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Mesenchymal hamartoma of chest wall in infancy: natural history of two cases. Two cases of mesenchymal hamartoma of chest wall in infancy are reported. These distinctive and rare lesions arise in the antenatal period, present at birth or in early life as chest wall masses with marked rib deformation, and may produce respiratory compromise through encroachment on the chest cavities. Histologically composed of chondroid and primitive mesenchymal elements with giant-cell formation, endochondral ossification, and maturation to trabecular bone, they exhibit some features of aneurysmal bone cyst. Because of their cellularity and proliferative appearance, they are often misinterpreted as sarcomas; however, they pursue a benign course and can be well managed surgically. Our cases possessed multiple chest wall masses that were clinically apparent at birth and sequentially resected over a period of several months, creating an opportunity to document their hitherto unreported histologic evolution. Their pattern of maturation is in keeping with a hamartomous malformation.

[Intestine dysbacteriosis meaning in pathogenesis of chronic diarrhea of celiac disease and syndrome of the short small intestine]. To study the mechanisms of chronic diarrhea in patients with celiac disease and the syndrome of short small intestine. The study included 24 patients: 9 with celiac disease with malabsorption syndrome of II and III degree, 15 patients with the syndrome of short small intestine and 9 healthy volunteers. Study of microflora in the small and large intestine was performed by seeding serial dilutions of the contents of upper small intestine and feces, followed by qualitative and quantitative view of selected microorganisms. Value of free and conjugated bile acids were determined by electrophoresis followed by densitometry. 2/3 of the examined patients revealed bacterial colonization of the small intestine. Were inoculated staphylococci, E. coli, enterococci. Was found a significant change in the ratio of bile acids: a significant increase in free, damaging the mucous, and a decrease in conjugated involved in the digestion of lipids. Unabsorbed lipids were one of the causes of diarrhea in the examined groups of patients. Sequential antibiotic drugs and probiotic promoted the normalization of the stool, microflora of the small and large intestine.

Analysis of errors in the calculation of irreversible enzyme inhibition kinetic constants. The kinetic constants for irreversible enzyme inhibition are determined by non-linear least-square regression using a new optimisation technique. An analysis is given of how calculation of the dissociation constant and the unimolecular rate constant is affected both by the inherent error involved in fitting an exponential curve to the plot of product concentration against time, and by the ill-conditioned nature of the equations relating these constants to the parameters of the exponential. The analysis is applied to simulated sets of product concentration curves.

The monitoring and surveillance of the psychosocial work environment in Canada: a forgotten determinant of health. The psychosocial working environment is an important determinant of health status and health inequalities in Canada. Particular dimensions of the psychosocial work environment such as low job control, job strain and imbalances between perceived efforts and rewards have been related to cardiovascular disease (the leading cause of mortality in Canada) and poorer mental health status. Despite its importance to the health of Canadians and health inequalities in Canada, the national surveillance of the psychosocial work environment is decreasing. Currently, the surveillance of the psychosocial work environment in Statistic Canada's population health surveys is limited to convenience-based samples within particular health regions. Not including important dimensions of the health, such as the psychosocial work environment, in our population-based surveys limits the ability of these surveys to help us better understand the challenges and opportunities to reducing health inequalities in Canada.

Isoprostanes in amniotic fluid: a predictive marker for fetal growth restriction in pregnancy. Isoprostanes are markers of free radical-catalyzed lipid peroxidation. Evidence suggests that oxidative stress occurs in pregnancies with fetal growth restriction (FGR). The aim of this study was to analyze F2-isoprostanes in amniotic fluid of FGR pregnancies. We tested the hypothesis that F2-isoprostanes are reliable markers to distinguish FGR pregnancies from normal ones and appropriate-for-gestational-age (AGA) from small-for-gestational-age (SGA) newborns. F2-isoprostanes levels were measured by colorimetric enzyme immunoassay in the amniotic fluid of 77 pregnancies with normal fetal growth (group I) and 37 with FGR (group II). Fetal biometry and Doppler measurements were obtained using an ATL HDI 3000 ultrasound system. Isoprostanes were higher in group II than group I. The ROC curve distinguished group I from group II, showing 100% sensitivity and 88.3% specificity at a cutoff of 94 pg/ml. There were no statistical differences in isoprostanes levels between AGA and SGA newborns in group II. The area under the ROC curve drawn to distinguish AGA and SGA newborns showed a sensitivity of 100% and a specificity of 72.3% at a cutoff of 94 pg/ml. The relative risk index indicated a 8.05 times higher risk of birth weight below the 3rd percentiles in group II than in group I. High isoprostanes concentrations can be detected in the amniotic fluid of FGR pregnancies and the assay of isoprostanes in amniotic fluid is a reliable assessment of fetal oxidative stress. Common use of this predictive marker in obstetrics will improve the ability of clinicians to identify those fetuses who will be born SGA or with a birth weight below the 25th percentile.

The future for electrocoagulation as a localised water treatment technology. Electrocoagulation is an electrochemical method of treating polluted water whereby sacrificial anodes corrode to release active coagulant precursors (usually aluminium or iron cations) into solution. Accompanying electrolytic reactions evolve gas (usually as hydrogen bubbles) at the cathode. Electrocoagulation has a long history as a water treatment technology having been employed to remove a wide range of pollutants. However electrocoagulation has never become accepted as a 'mainstream' water treatment technology. The lack of a systematic approach to electrocoagulation reactor design/operation and the issue of electrode reliability (particularly passivation of the electrodes over time) have limited its implementation. However recent technical improvements combined with a growing need for small-scale decentralised water treatment facilities have led to a re-evaluation of electrocoagulation. Starting with a review of electrocoagulation reactor design/operation, this article examines and identifies a conceptual framework for electrocoagulation that focuses on the interactions between electrochemistry, coagulation and flotation. In addition detailed experimental data are provided from a batch reactor system removing suspended solids together with a mathematical analysis based on the 'white water' model for the dissolved air flotation process. Current density is identified as the key operational parameter influencing which pollutant removal mechanism dominates. The conclusion is drawn that electrocoagulation has a future as a decentralised water treatment technology. A conceptual framework is presented for future research directed towards a more mechanistic understanding of the process.

Familial pervasive development disorder, Tourette disorder and hyperlexia. Four children and one adult have been found to have Pervasive Developmental Disorder, Tourette disorder and hyperlexia in North Dakota, a state with a population of 204,161 children ages 0-18. Assuming that these are independent disorders the probability of these three disorders occurring by chance in one child is 3.39 x 10(-12). Two of these individuals are from the same family. This suggests evidence for genetic linkage among these three disorders.

Brown-Séquard and cerebral localization as illustrated by his ideas on aphasia. Brown-Séquard's concept of localization was built on the phenomena of inhibition and dynamogenesis, constituting a dynamic system in which reflex mechanisms, that played a part not only in the spinal cord but in the brain as well, were considered of particular importance. The use of this concept is considered in Brown-Séquard's discussion of the subject of cerebral localization, and especially of aphasia. The origin and development of Brown-Séquard's ideas on aphasia from 1861 onwards are discussed, as is the part he possibly played in the transfer of knowledge from Paris to London (Broca and Jackson). In the 1870's Brown-Séquard debated on cerebral localization with Charcot before the Société de Biologie. Opposing the cluster theory of localization, Brown-Séquard developed the theory of "réseau de cellules anastomosées", a kind of network theory in which scattered cells subserving the same function are connected by nerve fibers. This was to him a plausible theory, with which he was able to explain the fact that damage in several locations may produce the same effect, and, to account for observations that some functions remain unimpaired despite extensive brain-injury. Although Brown-Séquard's arguments were not always valid, because they were based on imprecise observations, his dynamic model, nowadays, seems valuable. He influenced "anti-localizers" such as Goltz, but also Jackson and probably Von Monakow and Sherrington.

Interleukin-10 gene promoter polymorphism in Polish rheumatoid arthritis patients. Interleukin (IL)-10 is an important multifunctional cytokine with both anti-inflammatory and immunoregulatory effects in rheumatoid arthritis (RA). In the present study, we evaluated the frequency and potential impact of IL-10 promoter polymorphisms on susceptibility to and severity of RA in Polish in - patients with a high disease activity (mean DAS 28 C-reactive protein 5.25). DNA was obtained from 244 RA patients and 106 healthy controls. The -592C/A and -1082G/A IL-10 gene polymorphisms were amplified by polymerase chain reaction with restriction endonuclease mapping. The frequency of the IL-10-592CA, -592AA genotypes (respectively: 30% vs 5% and 7% vs 0%) and allele -592A (37% vs 5%) were significantly higher in RA patients as compared with a control group. We did not find any association of the IL-10-592C/A genotype distribution with disease parameters, except for an increased ESR (erythrocyte sedimentation rate) in patients with the -592CC genotype as compared with those with -592CA or -592AA genotypes (P = 0.01). The frequency of the IL-10-1082GG genotype was lower (P = 0.0001), and that of the IL-10-1082GA genotype was higher (P = 0.009) in RA patients comparing with the control group. In RA patients with -1082GA or -1082AA genotypes the time duration of the disease (P = 0.03), Health Assessment Questionnaire (HAQ) Score (P = 0.04) and PLT count (P = 0.001) were significantly increased as compared with subjects with -1082GG genotype. Presented findings indicate that IL-10-592C/A and IL-10-1082G/A polymorphisms may be considered genetic risk factors for RA susceptibility and severity.

Tuberculosis of the tongue. A case of pulmonary tuberculosis of the tongue is reported, and tuberculosis of the upper airway in a VA Hospital is reviewed. A regimen of triple antituberculous drugs, isoniazid, ethambutol, and rifampin, was prescribed. Repeated radiographs of the chest showed considerable improvement of the pulmonary lesions. The lesion of the tongue was surgically excised as a diagnostic procedure and has not recurred.

Application of solid-phase microextraction with gas chromatography and mass spectrometry for the early detection of active moulds on historical woollen objects. The goal of this work was to determine the microbial volatile organic compounds emitted by moulds growing on wool in search of particular volatiles mentioned in the literature as indicators of active mould growth. The keratinolytically active fungi were inoculated on two types of media: (1) samples of wool placed on broths, and (2) on broths containing amino acids that are elements of the structure of keratin. All samples were prepared inside 20 mL vials (closed system). In the first case (1) the broths did not contain any sources of organic carbon, nitrogen, or sulfur, i.e. wool was the only nutrient for the moulds. A third type of sample was historical wool prepared in a Petri dish without a broth and inoculated with a keratinolytically active mould (open system). The microbial volatiles emitted by moulds were sampled with the headspace solid-phase microextraction method. Volatiles extracted on solid-phase microextraction fibers were analyzed in a gas chromatography with mass spectrometry system. Qualitative and quantitative analyses of chromatograms were carried out in search of indicators of metabolic activity. The results showed that there are three groups of volatiles that can be used for the detection of active forms of moulds on woollen objects.

Female sexual preferences differ in Mus spicilegus and Mus musculus domesticus: the role of familiarization and sexual experience. Mating systems correspond to particular ecological conditions and result from proximate interactions between individuals. We compared the mating preferences of female mice of two species: the house mouse, Mus musculus domesticus, and the mound-builder mouse, Mus spicilegus. Because of differences in their habitat, we expected to observe differences in their sexual preferences. We studied female preferences for a familiar or an unfamiliar male and the occurrence of copulation with the unfamiliar male, during two states of female sexual activity: (1) the postpartum oestrus of paired females, to evaluate the stability of their sexual partnership; and (2) the oestrus of females familiarized with a male, to study the mechanisms underlying their sexual preferences. In the polygamous house mouse, postpartum oestrous females did not show a clear preference between their familiar male and the unfamiliar one. Moreover, oestrous females, familiarized with a male (without sexual interactions), preferred an unfamiliar male and copulated with him. In contrast, postpartum oestrous females and oestrous females of M. spicilegus preferred their familiar male and rarely copulated with the unfamiliar male. This study indicates a strong pair bond in established breeding pairs in M. spicilegus and shows that this bond can be established by familiarization, which is not the case in M. m. domesticus. Our study suggests the existence of monogamous traits in M. spicilegus in contrast to the polygamous M. m. domesticus. (c) 1998 The Association for the Study of Animal Behaviour.

Mean-field versus microconvection effects in nanofluid thermal conduction. Transient hot-wire data on thermal conductivity of suspensions of silica and perfluorinated particles show agreement with the mean-field theory of Maxwell but not with the recently postulated microconvection mechanism. The influence of interfacial thermal resistance, convective effects at microscales, and the possibility of thermal conductivity enhancements beyond the Maxwell limit are discussed.

Stiffness after total knee arthroplasty. Limitation of motion after knee arthroplasty can be the result of a multiplicity of factors. Among these are malpositioning of the components, especially in the sagittal plane; oversizing at the patellofemoral or tibiofemoral joint spaces; retaining posterior osteophytes; and persisting with a tight posterior cruciate ligament. Postoperatively, problems with physical therapy likewise can cause limitation of both extension and flexion. Specific patient factors also may affect the range of motion after surgery. Although most patients achieve a postoperative flexion that is highly correlated to that which was present preoperatively, factors such as pain, obesity, and deformities of adjacent joints may limit such motion.

Effect of captopril on high-density lipoprotein subfractions in patients with mild to moderate essential hypertension. Changes in serum lipids, apolipoproteins, and lipoproteins including high-density lipoprotein (HDL) subfractions following administration of captopril in patients with hypertension were studied. Captopril (25 mg twice daily) was administered over a 12-week period to 17 patients with mild to moderate essential hypertension. Captopril was observed to significantly reduce both systolic and diastolic blood pressure, as well as to increase HDL2- cholesterol (HDL2-C) and to decrease HDL3-cholesterol (HDL3-C); however, no significant changes in total HDL-C were recognized. Total cholesterol, low-density lipoprotein cholesterol, triglyceride, apolipoprotein (apo) A-I, apo A-II, apo B, apo C-II, apo C-III, and apo E did not change significantly. It is suggested that captopril monotherapy produces a favorable effect on HDL subfractions.

Association between availability of care providers and healthcare utilizations among adults with asthma. Limited accessibility to providers may delay appropriate control of asthma exacerbations. The objective of our study is to estimate the contributors to the hospital/emergency department (ED) visits among adults with asthma focusing on the availability of healthcare providers. We conducted a pooled cross-sectional analysis using the 2011-2013 Asthma Call-Back Survey linked with 2012-2016 Area Health Resource Files. We employed multivariable logistic regression with dichotomous outcomes of hospitalization and ED visits. Key covariates were the availability of county-level healthcare provider variables per 100,000 persons such as the number of lung disease specialists (including pulmonary care specialists, and allergy and immunology specialists), the number of hospitals, the number of safety-net facilities including rural health centers (RHCs) and federally qualified health centers (FQHCs), and the number of primary care physicians (PCPs). Among 25,621 adults, proportions of hospital visits and ED visits were 3.3% and 13.2%, respectively. An additional RHC reduced by 3% the odds of having an ED visit (odds ratio [OR] = 0.97, p = .004). Patients with cost barriers to seeing a PCP were 60% (OR = 1.60, p = .028) more likely to have a hospital visit than those without. In addition, patients with cost barriers to seeing a specialist were 90% (OR = 1.90, p = .007) and 111% (OR = 2.11, p = .001) more likely to have a hospital visit and ED visit, respectively, than those without. Hospital and ED visits among adults with asthma are partially related to the availability of providers, and more related to financial barriers. Therefore, financial support for the vulnerable asthma population might be a target for policy makers interested in reducing hospitalizations and ED visits.

[Case of drug-induced hypersensitivity syndrome due to lamotrigine: demonstration of sequential reactivation of herpesviruses]. Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe multiorgan disorder. The reactivation of human herpesvirus-6 (HHV-6) and other human herpesviruses has been reported to be associated with its pathogenesis. We herein report a case of 14-year-old female who developed DIHS during the treatment with lamotrigine, a novel antiepileptic drug. She initially presented with fever, skin rash, cervical lymphadenopathy, leukocytosis with eosinophilia and atypical lymphocytosis, liver dysfunction and hypogammaglobulinemia. Discontinuation of the drug and administration of prednisolone led to improvement;however, tapering of prednisolone and administration of midazolam and ketamine thereafter triggered clinical deterioration. She subsequently developed hyperthyroidism followed by hypothyroidism. Herpesviral loads were determined in her peripheral blood by real-time PCR during the course of the treatment, and sequential reactivation of Epstein-Barr virus (EBV), HHV-6 and cytomegalovirus was demonstrated. EBV viremia was detected throughout the course, except for a short period when HHV-6 viremia was at the peak. HHV-6 viremia developed after the secondary deterioration. Cytomegalovirus viremia appeared transiently before the hyperthyroidic state reversed and became hypothyroidic. Although this syndrome should be regarded as a systemic reaction induced by a complex interplay among herpesviruses and the immune responses against viral infections and drugs, it remains unknown how such a sequential reactivation is related to the pathogenesis of the condition.

Temperature induced changes in resonance Raman spectra intensity of all-trans-β-carotene: changes in the fundamental, combination and overtone modes. The resonance Raman spectra of the fundamental, combination and overtone modes around the CC and CC stretches of all-trans-β-carotene in 1,2-dichloroethane solution are obtained from the 293K to 83K temperature range. The results indicate that the intensity of the fundamentals in the liquid and solid phases generally increases as the temperature decreases, except for the liquid-solid phase transition, which exhibits a decreasing trend. The Raman intensities ratio between the fundamentals υ1 and υ2, combinations (overtones) and the fundamentals both increases with decreasing temperature. The Raman bandwidths of the CC bonds gradually become narrow as the temperature decreases. These varieties of relative intensity are analyzed using the coherent weakly damped electron-lattice vibration mode, the effective conjugation length mode as well as the theory of electron-phonon interaction in this work.

[Digoxin inhibits migration and invasion of human gastric carcinoma MKN45 cells through down-regulation of AEG-1]. This study was designed to investigate the effect of digoxin on migration and invasion of human gastric carcinoma MKN45 cells and its possible mechanism. MKN45 cells were treated with different concentrations of digoxin for 24 h. The shRNA-AEG-1 plasmid was transfected into MKN45 cells via lipofectamine to block the expression of astrocyte elevated gene-1 (AEG-1). Western blot was used to analyze the protein levels of matrix metalloproteinase-9 (MMP-9), E-cadherin and AEG-1. The result showed that digoxin reduced the abilities of migration and invasion (P < 0.05), up-regulated the protein level of E-cadherin (P < 0.05), and down-regulated the protein levels of MMP-9 and AEG-1 (P < 0.05) in MKN45 cells in a dose-dependent manner. Compared with shControl group, shAGE-1 group showed inhibited cellular migration and invasion, higher expression level of E-cadherin, and lower expression levels of MMP-9 and AEG-1. These results suggest that digoxin suppresses the migration and invasion of human gastric carcinoma MKN45 cells in a dose-dependent manner through inhibiting the expression of AEG-1, and then resulting in the up-regulation of the protein expression of E-cadherin and the down-regulation of the protein expression of MMP-9.

Thoracoscopic sympathectomy is a valuable addition in the management of recreational intra-arterial drug injection. Pilot study. Intra-arterial Injection (IAI) of illicit substances by drug abusers may result in acute ischemia, limb loss or permanent functional deficit. No prospective human studies have shown that any specific treatment is superior to another. Thoracoscopic sympathectomy (TS) has proven efficacy in upper limb ischemia due to organic blockade. This is a pilot study to evaluate the effect of thoracoscopic sympathectomy addition to the management protocol of recreational intra-arterial drug injection. A total of 11 victims of upper limb IAI of recreational drug were recruited (10 males) with age range from 18 to 43 years old (average 30+/-8.3 years). Tissue Ischemia Score (TIS) was used for pretreatment assessment of the degree of ischemic injury and severity of pain was evaluated pre- and post-operatively using visual analog score (VAS) and compared using Student's t test. Pre-operative VAS score was 6.9+/-1.8. All enrolled patients were treated according to the following protocol; anticoagulation, calcium channel blocker, opiates for pain, and TS. Patients received the stated protocol for minimum of 72h (range 3-8 days; mean 5; average 4.7+/-1.5 days). Freedom of amputation and improvement of pain scores were the study endpoints. No mortality, yet one case had bleeding secondary to anticoagulant and one case of post-operative pneumothorax that required chest tube drainage for 24h. No patients had wet gangrene or spreading infection. Freedom of amputation was achieved in nine patients, 81% (7 patients had normal outcome and other two had permanent neurological deficit). Two patients (18%) had tissue necrosis with dry gangrene and mummification of the affected digits with eventual amputation. Postoperative VAS pain score was 2.09+/-1.37 (p<0.05). Pain medications were suspended in 6 patients (54.5%), reduced in 4 (36%) and unchanged in 1 (9%). All patients with TIS score 2 or less had a normal outcome while those with scores 3 and 4 had a variable outcome. Using regression analysis, initial TIS was significant for outcome prediction (p=0.043) while age, arterial site, drug injected and time delay were not significant. The addition of TS was an attempt to halt the ischemic process after IAI which permitted, in our belief, optimal symptom control with maximum tissue salvage. Because the procedure is minimally invasive, safe, and associated with a low complication rate; it worth consideration whenever IAI is encountered.

[A Case of an Elderly Patient with Advanced Gastric Cancer Successfully Treated with Combination S-1 and Oxaliplatin Therapy]. The patient was an 80-year-old man. He had a chief complaint of epigastric pain. The upper gastrointestinal endoscopy showed a type 4 tumor of the stomach, and the CT scan showed multiple para-aortic lymph node metastases. The patient was diagnosed with cStage IV gastric cancer. At first, he could take only small amounts of liquid. After starting S-1 and oxaliplatin (SOX), he was able to resume a full diet and his general condition was improved. A CT scan after 4 courses of chemotherapy showed a significant reduction in the wall thickness of the stomach and the size of the lymph nodes. SOX chemotherapy could be a promising treatment option for elderly patients with advanced gastric cancer.

2,4-Diaminopyrimidine inhibitors of c-Met kinase bearing benzoxazepine anilines. Elaboration of the SAR around a series of 2,4-diaminopyrimidines led to a number of c-Met inhibitors in which kinase selectivity was modulated by substituents appended on the C4-aminobenzamide ring and the nature of the C2-aminoaryl ring. Further lead optimization of the C2-aminoaryl group led to benzoxazepine analogs whose pharmaceutical properties were modulated by the nature of the substituent on the benzoxazepine nitrogen. Tumor stasis (with partial regressions) were observed when an orally bioavailable analog was evaluated in a GTL-16 tumor xenograft mouse model. Subsequent PK/PD studies suggested that a metabolite contributed to the overall in vivo response.

[Effects of nitrogen deposition on diversity and composition of soil bacterial community in a subtropical Cunninghamia lanceolata plantation.] The increasing rate of atmospheric nitrogen (N) deposition has become the focus of research attention. Soil bacterial community plays an important role in soil nutrient cycling. We stimulated N deposition at the Forest Ecosystem of Fujian Normal University and Global Change Research Station in Chenda Town, Sanming City in the Fujian Province of China. We examined the effect of N deposition on the structure and composition of soil bacterial community using 16S rDNA amplification sequencing. The results showed that short-term addition of N had no significant effect on the soil bacterial diversity and composition, but high N treatment significantly affected therelative abundance of individual bacterial species, which increased the abundance of Copiotrophic group and decreased that of the corresponding Oligotrophic group, indicating that changes in soil bacterial nutrient strategies were driven by the availability of nutrients. Enhanced understanding of the responses of soil bacterial community and nutrient distribution pattern to rapid N deposition could improve the prediction ability about the future environment.

Natural occurrence of grape poisoning in two dogs. Clinical grape poisoning in two dogs (a 1.6-year-old male Shih Tzu and a 5-year-old female Yorkshire Terrier) was described in the present study. Clinical signs included decreased urine output in the Shih Tzu and ataxia in the Yorkshire Terrier after grape ingestion. The Shih Tzu died 5 days post-grape ingestion, while the Yorkshire Terrier died 3 days post-grape ingestion. Erythematous serosae and mucosae, multifocal red small intestinal foci, and blood and grape seeds were identified in the intestinal lumen. Brownish-yellow crystals were bilaterally identified in the renal pelvis. The primary histological findings were acute tubular necrosis of the proximal convoluted tubules, severe necrosis, and mineralization in the renal cortical tubules. Blood urea nitrogen, creatinine, and alanine aminotransferase were increased in the dogs. Many Korean veterinary clinicians have suspected clinical grape poisoning. However, to our knowledge, grape poisoning has not been identified by pathologic and clinicopathologic basis until this writing in Korea. Education and knowledge about the risks of grape poisoning is necessary for the prevention of accidental exposures.

Cross-reactivity between aspirin and ibuprofen in an asthmatic--a case report. A case of an adverse reaction occurring in a 53-year-old, aspirin-sensitive asthmatic male with nasal polyps following administration of a 400-mg ibuprofen tablet is reported. Symptoms of the adverse reaction included an urticarial rash, labored breathing, laryngeal edema and tightness of the chest. Treatment consisted of isoproterenol inhalant (self-administered), subcutaneous epinephrine 0.25 mg, intramuscular diphenhydramine hydrochloride 50 mg and intravenous hydrocortisone 250 mg. The pathogenesis of the patient's adverse reaction and the possible fole of aspirin, of other analgesics and of tartrazine in its development are discussed. The adverse reaction was not mediated immunologically but rather resulted from the prostaglandin synthetase (PGS)-inhibitor activity shared by aspirin, ibuprofen and other analgesics. Selection of an analgesic for an aspirin-sensitive patient should be based on the analgesic's PGS-inhibitor activity.

Growth of bacteria in intravenous fluids under stimulated actual-use conditions. The growth of microorganisms in nonnutritive intravenous solutions under simulated actual-use conditions was studied. Small quantities of Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae (final concentration 200-400 cells/ml) were injected into 500-ml containers (glass bottles and plastic bags) of 5% dextrose injection, 0.9% sodium chloride injection, and 5% dextrose and 0.9% sodium chloride injection. Additives (ampicillin, vitamin K, lidocaine, and vitamin B complex) were included in some i.v. solutions. Administration sets were attached to the i.v. containers, and the solutions were run into collection bottles; samples were withdrawn at 0, 1, 2, 3, 4, 5, 6, and 8 hours after contamination and plated for viable counts. Staph. aureus and K. pneumoniae remained viable in 5% dextrose injection and in 0.9% sodium chloride injection, but the numbers of these bacteria did not increase. The number of Ps. aeruginosa declined in all three solutions. In 5% dextrose and 0.9% sodium chloride injection, the number of K. pneumoniae declined but Staph. aureus maintained viability. The type of container and the drug additives had no effect on microbial growth, except that ampicillin was bactericidal to Staph. aureus. Low-level contamination of these bacteria in nonnutritive i.v. solutions under actual-use conditions does not result in large numbers of organisms within the time frame in which most solutions are administered.

Thermal incompatibility analysis of metal-ceramic systems based on flexural displacement data. The feasibility of simple tests or analytical methods for prediction of residual stress states in metal-ceramic (MC) prostheses has not been demonstrated. Biomaterial metal-ceramic strips have been proposed to provide sensitive measures of transient and residual stress states through the measurement of midpoint deflection after cooling from the ceramic sintering temperature. The objective of this study was to apply the elastic-viscoelastic analogy to calculate transient and residual midpoint deflections in MC biomaterial strips and to compare these values with deflections measured with a beam-bending viscometer (BBV). Calculations and measurements were made for five MC systems that were found from a clinical study to be "thermally compatible" systems. Metal strips, 64 mm in length, 3 mm wide, and either 0.5 mm, 1.0 mm, or 2.0 mm in thickness, were veneered with four 0.25-mm thick layers of opaque porcelain. Midpoint deflection of the MC strips (ceramic oriented in the posterior position) was measured during cooling from an initial temperature of 700 degrees C. In general, the directions of the measured residual deflections did not agree with the "textbook" convention that negative deflections are associated with positive thermal contraction mismatch (alpha(M) - alpha(c) > 0) regardless of metal thickness. For a metal thickness of 0.5 mm, the residual midpoint deflection for all thermal contraction mismatch cases, except one, was positive (upward deflection) whereas the residual midpoint deflections were all negative when the metal thickness was increased to 1 or 2 mm, independent of the thermal contraction mismatch. The best agreement between calculated and measured values of residual midpoint deflection (+16 microns vs. +14 +/- 2.3 microns, respectively was obtained for MC biomaterial strips with a Ni-Cr alloy (0.5 mm thick) while the largest difference (+346 microns vs. +61 +/- 43.8 microns) was obtained for MC bimaterial strips with a Au-Pd allow (0.5 mm thick). In all but one case, changes in deflection direction as a function of metal thickness were correctly predicted by the viscoelastic analysis. The results of this study indicate that a viscoelastic model is useful for estimating thermal compatibility conditions of MC systems.

Impact of variant pulmonary vein anatomy and image integration on long-term outcome after catheter ablation for atrial fibrillation. To investigate the impact of variant pulmonary vein (PV) anatomy and the use of three-dimensional image integration (3D-II) on long-term efficacy of catheter ablation for atrial fibrillation (AF). Consecutive procedures from 2002 to 2007 were analysed from a prospective database. All patients underwent wide area circumferential ablation, with linear lesions added and complex fractionated electrograms targeted for persistent AF. Imaging was segmented on Carto to assess PV anatomy. Three hundred and fifty patients underwent 1.9 ± 0.9 procedures. The mean age was 57 ± 11 years, 73% males, and 55% paroxysmal AF. Freedom from AF/atrial tachycardia was 42% for paroxysmal AF and 20% for persistent AF at 3.1 years after the first procedure, or 86 and 66%, respectively, at 2.5 years after the last procedure. The Kaplan-Meier analysis showed a trend towards improved single-procedure efficacy with 3D-II (8.9% difference, P = 0.087) and a reduction in the number of procedures per patient from 2.1 ± 1.1 to 1.8 ± 0.9 (P < 0.0001). The use of 3D-II improved single-procedure efficacy with Carto (13.3% difference, P = 0.018), but not with Ensite NavX. Variant PV anatomy was identified in 28% and was associated with a lower single-procedure efficacy (10.0% difference, P = 0.024) but with no effect on final outcome. Multivariate analysis confirmed the impact of 3D-II [hazard ratio (HR) for recurrence of AF 0.67, P = 0.020] and variant PV anatomy (HR 1.37, P = 0.044). The use of 3D-II improves single-procedure efficacy of PV isolation for AF. Variant PV anatomy was associated with a lower single-procedure success rate.

Prediction of somatic and non-somatic depressive symptoms between inpatient rehabilitation and follow-up. Longitudinal. We identified changes in the association of somatic and non-somatic symptoms (as measured by the Patient Health Questionnaire-9, PHQ-9) between inpatient rehabilitation after spinal cord injury (SCI) and 1 year after discharge. A specialty hospital in the Southeastern USA. A total of 584 adults with traumatic SCI were administered the PHQ-9 during inpatient rehabilitation. Of them, 227 completed the PHQ-9 by survey at 1-year follow-up. We performed time-lagged regression between times of measurement for somatic and non-somatic factors of the PHQ-9. The non-somatic factor at baseline was significantly predictive of the non-somatic (r=0.67, P=0.002) and somatic factors at follow-up (r=0.53, P=0.019). The somatic factor did not significantly predict either the somatic (r=0.10, n.s.) or non-somatic factors at follow-up (r=-0.01, NS). Factor analysis also indicated changing factor structure between inpatient rehabilitation and follow-up. Our results question the interpretation of somatic items during inpatient rehabilitation, as they are not predictive of either somatic or non-somatic symptoms at follow-up.

Genotyping field strains of African swine fever virus by partial p72 gene characterisation. A PCR-based sequencing method was developed which permits detection and characterization of African swine fever virus (ASFV) variants within 5 and 48 h, respectively, of receipt of a clinical specimen. Amplification of a 478 bp fragment corresponding to the C-terminal end of the p72 gene, confirms virus presence with genetic characterization being achieved by nucleotide sequence determination and phylogenetic analysis. The method was applied to 55 viruses including those representative of the major ASF lineages identified previously by restriction fragment length polymorphism (RFLP) analysis. Results confirmed that the p72 genotyping method identifies the same major viral groupings. Characterization of additional viruses of diverse geographical, species and temporal origin using the PCR-based method indicated the presence of ten major ASF genotypes on the African continent, the largest of which comprised a group of genetically homogeneous viruses recovered from outbreaks in Europe, South America, the Caribbean and West Africa (the ESAC-WA genotype). In contrast, viruses from southern and East African countries were heterogeneous, with multiple genotypes being present within individual countries. This study provides a rapid and accurate means of determining the genotype of field and outbreak strains of ASF and is therefore useful for molecular epidemiological clarification of ASF.

Temperature-strain discrimination in distributed optical fiber sensing using phase-sensitive optical time-domain reflectometry. A method based on coherent Rayleigh scattering distinctly evaluating temperature and strain is proposed and experimentally demonstrated for distributed optical fiber sensing. Combining conventional phase-sensitive optical time-domain domain reflectometry (ϕOTDR) and ϕOTDR-based birefringence measurements, independent distributed temperature and strain profiles are obtained along a polarization-maintaining fiber. A theoretical analysis, supported by experimental data, indicates that the proposed system for temperature-strain discrimination is intrinsically better conditioned than an equivalent existing approach that combines classical Brillouin sensing with Brillouin dynamic gratings. This is due to the higher sensitivity of coherent Rayleigh scatting compared to Brillouin scattering, thus offering better performance and lower temperature-strain uncertainties in the discrimination. Compared to the Brillouin-based approach, the ϕOTDR-based system here proposed requires access to only one fiber-end, and a much simpler experimental layout. Experimental results validate the full discrimination of temperature and strain along a 100 m-long elliptical-core polarization-maintaining fiber with measurement uncertainties of ~40 mK and ~0.5 με, respectively. These values agree very well with the theoretically expected measurand resolutions.

Evaluation of a single injection of 99mTc-labeled diethylenetriaminepentaacetic acid for measuring glomerular filtration rate in horses. Glomerular filtration rate (GFR) was measured in 12 clinically normal horses, using the standard inulin clearance method, and values were compared with values for 2 methods, using a single rapid IV injection of 99mTc-labeled diethylenetriaminepentaacetic acid (99mTc-DTPA). The first 99mTc-DTPA method used a 2-compartment model to calculate GFR blood clearance of the tracer. The second method used sequential digital gamma camera images of the kidneys to determine fractional accumulation of the total dose of the tracer in the kidneys (percentage of injected dose, gamma camera) from 0 to 10 minutes after radionuclide administration. Linear correlation among the 3 methods was determined. Mean (+/- SD) GFR, using the inulin clearance method, was 154.67 +/- 42.28 ml/min/100 kg of body weight. Mean GFR, using the 2-compartment blood clearance curve, was 146.92 +/- 27.49 ml/min/100 kg. Mean GFR, using percentage of injected dose (gamma camera method) was 154.7 +/- 22.00 ml/min/100 kg. The percentage of injected dose (gamma camera method) did not correlate significantly to the inulin clearance results. However, a significant (r = 0.666, P less than 0.018) correlation was observed between the inulin method and the 99mTc-DTPA blood clearance method. Significant (P less than 0.0001) difference also was observed in the split function of the equine kidneys, with GFR of the right kidney contributing 60.1 +/- 9.12% of the total function, as determined by 99mTc-DTPA gamma camera imaging. Because the 99mTc-DTPA blood clearance method does not require urine collection, it may be a more practical procedure to measure GFR in the horse.

[Automatic sutures in bronchopulmonary surgery]. Efficacy of automatic staplers in broncho-pulmonary surgery was evaluated in a series of 316 consecutive patients. The results confirm that utilization of staplers has drastically reduced the incidence of post-resection bronchial fistulae; moreover on parenchymal tissue such instruments guarantee excellent haemostasis and air tightness. On the contrary, indications for their use on pulmonary vessels seem to be very limited.

Optoelectrofluidic sandwich immunoassays for detection of human tumor marker using surface-enhanced Raman scattering. A sandwich immunoassay is a powerful tool for identifying a specific substance in a biological sample. However, its heterogeneous strategy always requires repetitive liquid handlings and long processing time. Here an optoelectrofluidic immunoassay platform for simple, fast, and automated detection of human tumor marker based on surface-enhanced Raman scattering (SERS) has been developed. By using a conventional optoelectrofluidic device and a liquid crystal display module, simple and quantitative detection of human tumor marker, alpha-fetoprotein, in a ∼500 nL sample droplet has been automatically conducted with lower detection limit of about 0.1 ng/mL within 5 min. This study depicts the first practical application, for protein detection, of the optoelectrofluidic manipulation technology. This image-driven immunoassay platform opens a new way for simple, fast, automated, and highly sensitive detection of antigens.

Transrectal ultrasonotomography of the prostate. New equipment for transrectal ultrasonomography has been developed. Wth this equipment an excellent cross-section picture of various intrapelvic organs is easily obtained. Diagnostic application of the technique is particularly significant for abnormalities of the prostate because the shape of the prostate cannot be revealed by x-ray. Diagnostic criteria for prostatic disease are described, with the demonstration of typical cases. In a test by well trained physicians the diagnostic accuracy of the new technique was more than 80 per cent. Ultrasonotomography provided for precise measurement of prostatic size. Transrectal ultrasonotomography is a promising new diagnostic technique that yeilds abundant information not available with former methods of examination. The procedure is likely to become one of th most important diagnostic tools in the field of urology.

Amperometric sensors based on Ni/Al and Co/Al layered double hydroxides modified electrode and their application for hydrogen peroxide detection. Two different hydrogen peroxide sensors were constructed with Ni/Al and Co/Al layered double hydroxides (LDHs) modified glassy carbon electrodes (GCE). Ni (Co)/Al-LDHs were synthesized by electrochemical method and were characterized by scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS). The advantages and shortcoming of the two hydrogen peroxide sensors were described in detail. Compared to Co/Al-LDHs modified electrode, sensors fabricated by Ni/Al-LDHs showed quicker heterogeneous electron transfer rate constants (k(s)), lower detection and better reproducibility. But Co/Al-LDHs modified electrode held the advantages of wider linear range and higher sensitivity. Further more, the different catalytic redox mechanisms of hydrogen peroxide on the Ni/Al/GCE and Co/Al/GCE were firstly comparatively explored.

Intervention thresholds and cesarean section rates: A time-trends analysis. To improve understanding of rising cesarean section (CS) rates in the UK, this study assessed the relation between clinician thresholds for performing CS for delayed labor progress or suspected fetal distress and corresponding CS rates in Aberdeen, UK. Time-trends analysis of term births from 1988 to 2012 in a population of nulliparous women (N = 53 745) in Aberdeen, UK, using Chi-square test for trend, and binary logistic regression. Data were obtained from the Aberdeen Maternity and Neonatal Databank. Unplanned CS rates per quintile increased from 11.0% (1391/12 686) to 21.1% (2383/11 273) between 1988 and 2012, while planned CS rates increased from 2.7% (338/12 686) to 5.2% (591/11 273). The median duration of labor before CS for delayed progress per quintile decreased from 17.2 (IQR 12.5-22.3) to 13.1 hours (9.6-16.9) before first stage CS and from 17.1 (12.6-22.3) to 15.3 (11.5-19.1) hours before second stage CS (P < .001). The proportion of CS for suspected fetal distress performed with evidence of fetal acidosis declined from 23.4% (98/418) to 17.4% (106/608) per quintile (P < .01). Neonatal unit admission (adjusted OR 1.99, 95% CI 1.85-2.14) was more likely following unplanned CS than vaginal births. Birth trauma was less likely following both unplanned (adjusted OR 0.48, 95% CI 0.39-0.60) and planned (adjusted OR 0.33, 95% CI 0.18-0.63) CS. Increased CS rates can be partly attributed to lowered clinical thresholds for intrapartum CS. Higher CS rates are associated with less birth trauma for the offspring.

Solid-phase assisted refolding of carbonic anhydrase using beta-cyclodextrin-polyurethane polymer. Artificial chaperone-assisted refolding has been shown to be an effective approach for improving the refolding yield of denatured proteins. Independent refolding of several structurally diverse proteins by this approach has provided promising results regarding significant suppression of aggregation along with enhanced refolding yields. However, from the industrial point of view, some modifications seem to be essential for making the technique more efficient. In that regard and with a cost-cutting goal we designed, for the first time, a beta-cyclodextrin-polyurethane polymer to replace the soluble beta-cyclodextrin as the stripping agent for refolding of carbonic anhydrase. Our results indicated that under the optimally developed refolding environment, the denatured carbonic anhydrase was refolded with a yield of 75% using 15 mg/mL of the beta-cyclodextrin-polyurethane polymer, a yield near to stripping by soluble beta-CD. This new stripping approach seems to constitute an ideal approach for refolding of proteins at much lower industrial costs compared to stripping with soluble beta-cyclodextrin. However, further-improvements in solid-phase artificial chaperone assisted technique are demanded either through synthesizing better stripping agents or by optimizing and defining better refolding environments.

[The expression of Cyclin D1 modulated by somatotropin on human pancreas cancer cell lines Bxpc-3]. To observe the growth effect of somatostapin on human pancreas cancer lines Bxpc-3. The Bxpc-3 pancreas cancer cells were treated with Somatotropin. The cells hyperplasia were detected by MTT and were observed apoptosis cells determinated quantitatively by TUNEL, quantify immune fluoresence double marked the proliferation cells and apoptosis cells, the expression of Cyclin D1 detected by immunohistochemical. The growth effect of pancrea cancer cells were limited by 10(-7) M, 10(-8) M, 10(-9) M Somatotropin on 2 day. The limited effect was decreased from 3 day. The cells proliferation were increased by somotostapin on 4day to 5day. The relationship between the expression of Cyclin D1 and apoptosis was negative correlation and the cells hyperplasia was positive correlation in Bxpc-3 cell line. From the cell study we knew the expression of Cyclin D1 reflected the prolefiration of pancreas cancer cells.

Nucleation of microbiologic calcification by proteolipid. The component of crude phospholipid responsible for B. matruchotii calcification was isolated. Crude phospholipid, extracted from the microorganism, was separated into five fractions by column chromatography. A single, protein-containing fraction catalyzed apatite formation in a metastable calcium phosphate solution. The nucleating fraction was identified as a proteolipid.

Clearance of Pseudomonas aeruginosa from normal rat lungs after immunization with somatic antigens or toxin A. In a recent study we observed that in most Danish CF patients a period of approximately one year of intermittent colonization precedes the onset of chronic P. aeruginosa lung infection. An experimental model of acute P. aeruginosa pneumonia in normal rats was utilized to investigate the possibility of improving bacterial clearance by vaccination. Rats were immunized with either P. aeruginosa whole bacterial sonicate, O-polysaccharide toxin A conjugate, alginate toxin A conjugate or purified alginate. Saliva and serum samples were obtained to investigate the potential of different vaccines to induce local IgA and systemic IgM, IgG and IgA antibodies. In all immunized rats a significant (p < 0.05) rise in antibody titers against the vaccine components could be demonstrated in both saliva and serum. The macroscopic pathological changes observed at 6, 24 and 48 h after bacterial challenge included a pronounced inflammatory reaction in all groups of rats, whether vaccinated or not (p > 0.05). Approximately 99.5% of the initial inoculum was cleared within the first 6 h after challenge in all groups of rats (p > 0.77). Four weeks after challenge no bacteria could be cultured and no sign of previous inflammation could be demonstrated in any of the groups. The results of this study show that the inflammatory reaction and the natural capacity to clear bacteria in the lungs of normal rats are very efficient against P. aeruginosa and could not be improved by immunization.

Gas-chromatographic screening of capsular polysaccharides of Neisseria meningitidis. Thirteen systemic strains, i e strains isolated from systemic infections, and 77 carrier isolates of Neisseria meningitidis were serogrouped by agglutination and analyzed by gas chromatography (GC) of phenol extracts. For systemic strains the sugar patterns were in accordance with their group-specific capsular polysaccharides (CPS). Some carrier isolates revealed unexpected GC profiles. Upon immunological retesting with new sera, GC results were generally confirmed. Occasional isolates initially serogrouped as B or Y completely lacked neuraminic acid. Some non-groupable isolates were shown by ultracentrifugation and GC to have significant amounts of this sugar likely to originate from CPS of known composition or from unknown polysaccharides. One such originally non-groupable isolate showed a weak agglutination reaction specifically with group B antiserum when reexamined. Generally, carrier isolates had lower amounts of CPS than systemic strains of the same group. Five successive isolates from one carrier were first serogrouped as X, Z or non-groupable, but they had high amounts of galactosamine and 2-keto-3-deoxy octonate, sugars characterizing CPS of serogroup 29E. These isolates were confirmed by agglutination with recently available group 29E antiserum to be of this serogroup, which has not been reported before in Norway. Ultracentrifugation revealed the presence of unknown polysaccharides containing glucose, galactose or glucosamine, but further purification of these polymers is required to determine their composition and immunological importance.

Identification and molecular cloning of Tetrahymena 138-kDa protein, a transcription elongation factor homologue that interacts with microtubules in vitro. Macronucleus of Tetrahymena divides amitotically, although in a microtubule-dependent fashion. Besides the localization study and pharmacological study of macronuclear microtubules, mechanism of the macronuclear division is poorly understood. A biochemical search for microtubule-associated protein was attempted from the isolated macronucleus. Improvement on macronucleus isolation method and microtubule coprecipitation assay led to the cloning of p138, a new homologue of transcription elongation factor FACT (facilitates chromatin transcription) 140kDa subunit. DNase treatment test of macronuclear extract and the sequence of p138 suggested that p138 is associated with chromosome in the macronucleus. The release tests of p138 from microtubules indicated that p138 is released from microtubules in the presence of ATP but not in the presence of AMP-PNP. Together, the results suggest a novel function of FACT homologue, that p138 interacts with both microtubules and chromosome.

Congenital ichthyosiform erythroderma: particulate staining pattern of TGK. A case of late onset non-bullous congenital ichthyosiform erythroderma (CIE) was studied. This patient was not born as a collodion baby and did not have skin abnormalities until 9-10 years of age. She gradually developed erythroderma and fine scales, callosities of her feet, and a mild ectropion. Since recent work has revealed that in the majority of CIE patients, transglutaminase (TGK) is distributed in the cytoplasm of granular cells and horny cells (11), TGK was studied in our case. It was found that TGK was distributed along the cell periphery of horny cells and also in the cytoplasm of granular cells. In the control skins, TGK was stained along the cell periphery of horny cells and granular cells. The marginal band formation was normal. Involucrine and loricrin, the building materials of the marginal band whose-cross-linking is mediated by TGK, were normally stained in the upper epidermis. Cytoplasmic TGK of granular cells and normal development of the marginal band may serve as a helpful diagnostic marker of CIE, particularly because the often confusing collodion baby of lamellar ichthyosis may lack TGK staining and the marginal band altogether.

Synthesis of some phthalazine derivatives chemically related to hydralazine. The potent antihypertensive properties of hydralazine and dihydralazine prompted the synthesis of sixteen new phthalazine derivatives with thiosemicarbazide or beta-propionamide residues to investigate their possible antihypertensive activity.

Synthesis of next generation dual-responsive cross-linked nanoparticles and their application to anti-cancer drug delivery. Rare earth metal-mediated group transfer polymerisation enables the synthesis of previously inaccessible block copolymers of 2-vinylpyridine, diethyl vinylphosphonate and the new diallyl vinylphosphonate monomer. This precision polymerisation and the selective cross-linking of allyl side groups via thiol-ene click chemistry leads to the formation of well-defined dual-responsive nanoparticles. We demonstrate that these next generation nanocarriers are pH- and temperature-responsive and are capable of efficiently delivering doxorubicin into the nucleus of cancer cells. High anti-cancer activity could be demonstrated via cytotoxicity tests on breast cancer (MCF-7) and cervical cancer (HeLa) cells. These results validate this modular synthesis route as an ideal platform for the development of sophisticated nanocarriers for future drug delivery applications.

Vector targeting makes 5-fluorouracil chemotherapy less toxic and more effective in animal models of epithelial neoplasms. 5-fluorouracil (5-FU) has been combined in the past with other drugs for the combination chemotherapy for cancers of the breast, ovary, and colon. These drug regimens were limited by the fact that 5-FU fails to kill nondividing cancer cells at the doses that are safe to deliver. The goal of the present study is to test the feasibility of replacing 5-FU in established 5-FU combination chemotherapy with the Ad-LpCDIRESE1A/5-fluorocytosine (5-FC) system for the purpose of reducing toxicity and increasing efficacy. We have replaced 5-FU in the weekly combination of CPT-11, folinic acid (FA) and 5-FU chemotherapy by 5-FC and an adenoviral vector that carries the L-plastin (Lp) tumor-specific promoter-driven transcription unit encoding the cytosine deaminase gene linked to the E1A gene by an internal ribosomal entry site element. This combination is called "genetic combination therapy." The goal of using the vector was to decrease the toxicity to normal tissue and to increase the efficacy of therapy in the cancer cells by increasing the concentration of 5-FU sufficiently high that even nondividing cancer cells would be killed by 5-FU through its incorporation into mRNA and consequent inhibition of synthesis of functional proteins. We compared the in vivo efficacy of the genetic combination therapy with the conventional combination chemotherapy in a mouse colon cancer model. Both replication-competent and -noncompetent adenoviral vectors carrying an L-plastin-driven cytosine deaminase transcription unit when combined with 5-FC, CPT-11, and FA showed increased in vitro therapeutic activity that was significantly higher than that of the conventional chemotherapy combination. Tumor-bearing mice treated with the genetic combination therapy showed a statistically significant advantage in terms of increased response rate, response duration, survival, and reduced toxicity when compared with tumor-bearing mice treated with the conventional combination chemotherapy. Replacement of 5-FU in 5-FU-based combination chemotherapy with the Ad-LpCDIRESE1A vector and 5-FU reduces toxicity and increases efficacy. This is a concept that could be potentially applied widely for many forms of cancer treatment.

Feasibility of e-Pain Reporter: A Digital Pain Management Tool for Informal Caregivers in Home Hospice. Informal hospice caregivers often have difficulty managing patient pain at home. We developed a digital application, e-Pain Reporter, for informal caregivers to record and providers to monitor patient pain and pain management. The purpose of this study was (1) to assess the feasibility of informal caregivers using the e-Pain Reporter for 9 days in home hospice by investigating recruitment and retention and caregiver satisfaction with and frequency of use of the e-Pain Reporter and (2) describe patient pain characteristics and caregiver's barriers to pain management and self-efficacy in providing patient care in the home. One-group pre-post design was used. Patient-caregiver dyads were recruited from 1 hospice agency. Caregivers were asked to report all patient pain and pain management using the e-Pain Reporter. Feasibility of the e-Pain Reporter was assessed by the average number of times caregivers recorded breakthrough and daily pain and caregiver satisfaction with the app. The 27-item Barriers Questionnaire II and 21-item Caregiver Self-efficacy Scale were administered at baseline. Fourteen dyads enrolled, 2 patients died, and 12 dyads completed the study. Mean number of pain reports over 9 days was 10.5. Caregivers reported high overall satisfaction with the e-Pain Reporter. Barriers scores were moderately high, suggesting erroneous beliefs and misconceptions about pain reporting and use of analgesics, but self-efficacy in managing pain was also high (93% confidence). Findings suggest that the e-Pain Reporter is a feasible method to report and monitor caregiver management of pain at home. Caregiver high barriers and high overconfidence suggest the need for an educational component to the e-Pain Reporter to address misconceptions about pain and pain management.

Associations of prenatal exposure to Ramadan with small stature and thinness in adulthood: results from a large Indonesian population-based study. A growing body of evidence suggests that maternal diet during pregnancy can lead to permanent alterations to the physiology of the fetus. It is unknown whether intermittent maternal fasting during Ramadan has long-term associations with the offspring's body composition. By using data from the third wave of the Indonesian Family Life Survey (2000), we compared the body mass indices (weight (kg)/height (m)(2)) of Muslims who had been in utero during Ramadan with those of Muslims who had not been in utero during Ramadan. Adult Muslims who had been in utero during Ramadan were slightly thinner than Muslims who had not been in utero during Ramadan (adjusted adult body mass index: -0.32, 95% confidence interval: -0.57, -0.06). Those who were conceived during Ramadan also had smaller stature, being on average 0.80 cm shorter than those who were not exposed to Ramadan prenatally. Among non-Muslims, no such associations were found. This study suggests that exposure to Ramadan during pregnancy may have lasting consequences for adult body size of the offspring.

Microvascular and endothelial function for risk prediction in dengue: an observational study. Dengue infection can result in a wide spectrum of disease. The defining feature of severe disease is increased capillary permeability, which can lead to hypovolaemic shock. Microvascular and endothelial dysfunction might underlie hypovolaemic shock, but they have not been assessed clinically. We aimed to investigate the use of microvascular assessment as a prognostic method in dengue. This is an ongoing prospective observational study that aims to recruit 300 participants: children over the age of 3 years and adults presenting to two outpatient departments in Vietnam with fever of less than 72 h duration and suspected dengue, and patients admitted to hospital with warning signs or severe disease. Participants are being clinically assessed daily for 6 days, and 2 weeks later. Microvascular imaging using sublingual sidestream darkfield imaging (SDF) and endothelial function testing using peripheral artery tonometry are being performed at enrolment, defervescence, and follow-up To date, 167 patients have been recruited (92 outpatient arm, 75 inpatient arm, median age 27 years [IQR 21-33], 78 male [47%]). Dengue has been confirmed in 67 individuals in the outpatient arm, of whom 29 (43%) developed warning signs, three (4%) developed severe disease, and 35 had uncomplicated dengue; the other 25 outpatients (27%) were diagnosed as other febrile illness. At enrolment, the reactive hyperaemic index, a marker of endothelial function, was lowest in the patients who went on to develop severe dengue (median 1·54, IQR 1·36-1·77) followed by those who developed warning signs (1·78, 1·43-2·36) and then uncomplicated dengue (2·18, 1·65-2·24). Initial SDF results showed a lower proportion of perfused vessels and mean flow index during the febrile phase of dengue compared with follow-up, and were worst in the severe group at defervescence. This study of vascular function at serial timepoints in dengue is, to our knowledge, the first and most comprehensive. Our preliminary results suggest that microvascular and endothelial dysfunction are associated with severity of dengue, and occur before the appearance of severe clinical manifestations. These techniques might be useful in risk prediction in dengue. A limitation is that a formal sample size could not be calculated because no previous microvascular data in dengue exist. Wellcome Trust.

Electromechanical delay of the vastus medialis obliquus and vastus lateralis in individuals with patellofemoral pain syndrome. Case-control study. To examine electromechanical delay (EMD) of the vastus medialis obliquus (VMO) and the vastus lateralis (VL) in individuals with patellofemoral pain syndrome (PFPS). EMD is a mechanical property of muscles related to protective reflex and sports performance. The time duration of the EMD can be shortened with strength training and, conversely, can be lengthened secondary to immobilization. However, it is unclear if EMD between various components of the quadriceps is affected in individuals with PFPS. Twenty-six individuals with PFPS and 26 healthy volunteers were studied. The VMO and VL were electrically stimulated to evoke muscle twitches. Ultrasound was used to assess patellar movement elicited by the muscle twitch. The time from the onset of electrical stimulation to the onset of patellar movement was measured as the EMD. The EMDs of the VMO and VL were compared between groups using a mixed-model analysis of variance. Subsequent to a significant interaction (P<.001), post hoc analysis indicated that the EMD of the VMO was longer (PFPS, 37.3 ± 0.7 milliseconds; control, 25.9 ± 0.7 milliseconds; P<.001) and the EMD of the VL was shorter (PFPS, 18.4 ± 0.5 milliseconds; control, 25.1 ± 0.5 milliseconds; P<.001) in the PFPS group. Therefore, in the individuals with PFPS, the EMD of the VMO was significantly longer than that of the VL (P<.001), which was not the case for those in the control group (P = .20). The mechanical properties of the VMO and VL may be altered in patients with PFPS.J Orthop Sports Phys Ther 2012;42(9):791-796, Epub 2 August 2012. doi:10.2519/jospt.2012.3973.

Novel natural fill telemetric pressure flow study of discomfort and bladder outlet obstruction. We evaluated the accuracy of natural fill telemetric pressure flow study performed in a private room, and assessed patient discomfort and experience after the procedure compared to those of standard pressure flow study. In 58 patients with lower urinary tract symptoms/benign prostatic hyperplasia free uroflowmetry, and natural fill telemetric and standard pressure flow studies were prospectively performed. Immediately after each step patients were asked to rate the experience in terms of pain, embarrassment, bother, boredom and repeat testing. Subjective items and objective urodynamic parameters were compared among the 3 tests. Maximum urine flow on natural fill telemetric pressure flow study was not different from that on free uroflowmetry. In contrast, maximum flow, detrusor pressure at maximum flow and bladder contractility index on the standard pressure flow study were significantly lower than on the natural fill pressure flow study. However, the bladder outlet obstruction index was not significantly different between the 2 studies, and the bladder outlet obstruction and bladder contractility indexes correlated well. There were also no differences in bother and embarrassment scores. However, natural fill telemetric pressure flow study was superior in terms of pain and boredom scores. Patients were more willing to undergo repeat natural fill telemetric pressure flow study than standard pressure flow study. Time to complete the test was significantly shorter for the natural fill study than for the standard study. Flow rate differences between pressure flow studies and free uroflowmetry are not due to mechanical obstruction by the catheter but to other factors, such as the bladder filling method. Objective parameters on the natural fill telemetric pressure flow study correlated with standard pressure flow study findings. The natural fill telemetric pressure flow study shortened the time needed for the test and may decrease the discomfort of the standard pressure flow study.

Whole-body high-field MRI shows no skeletal muscle degeneration in young patients with recessive myotonia congenita. Muscle magnetic resonance imaging (MRI) is the most sensitive method in the detection of dystrophic and non-dystrophic abnormalities within striated muscles. We hypothesized that in severe myotonia congenita type Becker muscle stiffness, prolonged transient weakness and muscle hypertrophy might finally result in morphologic skeletal muscle alterations reflected by MRI signal changes. To assess dystrophic and/or non-dystrophic alterations such as fatty or connective tissue replacement and muscle edema in patients with severe recessive myotonia congenita. We studied three seriously affected patients with myotonia congenita type Becker using multisequence whole-body high-field MRI. All patients had molecular genetic testing of the muscle chloride channel gene (CLCN1). Molecular genetic analyses demonstrated recessive CLCN1 mutations in all patients. Two related patients were compound heterozygous for two novel CLCN1 mutations, Q160H and L657P. None of the patients showed skeletal muscle signal changes indicative of fatty muscle degeneration or edema. Two patients showed muscle bulk hypertrophy of thighs and calves in line with the clinical appearance. We conclude that (i) chloride channel dysfunction alone does not result in skeletal muscle morphologic changes even in advanced stages of myotonia congenita, and (ii) MRI skeletal muscle alterations in myotonic dystrophy must be clear consequences of the dystrophic disease process.

Arthroscopic treatment of pigmented villonodular synovitis of the shoulder. Pigmented villonodular synovitis (PVNS) rarely affects the shoulder. Fewer than 30 cases have been reported in the English and French language literature. In those patients, PVNS was treated by open surgery involving total or local synovectomy, sometimes associated with total shoulder replacement, cuff tear repair, or arthroplastic head resection. The authors report 2 cases of PVNS of the shoulder treated arthroscopically and discuss the advantages and limitations of this technique in the treatment of shoulder PVNS.

The Changing Age of Individuals Seeking Presymptomatic Genetic Testing for Huntington Disease. Huntington disease (HD) is a progressive neurodegenerative disorder. Presymptomatic genetic testing allows at-risk individuals to clarify their risk status. Understanding the characteristics and motivations of individuals seeking HD presymptomatic genetic testing better equips genetic counselors and other healthcare professionals to provide comprehensive and personalized care. The aims of this study were to (1) determine whether the average age when individuals seek presymptomatic HD genetic testing has decreased over time, (2) assess motivations for seeking testing, (3) explore whether there is a relationship between age and motivations, and (4) explore genetic counselors' perceptions of the shift in age. Data from the US HD testing centers (N = 4) were analyzed. A small but statistically significant decrease in age of individuals seeking presymptomatic testing was observed (p = 0.045). HD community members (N = 77) were surveyed regarding presymptomatic testing motivations. Younger individuals were more likely than older individuals to cite "To learn whether or not you would develop HD" and "To make choices about further education or a career" compared to older individuals (p < 0.05). Conversely, older individuals more frequently cited "To give children a better idea of their risk" (p < 0.002). Sixteen percent of genetic counselors surveyed (6/37) perceived a change in age of testing. All of these respondents had provided HD testing for ten or more years and anecdotally believed the age at testing has decreased over time. Study results help providers personalize counseling based on patient's age and serve as a starting point for more research into the relationship between age at testing and motivations for testing.

Reliability of ultrasound in diagnosis of intracerebral hemorrhage and posthemorrhagic hydrocephalus: comparison with computed tomography. Subependymal and intraventricular hemorrhage are frequent complications of the high risk preterm infant. It has been stated recently that ultrasound may be used to diagnose intraventricular hemorrhage. A comparative prospective study of ultrasound scan (US) with a commercially available B-mode real time linear array US machine and the computed tomography (CT) scan was undertaken to determine the accuracy of US in diagnosing the presence and quantity of subependymal and intraventricular hemorrhage and in following infants with hemorrhage for the development of progressive hydrocephalus. There were 101 patients followed with serial US examination for evidence of subependymal and/or intraventricular hemorrhage. CT correlation was obtained on each patient. The US examination correlated with the CT scan in 77 of these 101 patients. The demonstration of hydrocephalus by US in eight infants with postthemorrhagic hydrocephalus was reliable, and the correlation with CT scan was excellent.

One-pot catalyst free synthesis of novel kojic acid tagged 2-aryl/alkyl substituted-4H-chromenes and evaluation of their antimicrobial and anti-biofilm activities. A number of 3-hydroxy-6-(hydroxymethyl)-2-(2-phenyl-4H-chromen-4-yl)-4H-pyran-4-ones (3) have been synthesized in a one pot catalyst free reaction of 2-hydroxy chalcone (1) with kojic acid (2) in toluene at reflux temperature and evaluated for antimicrobial and anti-biofilm activities. Compounds 3a, 3e, 3f, 3l showed potent antimicrobial activity against Staphylococcus aureus MLS-16 MTCC 2940, Bacillus subtilis MTCC 121 and Escherichia coli MTCC 739, whereas 3b and 3k exhibited excellent activity against Bacillus subtilis MTCC 121 and Escherichia coli MTCC 739, while 3g showed promising activity against Bacillus subtilis MTCC 121 and Escherichia coli MTCC 739. On the other hand, compounds 3a, 3b and 3l showed very good anti-biofilm activity and 3g showed moderate activity against Bacillus subtilis MTCC 121. Whereas, compounds 3a and 3f showed moderate activity against Escherichia coli MTCC 739, while compounds 3a, 3b, 3k and 3l displayed similar activity against Staphylococcus aureus MLS-16 MTCC 2940.

Role of the amino acid 45 residue in reduced folate carrier function and ion-dependent transport as characterized by site-directed mutagenesis. In previous reports, an E45K mutation in reduced folate carrier (RFC1) resulted in marked substrate-specific changes in folate binding and the induction of an obligatory inorganic anion requirement for carrier function. In this study, site-directed mutagenesis was employed to further characterize the role of glutamate-45 in carrier function by replacement with glutamine, arginine, aspartate, leucine, or tryptophan followed by tranfection of the mutated cDNAs into the MTX(r)A line, which lacks a functional endogenous carrier. Alterations in transport function with amino acid substitutions at this residue were not charge related. Hence, E45Q, E45R, and E45K all 1) increased carrier affinity for 5-formyltetrahydrofolate approximately 4-fold, 2) increased affinity for folic acid approximately 6- to 10-fold, 3) did not change affinity for 5-methyltetrahydrofolate, and 4) except for E45R decreased affinity for methotrexate (2- to 3-fold). In contrast, mutations E45D, E45L, and E45W generally reduced affinity for all these folates except for folic acid. Finally, chloride-dependent influx was only noted in the E45R mutant. These data further substantiate the important role that glutamate-45 plays in the selectivity of binding of folates to RFC1 and establish that it is the addition of a positive charge at this site and not the loss of a negative charge that results in the induced anion dependence. These and other studies indicate that mutations in the first transmembrane domain can have a markedly selective impact on the affinity of RFC1 for folate compounds and in particularly a highly salutary effect on binding of the oxidized folate, folic acid.

The failure patterns of oral cavity squamous cell carcinoma after intensity-modulated radiotherapy-the university of iowa experience. Determine the failure patterns of oral cavity squamous cell carcinoma (SCC) treated with intensity-modulated radiotherapy (IMRT). Between May 2001 and July 2005, 55 patients with oral cavity SCC were treated with IMRT for curative intent. Forty-nine received postoperative IMRT, 5 definitive IMRT, and 1 neoadjuvant. Three target volumes were defined (clinical target CTV1, CTV2, and CTV3). The failure patterns were determined by coregistration or comparison of the treatment planning computed tomography to the images obtained at the time of recurrence. The median follow-up for all patients was 17.1 months (range, 0.27-59.3 months). The median follow-up for living patients was 23.9 months (range, 9.3-59.3 months). Nine patients had locoregional failures: 4 local failures only, 2 regional failures only, and 3 had both local and regional failures. Five patients failed distantly; of these, 3 also had locoregional failures. The 2-year overall survival, disease-specific survival, local recurrence-free survival, locoregional recurrence-free survival, and distant disease-free survival was 68%, 74%, 85%, 82%, and 89%, respectively. The median time from treatment completion to locoregional recurrence was 4.1 months (range, 3.0-12.1 months). Except for 1 patient who failed in contralateral lower neck outside the radiation field, all failed in areas that had received a high dose of radiation. The locoregional control is strongly correlated with extracapsular extension. Intensity-modulated RT is effective for oral cavity SCC. Most failures are in-field failures. Further clinical studies are necessary to improve the outcomes of patients with high-risk features, particularly for those with extracapsular extension.

Identification and characterization of fructose 1,6-bisphosphate aldolase genes in Arabidopsis reveal a gene family with diverse responses to abiotic stresses. Fructose 1,6-biphosphate aldolase (FBA) is a key enzyme in plants, which is involved not only in glycolysis and gluconeogenesis in the cytoplasm, but also in the Calvin cycle in plastids. Research on FBAs in various organisms has been reported, but there is none on FBAs in Arabidopsis at the molecular level. In the current study, eight FBA family genes (AtFBA1-8) were identified and analyzed in Arabidopsis thaliana. These genes have a highly conserved aldolase-type TIM barrel domain and a C-terminal peptide, but variable N-terminal peptides. Based on the phylogenetic analysis of FBA protein sequences from Arabidopsis and other plant species, AtFBA family was classified into two subfamilies, including three members (AtFBA1-3) with high similarities to FBAs occurring at plastid, and five (AtFBA4-8) with high similarities to FBAs localized in the cytoplasm. By confocal microscopy analysis with GFP fusion protein, AtFBA3 and AtFBA4 as well as AtFBA6 were observed to be localized in the plastid and cytoplasm, respectively. At least two duplicated gene pairs of AtFBA1 and AtFBA2, as well as AtFBA4 and AtFBA8 were found. Transcript level analysis of AtFBA genes in various tissues revealed the unique and overlapping expression patterns of plastid and cytosol AtFBA genes, suggesting that these genes may function at different stages of plant growth and development. Interestingly, AtFBA1, AtFBA2, AtFBA5 and AtFBA7 showed undetectable expression in roots. The expression patterns of AtFBA genes under different stress conditions suggested that all the members showed different expression patterns in response to stresses, including ABA, NaCl, Cd, abnormal temperature and drought, and, except for AtFBA3, most of the AtFBA genes were significantly responsive to drought stress in roots. Moreover, AtFBA1, AtFBA2, AtFBA5, AtFBA7 and AtFBA8 were induced by at least one of three sugars (sucrose, glucose and fructose) after 24h of treatment. Further functional analyses indicated important clues of AtFBA2, AtFBA6 and AtFBA8 in plant growth, stress responses and development, respectively. Thus these results provide additional knowledge on AtFBA families and their roles.

Identification of immunoreactive tissue kallikrein in human ductal breast carcinomas. Various proteases have been shown to be present in malignant breast tissue. Although the question of the involvement of tissue kallikrein, a serine protease, in the pathophysiology of tumours has been raised, the presence of this enzyme in human breast carcinoma has so far not been examined. In the present study, both neoplastic and normal human breast are scanned by immunocytochemistry for the presence and cellular localization of tissue kallikrein. In the healthy breast, tissue kallikrein was observed as a deposit of immunoreactive material that localized in the apical portion of duct cells. In the malignant breast tumours surveyed, the enzyme was observed only in ductal carcinomas, whereas lobular carcinomas were devoid of immunostaining. In ductal carcinomas, the immunoreactivity for tissue kallikrein appeared to be associated with gradations of malignancy, being absent in dedifferentiated tumours. The presence of tissue kallikrein in malignant breast tumours poses the question of the role of this enzyme in malignant breast tissue. The enzyme may participate within the tissue either in proteolytic processes (it has been shown to activate procollagenase) or by enhancing vascularity or mitogenicity by the generation of kinins.

Succinic acid production by a newly isolated bacterium. A new bacterial strain producing succinic acid was enriched from bovine rumen content. It is facultatively anaerobic, belongs to the family Pasteurellaceae and has similarity to the genus Mannheimia. In batch cultivations with D-glucose or sucrose the strain produced up to 5.8 g succinic acid l(-1) with a productivity and a yield of up to 1.5 g l(-1) h(-1) and 0.6 g g(-1), respectively. With crude glycerol up to 8.4 g l(-1), 0.9 g l(-1) h(-1) and 1.2 g g(-1) were obtained.

Grading the severity of obstruction in patients with chronic obstructive pulmonary disease and morbid obesity. To evaluate the severity of airway obstruction in patients affected by chronic obstructive pulmonary disease (COPD) in the presence of concomitant restriction due to morbid obesity. Lung function test, six-minute walking distance (6MWD) test, body mass index measurement (BMI), and determination of dyspnoea using the Modified Medical Research Council Dyspnoea Scale (MMRC) were performed on each patient referred to our department according to their individual respiratory diagnosis or symptoms. Analysis was performed on smokers or ex-smokers patients, with both dyspnoea and chronic productive cough, showing non fully reversible airflow obstruction, with normal-weight (NW: BMI 22 to 24 kg/m2) or morbid-obesity (MO: BMI > or = 40 kg/m2). In 33 COPD patients, spirometric data differ between NW and MO only in fixed FEV1/FVC ratio (50 +/- 9 and 62 +/- 7, respectively; p = 0.0001) and FEV1/SVC % of predicted (57 +/- 15 and 71 +/- 11, respectively; p = 0.005). Furthermore, SVC was found to exceed FVC only in NW (2.82 +/- 0.7 L and 2.08 +/- 0.9 L, respectively; p = 0.03). NW and MO differ significantly also in MMRC (3.4 +/- 0.9 vs 2.4 +/- 1, respectively; p = 0.004), 6MWD in metres (226 +/- 100 and 331 +/-110, respectively, p = 0.007), 6MWD as % predicted (49 +/- 22 and 81 +/- 23, respectively; p = 0.0003), and BODE index (5.8 +/- 2 and 3.6 +/- 2, respectively; p = 0.003). There is a significant overgrading of obstruction in morbidly obese patients affected by COPD. Therefore, we suggest that an alternative grading system be used for patients with mixed ventilatory dysfunction.

Management of abnormal cervical cytology screening in adolescent and young women in a canadian colposcopy centre: a descriptive analysis. To describe and analyze the management of young women referred for colposcopy at a Canadian comprehensive cancer centre for evaluation of atypical squamous intraepithelial lesion of unknown significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL). We conducted a retrospective descriptive study by searching the eCancerCare Colposcopy Database at our centre for 15- to 29-year-old females with referral cytology of ASC-US and LSIL who were seen between January 2000 and January 2009. Women in three age cohorts (15 to 19 years, 20 to 24 years, and 25 to 29 years) were reviewed for risk factors and relevant medical history, cytology and histology results, treatment, and follow-up visits. A total of 407 women met the entry criteria, with 36 women in the group aged 15 to 19, 173 in the group aged 20 to 24, and 198 in the group aged 25 to 29. Ten excisional procedures were performed among the 36 participants in the group aged 15 to 19, with normal histology found in two (20%), low-grade cervical intraepithelial neoplasia (CIN) in four (40%), and high-grade CIN in four (40%). An excisional procedure was performed in 52 of 173 participants in the group aged 20 to 24, with normal histology in 15%, low-grade CIN in 37%, and high-grade CIN in 48%. Among the group aged 25 to 29, 74 of 198 participants had an excisional procedure, with normal histology in 12%, low-grade CIN in 27%, high-grade CIN in 59%, and microinvasive squamous cell carcinoma in one woman (1%). Many women under the age of 25 who were referred with low-grade abnormal cervical cytology underwent treatment(s) and many did not have significant pathology. One case of microinvasive cervical cancer was identified in a patient in the group aged 25 to 29 over the nine years of our study. Our results support the safety of developing a more conservative and coordinated approach to cervical cancer screening in adolescent and young women in Canada.

[Organization of Bsp-repeats in the fox genome]. Bsp repeats comprise approximately 1% of silver for total DNA and are preferentially localized in centromeric regions. Two of Bsp fragments cloned earlier, such as non-homologous rsV1 and rsV3, make up together a Bsp unit (680 bp) and possess a set of sites known to have regulatory functions in eucaryotic genomes. In this work, tandem organization of Bsp repeats is demonstrated. A stretched Bsp sequence (approximately 1460 bp, dimeric form) flanked by BamHI sites was cloned and its restriction map was plotted. With use of rsV1 and rsV3 probes the new sequence exhibited linked structure: rsV1-rsV3-rsV1-rsV3-rsV1. Blot-hybridization with the restriction fragments of fox total DNA suggested hierarchical order of Bsp clustes in the genome. It is supposed that the processes of selective amplification of individual fragments had been of real importance during evolution of Bsp repeats.

Recombinant human interleukin-8 is a potent activator of canine neutrophil aggregation, migration, and leukotriene B4 biosynthesis. Interleukin-8 (IL-8), formerly known as NAP-1, is formed by a variety of cells upon stimulation with IL-1 or tumor necrosis factor (TNF). The biologic activity of the cytokine involves activation of almost every neutrophil function studied so far in different species. In the present study, we compared the effects of recombinant human IL-8 (rIL-8) and the lipid mediators, leukotriene B4 (LTB4) and platelet-activating factor (PAF), on neutrophil functions in dogs. All three chemotactic factors induced neutrophil aggregation and chemotaxis, with rIL-8 being far more potent than LTB4 and PAF. The migration induced by rIL-8 was significantly greater than that observed towards LTB4 and PAF. In the aggregation assay, rIL-8 was shown for the first time to be a potent stimulant. The aggregation response was more persistent than that obtained with LTB4 and PAF and the potency of rIL-8 was greater. An intradermal dose-response study showed that rIL-8 is an extremely potent inducer of selective neutrophil infiltration in canine skin. The infiltration was more pronounced than following injection of LTB4 or PAF. It was proposed that the superior effect of rIL-8 was caused by a synergistic effect between injected rIL-8 and LTB4, which was shown to be produced in biologically active amounts by canine neutrophils stimulated with rIL-8. From a therapeutic point of view, the simultaneous presence of rIL-8 and LTB4 in inflammatory skin diseases highlights the need to develop drugs that inhibit the production and/or effect of both mediators.

[Development of the Saxon Health Target "Active aging - aging in health, autonomy, and participation"]. In Saxony, the consequences of demographic aging are observable already today. To manage the implications on the health sector, the Saxon Health Targets Steering Committee decided in March 2008 to develop a health target "Active Aging - Aging in Health, Autonomy, and Participation". Target development was based on a 7-level approach (fields of action, main goals, target areas, targets, strategies, intervention measures, indicators for evaluation). A quantitative content analysis was used to reveal 10 potential relevant fields of action, three of which were selected for target development. Targets were developed by 53 stakeholders in multiprofessional working groups. Criteria-based analyses were performed to assure appropriate scientific evidence and feasibility of targets and intervention measures. Over a period of 9 months, 24 targets were defined referring to the main goals "needs-based health care structures", "multiprofessional qualification", "self-rated health" and "intergenerational solidarity". Thirteen targets were developed into recommendations for specific intervention measures. Most of the proposed interventions aim to modify health-related structures or psychosocial determinants of health in the elderly. The best recommendations for intervention measures shall be implemented in cooperation with interested decision-makers.

Surgical management of intra-abdominal hypertension and abdominal compartment syndrome. The initial management of intra-abdominal hypertension (IAH) is medical measures to reduce intra-abdominal pressure (IAP). These, in combination with percutaneous drainage of peritoneal free fluid, may serve to reduce IAH. If these measures fail, surgical decompression of the abdomen by laparotomy is necessary to control the IAP, search for and treat inciting factors, and reduce the hypertension. The abdomen is usually left open with temporary abdominal closure techniques. Surgical decompression of IAH associated with acute pancreatitis or secondary abdominal compartment syndrome has other surgical options besides a complete celiotomy. Attention to detail in surgical technique and postoperative care is essential for optimal outcome.

Addressing the disproportionate representation of children of color: a collaborative community approach. The state of Indiana recommended a committee be formed to address the disproportional representation of black youth in out-of-home placements. In response, the Indiana Disproportionality Committee (IDC) was established. This article presents the development, objectives and future of the IDC. One of the objectives, research, will be offered as an example of the committee's collaborative strategies. The IDC, in partnership with another organization, has begun exploring relationships between ethnicity, risk factors and treatment outcomes. The results of this research effort have examined disproportion and disparity, leading the IDC to identify needs for change within the state. Barriers and successes of the IDC will be shared, so that others can use these efforts to guide their own strategies to reduce disproportionality.

Colour changes of chemical indicators-VI: metallochromic indicators for direct chelometric titrations of zinc. Eriochrome Blue SE, Eriochrome Red B, Naphthylazoxine 6S, SNAZOXS, and Zincon have been studied in order to find optimum conditions for their use as metallochromic indicators in direct visual chelometric titrations of zinc. The sharpness of the indicator transitions has been investigated by means of photometric titrations and the colour quality has been specified with the aid of the C.I.E. chromaticity systems. Zincon and Eriochrome Blue SE have been found to be the most convenient for visual titrations of zinc.

Acquired perforating dermatosis of diabetes mellitus and renal failure: further ultrastructural clues to its pathogenesis. An ultrastructural study of a typical case of acquired perforating dermatosis in a patient with renal failure and diabetes mellitus is reported. Crystal-like microdeposits of an electron-lucid material were detected in the upper dermis, close to the transepidermal channel. Compact macrophage conglomerations surrounded the deposits, and a strong histiocytic response was present. Mononuclear inflammatory cells of "activated" type penetrated the acanthotic epidermis provoking basement membrane dissolution and widening of interkeratinocyte spaces. Collagen fibers were seen in the keratotic plug, indicating the process of transepidermal elimination. Our observation supports the hypothesis suggesting that some kind of storage phenomenon may be at the origin of perforating skin lesions in renal failure patients.

Azacitidine in untreated acute myeloid leukemia: a report on 149 patients. Limited data are available on azacitidine (AZA) treatment and its prognostic factors in acute myeloid leukemia (AML). One hundred and forty-nine previously untreated AML patients considered ineligible for intensive chemotherapy received AZA in a compassionate patient-named program. AML diagnosis was de novo, post-myelodysplastic syndromes (MDS), post-MPN, and therapy-related AML in 51, 55, 13, and 30 patients, respectively. Median age was 74 years, median white blood cell count (WBC) was 3.2 × 10⁹ /L and 58% of the patients had ≥ 30% marrow blasts. Cytogenetics was adverse in 60 patients. Patients received AZA for a median of five cycles (range 1-31). Response rate (including complete remission/CR with incomplete recovery/partial remission) was 27.5% after a median of three cycles (initial response), and 33% at any time (best response). Only adverse cytogenetics predicted poorer response. Median overall survival (OS) was 9.4 months. Two-year OS was 51% in responders and 10% in non-responders (P<0.0001). Adverse cytogenetics, WBC >15 × 10⁹ /L and ECOG-PS ≥ 2 predicted poorer OS, while age and marrow blast percentage had no impact. Using MDS IWG 2006 response criteria, among patients with stable disease, those with hematological improvement had no significant survival benefit in a 7 months landmark analysis. Outcomes observed in this high-risk AML population treated with AZA deserve comparison with those of patients treated intensively in prospective studies.

Detection and genetic characterization of canine parvoviruses and coronaviruses in southern Ireland. Canine parvovirus (CPV) and canine coronavirus (CCoV) are considered the main pathogens responsible for acute gastroenteritis in dogs. From a collection of 250 samples, seven CPV strains and three CCoV strains were identified in symptomatic Irish dogs. Samples were screened for the viruses using polymerase chain reaction (PCR) and typed via DNA sequence analysis. Three CPV strains were characterized as CPV-2a, while four others were characterized as CPV-2b. To date, CPV-2c remains unreported in Ireland. Two CCoV strains were characterized as CCoV-II and one as CCoV-I. In the case of one sample, PH4/09/Ire, a mixed infection with CPV and CCoV was detected.

Role of PI-RADSv2 with multiparametric MRI in determining who needs active surveillance or definitive treatment according to PRIAS. To evaluate the role of Prostate Imaging Reporting and Data System v. 2 (PI-RADSv2) in triaging patients with prostate cancer according to Prostate Cancer Research International: Active Surveillance (PRIAS). Between January 2012 and December 2014, 456 patients with biopsy-proven cancer underwent multiparametric 3T magnetic resonance imaging (MRI) using T2 -weighted, diffusion-weighted, and dynamic contrast-enhanced MRI sequences, and then radical prostatectomy. Two radiologists independently reviewed MR images using PI-RADSv2. For AS, PRIAS required clinical stage <T3, prostate-specific antigen (PSA) ≤10 ng/mL, PSA density <0.2 ng/mL2 , Gleason score (GS) ≤6, and the number of positive cores ≤2. For AS, PI-RADSv2 required an index lesion scored <4. Standard reference was prostatectomy, in which insignificant cancer was defined as a small (<0.5 cm3 ) organ-confined lesion with GS ≤6. Sensitivity and specificity for insignificant cancer were obtained with PRIAS, PI-RADSv2, and both. The sensitivity and specificity with PRIAS were 82.9% (68/82) and 70.9% (265/374), respectively. PI-RADSv2 decreased the sensitivity to 61% (50/82) to 80.5% (66/82), but increased the specificity to 77.8% (291/374) to 90.8% (340/374). The combination of PRIAS and PI-RDASv2 increased significantly the specificity to 89.6% (335/374) to 92.8% (347/374) (P < 0.001). PRIAS using multiparametric MRI can identify a greater number of insignificant cancers than PI-RADSv2. However, PI-RADSv2 helps detect many significant cancers that are misdiagnosed as insignificant cancer with PRIAS. 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1753-1759.

Long Pauses in Cerebellar Interneurons in Anesthetized Animals. Are long pauses in the firing of cerebellar interneurons (CINs) related to Purkinje cell (PC) pauses? If PC pauses affect the larger network, then we should find a close relationship between CIN pauses and those in PCs. We recorded activity of 241 cerebellar cortical neurons (206 CINs and 35 PCs) in three anesthetized cats. One fifth of the CINs and more than half of the PCs were identified as pausing. Pauses in CINs and PCs showed some differences: CIN mean pause length was shorter, and, after pauses, only CINs had sustained reduction in their firing rate (FR). Almost all pausing CINs fell into same cluster when we used different methods of clustering CINs by their spontaneous activity. The mean spontaneous firing rate of that cluster was approximately 53 Hz. We also examined cross-correlations in simultaneously recorded neurons. Of 39 cell pairs examined, 14 (35 %) had cross-correlations significantly different from those expected by chance. Almost half of the pairs with two CINs showed statistically significant negative correlations. In contrast, PC/CIN pairs did not often show significant effects in the cross-correlation (12/15 pairs). However, for both CIN/CIN and PC/CIN pairs, pauses in one unit tended to correspond to a reduction in the firing rate of the adjacent unit. In our view, our results support the possibility that previously reported PC bistability is part of a larger network response and not merely a biophysical property of PCs. Any functional role for PC bistability should probably be sought in the context of the broader network.

Societal participation: examining the impact of a rehabilitation approach for young people with schizophrenia. This paper is based on research that focuses on the impact of a rehabilitation approach with respect to 99 young people diagnosed with schizophrenia in a Dutch mental health facility. The approach focused on societal participation goals. Nurses and social workers play a key role in such treatment. The research focused on developmental trajectories and showed significant improvement with respect to societal participation levels. Impairment scores remained stable. The results indicate that rehabilitation counselling by nurses and social workers, in addition to medication and psychosocial treatment and integrated in a multidisciplinary team, can make a difference in a patient's societal participation.

[Leber's hereditary optic nerve neuropathy]. The authors present a case report of 26 years old man with bilateral optic nerve neuropathy. Detection of heteroplasmic mutation of mitochondrial DNA at G3460A site confirmed the suspicion on Lebers hereditary optic nerve neuropathy (LHON). Genetic and environmental factors of the disease and various accompanying neurologic and other symptoms, which can together with the optic nerve defect participate in the development of of the LOHN clinical pattern are discussed. (Ref. 12.)

[Neuroretinitis]. The name "neuroretinitis" implies nothing but a fundus picture which can be caused by many infectious agents. The involvement of visual functions is variable and the prognosis relatively good. The treatment depends on which infectious agent is suspected.

Counterregulatory responses to hypoglycemia in patients with glucokinase gene mutations. The glucokinase gene is expressed not only in pancreatic B cells and in the liver, but also in pancreatic alpha cells, and in some cells of the central nervous system. A decreased glucokinase activity in the latter cell types may interfere with counterregulatory responses to hypoglycemia. In order to assess functional consequences of glucokinase mutations, counterregulatory hormones secretion and glucose production (6,6(- 2) H glucose) were monitored during an hyperinsulinemic clamp at about 2.4 pmol.kg(- 1).min(- 1) insulin with progressive hypoglycemia in 7 maturity onset diabetes of the young (MODY) type 2 patients, 5 patients with type 2 diabetes, and 13 healthy subjects. Basal glucose concentrations were significantly higher in MODY2 patients (7.6 +/- 0.4 mmol.l(- 1) ) and type 2 diabetic patients (12.4 +/- 2.3 mmol.l(- 1) ) than in healthy subjects (5.3 +/- 0.1 mmol.l(- 1), p<0.01) but counterregulatory hormones concentrations were identical. Insulin-mediated glucose disposal and suppression of endogenous glucose production at euglycemia were unchanged in MODY2 patients, but were blunted in type 2 diabetes. During progressive hypoglycemia, the glycemic thresholds of MODY2 patients for increasing glucose production (5.0 +/- 0.4 mmol.l(- 1) ) and for glucagon stimulation (4.5 +/- 0.4 mmol. l(- 1) ) were higher than those of healthy subjects and type 2 diabetic patients (3.9 +/- 0.1 and 4.1 +/- 0.1 mmol.l(- 1) respectively for glucose production and 3.7 +/- 0.1 and 3.5 +/- 0.1 mmol.l(- 1) for glucagon stimulation, p <0.02 in both cases). These results indicate that counterregulatory responses to hypoglycemia are activated at a higher plasma glucose concentration in MODY2 patients. This may be secondary to decreased glucokinase activity in hypothalamic neuronal cells, or to alterations of glucose sensing in pancreatic alpha cells and liver cells.

[Effect of the polymerase activity of DNA polymerase I on the development of moderate bacteriophages Mu, lambda red- and lambda red-gam-. II. The effect of the polymerase activity of DNA polymerase I on the development of bacteriophage Mu]. The paper reports on the influence of polymerizing activity of DNA-polymerase I on different developmental stages of temperate bacteriophage Mu in Escherichia coli K-12 cells. This activity is shown to be necessary for optimization of phage Mu primary integration into cell chromosomes. The relative frequency of Mu integration into bacterial chromosomes is 5-6 times lower in polA cells than in isogenic polA+ control strains, the phage yield from cells being delayed during the phage infectious development, but not in the course of induction from the prophage state. Data have been obtained that show the process of phage Mu DNA integration into the plasmid pRP1 .2 and the process of Mu transposition from the cell chromosome into the plasmid to be independent of the polymerizing activity of DNA-polymerase I.

Psychiatric manifestations of neurosyphilis. To investigate referral patterns, initial diagnoses and clinical features of patients with neurosyphilis who present with psychiatric manifestations, records were kept of 21 such patients admitted to an acute psychiatric ward. In none of the 12 cases referred from primary care workers was the possibility of neurosyphilis considered. In only 3 cases was this diagnosis considered on admission to the psychiatric ward before serum serological test results were known. Commonest presenting symptoms were personality change (16 patients) and memory impairment (13 patients). Neurological signs or symptoms were also common, particularly absent pupillary reaction to light (5 patients) and buccolingual masticatory movements (5 patients). A positive serological test remains the single most important factor in identifying patients with neurosyphilis.

The effect of improved modelling of plasma clearance in paediatric patients with expanded body spaces on estimation of the glomerular filtration rate. The glomerular filtration rate (GFR) is used clinically to assess renal function. The most accurate estimation technique is tracer clearance where deterministic compartment pharmacokinetic models are most widely used. The aim of this study was to assess the viability of alternative pharmacokinetic models to describe tracer clearance, and in turn, measure GFR. This study was carried out on 126 clearance datasets obtained from 44 patients with large solid tumours; these were fitted to four pharmacokinetic models with superiority of model determined by Akaike Information Criteria. A fractal model was found to be superior to the best deterministic compartment model (70% of datasets, P < 0.0020) as was a gamma-distributed residence time model (93% of datasets, P < 0.0020); both models also gave greater mean weighted coefficients of determination than deterministic compartment models. These results suggest that gamma-distributed residence time and fractal models better describe tracer clearance than deterministic compartment models and therefore should allow more accurate estimation of GFR.

Mild subclinical hypothyroidism is associated with paediatric dyslipidaemia. There is a lack of consensus on the cardiometabolic consequences of mild subclinical hypothyroidism (SCH) among children. The objective of the current study was to compare lipid profiles in children with mild SCH with those of euthyroid children. Retrospective medical record review. Children (ages 2-18 years) who had undergone simultaneous measurement of TSH, free thyroxine (T4) and lipids. Lipids in children with mild SCH (TSH 5-<10 mIU/L and normal free T4, n = 228) were compared with those in euthyroid children (n = 1215). TSH level was positively associated with total cholesterol and nonhigh density lipoprotein (non-HDL) cholesterol [β 0.05(0.03-0.08), P < .0001 and β 0.05(0.03-0.08), P < .0001, respectively]. Total cholesterol was significantly higher in children and adolescents with mild SCH compared with euthyroid children (4.43 ± 1.14 mmol/L vs 4.2 ± 0.85 mmol/L, P = .0005). Similarly, non-HDL cholesterol level was also higher in children with mild SCH relative to euthyroid children (3.08 ± 1.14 mmol/L vs 2.91 ± 0.8 mmol/L, P = .001). The adjusted odds ratio of having elevated total cholesterol and elevated non-HDL cholesterol was greater in children with mild SCH compared with euthyroid children (OR 1.88, 95% CI; 1.28-2.73; P = .001 and 1.72, 95% CI 1.2-2.5; P = .003, respectively). The presence of thyroid autoimmunity was not associated with higher rates of dyslipidaemia. Mild SCH in children and adolescents was associated with higher rates of elevated total cholesterol and elevated non-HDL cholesterol. Randomized placebo controlled studies are warranted to determine if treatment of mild SCH in children leads to improvement in lipid profile.

Aetiology of diabetic foot ulceration. A prospective study of 150 diabetic patients was undertaken with the aim of determining the factors associated with the development of foot ulcerations. Seventy five patients had foot ulceration and 75 had no foot lesions. Peripheral (78.7%) and autonomic (38.7%) neuropathy were more commonly found in the "ulcer" group, as were vascular insufficiency (49.3%) and hyperlipidaemia (60%). Renal failure (9.3%) and ketoacidosis (20%) were also commoner in patients with foot ulceration. Most, if not all, of the aetiological factors are related to prolonged uncontrolled hyperglycaemia.

Growth inhibition of Microcystis aeruginosa by white-rot fungus Lopharia spadicea. Harmful cyanobacterial blooms cause water deterioration and threaten human health. It is necessary to remove harmful cyanobacteria with useful methods. A bio-treatment may be one of the best ways to do this. A strain of specific white-rot fungus, Lopharia spadicea, with algicidal ability was isolated. Its algicidal ability on algae under various conditions was determined using three main influence factors: initial chlorophyll-a content, initial pH, and algal cell mixture. The result showed that the chlorophyll-a content of Microcystis aeruginosa FACHB-912, Oocystis borgei FACHB-1108, and Microcystis flos-aquae FACHB-1028 decreased from 798+/-13, 756+/-40, and 773+/-24 microg/L to 0 within 39 h. L. spadicea could also remove more than 95% chlorophyll-a when initial chlorophyll-a content increased from 397+/-13 to 2,132+/-4 microg/L. Moreover, the strain has great removal ability under a broad initial pH range of 5.5 to 9.5. The chlorophyll-a content of the three algal strain mixtures decreased from about 672+/-23 microg/L to 0 within 45 h. After superoxide dismutase (SOD) and malondialdehyde (MAD) were assessed in a co-culture of L. spadicea, it was observed that an increase in MAD content was correlated with the decrease in chlorophyll-a content of M. aeruginosa FACHB-912. This result suggested that the algae was not only greatly inhibited but also severely damaged by the fungus.

Failure to demonstrate a role for line Ib tumor-associated surface antigen in the etiology of age-dependent polioencephalomyelitis. In the preceding paper [Morris et al. (1982), Molec. Immun. 19, 973-982] we demonstrate an associative interaction between the line Ib tumor-associated surface antigen (Ib-TASA) and the Dk/Kk regions of the major histocompatibility complex, i.e. 'altered-self' antigen. We originally hypothesized that age-dependent polioencephalomyelitis (ADPE) occurred as the result of immune recognition of a 'self'-determinant on the 'altered-self' antigen. In this report we used the non-ionic detergent, NP-40, to solubilize Ib cell surface antigens. Although immunization of immunocompetent C58 mice with the soluble NP-40 Ib cell extract afforded protection to lethal tumor challenge, the extract failed to induce ADPE in immunosuppressed mice. Data presented here demonstrate that Ib-TASA is not involved in the etiology of ADPE. The evidence suggests that lactic dehydrogenase virus, which is a silent virus passaged with line Ib leukemia, is the causative agent of the paralytic disease.

Lymphocytes prime activation is required for nicotine-induced calcium waves. Lymphocytes are reported to express nicotinic acetylcholine receptors (nAChR). However, no data are available on the expression of these nAChR on activated lymphocyte relatively to resting lymphocytes. In this study, we examined nAChR subunits expression in PHA-stimulated versus un-stimulated lymphocytes, and four leukemic cell lines. Cell stimulation with nicotine triggered calcium responses only in some experiments conducted with PHA-stimulated lymphocytes. Likewise, only the Jurkat and HL-60 cell lines displayed calcium waves upon nicotine stimulation, whereas the Raji and CCRF-CEM did not. All responding cells displayed an active form of the nicotinic a-7 nAChR. Indeed, use of 2 different sets of primers for the corresponding mRNA showed that expression of the full-length a-7 subunit mRNA was only present in PHA-stimulated lymphocytes for which calcium waves had been evidenced. Microscopy analysis of lymphocytes structure showed a direct relationship between their size, their a-7 nAChR expression, and calcium release upon nicotine stimulation. Then, this relationship suggested that lymphocytes need a prime activation to express the a-7 nAChR, and therefore to release calcium in response to nicotine.

The cumulative risk of AIDS as the CD4 lymphocyte count declines. A method is proposed for assessing the cumulative risk of various AIDS-defining conditions as the CD4 lymphocyte count declines in HIV-infected individuals. The method is analogous to survival analysis but is based on the CD4 lymphocyte count rather than on time. Thus, the level to which the CD4 lymphocyte count has declined, rather than the length of time since seroconversion, is considered as an individual's survival interval. The survival interval may be censored (due to lack of follow-up) or treated as an interval to failure (if the individual develops AIDS). The Kaplan-Meier (product-limit) estimates, of the proportion of individuals developing AIDS before reaching a given low CD4 lymphocyte count, may be useful for determining when prophylactic treatment should begin.

Microcytic anemia. Differential diagnosis and management of iron deficiency anemia. Microcytic anemia is defined as the presence of small, often hypochromic, red blood cells in a peripheral blood smear and is usually characterized by a low MCV (less than 83 micron 3). Iron deficiency is the most common cause of microcytic anemia. The absence of iron stores in the bone marrow remains the most definitive test for differentiating iron deficiency from the other microcytic states, ie, anemia of chronic disease, thalassemia, and sideroblastic anemia. However, measurement of serum ferritin, iron concentration, transferrin saturation and iron-binding capacity, and, more recently, serum transferrin receptors may obviate proceeding to bone marrow evaluation. The human body maintains iron homeostasis by recycling the majority of its stores. Disruptions in this balance are commonly seen during menstruation, pregnancy, and gastrointestinal bleeding. Although the iron-absorptive capacity is able to increase upon feedback regarding total body iron stores or erythropoietic activity, this physiologic response is minimal. Significant iron loss requires replacement with iron supplements. The vast majority of patients respond effectively to inexpensive and usually well-tolerated oral iron preparations. In the rare circumstances of malabsorption, losses exceeding maximal oral replacement, or true intolerance, parenteral iron dextran is effective. In either form of treatment, it is necessary to replete iron stores in addition to correcting the anemia.

Depression and anxiety correlate with disease-related characteristics and quality of life in Chinese patients with gout: a case-control study. This study aims to evaluate the prevalence of depression and anxiety and investigate the potential risk factors for depression and anxiety in Chinese gout patients. A self-report survey was administered to 226 gout patients and 232 age- and gender-matched healthy individuals. Patients were asked to complete a set of standardized self-report questionnaires. Univariate and mutiple regression were used to analyze the data. We found 15.0% of gout patients had depression, and 5.3% had anxiety. After adjusted demographic variables, the prevalence of depression was significantly higher than the healthy controls (6.0%). There were significant correlations among education, total pain, disease duration, stage of gout, functional disability, number of tophi, number of flares/last year, presence of tender joints, nephropathy comorbidity, health-related quality of life (HRQoL), and psychological status. Meanwhile, logistic regression analysis identified number of tophi, functional disability, and mental component summary (MCS) as predictors of depression in gout patients. Education and MCS were significantly accounted for anxiety. In summary, the prevalence of depressive symptoms among gout patients was higher than healthy individuals. Education, disability, tophi and HRQoL were important risk factors linked to depression/anxiety in Chinese gout population.

The influence of drug incorporation on the structure and release properties of solid dispersions in lipid matrices. The effect of incorporating caffeine and paracetamol on the structure and behaviour of Gelucire 50/13 has been studied with a view to establishing whether the choice of drug influences the solid structure and release mechanism. Dispersions containing up to 30% w/w drug were prepared and studied using differential scanning calorimetry (DSC), hot stage differential interference contrast microscopy (HSM), dissolution studies and erosion, water uptake (WU) and diameter change measurements. Gelucire 50/13 alone showed a broad melting endotherm using DSC, with two dominant peaks at 36 and 44 degrees C. While incorporation of caffeine did not result in marked changes to the profile, the presence of paracetamol increased the proportion of material in the lower melting peak. HSM studies indicated that the Gelucire crystallised into two main spherulitic conformations; paracetamol appeared to act as a nucleation site for the lower melting fractions while caffeine particles changed into a needle-shaped morphology on cooling the system from the liquid state. Dissolution studies at 37 degrees C showed the caffeine to be released at a relatively faster rate than the paracetamol. Kinetic modeling and direct measurement of the erosion profile indicated that the caffeine systems showed a greater preponderance for erosion than did the corresponding paracetamol systems. It is suggested that the paracetamol promotes the generation of the lower melting form of Gelucire 50/13 which in turn influences the release rate and mechanism. The study therefore indicates that the influence of the drug should be carefully considered when studying Gelucire matrix systems.

Flow cytometric identification of cancer cells in effusions with Ca1 monoclonal antibody. The fluorescence of cells from 42 pleural and peritoneal effusions stained with Ca1 monoclonal antibody (Ca1MA) was studied by flow cytometry. In 14 of 17 malignant effusions a significantly higher intensity of fluorescence was observed in samples exposed to Ca1MA when compared with controls. There was no increase of fluorescence intensity in 25 benign effusions. The method failed in three malignant effusions: one due to endometrial carcinoma and two to malignant lymphoma. The sensitivity of the method was tested in experimental samples with a known percentage of malignant cells. The positive fluorescence with Ca1MA was detected in samples containing 0.1% of carcinoma cells. Flow cytometry with Ca1MA can be a relatively simple method of identification of malignant cells in effusions.

Multimodality Imaging Assessment of Pulmonary Nodules. A common clinical dilemma is the evaluation of pulmonary nodules detected on imaging. Differentiation between malignant and benign pulmonary nodules is a complex problem despite major advances in medical imaging. Accurate diagnosis helps to eliminate unnecessary surgical procedures in patients with benign diseases. It is important for the diagnostician to be aware of the role of multimodality imaging for characterization of pulmonary nodules.

Joint aspiration and injection. Joint aspiration/injection is an invaluable procedure for the diagnosis and treatment of joint disease. The knee is the commonest site to require aspiration although any non-axial joint is accessible for obtaining synovial fluid. Septic arthritis and crystal arthritis can be readily diagnosed by aspirating synovial fluid. Intra-articular injection of long-acting insoluble corticosteroids produces rapid resolution of inflammation in most injected joints and is a well established procedure in rheumatological practice. The technique involves only a knowledge of basic anatomy and should not be unduly painful for the patient. Provided sterile equipment and a sensible, aseptic approach are used it is a safe procedure. This chapter addresses the indications, technical principals, expected benefits and risks of intra-articular corticosteroid injection. The use of other intra-articular injections including osmic acid, radioisotopes and hyaluronic acid, which are less universally utilised than intra-articular corticosteroid, will also be addressed.

Strategies to promote healthier food purchases: a pilot supermarket intervention study. To pilot the design and methodology for a large randomised controlled trial (RCT) of two interventions to promote healthier food purchasing: culturally appropriate nutrition education and price discounts. A 12-week, single-blind, pilot RCT. Effects on food purchases were measured using individualised electronic shopping data ('Shop 'N Go' system). Partial data were also collected on food expenditure at other (non-supermarket) retail outlets. A supermarket in Wellington, New Zealand. Eligible customers were those who were the main household shoppers, shopped mainly at the participating store, and were registered to use the Shop 'N Go system. Ninety-seven supermarket customers (72% women; age 40 +/- 9.6 years, mean +/- standard deviation) were randomised to one of four intervention groups: price discounts, nutrition education, a combination of price discounts and nutrition education, or control (no intervention). There was a 98% follow-up rate of participants, with 85% of all reported supermarket purchases being captured via the electronic data collection system. The pilot did, however, demonstrate difficulty recruiting Maori, Pacific and low-income shoppers using the electronic register and mail-out. This pilot study showed that electronic sales data capture is a viable way to measure effects of study interventions on food purchases in supermarkets, and points to the feasibility of conducting a large-scale RCT to evaluate the effectiveness of price discounts and nutrition education. Recruitment strategies will, however, need to be modified for the main trial in order to ensure inclusion of all ethnic and socio-economic groups.

Appendices of the nipple and areola of the breast in Neurofibromatosis type 1 patients are neurofibromas. In NF1-patients, tumours arising in the areola region of the breast often appear similar to the nipple. The aim of this study was to analyse tumours of this region. Eighty-three specimens from 55 patients with NF1 were analysed [females: 42, males: 13, mean age of the total group: 41.6 years, range: 4-62 years]. NF1 patients with apparent extensive affections of the breast who received debulking procedures for disfiguring invasive or superficial plexiform neurofibroma were excluded. All specimens were found to be composed entirely from neurofibromas with no residues resembling segments of glandular structures. Following ablative surgery, no local recurrence was noted within a follow-up period of 10 years. Tumours arising in the areola and nipple area and mimicking an accessory nipple were all neurofibromas. Local excision of neurofibromas was adequate to relief patients from an often unsightly appearance.

[Mediastinal lymphatic filariasis]. Wuchereria bancrofti gravid adult female worms were detected in a mediastinal lymph node in a 76-year old man. The patient also had lung carcinoma. A blood cell counts did not show any eosinophilia, and three consecutive night blood samples were also negative for microfilariae. Filariasis and neoplasm association was purely coincidental. Epidemiological and histopathological aspects of adult filariasis are described.

Triptorelin (D-Trp-6-LHRH) in combination with carboplatin-containing polychemotherapy for advanced ovarian cancer: a pilot study. In experimental and clinical phase II trials GnRH agonists were shown to possess antitumor activity in ovarian cancer. The outcome of prostatic cancer was also improved experimentally by a combination of cytostatic chemotherapy and GnRH analogs. Encouraged by these results, we administered micro-encapsulated triptorelin (Decapeptyl CR), 3.75 mg on the first day of each chemotherapy course, to 15 patients with advanced ovarian cancer in addition to adjuvant, carboplatin-containing chemotherapy (Carboplatin, Epirubicin, Prednimustine and Carboplatin, Etoposide) after radical surgery. Patients received a total of 6 courses. After the completion of combined chemotherapy GnRH analogs were continued for another 6 months at 28-day intervals. Results were compared with those obtained in a group of 15 ovarian cancer patients receiving the same chemotherapy regimen without GnRH medication. At a median follow-up of 36 months no significant differences were seen in terms of response, survival and time to progression. However, patients undergoing chemotherapy+triptorelin tended to show a more positive outcome than those on chemotherapy alone. G1 and G2 tumors in particular were found to respond better to the combined treatment regimen.

Applications of fluorescence correlation spectroscopy: measurement of size-mass relationship of native and denatured schizophyllan. Diffusion dynamics of a polysaccharide, schizophyllan has been studied by fluorescence correlation spectroscopy (FCS). Several different sizes of nondenatured and denatured schizophyllan have been labeled with rhodamine 6G in borate buffer. The length of the nondenatured schizophyllan was calculated from FCS data by using the Broersma's relationship for rod-like macromolecules. The obtained length was close to that obtained by atomic force microscopy (AFM) measurements. Denatured schizophyllan possesses a random coil conformation. Its hydrodynamic radius R(h) was measured by FCS. The relationship between R(h) and the molecular mass M has been studied and the scaling relationship R(h)--M(0.59) has been obtained, which is in agreement with the random coil model with excluded volume effect. The persistence length q(denat) of the denatured schizophyllan was determined by Hearst's relationship, to be equal to 5.16 +/- 0.75 (nm). The work demonstrates the utility of FCS method for dynamics investigations of biopolymers especially in diluted regime (concentration lower than 10(-8)M could be measured) where other techniques could not be used.

Identity of Eumenodora encrypta Meyrick, a cryptic Australian moth (Lepidoptera:Gelechioidea). A hitherto neglected gelechioid moth genus Eumenodora Meyrick (Gelechioidea: Elachistidae; Cosmopterigidae; Xyloryctidae) is redescribed. The genus, originally assigned to the Elachistidae and later transferred to the Cosmopterigidae, is monotypic. The single constituent species, E. encrypta Meyrick, 1906, has long been known only from the holotype, collected in Brisbane, Queensland (Australia). The specimen lacks its abdomen. The genus is characterized and the single recognized species redescribed based on recently collected adult males and a female. Evidence from morphology, supported by DNA sequences, is provided to support the placement of the taxon in the Hierodoris group of the Xyloryctidae, in spite of its atypical external appearance.