corresponding to a desired subimage, thereby decreasing the computational load associated with further processing. A significant reduction in computation time is achieved when modeling is combined with 2D-BSDF and SIFFT as fewer points require modeling.

Open-loop control of liquid-crystal spatial light modulators for vertical atmospheric turbulence wavefront correction. We present an open-loop adaptive optics (AO) system based on two liquid-crystal spatial light modulators (LCSLMs) that profit from high precision wavefront generation and good repeatability. A wide optical bandwidth of 300 nm is designed for the system, and a new open-loop optical layout is invented to conveniently switch between the open and closed loop. The corresponding control algorithm is introduced with a loop frequency (the reciprocal of the total time delay of a correction loop) of 103 Hz. The system was mounted onto a 2.16 m telescope for vertical atmospheric turbulence correction. The full width at half-maximum of the image of the star α Boo reached 0.636 arc sec after the open-loop correction, while it was 2.12 arc sec before the correction. The result indicates that the open-loop AO system based on LCSLMs potentially has the ability to be used for general astronomical applications.

A trial of outpatient chemotherapy for recurrent head and neck tumors. A four-drug combination chemotherapy (bleomycin-methotrexate-vinblastine-CCNU) had been used in 38 evaluable patients with recurrent squamous cell carcinoma of the head and neck region on an outpatient basis. A large number of these patients had carcinoma of the oral cavity (45% of total). Nineteen patients (50%) responded to this regimen with a greater than or equal to 50% regression of their measured tumors. The median survival of all patients was 34 weeks. There was one chemotherapy-related death and the overall toxicity was mild. This convenient regimen can be considered a useful alternative to more aggressive therapy.

Interference with thymocyte differentiation by an inhibitor of S-adenosylhomocysteine hydrolase. Adenosine deaminase (ADA) deficiency causes severe combined immune-deficiency disease in humans. It is believed that the accumulation of the ADA substrate deoxyadenosine affects T cell development through interference with deoxynucleotide metabolism and/or S-adenosylmethionine-mediated methylation processes. In this study, we used a specific inhibitor of methylation, (Z)-5'-fluoro-4',5'-didehydro-5'-deoxyadenosine (FddA), to study the effect of inhibition of methylation on intrathymic T cell development in a murine model for ADA deficiency. FddA causes inhibition of thymocyte differentiation specifically at the CD8low and CD4CD8 double-positive stages. This inhibition is not due to induction of apoptosis, rather it is a result of specific inhibition of regulation of the levels of the mRNAs coding for TCR and CD4 and CD8 co-receptor molecules that normally occurs at these stages of thymocyte differentiation. We hypothesize that the transcription of these T cell-specific molecules is regulated by a common developmental stimulus involving a S-adenosylmethionine-mediated methylation step. Identification of this step will help in understanding the role of methylation in intrathymic differentiation and will also provide a molecular explanation for the tissue and developmental stage specificity observed in severe combined-immune-deficient patients with ADA deficiency.

Epistaxis during nasotracheal intubation: a randomized trial of the Parker Flex-Tip™ nasal endotracheal tube with a posterior facing bevel versus a standard nasal RAE endotracheal tube. Nasotracheal intubation is a widely performed technique to facilitate anesthesia induction during oral, dental, and maxillofacial surgeries. The technique poses several risks not encountered with oropharyngeal intubation, most commonly epistaxis due to nasal mucosal abrasion. The purpose of this study was to test whether the use of the Parker Flex-Tip™ (PFT) nasal endotracheal tube (ETT) with a posterior facing bevel reduces epistaxis when compared with the standard nasal RAE ETT with a leftward facing bevel. Sixty American Society of Anesthesiologists physical status I and II patients undergoing oral or maxillofacial surgery with nasotracheal intubation were recruited. Patients were randomized to either a standard nasal RAE ETT or a PFT nasal ETT. The ETT was thermosoftened and lubricated for both study groups prior to insertion, and the size of the tube was chosen at the discretion of the attending anesthesiologist. The primary outcome was the incidence of epistaxis, with a secondary outcome of epistaxis severity (scored as none, mild, moderate, or severe). An investigator measured both outcomes five minutes after intubation was completed. Mild or moderate epistaxis was experienced by 22 of 30 (73%) patients in the PFT group compared with 21 of 30 (70%) patients in the standard nasal RAE ETT group (absolute risk reduction, 3%; 95% confidence interval, -19 to 25; P = 0.78). There were no occurrences of severe epistaxis in either group. There was no difference in the incidence or severity of epistaxis following nasal intubation using the Parker Flex-Tip nasal ETT when compared with a standard nasal RAE ETT. This trial was registered at ClinicalTrials.gov, identifier: NCT02315677.

ACE inhibitory tetrapeptides from Amaranthus hypochondriacus 11S globulin. Amaranth seed is a valuable source of dietary protein with very high nutritional quality, and recently its potential as a nutraceutical has been proposed. The aim of this work was to provide experimental evidence for the presence of anti-hypertensive peptides in globulin 11S, one of the major constituents of the seed, by means of an in-silico based peptide library screening method. A three-dimensional model of globulin 11S was built, upon which anti-hypertensive peptides were mapped via a database-driven method. Solvent accessibility was evaluated for each potential peptide, and two potent and exposed tripeptides were detected: IKP and LEP. An N-terminal extension of these two peptides was built using the globulin 11S primary sequence information, and ACE inhibitory behaviour was simulated by automated ligand-protein docking. The occurrence of two inhibitory tetrapeptides, ALEP and VIKP, was predicted and experimentally validated by an in vitro ACE inhibition assay that showed IC50 values of 6.32 mM and 175 microM, respectively. This study is the first to provide experimental proof of the anti-hypertensive value of Amaranth. Furthermore, this is the first time that a peptide docking approach is used to find ACE-inhibitory peptides from a food protein source.

Gadolinium-enhanced MRI in central nervous system Behçet's disease. Two cases of central nervous system Behçet's disease, studied by gadolinium-enhanced MRI, are presented. In one patient, whose clinical picture was dominated by a brain syndrome, the gadolinium enhancement resolved with clinical improvement, although the hyperintense areas in the mesencephalon on T2-weighted images persisted. In the second, who had a pseudobulbar palsy and a mild right hemiparesis, there were many abnormal areas, but an enhancing focus in the posterior limb of the left internal capsule was probably the lesion responsible for the hemiparesis.

Aromatase inhibitors in prevention--data from the ATAC (arimidex, tamoxifen alone or in combination) trial and the design of IBIS-II (the second International Breast Cancer Intervention Study). Current prevention trials have shown that tamoxifen can reduce the incidence of breast cancer by about 30%-40% in high-risk women, but that the risk of thromboembolic disease and endometrial cancer are increased about twofold. An alternative approach for postmenopausal women is to use an aromatase inhibitor to reduce oestrogen to very low levels. Data from the ATAC adjuvant trial indicate that the aromatase inhibitor anastrozole is more effective than tamoxifen in reducing recurrence and preventing new contralateral tumours, and also has a more favourable side-effect profile. This has led us to launch a new prevention trial--IBIS-II--in 6,000 high-risk postmenopausal women comparing anastrozole against placebo. A parallel trial will compare anastrozole against tamoxifen in 4,000 women with locally excised DCIS.

Preparation and evaluation of rhenium-188-pamidronate as a palliative treatment in bone metastasis. Rhenium-188-hydroxyethylidene diphosphonate (188Re-HEDP) as a first generation bisphosphonate has been widely used for bone seeking radiopharmaceutical in cases of metastatic bone disease. No study has been yet reported on preparing a complex of 188Re with pamidronate (3-aminohydroxypropylidene-1,1-bisphosphonic acid) (PMA) as a second generation bisphosphonate. Based on this fact, it was hypothesized that a bone-seeking 188Re-PMA radiopharmaceutical could be developed as an agent for palliative radiotherapy of bone pain due to skeletal metastases. Pamidronate was labeled with 188ReO4- eluted from the alumina based 188W/188Re generator. Labeling was optimized, and radiochemical analysis was performed by thin layer chromatography (TLC) and high performance liquid chromatography (HPLC). Biodistribution of this radioconjugate was evaluated and verified further in mice. 188Re-PMA was prepared successfully in a high labeling yield (˃95%) corresponding to a specific activity of 124MBq/μmol and good in vitro stability, but it is likely to consist of multiple species. In biodistribution studies selective uptake and retention of activity in the skeletal system (0.81±0.25% ID/g and 0.57±0.16 at 4 and 48h in bone post injection respectively) followed by clearance in the soft tissues were observed. These results show that due to its biological capabilities it would be advantageous to use 188Re-PMA for bone pain palliation therapy.

Milia en plaque. Milia en plaque is a rarely reported entity which is usually appearing in the auricular region. We describe a well-defined, U-shaped milia en plaque arising in the infraorbital area, and emphasize that it should be considered in the differential diagnosis of xanthalesma.

Impact of the financial crisis on COPD burden: Greece as a case study. Poverty and low socioeconomic status have been associated with chronic obstructive pulmonary disease (COPD). The current financial crisis has forced millions back into poverty. Greece is one of the countries hit the hardest, and is in the middle of a deep ongoing collapse. There have been early reports stating the apparent effects of the Greek downturn on respiratory health. This review summarises the overall impact of the financial crisis on COPD burden throughout the period of economic downturn by analysing the case study of Greece. In all levels of the healthcare system, current economic restrictions have reduced the capacity to prevent, diagnose and treat COPD in parallel with current higher detection rates of COPD. Remarkably, expenditure on healthcare has been reduced by >25%, resulting in major healthcare equipment shortages. Lower wages (by up to 20%) and higher co-payments of up to 25% of a drug's purchase price have led to patients struggling to afford inhaled medications. Treatment nonadherence has been reported, resulting in 11.5% more exacerbations and 14.1% more hospitalisations annually, while the mean cost per severe COPD exacerbation has been approximated as €2600. Greece is a noteworthy example illustrating how COPD burden, quality of care and patients' outcome can be affected by economic crisis.

Surgical treatment of metastases to the pancreas. Metastases to the pancreas are rare and their surgical treatment is not well reported. We present a considerable experience from a single centre analysing various prognostic factors. Data were collected on 13 cases who underwent surgery between 1988 and 2002. Since 1997, data have been recorded prospectively on a dedicated database. Clinical and histopathological factors were reviewed. There were two women and 11 men with a median age of 62 years (range 40-73). There were seven cases of renal cell carcinomas, three colorectal carcinomas, two sarcomas and one lung carcinoma. A prolonged disease-free interval from primary surgery was characteristic for renal cell carcinoma cases (median = 10.8 years). The operative procedures performed included seven pancreatoduodenectomies, four total and two distal pancreatectomies. The operative mortality and morbidity was 7.7% and 46.1% respectively. The overall one- and two-year survival was 78.8% and 54% respectively. Median survival for renal cell carcinoma was 30.5 months and for non-renal cell carcinoma was 26.4 months (p = 0.76). Pancreatectomy should be considered for metastases to the pancreas in the absence of generalised metastatic disease. However, decision making and experience should be concentrated in centres with significant familiarity of this approach.

HPLC method for determination of the purity of a mebrofenin-ligand for 99mTc-complexes. A reversed-phase HPLC method has been developed for the estimation of purity and quantitative determination of mebrofenin UV detection at 205 nm was used. The stability of mebrofenin alone and in the presence of stannous chloride at 25 degrees C was studied. No decomposition product was found and there was no influence of SnCl2 on the stability of mebrofenin.

Human milk enhances antioxidant defenses against hydroxyl radical aggression in preterm infants. Preterm infants endowed with an immature antioxidant defense system are prone to oxidative stress. Hydroxyl radicals are very aggressive reactive oxygen species that lack specific antioxidants. These radicals cannot be measured directly, but oxidation byproducts of DNA or phenylalanine in urine are reliable markers of their activity. Human milk has a higher antioxidant capacity than formula. We hypothesized that oxidative stress associated with prematurity could be diminished by feeding human milk. We recruited a cohort of stable preterm infants who lacked perinatal conditions associated with oxidative stress; were not receiving prooxidant or antioxidant drugs, vitamins, or minerals before recruitment; and were fed exclusively human milk (HM group) or preterm formula (PTF group). Collected urine was analyzed for oxidative bases of DNA [8-hydroxy-2'-deoxyguanosine (8-oxodG)/2'-deoxyguanosine (2dG) ratio] and oxidative derivatives of phenylalanine [ortho-tyrosine (o-Tyr)/Phe ratio] by HPLC coupled to tandem mass spectrometry. Healthy term newborn infants served as control subjects. Both preterm groups eliminated greater amounts of metabolites than did the control group. However, the PTF group eliminated significantly (P < 0.02) higher amounts of 8-oxodG (8-oxodG/2dG ratio: 10.46 +/- 3.26) than did the HM group (8-oxodG/2dG ratio: 9.05 +/- 2.19) and significantly (P < 0.01) higher amounts of o-Tyr (o-Tyr/Phe ratio: 14.90 +/- 3.75) than did the HM group (o-Tyr/Phe ratio: 12.53 +/- 3.49). When data were lumped together independently of the type of feeding received, a significant correlation was established between the 8-oxodG/2dG and o-Tyr/Phe ratios in urine, dependent on gestational age and birth weight. Prematurity is associated with protracted oxidative stress, and human milk is partially protective.

Avascular necrosis of the hallucal sesamoids update with reference to two case-reports. We report two cases of nontraumatic metatarsal pain with sclerosis and fragmentation of the lateral sesamoid bone on roentgenographs and computed tomography images. One patient underwent magnetic resonance imaging (MRI), which showed low signal from the sesamoid bone. These imaging findings suggested osteonecrosis. Histology of the sesamoidectomy specimen confirmed this diagnosis in one patient. Avascular necrosis of the metatarsal sesamoid is an uncommon disorder. The suggestive roentgenographic and MRI findings rule out the other painful conditions of the sesamoid bone. The features are reviewed and the treatment options discussed.

[The practice of systematic reviews. III. Evaluation of methodological quality of research studies]. The methodological quality of the primary studies included in a systematic review may influence its results and final conclusions. Methodological quality may be defined in various ways. Partially because of this there are many different assessment lists. The most important dimension of quality is internal validity, defined as the confidence that the design, performance and report of a trial prevent or reduce systematic errors (bias) in the outcomes. For only a limited number of internal validity items a relationship with bias has been proven in empirical studies: concealment of randomisation and blinding of patients and outcome assessors. Preferably, quality should be assessed by at least 2 assessors independently. There is no consensus whether assessment should be done blinded for authors, journal, results and conclusions. Internal validity can be incorporated into statistical pooling in various ways: as a selection criterion, to be used as weight or to hierarchically order studies in a presentation. Well-designed comparative studies are needed to provide clearer guidelines for methodological assessment in the future.

Cancer drug troglitazone stimulates the growth and response of renal cells to hypoxia inducible factors. Troglitazone has been used to suppress the growth of a number of tumors through apoptosis and autophagy. However, previous in vitro studies have employed very high concentrations of troglitazone (≥10(-5) M) in order to elicit growth inhibitory effects. In this report, when employing lower concentrations of troglitazone in defined medium, troglitazone was observed to stimulate the growth of primary renal proximal tubule (RPT) cells. Rosiglitazone, like troglitazone, is a thiazolidinedione (TZD) that is known to activate Peroxisome Proliferator Activated Receptor Υ (PPARΥ). Notably, rosiglitazone also stimulates RPT cell growth, as does Υ-linolenic acids, another PPARΥ agonist. The PPARΥ antagonist GW9662 inhibited the growth stimulatory effect of troglitazone. In addition, troglitazone stimulated transcription by a PPAR Response Element/Luciferase construct. These results are consistent with the involvement of PPARΥ as a mediator of the growth stimulatory effect of troglitazone. In a number of tumor cells, the expression of hypoxia inducible factor (HIF) is increased, promoting the expression of HIF inducible genes, and vascularization. Troglitazone was observed to stimulate transcription by a HIF/luciferase construct. These observations indicate that troglitazone not only promotes growth, also the survival of RPT cells under conditions of hypoxia.

Human capabilities in advanced dementia: Nussbaum's approach. To explore how Martha Nussbaum's approach to human capabilities can apply to dignity in the lives of people with advanced dementia living in nursing homes. Challenges experienced when supporting people with advanced dementia who express problematic behaviours include understanding their needs and ensuring a dignified life for them. Data were gathered using an ethnographic approach based on participatory observation. Nussbaum's capability approach was then used as a framework for the analysis. Four women diagnosed with advanced dementia who also expressed problematic behaviours were recruited from a nursing home in Northern Sweden. The data collection was performed during 2015. Individuals with advanced dementia had difficulties in participating in the planning of their lives and achieving the human capability of practical reasoning. They were also at risk of being placed outside the social group, thus hindering them from attaining the human capability of affiliation. A dignified life for individuals with advanced dementia requires nursing staff to be present and to provide adapted support to ensure that the individual can actually pursue human capabilities. Creating opportunities for the human capabilities of practical reasoning and affiliation is essential as they permeate all other human capabilities. For these individuals, it was crucial not only to create opportunities for human capabilities but also to attend to their expressions and needs and to guide and steer them towards a dignified life. The normative structure of the capability approach described by Nussbaum can ensure that nursing staffs move beyond fulfilling patients' basic needs to consider other capabilities vital for a dignified life.

Lens fiber orientation during phaco chop: clinical sign to identify appropriate nucleus depth. Phaco chop is the preferred technique for many phaco surgeons. A critical step in chopping is the surgeon's ability to impale the nucleus in the middle of the core endonucleus, which can be challenging. We describe a clinical sign in the phaco chop technique to help surgeons identify the center of the endonucleus without estimating the nucleus thickness. This technique uses the morphological structure of the lens and the lens fiber orientation to precisely gauge the depth at which the surgeon should impale and hold the nucleus for effective chopping. No author has a financial or proprietary interest in any material or method mentioned.

The crystal structure of the human Mov34 MPN domain reveals a metal-free dimer. The 26S proteasome is a large protein complex involved in protein degradation. We have shown previously that the PSMD7/Mov34 subunit of the human proteasome contains a proteolytically resistant MPN domain. MPN domain family members comprise subunits of the proteasome, COP9-signalosome and translation initiation factor 3 complexes. Here, the crystal structure of two C-terminally truncated proteins, MPN 1-186 and MPN 1-177, were solved to 1.96 and 3.0 A resolution, respectively. MPN 1-186 is formed by nine beta-strands surrounded by three alpha-helices plus a fourth alpha-helix at the C terminus. This final alpha-helix emerges from the domain core and folds along with a symmetrically related subunit, typical of a domain swap. The crystallographic dimer is consistent with size-exclusion chromatography and DLS analysis showing that MPN 1-186 is a dimer in solution. MPN 1-186 shows an overall architecture highly similar to the previously reported crystal structure of the Archaeal MPN domain AfJAMM of Archaeoglobus fulgidus. However, previous structural and biophysical analyses have shown that neither MPN 1-186 nor full-length human Mov34 bind metal, in opposition to the zinc-binding AfJAMM structures. The zinc ligand residues observed in AfJAMM are conserved in the yeast Rpn11 proteasome and Csn5 COP-signalosome subunits, which is consistent with the isopeptidase activity described for these proteins. The results presented here show that, although the MPN domain of Mov34 shows a typical metalloprotease fold, it is unable to coordinate a metal ion. This finding and amino acid sequence comparisons can explain why the MPN-containing proteins Mov34/PSMD7, RPN8, Csn6, Prp8p and the translation initiation factor 3 subunits f and h do not show catalytic isopeptidase activity, allowing us to propose the hypothesis that in these proteins the MPN domain has a primarily structural function.

A modification of play audiometry to assess speech discrimination ability in severe-profoundly deaf 2- to 4-year-old children. The aim was to develop an assessment procedure that was independent of language and speech production ability, to test speech feature discrimination in severe-profoundly deaf children 2 to 4 yr of age. The procedure being trialed was adapted from existing procedures. The child was required to respond with a game-like motor response to a "change" in a speech stimulus that was being presented repeatedly through a speaker. The change occurred at randomly determined times, and false alarm responses were measured during the waiting periods (while the child waited for the change). Two- to four-yr-old normally hearing children and hearing-impaired children using hearing aids and a group of 4-yr-old hearing-impaired children using cochlear implants were assessed on the task. More than 82% of the 3- and 4-yr-old normally hearing and hearing-impaired children were able to complete the testing for the eight speech sound contrasts within three 20 minute sessions. Fifty percent of the 2-yr-old normally hearing and hearing-impaired children were able to condition and complete the task. All of the normally hearing children who completed the task successfully discriminated all speech sound contrasts. The performance of the hearing-impaired children using hearing aids was influenced by the degree of hearing loss and the type of speech contrast being tested. Similarly, the average performance of the children using cochlear implants was better for easier contrasts such as /ba/bi/ with contrasting vowel formant cues. This procedure has potential for use as a reliable clinical and research tool for assessing the development of auditory discrimination ability in 2- to 4-yr-old severe-profoundly deaf children.

[Study of side branch ostial deformation after interventional therapy of coronary bifurcation]. To quantitative analyzing the deformation of SB, by using intravascular ultrasound (IVUS), pre and post MV stenting after cross-over interventional treatment by proposing a concept of "deformation index(DI)". And, Trying to evaluate primarily the significances of such deformation. There were 53 bifurcation lesions treated by cross-over technique. All the diameter of side branch was >2.0 mm. Proposing the concept of DI as (MaxD-MinD)/MaxD (MaxD, Maximum Diameter; MinD: Minimum Diameter) to present the morphological changes of SB ostium which was measured by IVUS. The DI will be 0 theoretically for a regular round and tend to be a ellipse if close to 1. Comparison analysis the ID of SB pre and post MV stenting and try to observing the effective factor of it and relationship with quantitative coronary angiography (QAG) in coronary bifurcation intervention. The DI of SB before and after MV stenting was 0.18 ± 0.13 and 0.26 ± 0.16(P < 0.01) respectively , DI was one of correlative factors of MinD of SB ostium measured by QAG (CO:-0.103; P = 0.015). DI was still the independent factor with QCA- MinD of SB by using partial correlation analysis (P = 0.002) when other relative factors were controlled well. Ostium of SB showed a obviously ellipse trend after MV stenting in coronary bifurcation interventional treatment. DI was one of relatives of QCA-MinD of SB after procedure and may be one the causes of aggressive QCA-MinD of SB after interventional therapy using cross-over strategy in coronary bifurcation lesion.

[DNA probes for the alternative splicing region of the 6th exon of the human CSF-1 gene. Polymerase chain reaction and subcloning]. The DNA probes--pA6-CSF-1 and pA2-CSF-1 for the alternative splicing region of the 6 exon human CSF-1 gene were prepared using PCR and subsequent subcloning in pUC19 plasmid at the XmaI/BamHI sites. Due to the insert sequencing and blotting of human leukocytes DNA, the DNA probes obtained can be useful for screening of mutations in the human CSF-1 gene.

A Double-Edged Sword: A Review of Benefits and Risks of Online Nonsuicidal Self-Injury Activities. This review aimed to synthesize current evidence on the perceived benefits and risks of online activity pertinent to nonsuicidal self-injury (NSSI). A systematic literature search was conducted to identify peer-reviewed articles, which yielded a total of 27 articles published between 2005 and 2015. Following this, a thematic analysis was employed to identify perceived benefits and risks of online NSSI activity. Our thematic analysis identified 4 potential benefits (mitigation of social isolation, recovery encouragement, emotional self-disclosure, curbing NSSI urges) and 3 potential risks (NSSI reinforcement, triggering NSSI urges, stigmatization of NSSI) associated with online NSSI activities. Given the double-edged effect of online NSSI activities, clinicians may benefit from incorporating clients' online NSSI activity in the context of NSSI assessment and treatment. Future research ought to directly examine the link between online NSSI activity and NSSI behavior to better understand the nature of these benefits and risks.

Brainstem auditory outcomes and correlation with neurodevelopment after perinatal asphyxia. We used brainstem auditory-evoked responses and neurodevelopmental assessment to detect abnormalities and correlations between such responses and neurodevelopmental outcomes in 78 children (aged 4-12 years) who survived perinatal asphyxia. Twenty children had brainstem auditory-evoked response abnormalities, including increased threshold, reduced wave V amplitude, decreased V/I amplitude ratio, and prolonged I-V interval. Thirty-seven exhibited neurodevelopmental deficits, including cerebral palsy and developmental delay. The remaining 41 exhibited no deficits. Brainstem auditory-evoked response abnormalities were evident in 15 of 37 (40.5%) children with neurodevelopmental deficits, but in only 5 of 41 (12.2%) with no deficits, which differed significantly (chi(2) = 8.2, P < 0.05). The sensitivity, specificity, positive predictive value, and false-negative rate of brainstem auditory-evoked responses to reflect neurodevelopmental outcomes were 40.5%, 87.8%, 75.0%, and 59.5%, respectively. These findings suggest that in children who survive perinatal asphyxia, brainstem auditory impairment occurs more frequently in those with versus those without neurodevelopmental deficits. Brainstem auditory-evoked responses display a moderate correlation with clinically determined neurodevelopmental outcomes. Despite limitations, brainstem auditory-evoked response is valuable for assessing auditory and neurodevelopmental outcomes after perinatal asphyxia.

Unprecedented remote sensing data over King and Rim megafires in the Sierra Nevada Mountains of California. Megafires have lasting social, ecological, and economic impacts and are increasing in the western contiguous United States. Because of their infrequent nature, there is a limited sample of megafires to investigate their unique behavior, drivers, and relationship to forest management practices. One approach is to characterize critical information pre-, during, and post-fire using remote sensing. In August 2013, the Rim Fire burned 104,131 ha and in September 2014, the King Fire burned 39,545 ha. Both fires occurred in California's Sierra Nevada. The areas burned by these fires were fortuitously surveyed by airborne campaigns, which provided the most recent remote sensing technologies not currently available from satellite. Technologies include an imaging spectrometer spanning the visible to shortwave infrared (0.38-2.5 μm), a multispectral, high-spatial resolution thermal infrared (3.5-13 μm) spectroradiometer, and Light Detection and Ranging that provide spatial resolutions of pixels from 1 × 1 m to 35 × 35 m. Because of the unique information inherently derived from these technologies before the fires, the areas were subsequently surveyed after the fires. We processed and provide free dissemination of these airborne datasets as products of surface reflectance, spectral metrics and forest structural metrics ( http://dx.doi.org/10.3334/ORNLDAAC/1288). These data products provide a unique opportunity to study relationships among and between remote sensing observations and fuel and fire characteristics (e.g., fuel type, condition, structure, and fire severity). The novelty of these data is not only in the unprecedented types of information available from them before, during, and after two megafires, but also in the synergistic use of multiple state of the art technologies for characterizing the environment. The synergy of these data can provide novel information that can improve maps of fuel type, structure, abundance, and condition that may improve predictions of megafire behavior and effects, thus aiding management before, during, and after such events. Key questions that these data could address include: What drives, extinguishes, and results from megafires? How does megafire behavior relate to fire and fuel management? How does the size and severity of a megafire affect the ecological recovery of the system?

Lysinibacillus tabacifolii sp. nov., a novel endophytic bacterium isolated from Nicotiana tabacum leaves. A Gram-positive, catalase- and oxidase-positive, strictly aerobic, endospore-forming rod bacterium, designated K3514(T), was isolated from the leaves of Nicotiana tabacum. The strain was able to grow at temperatures of 8-40°C, pH 5.0-10.0 and NaCl concentrations of 0-7%. The predominant quinones (>30%) of this strain were MK-7(H2) and MK-7. Phylogenetic analysis of 16S rRNA gene sequence showed that strain K3514(T) was affiliated to the genus Lysinibacillus, with its closest relatives being Lysinibacillus mangiferihumi (98.3% sequence similarity), Lysinibacillus sphaericus (97.9% sequence similarity), Lysinibacillus fusiformis (97.4% sequence similarity), and Lysinibacillus xylanilyticus (97.3% sequence similarity). However, low levels of DNA-DNA relatedness values suggested that the isolate was distinct from the other closest Lysinibacillus species. Additionally, based on analysis of morphological, physiological, and biochemical characteristics, the isolate could be differentiated from the closest known relatives. Therefore, based on polyphasic taxonomic data, the novel isolate likely represents a novel species, for which the name Lysinibacillus tabacifolii sp. nov. and the type strain K3514(T) (=KCTC 33042(T) =CCTCC AB 2012050(T)) are proposed.

Total and Differential White Blood Cell Counts, Cocaine, and Marijuana Use in Patients With Schizophrenia. Schizophrenia is associated with blood inflammatory marker abnormalities. Illicit drug use, which is common in schizophrenia, may modulate inflammatory marker levels. We examined effects of marijuana and cocaine use on white blood cell (WBC) counts in acutely ill, hospitalized patients with schizophrenia using a within-subjects and between-groups design. Mean total and differential WBC counts were first compared in acutely ill patients with schizophrenia for hospitalizations with and without either marijuana (n = 18) or cocaine (n = 24) use. Mean total and differential WBC counts were then compared between patients with schizophrenia with either marijuana or cocaine use and patients with a negative urine drug screen (UDS; n = 43). Patients with schizophrenia had significantly higher total WBC, lymphocytes, and monocytes during hospitalizations with (vs. without) cocaine use. Patients with cocaine use also had significantly higher monocytes and eosinophils than those with a negative UDS. Our findings suggest that substance use, particularly of cocaine, may modulate inflammatory marker levels in acutely ill, hospitalized patients with schizophrenia.

Comparative evaluation of the prophylactic effect of slow release devices containing homidium bromide and isometamidium on Trypanosoma congolense in rabbits. Two consecutive experiments were carried out to evaluate the prophylactic effect of biodegradable slow release devices (SRD), containing either isometamidium or homidium bromide. Rabbits subcutaneously implanted with SRD, were challenged with different Trypanosoma congolense stocks at regular intervals between 1 and 6.5 months after treatment. In a first experiment the efficacy of two types of isometamidium-SRD (poly(D,L-lactide) and poly(D,L-lactide-co-glycolide)) was compared with the classical intramuscular (i.m.) injection of the drug. Since the former polymer gave an average protection period, which was much longer than the other isometamidium formulation, a second experiment was carried out to evaluate the prophylactic effect of poly(D,L-lactide) SRD, containing either isometamidium or homidium bromide, with that of the i.m. injections of the same drugs at a dose of 1 mg kg-1. The average protection period of the homidium bromide SRD was significantly longer than that of the i.m. injected drug (112 vs. 49 days). No significant difference was obtained, however, when isometamidium was administered either as a SRD or as an i.m. injection. The average protection periods were, respectively, 106 +/- 37 days and 84 +/- 18 days. When breakthrough isolates derived from SRD-treated animals were compared with the original stocks of T. congolense, the former showed some loss of sensitivity to homidium bromide. No difference in sensitivity was observed, however, for isometamidium.

Simultaneous double-opposing Z-plasty and posterior pharyngeal flap. Strategies to address severe anteroposterior palatal shortening with velopharyngeal insufficiency include palatal lengthening or manipulation of posterior pharyngeal tissue as a flap or sphincter. In some cases, a single procedure alone is not sufficient to achieve dynamic velopharyngeal closure. The objective of this study was to determine whether double-opposing Z-plasty coupled with a posterior pharyngeal flap would achieve adequate palatal length in severe velopharyngeal dysfunction. Six patients, 3 with previously unrepaired cleft palate and 3 children with previous straight-line repairs and significant anteroposterior shortening, were included. Demographic and perioperative information was tabulated. Subjective and objective speech data were gathered, if available. Complications, follow-ups, and postoperative nasometric results were compiled. Statistical analysis involved the paired t test. There were no perioperative complications. Follow-up was at least 1 year. No postoperative fistulas or nasal obstruction developed. Hypernasal speech and nasal emission were subjectively improved in all patients. Nasometric data showed a statistically significant improvement in nasal air escape with speech. Simultaneous double-opposing Z-plasty and posterior pharyngeal flap can be performed effectively. This strategy is useful for severe velopharyngeal dysfunction secondary to anteroposterior palatal shortening or a previously unrepaired cleft palate, and the technique optimizes palatal function and creates a mechanical blockade to nasal air escape.

[Neurobiological subtypes of geriatric depression. Their importance for diagnosis and treatment]. With age, increasing biological constraints on functioning are often aggravated by increases in multimorbidity. These effects, however, not only have an impact on somatic, but also psychological processes. In geriatric depression, for instance, there are both effects of recurrent depressive episodes on the neurobiology of the disorder as well as effects of cardiovascular comorbidity that interact with brain areas associated with the perception and regulation of emotions. These biobehavioral interactions have strong implications for both the differential diagnosis and treatment of geriatric depression.

cDNA cloning of the human retinal rod Na-Ca + K exchanger: comparison with a revised bovine sequence. To clone the complementary DNA of the human retinal rod Na-Ca + K exchanger. A human retinal cDNA library was screened initially with a radiolabeled probe representing the entire bovine rod Na-Ca + K exchanger cDNA and subsequently with probes from polymerase chain reaction fragments of the human retinal rod Na-Ca + K exchanger obtained after the initial screen. Twelve positive clones were used to obtain the entire coding sequence of the human retinal rod Na-Ca + K exchanger. The cDNA of the human retinal rod Na-Ca + K exchanger codes for a protein of 1081 amino acids, which shows 64.3% overall identity with the bovine retinal rod Na-Ca + K exchanger at the amino acid level. The two sets of putative transmembrane-spanning domains and their short connecting loops showed the highest degree of identity (94%-95%), whereas the extracellular loop at the N terminus showed a 59% identity. The large cytosolic loop that bisects the two sets of transmembrane-spanning domains contained two large deletions in the human exchanger; the first deletion contains 18 amino acids, whereas the second deletion involves a series of repeats that are dominated by acidic amino acid residues observed in the bovine, but not in the human, sequence. The authors observed that the bovine sequence contains a ninth repeat in addition to the eight repeats of the published sequence. The authors cloned the cDNA of the human retinal rod Na-Ca + K exchanger as a first step in examining the possibility that this gene could be the locus of disease-causing mutations.

[Are the indications and choice of labile blood products adapted? National survey on prescriber's knowledge]. There is little data available on current practice related to prescription of labile blood products (LBP) by French physicians. The aim of this study was to assess whether prescriptions were conform to Anaes (French Medicine's agency) guidelines, with regard not only to indications but also quality of the products, so as to define the improvements that could be made. Thirty-four clinical case reports, classified by specialties were sent to prescribing physicians working in the regional health centers, from 17 different blood banks, from October 1997 to February 1998. The prescribers were requested to answer only the questions that were specific to their particular field of experience. Each case description included multiple choice questions on the indication for transfusion of concentrated of red blood cells (RBC) and/or platelets (CP) and/or plasma, and the possible requirements for specification or modification of the guidelines applicable to these products. The primary end point of analysis was the adequation of the answers to the Anaes recommendations. Answers were obtained regarding 5092 clinical cases from 818 physicians. The participation rate was of 30%. The specialties were as follows: 34% anesthesiologists, 14% oncologists-haematologists, 13% internal medicine specialists, 11% emergency physicians, 10% paediatricians, 8% obstetricians, 7% geriatricians, and 3% transplantation surgeons. Eighty-two percent of the answers came from physicians working in the public health services. The adequation with the indication for transfusion was of 90.3% for RBC, 92.3% for platelets and 93.8% for plasma. The percentages of correct answers regarding the indications for specification or modification of the LBP were as follows: 90.3% were correct for irradiation (of either RBC or platelets); 68.8% and 53.2% respectively for leukocyte depletion from RBC and platelets; 64% for phenotyped RBC; 68.2% for compatibilized RBC; and 57.3% for apheresis platelet concentrates. There was no difference in results depending on the type of center, private or public, and the quality of LBP prescribed. The answers obtained from the anaesthesiologists' clinical cases were less accurate with regard to RBC but more accurate with regard to PC compared with other specialists. This study shows the correct management of the indications for transfusion by the prescribing physicians who participated in the study, but the lack of knowledge with regard to the indications for specifications and/or transformations of LBP. The respect of the indications for transfusion is the corner stone of safe transfusion and this phase should be optimized with improved dissemination of information on transfusion and training for the physicians and programs that would improve the quality.

[Expression of thioredoxin-2 for monitoring minimal residual disease in acute leukemia]. To investigate the significance of human thioredoxin-2 (TRX-2) in monitoring minimal residual disease (MRD) in acute leukemia (AL). We used real-time quantitative PCR to serially quantitize TRX-2 expression levels in the bone marrow of AL patients at diagnosis (n=68), at complete hematologic remission (CHR, n=57) and at relapse (n=25). Another 25 normal donors served as normal controls. The upper limit of the bone marrow at 91 was regarded as the reference. TRX-2 expression level at CHR with <5% blast cells in the bone marrow of relapse patients was analyzed and compared with MRD by flow cytometry. The TRX-2 levels between the CHR patients and newly diagnosed patients, and between the CHR patients and the relapse patients had significant difference. TRX-2 expression level of 21(21/25) relapse patients at CHR with <5% blast cells in the bone marrow was higher than the reference (>91). TRX-2 level was correlated to the expression level of MRD. TRX-2 may be the marker for AL and used in MRD monitoring.

Absence of effect of danazol on estrogen-induced luteinizing hormone release from rat hypothalamo-pituitary axis in vitro. The effects of danazol on luteinizing hormone (LH) release by estradiol (E2) were examined in a sequential double chamber superfusion system by superfusing the mediobasal hypothalamus (MBH) and pituitary excised from normal female rats in diestrus. Administration of 3x10(-13) mole E2 caused a significant (p less than 0.05) increase of LH (80-220% above the pre-injection level) from the pituitary in series with MBH superfused with Medium 199 alone or Medium 199 containing 10(-4)M danazol. These data indicate that acute administration of danazol does not affect estrogen-induced LH release in rats.

Obesity, Diabetes, and Acute Coronary Syndrome: Differences Between Asians and Whites. Most diabetes and cardiovascular studies have been conducted in white patients, with data being extrapolated to other population groups. For this analysis, patient-level data were extracted from 5 randomized clinical trials in patients with acute coronary syndrome; we compared obesity levels between Asian and white populations, stratified by diabetes status. By using an adjusted Cox proportional hazards model, hazard ratios (HRs) for cardiovascular outcomes after an acute coronary syndrome were determined. We identified 49,224 patient records from the 5 trials, with 3176 Asians and 46,048 whites. Whites with diabetes had higher body mass index values than those without diabetes (median 29.3 vs 27.2 kg/m2; P < .0001), whereas Asians with diabetes and without diabetes had similar body mass index (24.7 vs 24.2 kg/m2). Asians with diabetes (HR, 1.63; 95% confidence interval [CI], 1.32-2.02), whites with diabetes (HR, 1.15; 95% CI, 1.06-1.25), and Asians without diabetes (HR, 1.36; 95% CI, 1.14-1.64) had higher rates of the composite of death, myocardial infarction, or stroke at 30 days than whites without diabetes. Asians with diabetes (HR, 1.84; 95% CI, 1.47-2.31), whites with diabetes (HR, 1.47; 95% CI, 1.33-1.62), and Asians without diabetes (HR, 1.38; 95% CI, 1.11-1.73) had higher rates of death at 1 year compared with whites without diabetes. There were no significant interactions between race and diabetes for ischemic outcomes. Although Asians with diabetes and acute coronary syndrome are less likely to be obese than their white counterparts, their risk for death or recurrent ischemic events was not lower.

Construction of PCR primers to detect and distinguish Eimeria spp. in northern bobwhites and a survey of Eimeria on gamebird farms in the United States. Coccidiosis is an important disease in captive gamebirds, including northern bobwhites (Colinusvirginianus). Three Eimeria species, Eimeria lettyae, Eimeria dispersa, and Eimeria colini, have been described in bobwhites. Distinguishing the various Eimeria spp. is often problematic because of similarity in oocyst morphology and site of infection and thus requires live bird infections to distinguish between the coccidian species. To aid in identification and diagnosis, PCR specific primers were generated against the internal transcribed spacer region 1 (ITS-1) of the ribosomal RNA gene using sequences obtained from coccidian-positive samples collected from diagnostic cases or litter from captive bobwhites. Three distinct Eimeria spp. were detected. Species-specific primers were constructed and used to survey the prevalence of the species in 31 samples collected from 13 states. The primers survey results identified E. lettyae, E. dispersa, and Eimeria sp. in 20 (64.5%), 22 (71%), and 29 (93.5%) of the samples, respectively. Mixed infections were common: 13 (41.9%) samples had 3 Eimeria spp., 14 (45.2%) had 2 spp., and 4 (12.9%) samples had only 1 species. The species were widely distributed over the area sampled and were not associated with the age of the flock.

Clinical and hemodynamic evaluation of propranolol in combination with verapamil, nifedipine and diltiazem in exertional angina pectoris: a placebo-controlled, double-blind, randomized, crossover study. The clinical and hemodynamic effects of propranolol, propranolol-verapamil (P-V), propranolol-nifedipine (P-N) and propranolol-diltiazem (P-D) were studied in 19 patients with chronic exertional angina pectoris. A placebo-controlled, double-blind, randomized, crossover study design was used in which patients took each treatment for a 4-week period. The 3 combinations equally reduced the incidence of angina attacks and decreased ST-segment depression. Left ventricular hypokinesia during exercise was lessened and end-systolic volume during exercise decreased with all combinations. Because of a corresponding reduction of normokinetic segmental function, global ejection fraction during exercise remained unchanged. Heart size increased (p less than 0.05) and the PR interval lengthened (p less than 0.001) with P-V and P-D compared to P-N. The largest number of adverse clinical reactions occurred with P-V, whereas the fewest occurred with P-D. Almost all patients preferred combined therapy over propranolol and many favored 1 combination over the others. In summary, when therapy with combined beta- and calcium channel-blocking drugs is planned, P-D should be considered the combination of first choice because of its low incidence of adverse clinical effects. In the presence of possible or definite abnormalities of atrioventricular nodal conduction or decreased left ventricular function, P-N should be considered. Although P-V is associated with frequent adverse reactions, a trial may be warranted if the other combinations are unsuccessful.

Chronic hemodialysis of spinal cord injury patients. Fifteen paraplegics with ESRD have been treated at the Richmond VA Medical Center. The cumulative one year survival was 57%. This is somewhat less than expected for chronic hemodialysis patients from the general population. No patients have received a kidney transplant or been supported with peritoneal dialysis for a long period. The rate of acquisition of patients in this center indicates the rate of treatable ESRD is significantly higher in the spinal cord injury population than in the general population.

5,5-Diaryl-2-amino-4-pentenoates as novel, potent, and selective glycine transporter type-2 reuptake inhibitors. A novel series of 5,5-diaryl-2-amino-4-pentenoates was synthesized and found to be potent and selective glycine transporter type-2 reuptake inhibitors.

Numerical implementation of sealed-end boundary conditions in cable theory. We show that a frequently used numerical implementation of von Neumann boundary conditions (zero inflowing current) in cable theory is incorrect. Correct implementations are given and it is shown that they yield results in good agreement with known analytical solutions.

Factors associated with mortality risk in critical care patients treated with veno-arterial extracorporeal membrane oxygenation. To identify factors associated with mortality in patients treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and to validate the discrimination of the risk assessment tools to predict mortality. VA-ECMO is a rescue therapy for patients with life-threatening cardiac failure, but mortality remains high. In this retrospective study, we reviewed the medical records of adult patients who underwent VA-ECMO in an intensive care unit of a university hospital, between 2009 and 2013. VA-ECMO was performed in 89 patients, with a median duration of 116 h. The survival rate until hospital discharge was 27%. The pre-ECMO simplified acute physiology score (SAPS) II and diabetes mellitus were significant predictors of hospital mortality. The optimal prognostic SAPS II score was 81 overall, 80 in patients with diabetes, and 84 in those without diabetes. Our findings indicate that high pre-ECMO SAPS II score and diabetes are risk factors for mortality in patients who undergo VA-ECMO.

[Species composition of yeast-like fungi isolated from HIV-infected patients]. The strains of yeast-like fungi isolated from HIV-infected people in 1994-2005 were examined. It was found that a share of non-albicans strains increased up to 46.2%, in monoculture they were present in 40% of examined patients, Candida glabrata (21.3%) being the dominant species. The definition of proteolytic activity as one of the factors of pathogenicity showed that it was typical of 90% of museum strains and 58% of fresh isolates.

Electronic structure of the YH3 phase from angle-resolved photoemission spectroscopy. Yttrium can be loaded with hydrogen up to high concentrations causing dramatic structural and electronic changes of the host lattice. We report on angle-resolved photoemission experiments of the Y trihydride phase. Most importantly, we find the absence of metal d bands at the Fermi level and a set of flat, H-induced bands located at much higher binding energy than predicted, indicating an increased electron affinity at H sites.

AltitudeOmics: impaired pulmonary gas exchange efficiency and blunted ventilatory acclimatization in humans with patent foramen ovale after 16 days at 5,260 m. A patent foramen ovale (PFO), present in ∼40% of the general population, is a potential source of right-to-left shunt that can impair pulmonary gas exchange efficiency [i.e., increase the alveolar-to-arterial Po2 difference (A-aDO2)]. Prior studies investigating human acclimatization to high-altitude with A-aDO2 as a key parameter have not investigated differences between subjects with (PFO+) or without a PFO (PFO-). We hypothesized that in PFO+ subjects A-aDO2 would not improve (i.e., decrease) after acclimatization to high altitude compared with PFO- subjects. Twenty-one (11 PFO+) healthy sea-level residents were studied at rest and during cycle ergometer exercise at the highest iso-workload achieved at sea level (SL), after acute transport to 5,260 m (ALT1), and again at 5,260 m after 16 days of high-altitude acclimatization (ALT16). In contrast to PFO- subjects, PFO+ subjects had 1) no improvement in A-aDO2 at rest and during exercise at ALT16 compared with ALT1, 2) no significant increase in resting alveolar ventilation, or alveolar Po2, at ALT16 compared with ALT1, and consequently had 3) an increased arterial Pco2 and decreased arterial Po2 and arterial O2 saturation at rest at ALT16. Furthermore, PFO+ subjects had an increased incidence of acute mountain sickness (AMS) at ALT1 concomitant with significantly lower peripheral O2 saturation (SpO2). These data suggest that PFO+ subjects have increased susceptibility to AMS when not taking prophylactic treatments, that right-to-left shunt through a PFO impairs pulmonary gas exchange efficiency even after acclimatization to high altitude, and that PFO+ subjects have blunted ventilatory acclimatization after 16 days at altitude compared with PFO- subjects.

[A peculiar form of neonatal adrenal insufficiency: the IMAGe association. Two new cases]. We report two siblings with an IMAGe syndrome. IMAGe is a newly reported syndrome characterized by the association of intra-uterine growth retardation, metaphyseal dysplasia, congenital adrenal hypoplasia and genital anomalies. This clinical association has only been described in five unrelated males. These two additional patients (one brother and one sister) suggest an autosomal recessive inheritance although identification of new cases will give further insight into the pathogenesis. The radiologic signs of osteopenia and metaphyseal dysplasia can suggest this diagnosis in affected individuals.

Identification of a novel PYP-1 gene in Sarcoptes scabiei and its potential as a serodiagnostic candidate by indirect-ELISA. Scabies is a parasitic disease caused by the ectoparasite Sarcoptes scabiei, affecting different mammalian species, including rabbits, worldwide. In the present study, we cloned and expressed a novel inorganic pyrophosphatase, Ssc-PYP-1, from S. scabiei var. cuniculi. Immunofluorescence staining showed that native Ssc-PYP-1 was localized in the tegument around the mouthparts and the entire legs, as well as in the cuticle of the mites. Interestingly, obvious staining was also observed on the fecal pellets of mites and in the integument of the mites. Based on its good immunoreactivity, an indirect enzyme-linked immunosorbent assay (ELISA) using recombinant Ssc-PYP-1 (rSsc-PYP-1) as the capture antigen was developed to diagnose sarcoptic mange in naturally infected rabbits; the assay had a sensitivity of 92·0% and specificity of 93·6%. Finally, using the rSsc-PYP-1-ELISA, the Ssc-PYP-1 antibody from 10 experimentally infected rabbits could be detected from 1 week post-infection. This is the first report of S. scabiei inorganic pyrophosphatase and the protein could serve as a potential serodiagnostic candidate for sarcoptic mange in rabbits.

The use of research abstracts in formulary decision making by the Joint Oncology Drug Review of Canada. Opinions on the use of research abstracts in policy decision making are conflicting. We sought to evaluate the influence of research abstracts in guiding decisions of the Joint Oncology Drug Review of Canada (JODR), which conducts clinical and economic reviews of new cancer treatment drugs for formulary listing. The minutes of the monthly meetings of the JODR between 2005 and 2007 were reviewed. One submission per drug indication was included. Elements evaluated included the level of evidence supporting each decision, the year the study was published and subsequent publication of any abstracts. There were 73 recommendations reviewed over the 36 months. Ten recommendations were deferred and eight recommendations were re-submissions, thus 55 recommendations underwent analysis. There were 31 recommendations based to some extent on abstracts, of which 14 (45%) were in favour of formulary listing and 17 (55%) were opposed. Twelve recommendations were based exclusively on abstracts, seven (58%) of which were in favour of formulary listing. As a comparison, published randomized controlled trials were part of the evidentiary base in 30 committee recommendations (55%). Of these, 17 (57%) were in favour of formulary listing, while 13 (43%) were opposed. Research abstracts are commonly involved in evidence-based decision making for formulary listing. The rates of approving cancer drugs for funding by the JODR were similar among recommendations based on abstracts and other levels of evidence. Abstracts can play an important role in guiding decision making.

Prinzmetal's variant form of angina as a manifestation of alpha-adrenergic receptor-mediated coronary artery spasm: documentation by coronary arteriography. In four patients with Prinzmetal's variant form of angina, the attack was induced by the combined administration of epinephrine (0.4 to 0.5 mg, given subcutaneously at 7:30 to 8:00 A.M.) and propranolol (40 mg. given orally at 5:00 A.M.). Selective coronary cinearteriography was done before, during, and after the attack with constant monitoring of the ECG and blood pressure. Severe spasm of the right coronary artery occurred at the proximal portion in association with ST-segment elevation in Lead III during the attack and disappeared with the subsidence of the attack in all of them. These results strongly suggest that severe spasm of a large coronary artery mediated by alpha-adrenergic receptors is responsible for the attack of Prinzmetal's variant form of angina.

Middle aortic syndrome: distal thoracic and abdominal coarctation, a disorder with multiple etiologies. Congenital coarctation of the thoracic aorta at the ligamentum arteriosum or the aortic arch is well recognized. But a much less common variety (0.5% to 2.0%) of aortic coarctation is located in the distal thoracic aorta, or abdominal aorta, or both and is often called "middle aortic syndrome" or "mid-aortic dysplastic syndrome." These types of aortic coarctation are most often secondary to a form of granulomatis vasculitis commonly known as Takayasu's disease in this country or aortitis syndrome in Japan. No single genesis explains every case and beside vasculitis as a cause, some are thought to be congenital in origin and others are associated with von Recklinghausen's disease. Eight patients with severe hypertension or claudication secondary to middle aortic coarctation were studied with aortograms and subsequently treated by vascular reconstruction procedures. Vascular reconstructions consisted of aortoaortic bypass, aortic resection with interposed grafting, reanastomotic resection of renal arteries into prosthetic grafts, and renal artery bypass with autogenous material. All eight patients' grafts have remained patent, with followups of 4 to 9 years, with relief of hypertension and claudication. Although Takayasu's disease can be progressive, aggressive surgical treatment in eight patients followed for 4 to 8 years postoperatively demonstrates that severe hypertension, claudication, or both are important indications for revascularization. Whatever the cause, assuming that active aortic inflammation has been medically treated and is in a burned-out state, patients with abdominal coarctation who have symptomatic renovascular hypertension, claudication, or both are good candidates for revascularization. Although surgical repair is more difficult than with congenital thoracic coarctation, because aortic walls are fibrotic and often also involve the renals, all eight of our patients had successful longterm correction of their hypertension and coarctation.

[Efficacy of educational intervention for patients wearing peripherall inserted central catheter. A pilot study]. Peripherally Inserted Central Catheter (PICC) is a central venous catheter suitable for patients who receive chemotherapy in Day Hospital regimen. The patient must be educated to a proper home management of the PICC through targeted education. To evaluate the effectiveness of a targeted educational intervention through the comparison of: indi- vidual interview, brochure paper, informative video. Single-centre randomized controlled clinical trial with a simple three-arm comparative scheme. The study population is represented by all patients undergoing the insertion of PICC at the Oncological Day Hospital and Breast Unit in the observation period between October 2013 and February 2014. The Standard educational session is performed by the nurse positioning the PICC. PICC team consists of two nurses in possession of the first level master in venous access management. Following randomization eligible patients were divided in three groups: group A received Standard educational session; group B received the standard information and the brochure; group C received the stan- dard information and the informative video. The level of the achieved knowledge was investigated by administering targeted questionnaires. A total of 40 patients joined the study: a convenience sample represented by people between the ages of 18 and 75 years, in outpatient care. Statistically significant difference in key areas necessary for the proper management of PICC: when to change the dressing (p=0.001), when to wash the catheter (p=0), how to recognize signs and symptoms of infection (p=0.001), identify at-risk behaviors (p=0.005), when carrying out the inspection of the catheter's insertion site (p=0). The administration of a multimedial educational tool was found to be superior in efficacy compared to the only Standard educational session to increase patient's knowledges. The video appears to be more effective than the brochure. The obtained results are influenced by the small sample size and by the shortness of the follow up timing; this leads to a low generalizability of the conclusions.

Bone mineral density and metabolism in levothyroxine-treated adolescent girls with euthyroid diffuse goiter. Bone and mineral metabolism is influenced by thyroid hormones, and levothyroxine (LT(4)) therapy may be associated with reduced bone mass in postmenopausal women. The aim of the study was to assess the influence of one year of LT(4) treatment in a group of 21 adolescent girls with euthyroid diffuse goiter. Lumbar (L(2)-L(4)) and total body bone mineral density (TOBMD) (Lunar - DXA), serum PTH, osteocalcin, bone alkaline phosphate, vitamin D(3), calcium, and phosphorus levels and urinary excretion of Ca, P, and hydroxyproline were measured before and after one year of combined LT(4) and iodine treatment. Patients were matched for age, sex, BMI, and maturation status, with controls treated with iodine only. Markers of bone turnover changed in a similar manner in both groups. There was no significant difference in TOBMD value after one year of therapy between LT(4) treated group and controls. Densitometric lumbar spine parameters increased significantly after 12 months in both groups, with no significant differences between them. It can be concluded that one year of LT(4) treatment of adolescent girls with euthyroid diffuse goiter does not have a negative impact on their bone remodelling and metabolism. (Pol J Endocrinol 2010; 61 (1): 14-19).

[Does the electronic cigarette have a future in medicine?]. The electronic cigarette is a subject of lively debate in the literature and the legislative. We will review the updates regarding progress on this issue by analyzing the device, the electronic cigarette composition, legislative issues and medical strategy. All will be analyzed in terms of the benefits, but also the immediate and remote consequences

Essential amino acids regulate both initiation and elongation of mRNA translation independent of insulin in MAC-T cells and bovine mammary tissue slices. Current nutrient requirement models assume fixed efficiencies of absorbed amino acid (AA) conversion to milk protein. Regulation of mammary protein synthesis (PS) potentially violates this assumption by changing the relationship between AA supply and milk protein output. The objective of this study was to investigate the effects of essential AA (EAA) and insulin on cellular signaling and PS rates in bovine mammary cells. MAC-T cells were subjected to 0 or 100% of normal EAA concentrations in DMEM/F12 and 0 or 100 μg insulin/L in a 2 × 2 factorial arrangement of treatments. Lactogenic bovine mammary tissue slices (MTS) were subjected to the same treatments, except low-EAA was 5% of normal DMEM/F12 concentrations. In MAC-T cells, EAA increased phosphorylation of mammalian target of rapamycin (mTOR; Ser2448), ribosomal protein S6 kinase 1 (S6K1; Thr389), eIF4E binding protein 1 (4EBP1; Thr37/46), and insulin receptor substrate 1 (IRS1; Ser1101), and reduced phosphorylation of eukaryotic elongation factor 2 (eEF2; Thr56) and eukaryotic initiation factor (eIF) 2-α (Ser51). In the presence of insulin, phosphorylation of Akt (Ser473), mTOR, S6K1, 4EBP1, and IRS1 increased in MAC-T cells. In MTS, EAA had similar effects on phosphorylation of signaling proteins and increased mammary PS rates. Insulin did not affect MTS signaling, perhaps due to inadequate levels. Effects of EAA and insulin were independent and additive for mTOR signaling in MAC-T cells. EAA did not inhibit insulin stimulation of Akt phosphorylation. PS rates were strongly associated with phosphorylation of 4EBP1 and eEF2 in MTS. EAA availability affected translation initiation and elongation control points to more strongly regulate PS than insulin.

Comparative evaluation of three supplements for Helicobacter pylori growth in liquid culture. Helicobacter pylori, a microaerophilic fastidious bacterium, has been cultured on various plating and broth media since its discovery. Although the agar media can be sufficient for the identification, typing, and antibiotic resistance studies, no secretory antigen of H. pylori can be evaluated in such media. Thus, satisfactory growth of H. pylori in liquid culture which is needed for analysis of secretory proteins without the presence of interfering agents is in demand. We assessed the impact of beta-cyclodextrin, Fetal Bovine Serum (FBS), and charcoal as supplements for H. pylori growth. Furthermore, we aimed to identify the most favorable supplement that supports the secretion of the dominant secretory protein, vacuolating cytotoxin (VacA). Five clinical strains were cultured on broth media and the growth, viability, morphology, and protein content of each strain were determined. Our results revealed that beta-cyclodextrin supports the growth rate, viability, and cell lysate protein content to the extent similar to FBS. Application of beta-cyclodextrin is found to postpone spiral to coccoid conversion up to 72 h of incubation. Although FBS supports a higher VacA protein content, presence of interfering macromolecules in FBS questions its utility particularly for purposes of studying extra cellular proteins such as VacA. This study recommends further application of beta-cyclodextrin as a culture supplement with the potential capacity in neutralizing toxic compounds and flourishing the secretion of H. pylori proteins without addition of interfering proteins.

Challenges in applying chemometrics to LC-MS-based global metabolite profile data. Metabolite profiling can provide insights into the metabolic status of complex living systems through the non-targeted analysis of metabolites in any biological sample. Metabolite profiling is complementary to genomics, transcriptomics and proteomics, and its applications span epidemiology, disease diagnosis, nutrition, pharmaceutical research, and toxicology. Metabolic phenotypes are a reflection of an organism's environment, lifestyle, diet, gut microfloral composition and are also influenced by genetic factors, with important implications in genome-wide-association studies. Specialized analytical platforms, such as NMR spectroscopy and MS, are required to interrogate such metabolic complexity. The increased sophistication of such techniques has lead to a demand for improved data analysis approaches, including preprocessing and advanced chemometric techniques. This article discusses data generation, preprocessing, multivariate analysis and data interpretation for LC-MS-based metabolite profiling, focusing on challenges encountered and potential solutions.

Schedules of Controlled Substances: Placement of Eluxadoline Into Schedule IV. Final rule. With the issuance of this final rule, the Administrator of the Drug Enforcement Administration places the substance 5-[[[(2S)-2-amino-3-[4-aminocarbonyl)-2,6-dimethylphenyl]-1-oxopropyl][(1S)-1-(4-phenyl-1H-imidazol-2-yl)ethyl]amino]methyl]-2-methoxybenzoic acid (eluxadoline), including its salts, isomers, and salts of isomers, into schedule IV of the Controlled Substances Act. This scheduling action is pursuant to the Controlled Substances Act which requires that such actions be made on the record after opportunity for a hearing through formal rulemaking. This action imposes the regulatory controls and administrative, civil, and criminal sanctions applicable to schedule IV controlled substances on persons who handle (manufacture, distribute, dispense, import, export, engage in research, conduct instructional activities, or possess) or propose to handle eluxadoline.

[Nasal packing and packing materials chosing after ESS (with clinical analysis of 769 cases)]. Nasal packing after endoscopic sinus surgery is an important factor affecting the outcome of the operation. In order to discuss the clinical effect of no packing method and packing with different materials, we summarized our six years packing experiences of 769 cases (993 nasal cavities) undergoing ESS. The paper disclosed that if operation cavities didn't involve in middle turbinate, inferior turbinate and nasal septum, no packing method could be chosen; Otherwise, packing with different materials could be chosen, both methods could control the postoperative hemorrhage in a safe range. But in order to reducing patients' pain and operation cavities' reaction, it suggests operators had better choose no packing method or packing with absorbable hemostate gauze.

Intravenous abuse of propylhexedrine (Benzedrex) and the risk of brainstem dysfunction in young adults. In 1949, amphetamine sulfate was replaced by propylhexedrine in the nasal decongestant agent Benzedrex because of psychosis, sudden death, and widespread abuse. Propylhexedrine is not without risks, and reported cases of psychosis, myocardial infarction, pulmonary vascular disease and pulmonary hypertension, and sudden death are well documented in the medical literature. We are reporting 2 cases of definite brainstem dysfunction and 5 cases of transient diplopia secondary to IV abuse of Benzedrex. This widely abused drug is prepared by heating Benzedrex and hydrochloric acid, and the resulting crystals are dissolved in water for injection. This agent is called "stove-top speed". All 7 patients had transient diplopia, within seconds after injection. One patient had evidence of a right-internuclear ophthalmoplegia, and another had a depressed right gag reflex and paralysis of the right half of the tongue. The deficits in these two patients, persisted for many months. In young adults with history of drug abuse, the IV use of Benzedrex should be considered in the differential diagnosis of transient or permanent focal brainstem deficits.

Antioxidants in Chinese herbal medicines: a biochemical perspective. Recently, intense interest has focused on the antioxidant properties of natural products. In particular, Chinese herbal medicines (CHM) have become hot topics for life science researchers since many are reported to possess cardioprotective compounds, many of which remain to be identified. Indeed, the exact mechanisms by which CHM work remain unknown. Although many of these herbal remedies are undoubtedly efficacious, few have been scientifically investigated for their active chemical constituents and biological activities. We have previously reported higher activities of antioxidant defence enzymes such as superoxide dismutase, catalase, glutathione peroxidase and glutathione S-transferases in the liver of rats treated with the herb Salvia miltiorrhiza in a model of acute myocardial infarction. Using well established in vitro antioxidant assays employing 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) and diphenyl-l-picrylhydrazyl (DPPH) we have shown that in addition to elevating endogenous antioxidant enzyme activity, Salvia miltiorrhiza and other CHM traditionally used for cardiovascular disorders (such as Rhizoma ligustici, Herba leonuri, Radix achyranthis bidentatae, and Camellia sinensis) contain potent antioxidant moieties in addition to their phenolic constituents. Furthermore, these novel non-phenolic components are effective inhibitors of oxidative reactions mediated by the inflammatory oxidants, peroxynitrite,hypochlorous acid and hydroxyl radical as well as iron-dependent lipid peroxidation. In this review, we discuss the various antioxidant properties of CHM in the context of their biochemical mechanisms.

Correlation between presence of allodynia and sleep quality in migraineurs. Cutaneous allodynia is a frequent complaint in migraine patients, possibly induced by central sensitisation of trigeminal nucleus. The objective of this study is to investigate if sleep quality is related to the presence of migraine-associated allodynia. A total of 175 consecutive migraineurs were included, 124 with episodic and 51 with chronic forms. As control group, 73 subjects free from any kind of headache were included (HC). The presence of allodynia and sleep disturbances was assessed by a set of semi-structured questions. Chi-square test was applied to compare frequencies among groups. Sleep quality was worse among migraineurs with respect to controls for each sleep item analysed. This difference was significant for all items but one (i.e. frequency in drug use to induce sleep). The frequency of sleep disturbances was higher than in controls in both allodynic and non-allodynic migraineurs, although statistical analysis showed that all these differences were still significant in allodynic migraineurs (also in this case for all the sleep items but one, i.e. frequency in drug use to induce sleep), whilst non-allodynic migraineurs were significantly different from controls only for one item (frequency of initial insomnia). These results suggest that allodynia is strongly related to sleep quality, in a bi-directional way: sleep disturbances may favour central sensitisation, and, in turn, allodynia may impair sleep.

Study of the interactions of PAMAM G3-NH2 and G3-OH dendrimers with 5-fluorouracil in aqueous solutions. The results of spectroscopic measurements (increase in solubility, equilibrium dialysis, (1)H NMR titration) and calorimetric measurements (isothermal titration ITC) indicate spontaneous (ΔG<0) bonding of 5-fluorouracil by both cationic PAMAM G3-NH2 dendrimer and hydroxyl PAMAM G3-OH dendrimer in aqueous solutions. PAMAM G3-NH2 dendrimer bonds about n= 25±8 drug molecules. Some of them n1= 5±1 are bonded by terminal amine groups with equilibrium constant K1= 3890±930, while the remaining ones n2= 24 ±3 are bonded by amide groups with equilibrium constant K2= 110±30. Hydroxyl PAMAM G3-OH dendrimer bonds n=6.0±1.6 molecules of 5-fluorouracil through tertiary amine groups with equilibrium constant K= 65±10. The parameters of bonding 5-fluorouracil by PAMAM G3-NH2 and G3-OH dendrimer were compared with those of bonding this drug by the macromolecules of PAMAM of generations G4-NH2, G5-NH2 and G5-OH.