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PCI Alternative Using Sustained Exercise (PAUSE): Rationale and trial design. Cardiovascular disease (CVD) currently claims nearly one million lives yearly in the US, accounting for nearly 40% of all deaths. Coronary artery disease (CAD) accounts for the largest number of these deaths. While efforts aimed at treating CAD in recent decades have concentrated on surgical and catheter-based interventions, limited resources have been directed toward prevention and rehabilitation. CAD is commonly treated using percutaneous coronary intervention (PCI), and this treatment has increased exponentially since its adoption over three decades ago. Recent questions have been raised regarding the cost-effectiveness of PCI, the extent to which PCI is overused, and whether selected patients may benefit from optimal medical therapy in lieu of PCI. One alternative therapy that has been shown to improve outcomes in CAD is exercise therapy; exercise programs have been shown to have numerous physiological benefits, and a growing number of studies have demonstrated reductions in mortality. Given the high volume of PCI, its high cost, its lack of effect on survival and the potential for alternative treatments including exercise, the current study is termed "PCI Alternative Using Sustained Exercise" (PAUSE). The primary aim of PAUSE is to determine whether patients randomized to exercise and lifestyle intervention have greater improvement in coronary function and anatomy compared to those randomized to PCI. Coronary function and anatomy is determined using positron emission tomography combined with computed tomographic angiography (PET/CTA). Our objective is to demonstrate the utility of a non-invasive technology to document the efficacy of exercise as an alternative treatment strategy to PCI.

TiO2 nanotubes for bone regeneration. Nanostructured materials are believed to play a fundamental role in orthopedic research because bone itself has a structural hierarchy at the first level in the nanometer regime. Here, we report on titanium oxide (TiO(2)) surface nanostructures utilized for orthopedic implant considerations. Specifically, the effects of TiO(2) nanotube surfaces for bone regeneration will be discussed. This unique 3D tube shaped nanostructure created by electrochemical anodization has profound effects on osteogenic cells and is stimulating new avenues for orthopedic material surface designs. There is a growing body of data elucidating the benefits of using TiO(2) nanotubes for enhanced orthopedic implant surfaces. The current trends discussed within foreshadow the great potential of TiO(2) nanotubes for clinical use.

Standardised protocol for primate faecal analysis. Macroscopic analysis of primate faeces as a way to study diet is well established, but lack of standardisation of methods may handicap comparative studies of the resulting data. Here we present a proven technique, including equipment and supplies, protocol and procedure, that yields quantitative data suitable for systematic investigation within and across primate taxa. As the problems of habituation become more obvious, the application of such indirect methods may increase in usefulness.

Examination of factors affecting gait properties in healthy older adults: focusing on knee extension strength, visual acuity, and knee joint pain. Gait properties change with age because of a decrease in lower limb strength and visual acuity or knee joint disorders. Gait changes commonly result from these combined factors. This study aimed to examine the effects of knee extension strength, visual acuity, and knee joint pain on gait properties of for 181 healthy female older adults (age: 76.1 (5.7) years). Walking speed, cadence, stance time, swing time, double support time, step length, step width, walking angle, and toe angle were selected as gait parameters. Knee extension strength was measured by isometric dynamometry; and decreased visual acuity and knee joint pain were evaluated by subjective judgment whether or not such factors created a hindrance during walking. Among older adults without vision problems and knee joint pain that affected walking, those with superior knee extension strength had significantly greater walking speed and step length than those with inferior knee extension strength (P < .05). Persons with visual acuity problems had higher cadence and shorter stance time. In addition, persons with pain in both knees showed slower walking speed and longer stance time and double support time. A decrease of knee extension strength and visual acuity and knee joint pain are factors affecting gait in the female older adults. Decreased knee extension strength and knee joint pain mainly affect respective distance and time parameters of the gait.

Formulation and application of a biosurfactant from Bacillus methylotrophicus as collector in the flotation of oily water in industrial environment. The present study describes the formulation of a biosurfactant produced by Bacillus methylotrophicus UCP1616 and investigates its long-term stability for application as a collector in a bench-scale dissolved air flotation (DAF) prototype. For formulation, the conservative potassium sorbate was added to the biosurfactant with or without prior heat treatment at 80 °C for 30 min. After formulation, the biosurfactant samples were stored at room temperature for 180 days and the tensioactive properties of the biomolecule were determined with different pH values, temperatures and concentrations of salt. Then, a central composite rotatable design was used to evaluate the influence of the independent variables (effluent flow rate and formulated biosurfactant flow rate) on the oil removal efficiency in the DAF prototype. The formulated biosurfactant demonstrated good stability in both conservation methods, with tolerance to a wide pH range, salinity and high temperatures, enabling its use in environments with extreme conditions. The efficiency of the formulated biomolecule through heating and addition of sorbate was demonstrated by the 92% oil removal rate in the DAF prototype. The findings demonstrate that the biosurfactant from Bacillus methylotrophicus enhances the efficiency of the DAF process, making this technology cleaner. This biosurfactant can assist in the mitigation and management of industrial effluents, contributing toward a reduction in environmental pollution caused by petroleum-based hydrocarbons.

Computer assisted learning: the potential for teaching and assessing in nursing. This article discusses computer assisted learning (CAL) and the importance of applying it in nurse education. The articles recognizes the general technological developments as exemplified by the Teaching and Learning Technology Programme (TLTP) from which ideas about application and benefits came. The ideas from TLTP are hereby used in CAL and applied to nursing and health-care undergraduate programmes in one university. In the light of this experience the main intention of this article is to consider the benefits and costs of introducing computer programmes as part of the teaching provision for nurses and other health-care professionals both at beginner and advanced level. The article further argues that CAL can also be used for patient teaching thus providing transferable skills and benefits for teachers as well as learners, be they students or patients. To support such multiple uses of CAL selected examples will be offered and appropriate conclusions will be drawn.

Inorganic phosphate uptake in intact vacuoles isolated from suspension-cultured cells of Catharanthus roseus (L.) G. Don under varying Pi status. Inorganic phosphate (Pi) uptake across the vacuolar membrane of intact vacuoles isolated from Catharanthus roseus suspension-cultured cells was measured. Under low Pi status, Pi uptake into the vacuole was strongly activated compared to high Pi status. Since Pi uptake across the vacuolar membrane is correlated with H+ pumping, we examined the dependency of H+ pumping on plant Pi status. Both H+ pumping and the activities of the vacuolar H+-pumps, the V-type H+-ATPase and the H+-PPase were enhanced under low Pi status. Despite this increase in H+ pumping, Western blot analysis showed no distinct increase in the amount of proton pump proteins. Possible mechanisms for the activation of Pi uptake into the vacuole under low Pi status are discussed.

Dorsomedial hypothalamic lesions alter intake of an imbalanced amino acid diet in rats. Within 3 h of ingesting an imbalanced amino acid diet (IAAD), rats show attenuated intake. The associated conditioned taste aversion can be ameliorated by giving the serotonin3 receptor blocker, tropisetron (TROP). A recent c-fos study indicated that the dorsomedial hypothalamic nucleus (DMN) may be activated 2-3 h after ingestion of IAAD. In Experiment 1, DMN-lesioned rats (DMNL) or sham-operated (SHAM) rats were injected with saline (SAL) or TROP just before introduction of IAAD. By 3 h, SAL-DMNL rats consumed more (P < 0.01) of the IAAD than did the SAL-SHAM rats. Thereafter, over the next 21 h, the intake of the SAL-DMNL group returned to control levels. TROP treatment enhanced the intake of the treated groups; the TROP and the lesion effect were additive (P < 0.01). By d 4 of receiving the IAAD, the DMNL groups were eating less than SHAM rats (P < 0.05). The data suggest that the DMN may be involved in the early detection of the amino acid deficiency induced by IAAD, is not involved in the TROP effect and is necessary for proper long-term adaptation to an IAAD.

Retrieval of blade implants with piezosurgery: two clinical cases. In this work an ultrasound device was used to perform an ostectomy for the removal of blade implants in order to save as much bone tissue as possible, so that root form implants might later be inserted. Two patients underwent surgery for the removal of two blade implants (one maxillary, the other mandibular) that were no longer functional. The peri-implant ostectomy was carried out with a piezoelectric surgery device. The instrument demonstrated to be effective and precise during ostectomy, providing an extremely thin cutting line. During the course of the operation and at controls after 7 and 30 days, patients did not show any relevant complications and both still had sufficient alveolar bone to be treated with root form implants. The piezosurgery device proved to be an effective instrument in interventions requiring a significant saving of bone tissue, extreme precision in cutting, and respect of soft tissues.

Allele-specific wild-type blocker quantitative PCR for highly sensitive detection of rare JAK2 p.V617F point mutation in primary myelofibrosis as an appropriate tool for the monitoring of molecular remission following therapy. Screening of JAK2 V617F point mutation becomes more and more important in monitoring of JAK2 positive MPN following stem cell transplantation. In an attempt to achieve the required high sensitivity (1:10(5)), specifity and robustness we created an approach applicable on bone marrow biopsies where we adapted the principle of wild-type blocker PCR with allele-specific Q-PCR. The significance of the assay was demonstrated on a retrospective series of sequential bone marrow biopsies as diagnosis of molecular relapse now preceded the diagnosis of clinical relapse by far. This method offers the urgently needed tool for a systematic molecular analysis of sequential biopsies in the course of stem cell transplantation to develop guidelines for the management of these patients.

Primary care for women. Comprehensive assessment and management of common mental health problems. This article emphasizes the importance of the role of the certified nurse-midwife (CNM) in the primary care assessment of, and appropriate referral for women with mental health problems, especially in cases of psychiatric emergencies. Essential aspects of assessment, diagnosis, and treatment of the more common psychiatric problems are included, and the treatment modalities that are considered when referral results in psychiatric intervention are reviewed. In addition, the overall prevalence of mental health problems in women, the frequency with which primary care providers may encounter mental health problems, and issues of mental health care utilization are discussed.

Three-dimensional structures of H-ras p21 mutants: molecular basis for their inability to function as signal switch molecules. The X-ray structures of the guanine nucleotide binding domains (amino acids 1-166) of five mutants of the H-ras oncogene product p21 were determined. The mutations described are Gly-12----Arg, Gly-12----Val, Gln-61----His, Gln-61----Leu, which are all oncogenic, and the effector region mutant Asp-38----Glu. The resolutions of the crystal structures range from 2.0 to 2.6 A. Cellular and mutant p21 proteins are almost identical, and the only significant differences are seen in loop L4 and in the vicinity of the gamma-phosphate. For the Gly-12 mutants the larger side chains interfere with GTP binding and/or hydrolysis. Gln-61 in cellular p21 adopts a conformation where it is able to catalyze GTP hydrolysis. This conformation has not been found for the mutants of Gln-61. Furthermore, Leu-61 cannot activate the nucleophilic water because of the chemical nature of its side chain. The D38E mutation preserves its ability to bind GAP.

Dietary sodium chloride intake independently predicts the degree of hyperchloremic metabolic acidosis in healthy humans consuming a net acid-producing diet. We previously demonstrated that typical American net acid-producing diets predict a low-grade metabolic acidosis of severity proportional to the diet net acid load as indexed by the steady-state renal net acid excretion rate (NAE). We now investigate whether a sodium (Na) chloride (Cl) containing diet likewise associates with a low-grade metabolic acidosis of severity proportional to the sodium chloride content of the diet as indexed by the steady-state Na and Cl excretion rates. In the steady-state preintervention periods of our previously reported studies comprising 77 healthy subjects, we averaged in each subject three to six values of blood hydrogen ion concentration ([H]b), plasma bicarbonate concentration ([HCO(3)(-)]p), the partial pressure of carbon dioxide (Pco(2)), the urinary excretion rates of Na, Cl, NAE, and renal function as measured by creatinine clearance (CrCl), and performed multivariate analyses. Dietary Cl strongly correlated positively with dietary Na (P < 0.001) and was an independent negative predictor of [HCO(3)(-)]p after adjustment for diet net acid load, Pco(2) and CrCl, and positive and negative predictors, respectively, of [H]b and [HCO(3)(-)]p after adjustment for diet acid load and Pco(2). These data provide the first evidence that, in healthy humans, the diet loads of NaCl and net acid independently predict systemic acid-base status, with increasing degrees of low-grade hyperchloremic metabolic acidosis as the loads increase. Assuming a causal relationship, over their respective ranges of variation, NaCl has approximately 50-100% of the acidosis-producing effect of the diet net acid load.

Chronic energy deficiency and its association with dietary factors in adults of drought affected desert areas of Western Rajasthan, India. To asses the impact of drought on nutritional status of adults of a rural population in desert area. Threestage sampling technique. 24 villages belonging to 6 tehsils (sub units of district) of Jodhpur district, a drought affected desert district of Western Rajasthan, in 2003. 1540 adults were examined for their anthropometry, dietary intake and nutritional deficiency signs. Overall chronic energy deficiency (CED) was found high (42.7 %). Severe CED was 10.7 percent, significantly higher in males than females. Regarding vitamin A deficiency, overall prevalence of Bitot spot and night blindness was 1.8 and 0.2 percent respectively, higher in females than males. Regarding vitamin B complex deficiency, angular stomatitis, cheliosis, and glossitis was 1.0, 2.6 and 5.4 percent. Anemia was 35.6 percent. Overall mean calorie and protein intake deficit was very high (38 and 16.4 %). The comparison of present drought results with earlier studies in desert normal and desert drought conditions showed higher deficiencies of calories and proteins in their diet. Severity of malnutrition is critical as CED was more than the cut-off point of 40 percent stated by World Health Organization. Vitamin A and B complex deficiencies, anemia, protein calorie malnutrition along with deficit in calories and proteins in their diet were higher in comparison to non desert areas, which may be due to the harsh environmental conditions in desert areas. Efforts should be made to incorporate intervention measures to ensure the supply of adequate calories and proteins to all age groups.

Molecular-dynamics simulations of electron-ion temperature relaxation in a classical Coulomb plasma. Molecular-dynamics simulations are used to investigate temperature relaxation between electrons and ions in a fully ionized, classical Coulomb plasma with minimal assumptions. Recombination is avoided by using like charges. The relaxation rate agrees with theory in the weak coupling limit (g identical with potential/kinetic energy << 1), whereas it saturates at g > 1 due to correlation effects. The "Coulomb log" is found to be independent of the ion charge (at constant g) and mass ratio > 25.

The Effects of Event Rate on a Cognitive Vigilance Task. The present experiment sought to examine the effects of event rate on a cognitive vigilance task. Vigilance, or the ability to sustain attention, is an integral component of human factors research. Vigilance task difficulty has previously been manipulated through increasing event rate. However, most research in this paradigm has utilized a sensory-based task, whereas little work has focused on these effects in relation to a cognitive-based task. In sum, 84 participants completed a cognitive vigilance task that contained either 24 events per minute (low event rate condition) or 40 events per minute (high event rate condition). Performance was measured through the proportion of hits, false alarms, mean response time, and signal detection analyses (i.e., sensitivity and response bias). Additionally, measures of perceived workload and stress were collected. The results indicated that event rate significantly affected performance, such that participants who completed the low event rate task achieved significantly better performance in terms of correction detections and false alarms. Furthermore, the cognitive vigil utilized in the present study produced performance decrements comparable to traditional sensory vigilance tasks. Event rate affects cognitive vigilance tasks in a similar manner as traditional sensory vigilance tasks, such that a direct relation between performance and level of event rate was established. Cognitive researchers wishing to manipulate task difficulty in their experiments may use event rate presentation as one avenue to achieve this result.

Ability of MR cholangiography to reveal stent position and luminal diameter in patients with biliary endoprostheses: in vitro measurements and in vivo results in 30 patients. Our goal was to evaluate the ability of MR cholangiography to show stent position and luminal diameter in patients with biliary endoprostheses. Susceptibility artifacts were evaluated in vitro in three different stent systems (cobalt alloy-based, nitinol-based, and polyethylene) using two breath-hold sequences (rapid acquisition with relaxation enhancement, half-Fourier acquisition single-shot turbo spin echo) on a 1.5-T MR imaging system. The size of the stent-related artifact was measured, and the relative stent lumen was calculated. In vivo stent position and patency were determined in 30 patients (10 cobalt alloy-based stents, five nitinol-based stents, and 15 polyethylene stents). In vitro, the susceptibility artifact of the cobalt stent caused complete obliteration of the stent lumen. The relative stent lumens of the nitinol-based and polyethylene stents were 38-50% and 67-100%, respectively. In vivo, all stents were patent at the time of imaging. The position of the cobalt alloy-based stent could be determined in nine of 10 patients, but stent patency could not be evaluated. Stent position of nitinol stents could not be adequately evaluated in any of the five patients, and internal stent diameter could be visualized in only one patient. In nine of 15 patients, the fluid column within the implanted polyethylene stent was seen on MR cholangiography. The internal stent lumen could be visualized in most patients with an indwelling polyethylene stent, but not in patients with cobalt alloy- or nitinol-based stents.

Characterization of biofilm and encrustation on ureteric stents in vivo. To examine the relationship between encrustation and microbial biofilm formation on indwelling ureteric stents. Ureteric stents from 40 patients were examined for the presence of a microbial biofilm and encrustations. Bacteria in stent biofilms were isolated and identified. A profuse biofilm (> 10(4) c.f.u. cm-3) was identified on 11 (28%) stents. Enterococcus faecalis was the most common biofilm organism identified and Proteus spp. were not present. Encrustation was seen in 23 (58%) of stents and was not associated with the level of urinary calcium. The major risk factor for stent encrustation was the presence of urolithiasis. Importantly, there was no causative link between stent biofilm formation and encrustation. Both biofilm formation and encrustation increased with the duration of stenting. The results indicate that polyurethane is readily encrusted and colonized by bacteria in vivo despite antibiotic prophylaxis. Newer materials must be sought if effective long-term stenting is to be achieved.

From typical sequences to typical genotypes. We demonstrate an application of a core notion of information theory, typical sequences and their related properties, to analysis of population genetic data. Based on the asymptotic equipartition property (AEP) for nonstationary discrete-time sources producing independent symbols, we introduce the concepts of typical genotypes and population entropy and cross entropy rate. We analyze three perspectives on typical genotypes: a set perspective on the interplay of typical sets of genotypes from two populations, a geometric perspective on their structure in high dimensional space, and a statistical learning perspective on the prospects of constructing typical-set based classifiers. In particular, we show that such classifiers have a surprising resilience to noise originating from small population samples, and highlight the potential for further links between inference and communication.

Serial imaging and SWAN sequence of developmental venous anomaly thrombosis with hematoma: Diagnosis and follow-up. Developmental venous anomalies (DVAs) are usually asymptomatic. We report a case of DVA thrombosis with recurrent tiny frontal hematoma in a 24-year-old man. The contribution of T2-GRE and SWAN sequences are discussed. Follow-up attested complete recanalization after anticoagulation.

Social deprivation and primary hyperparathyroidism. To investigate the potential relationship between social status or deprivation and the prevalence of primary hyperparathyroidism (PHPT). We retrospectively identified a cohort of patients diagnosed as having PHPT between 1981 and 2007 from the Scottish Morbidity Records database. The Scottish Index of Multiple Deprivation (SIMD) 2006 quintiles were derived for these patients by using the postal codes. The distribution of the SIMD quintiles was examined to determine the possible influence of deprivation on the incidence of PHPT. In Scotland between 1981 and 2007, 3,039 patients were diagnosed as having PHPT, in accordance with the International Classification of Diseases code for PHPT. The distribution of the PHPT cohort across the SIMD 2006 quintiles was significantly different from that expected, with a higher representation (27.2%) among the most deprived and a lower representation (14.5%) in the least deprived quintile, in comparison with the 20% expected in each quintile (P<.0001). The findings in this study suggest that socioeconomic deprivation is associated with an increased risk of developing PHPT.

Free peritoneal tumour cells are an independent prognostic factor in curatively resected stage IB gastric carcinoma. Several studies have shown that the cytological detection of free peritoneal tumour cells (FPTCs) in patients with gastric cancer indicates the presence of metastatic disease. The immunocytochemical detection of FPTCs, especially in early-stage tumours, has not been examined comprehensively. Peritoneal lavage was performed in 351 patients before curative resection of a gastric carcinoma between 1987 and 2001, and an adequate sample was obtained from 346 patients. FPTCs were detected immunocytochemically using Ber-EP4 antibody. Median follow-up time was 70 months. FPTCs were detected in the lavage fluid of 74 patients (21.4 per cent) and correlated with increasing pathological tumour depth (pT) and lymph node (pN) status (P < 0.001). The 5-year overall survival of patients with FPTCs was significantly worse than that of patients without FPTCs (35 versus 71.9 per cent; P < 0.001). FPTCs were present in 14 (8.5 per cent) of 164 patients with stage IA or IB tumours. Although the detection of FPTCs had no prognostic significance for stage IA tumours, the presence of FPTCs in those with stage IB tumours was associated with a worse prognosis (P < 0.001). Multivariate analysis identified the presence of FPTCs as an independent prognostic factor in the whole cohort and in the stage IB subgroup. Detection of FPTCs is associated with poor prognosis even in patients with early-stage gastric cancer and should be used for risk-group stratification.

Sequencing of the cholesteryl ester transfer protein 5' regulatory region using artificial transposons. We have isolated and sequenced genomic clones encompassing more than 5 kb of the 5' flanking region of the cholesteryl ester transfer protein gene. This region contains multiple Alu repeats, a Mermaid repeat, and an extensive GA repeat, which made sequencing exceedingly difficult. To circumvent the problems that these repeats posed to traditional sequencing methodologies, we employed a novel transposon-facilitated technique, which greatly simplified sequencing of regions that had been difficult to accomplish otherwise. We utilized the artificial transposon, AT-2, a Bluescript derivative containing the dhfr gene and unique primer sites at both ends of the insertion DNA. Integration of the transposon occurred efficiently and covered the entire region of interest. Analysis of the sequence indicates a number of potential regulatory factor binding sites upstream of the previously characterized minimal promoter. The 5.7-kb regulatory region confers significant transcriptional activation in a conditionally transformed mouse hepatocyte line as compared to a minimal 137-bp promoter fragment. In addition, a tetranucleotide repeat of variable length that may provide a useful genetic marker has been identified 2 kb upstream of the CETP transcriptional start site.

Modulatory effects of PLG and its peptidomimetics on haloperidol-induced catalepsy in rats. A behavioral model of dopaminergic function in the rat was used to examine the anticataleptic effects of L-prolyl-L-leucyl-glycinamide (PLG) and peptidomimetic analogs of PLG. Administration of 1 mg/kg PLG intraperitoneally significantly attenuated haloperidol (1 mg/kg)-induced catalepsy (as measured by the standard horizontal bar test), whereas doses of 0.1 and 10 mg/kg PLG did not. Eight synthetic PLG peptidomimetics (Calpha, alpha-dialkylated glycyl residues with lactam bridge constraint [1-4] and without [5-8]) were tested in the same manner (at a dose of 1 microg/kg) and categorized according to their activity, i.e. very active (5), moderately active (2, 3, 4, and 6), and inactive (1, 7, and 8). The catalepsy-reversal action of the diethylglycine-substituted peptidomimetic 5 was examined further and found to exhibit a U-shaped dose-response effect with an optimal dose of 1 microg/kg. The similarity between the effects of PLG and the synthetic peptidomimetics suggests a common mechanism of action. Finally, the synthetic peptidomimetics examined here, particularly peptidomimetic 5, were more effective than PLG in attenuating haloperidol-induced catalepsy.

[Plantar-palmar erythrodysesthesia. A new and relatively frequent side effect in antineoplastic treatment]. Palmar-plantar erythrodysesthesia (PPE, hand-foot syndrome) is a relatively frequent cutaneous toxicity related to antineoplastic treatment with e.g. fluorouracil, capecitabine, and liposomal doxorubicin. It usually presents as paresthesia and painful erythema of the palms and soles and may lead to ulceration of the skin. The symptoms are dose-dependent, and the condition may be dose-limiting. Two cases of chemotherapy-associated PPE are presented.

Perinatal outcome with the modified biophysical profile. Our purpose was to evaluate perinatal outcomes in high-risk pregnancies monitored with a modified biophysical profile. All non-insulin-dependent patients referred for antepartum fetal surveillance received a modified biophysical profile biweekly. A modified biophysical profile is a combination of a nonstress test and an amniotic fluid index. Patients with a singleton gestation and intact membranes were entered into a protocol of randomized backup testing for an abnormal modified biophysical profile. Those patients having a nonreactive fetal heart rate, significant variable decelerations, late decelerations, or an amniotic fluid index < or = 5.0 cm received either a contraction stress test or a biophysical profile immediately. Once randomized, a patient received the same backup test, when indicated, with subsequent testing. A total of 2774 patients had 17,429 tests with an uncorrected perinatal mortality rate of 2.9 per 1000. The overall incidence of an adverse perinatal outcome (i.e., perinatal death or nursery death before infant hospital discharge, cesarean delivery for fetal distress within the first 2 hours of labor, 5-minute Apgar score < 7, neonatal seizures or grade III or IV central nervous system hemorrhage) was 7.0%. When compared with patients having persistently normal modified biophysical profile, patients requiring a backup test had a significantly greater incidence of adverse perinatal outcome (9.3% vs 4.9%, p < 0.001, odds ratio 2.0, 95% confidence interval 1.5 to 2.7) and small-for-gestational-age infants (5.2% vs 2.4%, p < 0.001, odds ratio 2.2, 95% confidence interval 1.5 to 3.5). No differences in outcomes between patients randomized to a contraction stress test versus a biophysical profile could be identified either overall or in limiting the analysis to outcome after a negative last test. However, patients having contraction stress test as a backup test had a significantly higher rate of intervention for an abnormal test result than did those having a biophysical profile backup test (23.7% vs 16.6%, p < 0.002, odds ratio 1.6, 95% confidence interval 1.2 to 2.1). The modified biophysical profile is an excellent means of fetal surveillance and identifies a group of patients at increased risk for adverse perinatal outcome and small-for-gestational-age infants. There does not appear to be a significant benefit with the contraction stress test compared with the biophysical profile as a backup test. Further, the contraction stress test is associated with a higher rate of intervention for an abnormal test than is the biophysical profile.

The effect of a traditional dance training program on the physical fitness of adults with hearing loss. The purpose of this study was to evaluate the effect of a traditional dance training program on aerobic capacity and muscle strength of adults with hearing loss. Twenty-three adults with hearing loss were separated into 2 groups. Thirteen subjects (6 men, 7 women, mean age, 25.7 +/- 3.9 years) constituted the intervention group, whereas 10 subjects (5 men, 5 women, mean age, 26.4 +/- 5.9 years) formed the control group. Pretraining and posttraining treadmill tests were performed to determine heart rate (HR peak), peak minute ventilation (VE peak), peak oxygen consumption (VO2 peak, absolute and relative), and time to exhaustion (min). Peak torque of hamstring and quadriceps muscles at angular velocities of 60 degrees /s, 180 degrees /s, and 300 degrees /s was also measured. The intervention group followed a 12-week traditional dance training program, whereas the control group received no training during this period. Repeated measures of multiple analyses of variance were used to test mean differences between the values of both groups. A paired t-test was used to compare the values within each group prior and after program participation. A significance level of 0.05 was used for all tests. Following the 12-week training program, significant improvements in peak physiological parameters were seen for the intervention group for peak minute ventilation, peak oxygen consumption (both absolute and relative), time to exhaustion, and peak torque values between the 2 measurements (initial and final). No significant improvements in peak physiological parameters and peak torque were noticed in the control group. In conclusion, adults with hearing loss can improve their physical fitness levels with the application of a systematic and well-designed traditional dance training program.

Milestones to recovery: preliminary validation of a framework to promote recovery and map progress through the medium secure inpatient pathway. Forensic mental health care in the UK has undergone a rapid expansion since the late 1990s. In medium secure units (MSUs), there is growing emphasis on developing care pathways without much theoretical underpinning. We developed a concept of 'Milestones to Recovery' (MTR) to measure progress through the MSU pathway. Our aim was to validate the MTR framework. Our hypotheses were that patients scoring higher on the MTR Scale would be more likely to be aggressive to others in the following 6 months and resident in the acute areas of the unit and that those scoring lower would be more likely to be discharged within 6 months of the assessment. An MTR scale was developed to enable the investigation of the validity of the MTR framework and evaluated with staff evaluations of 80 resident patients using a prospective, longitudinal and naturalistic design. The results suggest that the MTR framework is valid in discriminating between different stages on the MSU pathway. Therapeutic engagement was particularly important in terms of progress through the MSU, whereas current behaviour was important in predicting future aggression. Further research is required to test the MTR framework across different levels of security, with larger samples and within different populations. Provides a framework to map progress through the service. Identifies key factors that influence recovery and rehabilitation. Potential to promote dialogue between patients and staff, and enhance motivation.

Eochrysis, a new replacement name for the fossil Protochrysis Bischoff, 1916 (Insecta: Hymenoptera: Chrysididae) nec Pascher, 1911 (Protista: Cryptomonada). The genus Protochrysis (type species P. succinalis Bischoff, 1916, by monotypy) was established by Bischoff (1916: 139) for distinctive fossil insect remains of Eocene (Lutetian) age from the former Königsberg outskirts of East Prussia (now Kalinigrad, Russian Federation), referred at present to the Chrysididae (Hymenoptera) (Brues 1933; Carpenter 1985, 1992). However, an identical generic name Protochrysis had previously been proposed by Pascher (1911: 191) for a living protist (Cryptomonada). Bischoff's (1916) name is therefore an invalid junior homonym. Carpenter (1985: 577) proposed a new replacement name for the fossil genus, but overlooked the fact that his newly proposed generic name Protochrysidis was also preoccupied, again by the name of another protist genus, Protochrysidis [Protista: Chrysomonada] described by Skvortzov (1969: 346) from Harbin (China). In fact, the protistan genus Protochrysidis had initially been published as chrysophyte algae following the International Code of Nomenclature for Algae, Fungi, and Plants (McNeill et al. 2012) by Skvortzov (1961: 4) who had failed to designate holotype of the species, but later fulfilled all conditions for valid publication in 1969 by providing necessary typification and reference to formerly published description and illustrations. At present chrysophyte algae are still maintained as Chrysomonada in protozoology due to a continued somewhat archaic tradition (Preisig & Anderson 2002). Protochrysidis Skvortzov, 1969 remained little studied since the time of its first description and is currently treated as an incertae sedis protistan taxon.

Life at depth: Photobacterium profundum genome sequence and expression analysis. Deep-sea life requires adaptation to high pressure, an extreme yet common condition given that oceans cover 70% of Earth's surface and have an average depth of 3800 meters. Survival at such depths requires specific adaptation but, compared with other extreme conditions, high pressure has received little attention. Recently, Photobacterium profundum strain SS9 has been adopted as a model for piezophily. Here we report its genome sequence (6.4 megabase pairs) and transcriptome analysis. The results provide a first glimpse into the molecular basis for life in the largest portion of the biosphere, revealing high metabolic versatility.

Perirhinal and hippocampal contributions to visual recognition memory can be distinguished from those of occipito-temporal structures based on conscious awareness of prior occurrence. The ability of humans to distinguish consciously between new and previously encountered objects can be probed with visual recognition memory tasks that require explicit old-new discriminations. Medial temporal-lobe (MTL) lesions impair performance on such tasks. Within the MTL, both perirhinal cortex and the hippocampus have been implicated. Cognitive processes can also be affected by past object encounters in the absence of conscious recognition, as in repetition priming tasks. Past functional neuroimaging findings in healthy individuals suggest that even in tasks that require conscious recognition decisions for visual stimuli, posterior cortical structures in the ventral visual pathway distinguish between old and new objects at a nonconscious level. Conclusive evidence that differentiates the neural underpinnings of conscious from nonconscious processes in recognition memory, however, is still missing. In particular, functional magnetic resonance imaging (fMRI) findings for the MTL have been inconsistent towards this end. In the present fMRI study, we tested whether perirhinal and hippocampal contributions to recognition memory can be distinguished from those of occipito-temporal structures in the ventral visual pathway based on the participants' reported conscious awareness of prior occurrence. Images of objects with a large degree of feature overlap served as stimuli; they were selected to ensure an involvement of perirhinal cortex in the present recognition task, based on evidence from past lesion-based research. We found that both perirhinal cortex and occipito-temporal cortex showed a differential old-new response that reflected a repetition-related decrease in activity (i.e., new > old). Whereas in perirhinal cortex this decrease was observed with respect to whether subjects reported objects to be old or new, irrespective of the true item status, in occipito-temporal cortex it occurred in relation to whether objects were truly old or new, irrespective of the participants' conscious reports. Hippocampal responses differed in their exact pattern from those of perirhinal cortex, but were also related to the conscious recognition reports. These results indicate that both perirhinal and hippocampal contributions can be distinguished from those of occipito-temporal structures in the ventral visual pathway based on the participants' reported conscious awareness of prior occurrence.

Breech position, delivery route and congenital hip dislocation. The purpose of this study was to investigate whether the mode of delivery for fetuses in breech presentation in any way influenced the frequency of congenital hip dislocation. In 13,559 singleton births 583 fetuses were in breech position, and the cesarean section rate was 39.1%. Eighty-three infants were born with congenital hip dislocation, 11 of whom had been in breech position. Of these 11, cesarean section was required in 5 cases. There was no difference in frequency of congenital hip dislocation between fetuses in breech presentation delivered by cesarean section vs. by the vaginal route. The frequency of breech presentation in congenital hip dislocation was 13.3%. Including 7 external versions, the rate was 21.7%. Female to male ratio was 4:1. The frequency of congenital hip dislocations in infants born in vertex presentation was 5.5 per mille and for infants born in breech presentation it was 18.9 per mille.

Comparison of pulpal sensitivity between a conventional and two resin-modified glass ionomer luting cements. This clinical study compared handling and any short-term tooth sensitivity associated with using one conventional and two resin-modified glass ionomer cements marketed for luting gold and ceramometal crowns. The patient's response to a 10-second blast of air applied to the vital tooth was scored pre-operatively and again within a one-to-four week post-cementation recall period. A score was also recorded for any sensitivity present at the time of cementation of the crown on the unanesthetized tooth. All three cements were easy to mix and place. Most of the teeth had no response to pulpal stimulation pre-operatively, associated with the cementation procedure or post-cementation, and there were no instances of severe sensitivity recorded. For all cements, the level of post-cementation tooth sensitivity was similar, and less than that found pre-operatively.

Local graft-versus-host-reaction in mice specifically inhibited by anti-receptor antibodies. The local graft-versus-host (GVH) reaction provoked by parental spleen cells in F1 mice was shown to be T-cell-dependent. GVH reactions were suppressed in F1 hybrid mice immunized with parental T lymphocytes of the same genotype, but not in F1 mice immunized with parental B cells. In some cases this immunity could be passively transferred by serum into normal F1 mice. The specific activity of such sera could be removed by absorption with either parental T or B cells. Some of the F1 antisera were specificlly cytotoxic for parental GVH-reactive lymphocytes.

Enhanced absorption and inhibited metabolism of emodin by 2, 3, 5, 4'-tetrahydroxystilbene-2-O-β-D-glucopyranoside: Possible mechanisms for Polygoni Multiflori Radix-induced liver injury. Polygoni Multiflori Radix (PMR) has been commonly used as a tonic in China for centuries. However, PMR-associated hepatotoxicity is becoming a safety issue. In our previous in vivo study, an interaction between stilbenes and anthraquinones has been discovered and a hypothesis is proposed that the interaction between stilbene glucoside-enriching fraction and emodin may contribute to the side effects of PMR. To further support our previous in vivo results in rats, the present in vitro study was designed to evaluate the effects of 2, 3, 5, 4'-tetrahydroxystilbene-2-O-β-D-glucopyranoside (TSG) on the cellular absorption and human liver microsome metabolism of emodin. The obtained results indicated that the absorption of emodin in Caco-2 cells was enhanced and the metabolism of emodin in human liver microsomes was inhibited after TSG treatment. The effects of the transport inhibitors on the cellular emodin accumulation were also examined. Western blot assay suggested that the depressed metabolism of emodin could be attributed to the down-regulation of UDP-glucuronosyltransferases (UGTs) 1A8, 1A10, and 2B7. These findings definitively demonstrated the existence of interaction between TSG and emodin, which provide a basis for a better understanding of the underlying mechanism for PMR-induced liver injury.

Probing molecules in integrated silicon-molecule-metal junctions by inelastic tunneling spectroscopy. Molecular electronics has drawn significant attention for nanoelectronic and sensing applications. A hybrid technology where molecular devices are integrated with traditional semiconductor microelectronics is a particularly promising approach for these applications. Key challenges in this area include developing devices in which the molecular integrity is preserved, developing in situ characterization techniques to probe the molecules within the completed devices, and determining the physical processes that influence carrier transport. In this study, we present the first experimental report of inelastic electron tunneling spectroscopy of integrated metal-molecule-silicon devices with molecules assembled directly to silicon contacts. The results provide direct experimental confirmation that the chemical integrity of the monolayer is preserved and that the molecules play a direct role in electronic conduction through the devices. Spectra obtained under varying measurement conditions show differences related to the silicon electrode, which can provide valuable information about the physics influencing carrier transport in these molecule/Si hybrid devices.

Prevalence of varicocoele and its association with body mass index among 39,559 rural men in eastern China: a population-based cross-sectional study. Varicocoele is a common cause of male infertility. We undertook a population-based cross-sectional study to evaluate the prevalence of varicocoele among rural men in eastern China and its association with body mass index. A total of 39,559 rural men in six counties in Beijing, Guangdong and Shandong provinces were recruited from 2011 to 2012. The presence and severity of varicocoele were measured by physical examinations. Univariate and multivariate logistic regression models were constructed to assess the association between varicocoele and body mass index after adjusting for possible confounders. Varicocoele was diagnosed in 1911 of 39,559 participants with an overall prevalence of 4.83%. The prevalence of varicocoele was highest in underweight (6.29%) and lowest in obese patients (3.71%, p < 0.05). The prevalence also decreased as body mass index increased in all three varicocoele grades. In multivariate logistic regression analysis after adjusting for region, age, height, occupation, cigarette smoking and alcohol consumption, body mass index was still inversely and independently associated with varicocoele (p < 0.001). Compared with normal weight men, underweight men (OR = 1.34; 95% CI, 1.10-1.63) were more likely to have varicocoele, whereas overweight men (OR = 0.88; 95% CI, 0.79-0.99) and obese men (OR = 0.75; 95% CI, 0.58-0.97) were less likely to have varicocoele. This study revealed that the prevalence of varicocoele was 4.83% among rural men in eastern China; body mass index was inversely and independently associated with the presence of varicocoele. Future efforts should be made to validate the risk factors for varicocoele and strengthen the prevention and treatment of varicocoele, especially in underweight men.

Methylglyoxal activates NF-κB nuclear translocation and induces COX-2 expression via a p38-dependent pathway in synovial cells. There is growing evidence of an increased prevalence of osteoarthritis (OA) among people with diabetes. Synovial inflammation and increased expression of cyclooxygenase-2 (COX-2) are two key features of patients with OA. Methylglyoxal (MGO) is a common intermediate in the formation of advanced glycation end-products, and its concentration is also typically higher in diabetes. In this study, we investigated the effects of the treatment of different MGO concentrations to rabbit HIG-82 synovial cells on COX-2 expression. The MGO induced COX-2 mRNA expression was detected by quantitative polymerase chain reaction. The MGO induced COX-2 protein production and its signaling pathways were detected by western blotting. The nuclear factor-kappa B (NF-κB) nuclear translocation by MGO was examined by immunofluorescence. In the present study, we find that MGO has no toxic effects on rabbit synovial cells under the experimental conditions. Our analysis demonstrates that MGO induced COX-2 mRNA and protein production. Moreover, MGO induces p38-dependent COX-2 protein expression as well as the phosphorylations of extracellular signal-regulated kinase, c-Jun N-terminal kinase (JNK), and Akt/mammalian target of rapamycin (mTOR)/p70S6K; however, inhibition of JNK and Akt/mTOR/p70S6K phosphorylations further activates COX-2 protein expression. Furthermore, MGO is shown to activate of nuclear factor-kappa B (NF-κB) nuclear translocation. Our results suggest that MGO can induce COX-2 expression via a p38-dependent pathway and activate NF-κB nuclear translocation in synovial cells. These results provide insight into the pathogenesis of the synovial inflammation under the diabetic condition associated with higher MGO levels.

[A meningioma in the posterior fossa without dural attachment: case report]. An extremely rare case of a meningioma in the posterior fossa without dural attachment has been reported. The patient was a 56-year-old male whose chief manifestation was the abnormality of his CT scan. His past history included gastric and colonic polyp when he was 54, 55 years old, and non-Hodgkin's lymphoma before hospitalization in our department. CT scan showed a small round non-enhancing lesion located at the lateral site of the right cerebellar cortex. T1 weighted image of MRI showed a homogeneous low intensity lesion with partial enhancing with Gd-DTPA. Proton image showed a remarkable low intensity lesion which showed an extramedullary mass. Right retromastoid craniectomy was performed. The mass was an extramedullary tumor which had no relation with the cerebellar cortex and dura matter. The arachnoid membrane around the tumor was intact. The tumor was totally resected and the patient had no neurological deficits. Histopathologically, the tumor was delineated into laminar structures by collagen fiber. Tumor cells were spindle in shape and made a whorling formation. There was no psammoma body and it had a hyperchromatic nuclei without mitotic features. Electron microscopic studies revealed no typical interdigitation but irregularity of the cell membrane. Abundant collagen fibers were in contact with basement membrane of the tumor. According to these findings, we diagnosed fibroblastic meningioma with atypical forms. Meningiomas without dural attachment are rare in adults, especially extremely rare of the posterior fossa. There are only 23 previous reports of "meningioma of the posterior fossa without dural attachment". Cantore divided these meningiomas into three groups (IV ventricle, inferior tela choroidea and cisterna magna).(ABSTRACT TRUNCATED AT 250 WORDS)

Genetic diversity studies of Brazilian garlic cultivars and quality control of garlic-clover production. The garlic cultivars grown in Brazil evolved from somatic mutations and clone selection by breeding programs and by the introduction of germplasm from other countries. Morphological characters have been used to differentiate these cultivars. Two hundred and six random amplified polymorphic DNA markers were utilized for a diversity analysis of the 17 most planted garlic cultivars in Brazil. Bootstrap analysis showed that the number of markers was efficient and sufficient to obtain a coefficient of variation of 10%. Similarity varied between 16 and 98% and cluster analysis showed that, in general, genetic similarities correlate with morphological characters of the cultivars and production cycle variation. High bootstrap values at most of the nodes supported the dendrogram stability. The grouping of most varieties agreed well with previous reports based on morphological characters. As a vegetative-propagated species, viral diseases are a key problem regarding production and quality of the bulbs, causing gradual loss of yield and decrease in storage capacity. To improve the health quality of garlic seed, a virus-free stock of garlic cloves of the Amarante cultivar was obtained. The ability to distinguish garlic cultivars to detect varietal mixing after in vitro multiplication is extremely important, since correct identification is not possible until bulbs are produced. Random amplified polymorphic DNA markers were also used to differentiate cultivars while they are in vitro and not amenable to morphological discrimination. No difference was identified between the fingerprints of the virus-free or of the infected bulks of Amarante, showing that there was no clove mixing in the handling of material in the clonal multiplication phase.

Failure of covalently cross-linked human IgG myeloma subclass protein to release histamine from human leukocytes. We have examined the ability of IgG subclass antibodies to release histamine from human leukocytes using covalently cross-linked oligomers of human myeloma proteins. Purified IgG1, G2, G3, G4, (or IgE) was incubated with dimethyl suberimidate to induce cross-linking. The resulting dimers, trimers, and higher molecular weight oligomers were isolated using gel filtration columns (Sephadex G200 and Ultrogel AcA 22) connected in tandem. None of the oligomers of IgG1, G2, G3, or G4 released histamine from leukocytes of donors whose basophils released histamine when challenged with IgE dimer. Furthermore, preincubation with subclass specific oligomers did not desensitize cells to challenge with IgE dimer or to anti-IgE. We conclude that, under our experimental conditions, oligomers of human IgG myeloma subclass antibodies do not trigger histamine release nor modulate IgE-mediated reactions.

Cognitive and behavioral effects of carbamazepine in children: data from benign rolandic epilepsy. The effects of antiepileptic drugs on cognition are difficult to delineate, yet of critical importance for children with epilepsy. We investigated the cognitive and behavioral effects of carbamazepine in children with benign rolandic epilepsy. Ten subjects with benign rolandic epilepsy were evaluated with and without carbamazepine treatment. Fourteen unmedicated subjects with migraine headache evaluated twice served as a control group. Subjects were 6 to 12 years of age, fluent in English, and not mentally retarded. We found that children with benign rolandic epilepsy were quicker on a visual-search task and recalled stories better when not treated than when treated with carbamazepine. After correction for multiple comparisons only the memory finding remained significant. Higher carbamazepine serum level was associated with slower performance on the same visual-search task. This latter finding did not meet multiple comparison criteria. Numerous significant practice effects were found within the control group. Comparisons with reliable change indices identified two subjects with benign rolandic epilepsy with particularly poor scores while receiving carbamazepine. These findings suggest some effects on memory from carbamazepine; however, they do not support meaningful dosage-related effects, within the recommended range. Significant practice effects confirmed the need to control for such effects when evaluating treatments. Finally, identification of two subjects who performed more poorly while on carbamazepine suggests that some children might experience particular difficulties while receiving this medication and highlights the need to investigate individual subject responses to treatment.

Twist relates to tubular epithelial-mesenchymal transition and interstitial fibrogenesis in the obstructed kidney. Epithelial-mesenchymal transition (EMT) is a critical step in renal fibrosis. It has been recently reported that a transcription factor, Twist, plays a pivotal role in metastasis of breast tumors by inducing EMT. In this study, we examined whether Twist relates to renal fibrogenesis including EMT of tubular epithelia, evaluating Twist expression level in the unilateral ureteral obstruction (UUO) model. Kidneys of mice subjected to UUO were harvested 1, 3, 7, and 10 days after obstruction. Compared with control kidneys, Twist mRNA-level significantly increased 3 days after UUO (UUO day 3 kidney) and further augmented until 10 days after UUO. Twist expression increased in tubular epithelia of the dilated tubules and the expanded interstitial areas of UUO kidneys, where cell-proliferating appearances were frequently found in a time-dependent manner. Although a part of tubular cells in whole nephron segment were immunopositive for Twist in UUO day 7 kidneys, tubular epithelia downstream of nephron more frequently expressed Twist than upstream of nephron. In UUO day 7 kidneys, some tubular epithelia were confirmed to coexpress Twist and fibroblast-specific protein-1, a marker for EMT, indicating that Twist is involved in tubular EMT under pathological state. Twist was expressed also in a number of alpha-smooth muscle actin-positive myofibroblasts located in the expanded interstitial area of UUO kidneys. From these findings, the present investigation suggests that Twist is associated with tubular EMT, proliferation of myofibroblasts, and subsequent renal fibrosis in obstructed kidneys.

Retroactive effects of irrelevant speech on serial recall from short-term memory. The authors report 5 serial-recall experiments. In 4 of the 5 experiments, they show that irrelevant sound (IS) has a retroactive effect on material already in memory. In Experiment 1, IS presented during a filled retention interval had a reliable effect on list recall. Four further experiments, 3 of which used retroactive IS, showed that IS continued to-have an effect on recall following a long, filled retention interval. Articulatory suppression during visual input was found to abolish the long-lasting, retroactive effect of IS, supporting the idea that IS affects the phonological-loop component of short-term memory. IS also, therefore, seems to affect a longer term memory system with which the loop interacts.

One hundred years of chronic obstructive pulmonary disease (COPD). Chronic obstructive pulmonary disease (COPD) is an increasing health problem and one of the leading causes of morbidity and mortality worldwide, but knowledge about its pathogenesis has increased substantially in recent years. The disease results from interaction between individual risk factors (like enzymatic deficiencies) and environmental exposures to noxious agents, like cigarette smoking, occupational dusts, air pollution and infections in childhood. The main mechanisms that may contribute to airflow limitation in COPD are fixed narrowing of small airways, emphysema and luminal obstruction with mucus secretions. COPD is characterised by a chronic inflammatory process in the pulmonary tissue, with a pattern different from bronchial asthma, associated with extrapulmonary effects and is considered now a complex, systemic disease. Optimal therapeutic targeting of COPD depends on a clear understanding of the precise mechanisms of these complex processes and on early and correct evaluation of disease severity. A combination of pharmacological and non-pharmacological approaches is used to treat COPD. Bronchodilators are the mainstay of COPD treatment and can be combined with inhaled corticosteroids for greater efficacy and fewer side effects. The use of LTOT for hypoxemic patients has resulted in increased survival, and expanded drug therapy options have effectively improved dyspnoea and quality of life. Recent studies have documented the benefits of pulmonary rehabilitation. In addition, non-invasive mechanical ventilation offers new alternatives for patients with acute or chronic failure.

[Significance of serum CD62p and CD63 levels in patients with head injury]. To determine the serum levels of CD62p (alpha-granular membrane protein) and CD63 (lysosome intact membrane protein) in patients with head injury and to observe its relation to injury severity. Fifty-three patients with head injury were divided into 3 groups; Group A patients with mild head injury; Group B with moderate head injury; and Group C with severe head injury. The serum levels of CD62p, CD63 were measured on 12 h, d 1, 3, 5 and 7 after injury. The serum levels of CD62p and CD63 in Group B and Group C were higher than those in Group A and control (P<0.05). The serum level of CD62p in Group C was higher than that in Group B (P<0.05). The serum levels of CD62p in Group C on d 1, 3, 5 after injury were higher than those on 12 h (P<0.05). The serum level of CD63 in Group B on d 3 after injury were higher than that on 12 h (P<0.05). The serum levels of CD63 in Group C on d 1, 3, 5 after injury were higher than those on 12 h (P<0.05). The serum levels of CD62p and CD63 in patients with head injury may be helpful for identifying the severity of injury, and CD62p seems to be more sensitive.

Moss (Physcomitrella patens) GH3 proteins act in auxin homeostasis. Auxins are hormones involved in many cellular, physiological and developmental processes in seed plants and in mosses such as Physcomitrella patens. Control of auxin levels is achieved in higher plants via synthesis of auxin conjugates by members of the GH3 family. The role of the two GH3-like proteins from P. patens for growth and auxin homeostasis was therefore analysed. The in vivo-function of the two P. patens GH3 genes was investigated using single and double knockout mutants. The two P. patens GH3 proteins were also heterologously expressed to determine their enzymatic activity. Both P. patens GH3 enzymes accepted the auxin indole acetic acid (IAA) as substrate, but with different preferences for the amino acid to which it is attached. Cytoplasmic localization was shown for PpGH3-1 tagged with green fluorescent protein (GFP). Targeted knock-out of either gene exhibited an increased sensitivity to auxin, resulting in growth inhibition. On plain mineral media mutants had higher levels of free IAA and less conjugated IAA than the wild type, and this effect was enhanced when auxin was supplied. The DeltaPpGH3-1/DeltaPpGH3-2 double knockout had almost no IAA amide conjugates but still synthesized ester conjugates. Taken together, these data suggest a developmentally controlled involvement of P. patens GH3 proteins in auxin homeostasis by conjugating excess of physiologically active free auxin to inactive IAA-amide conjugates.

[Central venous dialysis catheter. Silicone rubber dialysis catheter used for permanent vascular access]. 51 dual lumen jugularis dialysis catheters (Permcath, Quinton) were placed by surgical technique in 34 patients and by percutaneous technique in eight patients. Mean catheter life-time was 4.1 months. Seven catheters were removed due to complications (infection three catheters, clotting four catheters). Minor flow problems occurred in 8.8% of all procedures. Seven occluded catheters were successfully reopened by use of locally applied streptokinase. A strict aseptic technique is essential to avoid infection. Permcath is an acceptable vascular access device for patients in whom it is impossible to create an arterio-venous fistula.

Further studies on hepatitis C virus NS5A-SH3 domain interactions: identification of residues critical for binding and implications for viral RNA replication and modulation of cell signalling. The NS5A protein of hepatitis C virus has been shown to interact with a subset of Src homology 3 (SH3) domain-containing proteins. The molecular mechanisms underlying these observations have not been fully characterized, therefore a previous analysis of NS5A-SH3 domain interactions was extended. By using a semi-quantitative ELISA assay, a hierarchy of binding between various SH3 domains for NS5A was demonstrated. Molecular modelling of a polyproline motif within NS5A (termed PP2.2) bound to the FynSH3 domain predicted that the specificity-determining RT-loop region within the SH3 domain did not interact directly with the PP2.2 motif. However, it was demonstrated that the RT loop did contribute to the specificity of binding, implicating the involvement of other intermolecular contacts between NS5A and SH3 domains. The modelling analysis also predicted a critical role for a conserved arginine located at the C terminus of the PP2.2 motif; this was confirmed experimentally. Finally, it was demonstrated that, in comparison with wild-type replicon cells, inhibition of the transcription factor AP-1, a function previously assigned to NS5A, was not observed in cells harbouring a subgenomic replicon containing a mutation within the PP2.2 motif. However, the ability of the mutated replicon to establish itself within Huh-7 cells was unaffected. The highly conserved nature of the PP2.2 motif within NS5A suggests that functions involving this motif are of importance, but are unlikely to play a role in replication of the viral RNA genome. It is more likely that they play a role in altering the cellular environment to favour viral persistence.

Soluble di- and aminopeptidases in Escherichia K-12. Dispensible enzymes. As part of a study of the peptidase content of Escherichia coli K-12, two peptidase-deficient amino acid auxotrophs isolated and characterized by Miller as pepD- (strain CM17) and pepD- pepN- pepA- pepB- pepQ- (strain CM89) were examined for the presence of several peptidases previously obtained from strain K-12 in this laboratory. The soluble fraction of each mutant was found to lack the broad-specificity strain K-12 dipeptidase DP and the strain CM89 fraction also lacked activity characteristic of the strain K-12 aminopeptidases AP, L, and OP; like strain CM17, strain CM89 contained the tripeptide-specific aminopeptidase TP. Strain CM89 (but not CM17) appeared to contain little if any activity attributable to the ribosome-bound aminopeptidase I of strain K-12. Whereas loss of DP, AP, OP, and aminopeptidase I activity may be attributed to the pepD-, pepB-, pepN-, and pepA- mutations, respectively, the reason for the loss of L activity remains uncertain. Grown responses of strain CM89 in liquid media containing di- or tripeptides were in accord with absence of enzymes catalyzing rapid hydrolysis of dipeptides. In synthetic liquid media supplemented with the required amino acids per se or with peptone, cultures of both CM strains grew more slowly than strain K-12 and produced smaller cell-yields than those produced by strain K-12.

Longitudinal impedance variability in patients with chronically implanted DBS devices. Deep brain stimulation (DBS) is an effective therapy for advanced movement disorders, but its optimal use is still controversial. One factor that could play a role in the proper delivery of therapeutic stimulation by current DBS devices is the variability of the impedance at the interface between the electrode surface and surrounding tissue. To analyze variability and trends in the impedance of chronically-implanted DBS electrodes in subjects with movement disorders. We reviewed impedance values from medical records of DBS patients at an academic tertiary-care movement disorders center. The standard deviation of data recorded within individual subjects and single contacts were used as measures of longitudinal impedance variability. A generalized linear mixed model (GLMM) determined if a number of effects had significant influences on impedance. We analyzed 2863 impedance measurements from 94 subjects. Median variability, for subjects with follow-up from 6 months to 5 years (n = 77), was 194 Ω for individual subjects and 141 Ω for individual contacts, with a range spanning from 18 to over 600 Ω. The GLMM, incorporating all subjects (n = 94), identified time, electrical activity, implanted target, contact position on the electrode and side of implantation as significant predictors of impedance. Age and disease duration at surgery, gender or ethnicity were not significant predictors. Our analysis suggests that a significant amount of impedance variability can be expected in chronically implanted DBS electrodes and indicates a number of factors with possible predictive value. Further studies are needed to link impedance characteristics to clinical outcomes.

Effect of two prophylaxis methods on adherence of Streptococcus mutans to microfilled composite resin and giomer surfaces. Surface attributes of a restoration play an important role in adherence of plaque bacteria. Prophylaxis methods may be involved in modification of or damaging the restoration surface. The aim of the present study was to evaluate the effect of two prophylaxis methods on adherence of Streptococcus mutans to the surface of two restorative materials. A total of 60 specimens were prepared from each material; a microfilled composite resin (HelioProgress) and a giomer (Beautifil II). For each material, the specimens were randomly divided into three groups (n=20). Group 1: no prophylaxis treatment (control); Group 2: prophylaxis with pumice and rubber cup; Group 3: prophylaxis with air-powder polishing device (APD). The surfaces of selected specimens from each group were evaluated under a scanning electron microscope (SEM), and the surface topography formed by the two prophylaxis methods was determined by atomic force microscopy (AFM). Adherence of Streptococcus mutans to the surface of specimens was determined by the plate counting method following immersion in a bacterial innoculum for 4 hours, rinsing and sonication. Data were analyzed by two-way ANOVA and post hoc Tukey test for multiple comparisons. Statistical significance was set at P<0.05. Bacterial adherence was significantly affected by both factors: restorative material type and prophylaxis method (P<0.0005). Mean bacterial adhesion was significantly higher in composite groups compared to corresponding giomer groups. Within each material, bacterial adherence was significantly lower in the control group compared to prophylaxis groups. Prophylaxis with pumice and rubber cup resulted in a significantly lower bacterial adherence compared to prophylaxis with APD. Based on the results of the present study, giomer specimens demonstrated lower bacterial adherence compared to composite resin specimens. In both materials, the highest bacterial adherence was observed with prophylaxis with APD, pumice and rubber cup and the control group, respectively.

Comparison of patient satisfaction with acrylic and flexible partial dentures. Restoration of partial edentulous mouth may be done using a variety of treatment options. Removable partial denture (RPD) is commonly used because of its availability. RPDs from flexible resins unlike those from acrylic engage hard and soft tissue undercuts and feel more comfortable in the mouth. The aim of the study was to compare satisfaction with dentures made from these two types of materials. It was a quasi-experimental study among thirty patients at the Prosthetics Clinic, University College Hospital, Ibadan. Patients aged 16 years or more, requiring RPDs with one to three missing teeth in the anterior region of either the upper or lower arch participated. A modified semi-structured interviewer-administered questionnaire was used to collect data on sociodemographics and oral health variables. The level of satisfaction was assessed using a visual analogue scale. Data were analysed using descriptive and multivariate statistics at a significance level of P < 0.05. The participants' ages ranged between 16 and 51 years, mean age was 33.8 ± 10.01 years. Male: female ratio was 1:1 and mean duration of edentulousness was 11.37 ± 10.52 years (median - 9.50). Most 28 (93.3%) subjects delayed replacement of their missing teeth; reasons were indifference 13 (43.4%), financial constraint 10 (33.3%), ignorance 4 (13.3%) and fear of aspiration 1 (3.3%). Overall, 21 (70.0%) participants were more satisfied with the flexible dentures, 6 (20.0%) with acrylic dentures while 3 (10.0%) were equally satisfied with both types of dentures (P = 0.04). Subjects were more satisfied with the flexible RPD than the acrylic resin RPD.

Randomised trial comparing forced-air warming to the upper or lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position. In the supine position, forced-air warming is more effective on the lower body than on the upper body to prevent intraoperative hypothermia. However, it is unknown in the lateral decubitus position. We thus compared forced-air warming on the upper and lower bodies in the lateral position. Patients (n=123) were randomised to receive forced-air warming on the upper body or lower body during thoracoscopic surgery in the lateral position. We measured the nasopharyngeal temperature at 0, 30, 60, 90, and 120 min after lateral positioning during surgery and the infrared tympanic membrane temperature at 0, 30, 60, 90, and 120 min after surgery. Patients received both upper and lower body warming at a temperature of <35.5°C. The primary outcome was the incidence of intraoperative hypothermia with a temperature of <36.0°C. Intraoperative hypothermia was less frequent with the upper body warming than with the lower body warming {21/62 vs 35/61, risk ratio [95% confidence interval (CI)] 0.6 (0.4-0.9), P=0.011}. The intraoperative temperature was higher with the upper body warming than with the lower body warming at 30 (P=0.002), 60 (P<0.001), and 90 (P<0.001) min after lateral positioning, and the postoperative temperature was higher at 0 (P<0.001) and 30 (P=0.001) min after surgery. Fewer patients received both upper and lower body warming in the upper body warming group than in the lower body warming group during surgery (1 vs 7, P=0.032). Forced-air warming was more effective on the upper body than on the lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position. NCT02993666.

Expression of four growth factors in recessed extraocular muscles of rabbits. The study was designed to determine the temporal expression of insulin-like growth factor (IGF)-I, IGF-II, basic fibroblast factor 2 (bFGF-2), and transforming growth factor beta 1 (TGF-beta1) in recessed extraocular muscles. Sixteen eyes of eight rabbits were subjected to conventional 4-mm recession of superior rectus muscles. Two rabbits were untreated as control. The rabbits were killed and their eyes were enucleated at 3 (group 3), 6 (group 6), 24 (group 24), and 72 (group 72) hours after the operation (two rabbits per group), and the expression of IGF-I, IGF-II, bFGF-2, and TGF-beta1 was immunohistochemically examined. The peak levels of IGF-I, IGF-II, and TGF-beta1 expression were observed in groups 24, 6, and 3, respectively. However, bFGF-2 was less expressed than the other growth factors in all groups. IGF-I, IGF-II, bFGF-2, and TGF-beta1 in regenerating muscle cells were expressed by different kinetics, suggesting a distinct role of each growth factor during wound healing after recession of extraocular muscles.

Steroid hormone modulation of olfactory processing in the context of socio-sexual behaviors in rodents and humans. Primer pheromones and other chemosensory cues are important factors governing social interactions and reproductive physiology in many species of mammals. Responses to these chemosignals can vary substantially within and between individuals. This variability can stem, at least in part, from the modulating effects steroid and non-steroid hormones exert on olfactory processing. Such modulation frequently augments or facilitates the effects that prevailing social and environmental conditions have on the reproductive axis. The mechanisms underlying the hormonal regulation of responses to chemosensory cues are diverse. They are in part behavioral, achieved through the modulation of chemoinvestigative behaviors, and in part a product of the modulation of the intrinsic responsiveness of the main and accessory olfactory systems to conspecific, as well as other classes, of chemosignals. The behavioral and non-behavioral effects complement one another to ensure that mating and other reproductive processes are confined to reproductively favorable conditions.

Visual attention to features by associative learning. Expecting a particular stimulus can facilitate processing of that stimulus over others, but what is the fate of other stimuli that are known to co-occur with the expected stimulus? This study examined the impact of learned association on feature-based attention. The findings show that the effectiveness of an uninformative color transient in orienting attention can change by learned associations between colors and the expected target shape. In an initial acquisition phase, participants learned two distinct sequences of stimulus-response-outcome, where stimuli were defined by shape ('S' vs. 'H'), responses were localized key-presses (left vs. right), and outcomes were colors (red vs. green). Next, in a test phase, while expecting a target shape (80% probable), participants showed reliable attentional orienting to the color transient associated with the target shape, and showed no attentional orienting with the color associated with the alternative target shape. This bias seemed to be driven by learned association between shapes and colors, and not modulated by the response. In addition, the bias seemed to depend on observing target-color conjunctions, since encountering the two features disjunctively (without spatiotemporal overlap) did not replicate the findings. We conclude that associative learning - likely mediated by mechanisms underlying visual object representation - can extend the impact of goal-driven attention to features associated with a target stimulus.

Olefin cyclopropanation via carbene transfer catalyzed by engineered cytochrome P450 enzymes. Transition metal-catalyzed transfers of carbenes, nitrenes, and oxenes are powerful methods for functionalizing C=C and C-H bonds. Nature has evolved a diverse toolbox for oxene transfers, as exemplified by the myriad monooxygenation reactions catalyzed by cytochrome P450 enzymes. The isoelectronic carbene transfer to olefins, a widely used C-C bond-forming reaction in organic synthesis, has no biological counterpart. Here we report engineered variants of cytochrome P450(BM3) that catalyze highly diastereo- and enantioselective cyclopropanation of styrenes from diazoester reagents via putative carbene transfer. This work highlights the capacity to adapt existing enzymes for the catalysis of synthetically important reactions not previously observed in nature.

The establishment of a radioactive waste disposal facility in Western Australia for low level waste. The Radiation Health Section of the Health Department of Western Australia has been a repository for unwanted radioactive sources for many years. They had been placed in the radioactive store located on the Queen Elizabeth II Medical Centre Campus. After a collection period of more than 20 years the storage facilities of the Radiation Health Section were nearing capacity. A decision was made to relocate these sources into a permanent near surface burial facility. Following extensive community consultation and site investigations, waste originating in Western Australia was disposed of at Mt Walton (East), 80 km North East of Koolyanobbing, Western Australia in November 1992.

Mucosal involvement is a risk factor for poor clinical outcomes and relapse in patients with pemphigus treated with rituximab. Many studies have reported the outcome of rituximab use in pemphigus but studies regarding the clinical risk factors for poor clinical outcomes or relapse are lacking. To clarify the risk factors for poor clinical outcomes or relapse in patients with pemphigus treated with rituximab, a retrospective chart analysis was performed on patients with pemphigus who were treated with rituximab in the dermatology clinic of Seoul National University Hospital. Forty patients with pemphigus were treated with rituximab, of which 39 (97.5%) experienced remission and 19 (48.7%) experienced relapse. Patients with mucosal lesions demonstrated poor clinical outcomes. The risk for relapse was 4.626 (confidence interval: 1.126-19.001, p = .034) times higher in patients with mucosal lesions than in those without lesions. In patients with pemphigus treated with rituximab, the presence of mucosal lesions resulted in poor clinical outcomes and frequent recurrence.

Management of ventricular tachycardia in the ablation era: results of the European Heart Rhythm Association Survey. Patients with sustained ventricular tachycardia (VT) are at risk of sudden death. Treatment options for VT include antiarrhythmic drug therapy, insertion of an implantable cardioverter-defibrillator, and catheter ablation. Evidence on indications for VT ablation, timing, ablation strategies, and periprocedural management is sparse. The aim of this European Heart Rhythm Association (EHRA) survey was to evaluate clinical practice regarding management of VT among the European countries. An electronic questionnaire was sent to members of the EHRA Electrophysiology Research Network. Responses were received from 88 centres in 12 countries. The results have shown that management of VTs is very heterogeneous across the participating centres. Indications, periprocedural management, and ablation strategies vary substantially. This EP Wire survey has revealed that catheter ablation is the first-line therapy for the treatment of recurrent monomorphic stable VT in patients without structural heart disease as well as in patients with ischaemic cardiomyopathy and impaired left ventricular ejection fraction in the majority of centres. Furthermore, in patients with ischaemic cardiomyopathy and the first episode of monomorphic VT, most centres (62.0%) performed catheter ablation. On the contrary, in patients with non-ischaemic cardiomyopathy, amiodarone (41.4%) and catheter ablation (37.1%) are used in a very similar proportion. Ablation strategies, endpoints, and post-ablation antithrombotic management vary substantially among European centres.

Metrics and proxies for stringency of regulation of plant water status (iso/anisohydry): a global data set reveals coordination and trade-offs among water transport traits. Plants operate along a continuum of stringency of regulation of plant water potential from isohydry to anisohydry. However, most metrics and proxies of plant iso/anisohydric behavior have been developed from limited sets of site-specific experiments. Understanding the underlying mechanisms that determine species' operating ranges along this continuum, independent of site and growing conditions, remains challenging. We compiled a global database to assess the global patterns of metrics and proxies of plant iso/anisohydry and then explored some of the underlying functional traits and trade-offs associated with stringency of regulation that determines where species operate along the continuum. Our results showed that arid and semi-arid biomes were associated with greater anisohydry than more mesic biomes, and angiosperms showed marginally greater anisohydry than gymnosperms. Leaf water potential at the turgor loss point (Ψtlp) and wood density were the two most powerful proxies for ranking the degree of plant iso/anisohydry for a wide range of species and biomes. Both of these simple traits can be easily and rapidly determined, and therefore show promise for a priori mapping and understanding of the global distribution pattern of the degree of plant iso/anisohydry. Generally, the most anisohydric species had the most negative values of Ψtlp and highest wood density, greatest resistance to embolism, lowest hydraulic capacitance and lowest leaf-specific hydraulic conductivity of their branches. Wood density in particular appeared to be central to a coordinated series of traits, trade-offs and behaviors along a continuum of iso/anisohydry. Quantification of species' operating ranges along a continuum of iso/anisohydry and identification of associated trade-offs among functional traits may hold promise for mechanistic modeling of species-specific responses to the anticipated more frequent and severe droughts under global climate change scenarios.

Cast metal bases as an economical alternative for the severely resorbed mandible. Resorption of the alveolar ridge is a common problem in edentulous patients and can compromise the stability and function of dentures. Resorption and its consequences can be minimized when strategically placed implants are used; however, this option is financially out of reach for many patients. The article discusses a more cost-effective alternative (metalbased dentures) for patients with ridge resorption. In certain environments, like a dental school, where patients are looking for solutions to their dental problems at a reasonable price, cast metal bases can be a feasible economical alternative for edentulous patients. Both cases presented here demonstrated a significant improvement in stability, phonation, and mastication.

Pancreatic trauma: Management and literature review. Pancreatic injury is an uncommon event often difficult to diagnose at an early stage. After abdominal trauma, the surgeon must always be aware of the possibility of pancreatic trauma due to the complications associated with missed pancreatic injuries. Due to its retroperitoneal position, asociated organs and vascular injuries are almost always present, which along with frequent extra abdominal injuries explain the high morbidity and mortality. The aim of this study is to present a concise description of the incidence of these injuries, lesional mechanisms, recommended diagnostic methods, therapeutic indications including nonoperative management, endoscopy and surgery, and an analysis of pancreas-specific complications and mortality rates in these patients based on a 60-year review of the literature, encompassing 6,364 patients. Due to pancreatic retroperitoneal position, asociated organs and vascular injuries are almost always present, which along with frequent extraaabdominal injuries explain the high morbidity and mortality of these patients.

[Patterns of Candida esophagitis in cancer and AIDS patients: histopathological study of 23 patients]. Candida oesophagitis is a common concomitant disease in neutropenic cancer patients after chemotherapie as well as in HIV-patients. In order to characterize the features of oesophagitis in each population, we reviewed the medical history and pathology records of 23 patients (18 cancer-patients, 5 HIV-patients) with culture and autopsy-proven Candida oesophagitis. Histopathological patterns of morphology, invasion, angioinvasion and inflammation were evaluated. Virtually all patients, 17/18 cancer- and 5/5 HIV-patients, had a history of previous mucosal candidosis or candidemia. There was a significant difference histopathologically in depth of invasion of the Candida-organisms between cancer and HIV-patients. Only in HIV-patients organisms were observed within the muscularis propria and the adventitia (2/5 vs 0/18; p = 0.04). The frequency of angioinvasion (12/18 vs 3/5) was similar in both groups. Neutropenia (< 500/microliter) was present in 12 (68%) of 18 cancer patients vs 0/5 HIV-patients (p = 0.01). Correspondingly there was a significant higher PMN/MN ratio in the oesophageal inflammatory infiltrate in HIV-patients, reflecting chemotherapy-induced neutropenia in cancer patients (p = 0.02). Oesophageal candidosis in HIV-patients may be highly invasive despite the presence of neutrophils. These findings suggest an impaired inflammatory response of HIV-patients to invasive candidosis, leading to impaired mucosal host defence.

Training in youth-friendly service provision improves nurses' competency level in the Great Lakes Region. This survey investigates whether relevant training and availability of guidelines improve self-reported competencies of nurses in the provision of youth-friendly sexual and reproductive health services in South-Kivu Province in the Democratic Republic of the Congo, Burundi, and Rwanda. A quantitative baseline survey was conducted among nurses in randomly selected health facilities. Nurses providing youth-friendly sexual and reproductive health services were asked to self-rate their competencies with regards to technical knowledge, clinical, and communication skills. In South-Kivu, Burundi, and Rwanda, 135, 131, and 99 nurses were interviewed, respectively. Overall differences of service and guideline availability and self-rated competencies can be observed between the three countries. In two countries, more than one in five nurses considered themselves to be only somewhat or not confident to counsel young people. Nurses from Rwanda showed the highest level of competencies followed by Burundi and South-Kivu. Lack of training in youth-friendly health services or family planning showed significant associations with reporting feeling somehow or not competent. The lack of training, supervision, and guidelines expressed by the nurses is of great concern. Competency-based training in youth-friendly health services is an important approach in improving nurses' competency level.

Risk factors for conversion to laparotomy during laparoscopic management of an ectopic pregnancy. To identify risk factors for conversion to laparotomy during laparoscopic management of ectopic pregnancy. A retrospective chart review of patients who underwent laparoscopy for treatment of ectopic pregnancy, during a 32-month period (6/1999-2/2002), at the University of Miami Jackson Memorial Hospital. We identified 229 patients; 201 had a successful laparoscopy (non-converted group) and 28 who were converted to laparotomy (converted group). Variables analyzed between the two groups were demographic data, patient-related risk factors available to the surgeon prior to the surgery (previous laparotomy, previous laparoscopy, history of PID, history of endometriosis, diameter of ectopic pregnancy as measured by ultrasound, amount of free fluid on ultrasound, BMI), and surgeons' experience. Out of the 229 laparoscopies, 28 were converted to laparotomy (12.2%). The rate of conversion was significantly higher for less experienced compared to experienced surgeon (OR = 6.1, 95% CI = 2.35-15.88). Significantly more women had a BMI > 30 kg/m2 in the converted group compared to the non-converted group (42% vs. 14%; OR = 4.28, 95% CI = 1.7-10.75) and the converted group had significantly higher rate of large free fluid reported on ultrasound compared to the non-converted group (21.42% vs. 7.46%; OR = 3.38, 95% CI = 1.04-10.61). Less experienced surgeon, BMI > 30 kg/m2, and large amount of free fluid on ultrasound increase the risk of conversion to laparotomy during laparoscopic management of ectopic pregnancy.

Immunohistochemical study of delta and mu opioid receptors on synaptic glomeruli with substance P-positive central terminals in chicken dorsal horn. In an attempt to clarify the mechanism underlying the regulation of the release of substance P (SP) from the central axon terminals of the synaptic glomeruli in lamina II of the dorsal horn, we examined the expression patterns of delta and mu opioid receptors (DOR and MOR) in relation to those of enkephalin (ENK) and SP in the synaptic glomeruli. DOR, MOR, ENK and SP immunoreactivities in lamina II of the dorsal horn in the chicken were examined by confocal laser scanning and electron microscopies. DOR immunoreactivity was localized in both SP-positive central terminals and peripheral elements, while MOR immunoreactivity was only localized in the peripheral elements of the synaptic glomeruli. Both of the peripheral DOR- and MOR-immunoreactive elements were shown to be vesicle-containing dendrites by electron microscopy. Dual immunohistochemistry indicated that DOR, MOR and ENK immunoreactivities were located in distinct peripheral elements. On the basis of present results, the possible roles of DOR and MOR in the regulation of the release of SP from the central axon terminals in the synaptic glomeruli are discussed.

An exploration of patient safety culture in Kuwait hospitals: a qualitative study of healthcare professionals' perspectives. Patient safety culture (PSC) represents a key component of the quality of care offered by healthcare professionals. Therefore, it is crucial to understand the factors that influence the implementation of a safe culture. This study explored the knowledge and attitudes of healthcare professionals in Kuwait towards the factors that might affect the PSC. A qualitative study using semi-structured interviews with healthcare professionals was conducted between February and June 2018 at two major hospitals in Kuwait. Both hospitals had been accredited and have been applying the safety programmes recommended by the Kuwaiti Ministry of Health. Participants were purposively selected where 20 healthcare professionals were interviewed. The interviewees comprised of six physicians, six clinical pharmacists, six nurses and two members of the patient safety committee. Inclusion criteria involved healthcare professionals who had more than 1-year clinical experience, have interest in patient safety and had a good level of English. Interviews were audio-recorded and transcribed verbatim. Thematic analysis of the interview transcripts was conducted to identify the emergent themes. Thematic analysis of the interviews yielded three major themes related to 'management', 'regulations and policies' and 'healthcare professionals'. Management issues included managerial support, resources, safety environment and staff training. Regulations and policies highlighted issues related to policies and procedures and incident reporting system. Healthcare professionals' theme covered factors related to knowledge, communication and teamwork among healthcare professionals. This study gave insight into how healthcare professionals perceive the current PSC in Kuwait. Despite their positive attitudes and knowledge towards patient safety, various barriers were reported that hinder optimal PSC. These barriers were related to support, staffing, resources and response to error.

UK Commission concludes international patent laws hinder access to medicines in developing countries. On 12 September 2002, the UK Commission on Intellectual Property Rights, an independent body established in May 2001 by the British government, released its report analyzing the impact of international agreements on patents. The report, Integrating Intellectual Property Rights and Developmental Policy, makes 55 recommendations "aimed at aligning [intellectual property] protection with the goal of reducing poverty".

Cardiotoxicity among adult survivors suffered from childhood malignancies. Late cardiotoxicity following treatment of malignancy diseases has been long established. Cancer therapeutics-related cardiac dysfunction (CTRCD), acute arrhythmias, pericardial disease, valvopathies and early atherosclerotic Cardiovascular Disease (CVD), are the clinical presentations of cardiotoxicity. Although these clinical modalities can affect adults treated for malignancies, they are more common to present in the pediatric survivors as improvement of prognosis, nowadays exists. Studies have shown that CVD can present earlier than thirty years, post treatment. If adding on this the early and late effect of cardiotoxicity on the developing in childhood cardiovascular system, we are then faced with a new Risk Factor (RF) for CVD. Anthracyclines and its derivatives have served for over fifty years as the road model of studding early, mid and late term cardiotoxicity. Today a vast number of chemical agents are used, many of them with very good results in treating the existing malignancies. Unfortunate, little or even less are known on their potential mechanism of derived cardiotoxicity when used by their own or combined with others and/or radiotherapy (RT). The 2013 existing guidelines by ACC/AHA on surveillance of the cardiovascular health of oncology survivors, are mostly addressing early cardiac adverse effects and CTRCD. Little is mentioned about the development of early CVD, its subclinical diagnosis, prevention and the need of early intervention before clinical events are present. The aim of this paper is to review the exist knowledge and practice on this condition with growing numbers of survivors facing the risk of early atherosclerotic CVD.

Immune dysregulation in primary immune thrombocytopenia patients. To explore the immunological abnormalities in patients with primary immune thrombocytopenia (ITP), and analyze its relationship with treatment. Proportion of different immune cell subsets were detected in the peripheral blood of 124 ITP patients at different time points and 45 normal controls by flow cytometry. The treatments included glucocorticoids, intravenous IgG as first-line treatment and second-line drugs. Elevated CD4/CD8 ratio and decreased the proportion of NK and CD4 + CD25 + CD127low regulatory T cells (Tregs) were found in pre-treated ITP patients than healthy controls. The newly diagnosed group had a significantly higher CD4/CD8 ratio than the relapsed group, but no differences in the proportion of B cells, NK cells and Tregs. No relationships were found between the curative effect and the pre-treated cell subsets within both the effective and ineffective groups. Furthermore, compared with the ineffective group, the effective group had higher Tregs and lower CD4/CD8 ratio post-treatment, but no significant differences in NK and B cells. ITP patients presented with a high CD4/CD8 ratio and low levels of Tregs and NK cells, suggesting that immune deregulation was involved in the pathogenesis of ITP. The pre-treated immune status of ITP patients may not be related to the curative effect. Tregs significantly increased in the effective group post-treatment, highlighting that the mechanism of restoring Tregs may be involved in the treatment of ITP. However, whether or not the targeted regulation of Tregs is an effective treatment for ITP still requires further studies.

Effects of exhaustive exercise on biochemical characteristics of sarcoplasmic reticulum from rat soleus muscle. This study examined the effects of acute high-intensity and moderate-intensity exercise on Ca2+-stimulated adenosine triphosphatase (ATPase) activity and the Ca2+ and ATP dependence of Ca2+-ATPase of the sarcoplasmic reticulum (SR) in the soleus muscle. The rats were run on 10% grade at 50 m min(-1) or 25 m min(-1) until fatigued (avg. time to exhaustion 2.8 and 87.7 min, respectively). The catalytic activities of SR Ca2+-ATPase were significantly depressed immediately after both types of exercise. Kinetic analyses demonstrated that the Ca2+ affinity of Ca2+-ATPase was elevated by both types of exercise adopted in the present investigation whereas the increase in the ATP affinity was brought about by only high-intensity exercise. These results suggest that exhaustive exercise may induce in slow-twitch muscle fibre the environmental changes, which adversely affect SR Ca2+-ATPase activity and can overcome the positive influence arising from the increase in the Ca2+ and/or ATP affinities of SR Ca2+-ATPase.

Actinobacillus actinomycetemcomitans in adult periodontitis. I. Topographic distribution before and after treatment. The aim of this investigation was to study the topographic distribution of Actinobacillus actinomycetemcomitans in patients with adult periodontitis before and after mechanical periodontal treatment (repeated oral hygiene instructions, systematic deep scaling, and root planing). In 10 A. actinomycetemcomitans-positive patients, subgingival microbial samples were obtained from the mesial and distal aspect of every tooth (38 to 56 sites per patient, 479 sites in total) before and one month after treatment. The samples were cultured on TSBV agar. A. actinomycetemcomitans was identified based on phenotypical and serological criteria. A. actinomycetemcomitans was present in 40% of the samples taken before and in 23% of the samples taken after treatment. Before treatment, the frequency of A. actinomycetemcomitans-positive samples per patient was wide spread and ranged from 7 to 90%. After treatment, two patterns of A. actinomycetemcomitans distribution could be recognized: the majority of the patients showed only a limited percentage of positive samples and yielded less than 10(5) A. actinomycetemcomitans. In three subjects, however, relatively high numbers of positive sites were still present, and many of these positive sites showed high A. actinomycetemcomitans counts. Logistic multiple regression showed the presence of A. actinomycetemcomitans before treatment depended strongly on the individual and was significantly associated with probing depth (P < 0.001) and bleeding upon sampling (P = 0.07). The highest chance of detecting A. actinomycetemcomitans existed in deep pockets which bled upon sampling. After treatment, there was a strong individual influence and an influence of probing depth (P < 0.001). The highest chance of detecting A. actinomycetemcomitans existed in residual pockets in the range of 5 mm.

Effects of fetal respiratory movements on the short-term fractal properties of heart rate variability. We evaluated the effect of fetal respiratory movements (RM) on the heart rate (HR) fractal dynamics.Abdominal ECG recordings were collected from low-middle-risk pregnant woman at rest. Mean gestational age was 34.8 ± 3.7 weeks. Ultrasound images were simultaneously acquired determining if RM were exhibited by fetuses. 13 pairs of HR series were compared. Each pair included 5 min of data from the same fetus either during the manifestation of RM or when there was no persistent indication of them. Detrended fluctuation analysis was applied to these series for obtaining the scaling exponent α1. HR series were also assessed using the conventional parameters RMSSD and HF power.The main findings of this contribution were the lack of significant changes in the scaling exponent α1 of fetal HR fluctuations as a result of RM. By contrast, HF power and RMSSD did show significant changes associated with the manifestation of fetal RM (p < 0.001 and p < 0.05, respectively). Yet the scaling exponent was the only parameter showing a significant relationship with the particular frequency of fetal RM (r s = 0.6, p < 0.03). Given the invariability of α1 regarding the manifestation of fetal RM, we consider that the HR short-term fractal properties are convenient for assessing the cardiovascular prenatal regulation.

Characterization of clinical strains of Aspergillus terreus complex: molecular identification and antifungal susceptibility to azoles and amphotericin B. We used molecular techniques to analyse 87 (n = 70 patients) Aspergillus terreus complex isolates, all of which were identified as A. terreus sensu stricto. The antifungal susceptibilities determined with CLSI M38-A2 (and Etest for amphotericin B) and expressed as mg/L for range of MIC/MIC(90) /geometric mean were as follows: itraconazole, 0.25-2/2/1.097; voriconazole, 0.125-2/2/1.176; posaconazole, 0.25-1/1/0.836; amphotericin B CLSI, 4-32/16/9.689; and Etest, 0.75-64/6/3.106. The MICs for amphotericin B were significantly higher than those found for the triazoles.

Magnetic resonance imaging of uterine version in a multiethnic, nulliparous, healthy female population. To determine measurement and topography of uterine position in asymptomatic women with different ethnicity. The angle and direction of uterine version were measured using magnetic resonance imaging in nulliparous, young volunteers from 5 ethnic groups (Emiratis, other Arabs, Indians/Pakistanis, Filipinos and Europeans/ Caucasians; N=55) and compared using Europeans/Caucasians as the reference group. The uterus was anteverted on the vagina in 46 (83.6%) and retroverted in 9 (16.4%) women, with no significant difference between Europeans/Caucasians and non-Caucasians. The angle of uterine version was significantly less (i.e., the cervix was more anteverted or retroverted on the vagina) in Europeans/Caucasians as compared to other women (p=0.002), particularly Indians/Pakistanis (p < 0.00001). The degree of uterine version is different in healthy, nulliparous European/Caucasian and non-Caucasian women.

Fractures in proximal spinal muscular atrophy. Fractures are a common problem for patients with spinal muscular atrophy (SMA). A total of 131 patients with proximal SMA with an average age of 13.2 +/- 9.2 years (0.7-65.6) were evaluated retrospectively. In 60 patients 94 different fractures were observed. The group consisted of 11 patients with type Ib, 81 with type II, 33 with type IIIa, 4 with IIIb and 2 with type IV. 38 of 81 SMA II patients and 17 of 33 SMA IIIa patients had suffered fractures at an average age of 8.3 +/- 5.3 years (0.0-25.1) (SMA II) and 9.3 +/- 6.0 years (0.0-22.1) (SMA IIIa). The most frequent fractures were of the femur (50), usually distal, of the lower leg and ankle (15), and upper arm (9). The distribution of fractures was different in SMA II and SMA IIIa. Most of the fractures could be treated conservatively. Only two femoral shaft fractures, one upper arm and a lower arm fracture were treated surgically by osteosynthesis. Competent fracture treatment is an important part of the orthopaedic care of SMA patients.

Sulfadoxine-pyrimethamine resistance in Plasmodium falciparum: a zoomed image at the molecular level within a geographic context. Antimalarial chemotherapy is one of the main pillars in the prevention and control of malaria. Following widespread resistance of Plasmodium falciparum to chloroquine, sulfadoxine-pyrimethamine came to the scene as an alternative to the cheap and well-tolerated chloroquine. However, widespread resistance to sulfadoxine-pyrimethamine has been documented. In vivo efficacy tests are the gold standard for assessing drug resistance and treatment failure. However, they have many disadvantages, such as influence of host immunity and drug pharmacokinetics. In vitro tests of antimalarial drug efficacy also have many technical difficulties. Molecular markers of resistance have emerged as epidemiologic tools to investigate antimalarial drug resistance even before becoming clinically evident. Mutations in P. falciparum dihydrofolate reductase and dihydrofolate synthase have been extensively studied as molecular markers for resistance to pyrimethamine and sulfadoxine, respectively. This review highlights the resistance of P. falciparum at the molecular level presenting both supporting and opposing studies on the utility of molecular markers.

The effects of turbulent jet flows on plant cell suspension cultures Cell suspensions of Morinda citrifolia were subjected to turbulent flow conditions in a submerged jet apparatus, to investigate their hydrodynamic shear susceptibility. The suspensions were exposed to repeated, pressure-driven passages through a submerged jet. Two nozzles, of 1 mm and 2 mm diameter, were employed. Average energy dissipation rates were in the range 10(3)-10(5) W/kg and cumulative energy dissipation in the range 10(5)-10(7) J/m3. System response to the imposed conditions was evaluated in terms of suspension viability (determined using a dye exclusion technique) and variations in both chain length distribution and maximum chain length. Viability loss was well-described by a first-order model, and a linear relationship was identified between the specific death rate constant and the average energy dissipation rate. This relationship was consistent with results obtained using the same suspension cultures in a turbulent capillary flow device. Morphological measurements indicated that exposure to the hydrodynamic environment generated in the jet resulted in a significant reduction in both the average and maximum chain lengths, and the reduction in the maximum chain length was identified as an appropriate measure of sustained damage. Analysis of both viability and chain length in terms of cumulative energy dissipated revealed good agreement with results reported by other authors for morphologically different plant cell systems. Copyright 1998 John Wiley & Sons, Inc.

Demonstration of scrotal disease on bone scintigraphy. The identification of scrotal disease on a bone scan is reportedly rare. Most previous reports involve abnormally increased accumulation of radioisotope in the scrotal region. This article includes a compilation of three cases of incidental scrotal photopenic defects on bone scintigraphy and a brief review of the literature.

Inhibition of S-adenosylhomocysteine hydrolase by acyclic sugar adenosine analogue D-eritadenine. Crystal structure of S-adenosylhomocysteine hydrolase complexed with D-eritadenine. D-eritadenine (DEA) is a potent inhibitor (IC(50) = 7 nm) of S-adenosyl-l-homocysteine hydrolase (AdoHcyase). Unlike cyclic sugar Ado analogue inhibitors, including mechanism-based inhibitors, DEA is an acyclic sugar Ado analogue, and the C2' and C3' have opposite chirality to those of the cyclic sugar Ado inhibitors. Crystal structures of DEA alone and in complex with AdoHcyase have been determined to elucidate the DEA binding scheme to AdoHcyase. The DEA-complexed structure has been analyzed by comparing it with two structures of AdoHcyase complexed with cyclic sugar Ado analogues. The DEA-complexed structure has a closed conformation, and the DEA is located near the bound NAD(+). However, a UV absorption measurement shows that DEA is not oxidized by the bound NAD(+), indicating that the open-closed conformational change of AdoHcyase is due to the substrate/inhibitor binding, not the oxidation state of the bound NAD. The adenine ring of DEA is recognized by four essential hydrogen bonds as observed in the cyclic sugar Ado complexes. The hydrogen bond network around the acyclic sugar moiety indicates that DEA is more tightly connected to the protein than the cyclic sugar Ado analogues. The C3'-H of DEA is pointed toward C4 of the bound NAD(+) (C3'...C4 = 3.7 A), suggesting some interaction between DEA and NAD(+). By placing DEA into the active site of the open structure, the major forces to stabilize the closed conformation of AdoHcyase are identified as the hydrogen bonds between the backbone of His-352 and the adenine ring, and the C3'-H...C4 interaction. DEA has been believed to be an inactivator of AdoHcyase, but this study indicates that DEA is a reversible inhibitor. On the basis of the complexed structure, selective inhibitors of AdoHcyase have been designed.

Why bluefin tuna have warm tummies: temperature effect on trypsin and chymotrypsin. Giant bluefin tuna warm their viscera during and after a meal. The cecum of a 500-kg bluefin weighs about 9 kg and contains about 20,000 pyloric ceca, each about 10 cm long and 1.5 mm diam. Trypsin was assayed with alpha-benzoyl-DL-arginine-p-nitroanilide HCl and chymotrypsin with glutaryl-L-phenylalanine-p-nitroaniline. The effects of pH on specific activity over the range 7.5-9.5 were negligible relative to temperature effects. Specific activity and maximal reaction velocity extrapolated from a Lineweaver-Burke plot (Vmax) increased with an increase in temperature in a similar fashion (Q10 ca. 2 over temperature range of physiological significance), whereas Km was constant over the same temperature range. The advantage of the warm cecum is that protein is digested in about one-third the time, so that these tuna can process about three times as much food per day.

Further characterization of the loop structure of platelet glycoprotein IIIa: partial mapping of functionally significant glycoprotein IIIa epitopes. Glycoprotein (GP) IIb-IIIa serves as the platelet fibrinogen receptor. Studies of the tertiary structure of GPIIIa have shown that the protein has a large loop structure of at least 325 amino acids in length. To further characterize this loop structure, intact platelets were digested with alpha-chymotrypsin. Digestion products were examined using the anti-GPIIIa monoclonal antibodies (MoAbs) AP3, D3GP3, and C5GP3, as well as the human alloantibody, anti-PLA1. AP3 recognized GPIIIa digestion products of 109, 95, and 68 Kd. D3GP3 and C5GP3 recognized an additional band of 51 Kd. Time course digestions demonstrated that the 51-Kd fragment was generated by proteolysis of the 68-Kd peptide. Sequence analysis of the reduced 51-Kd peptide showed that this fragment began at amino acid 422. The nonreduced 51-Kd peptide was reactive with antibodies directed against the first 13 amino acids of GPIIIa, demonstrating the presence of a covalently attached N-terminal peptide. These data suggest that: (1) the minimum length of the loop structure is at least 384 amino acids; (2) the AP3 epitope is formed at least in part by a determinant contained within residues 348 to 421; and (3) the D3GP3 and C5GP3 epitopes are contained within amino acids 422 to 692 of GPIIIa, a region that may be flexible and involved in conformational changes that occur after ligand binding.

Chromosome 22q11.2 deletion syndrome: prenatal diagnosis, array comparative genomic hybridization characterization using uncultured amniocytes and literature review. We present prenatal diagnosis of de novo 22q11.2 microdeletion syndrome using uncultured amniocytes in a pregnancy with conotruncal heart malformations in the fetus. We discuss the genotype-phenotype correlation and the consequence of haploinsufficiency of TBX1, COMT, UFD1L, GNB1L and MED15 in the deleted region. We review the literature of chromosomal loci and genes responsible for conotruncal heart malformations and tetralogy of Fallot.

Reductive dechlorination of BCl3 for efficient ammonia borane regeneration. This paper reports a complete ammonia borane (AB) regeneration process in which Bu3SnH was utilized as a reductant for the reductive dechlorination of BCl3, and Et2PhN was selected as a 'helper ligand' to generate Et2PhN·BH3, which gives rise to a high yield of AB by a base-exchange reaction at ambient temperature.

A phase II study of personalized peptide vaccination combined with gemcitabine for non-resectable pancreatic cancer patients. We evaluated the safety of, and clinical and immune responses to personalized peptide vaccination with gemcitabine (GEM) as the first line therapy in patients with non-resectable pancreatic cancer. Pre-vaccination peripheral blood mononuclear cells (PBMCs) and plasma were prepared to examine cellular and humoral responses to 14 and 16 peptides in human leukocyte antigen (HLA)-A24+ or -A2+ patients, respectively. Only the reactive peptides (maximum of 4) were administered weekly at 3 mg/peptide. GEM was administered at 1000 mg/m(2) per week for 3 weeks, followed by 1 week of rest. Twenty-one patients with untreated and non-resectable pancreatic cancer were enrolled. The combination therapy was generally well tolerated. Boosting of cellular and humoral responses to the vaccinated peptides was observed in the post-vaccination (eighth) PBMCs and plasma from 14 of 18 and 13 of 18 patients tested, respectively. The best clinical responses were 7 cases of partial response, 9 cases of stable disease, and 5 cases of progressive disease. Median survival time of all 21 patients was 9.0 months (95% CI, 6-15.5 months) with a one year survival rate of 38%. Immune boosting in both cellular and humoral responses was well correlated with overall survival with a hazard ratio of 0.2 (95% CI, 0.06-0.73; log-rank p=0.0239). These results suggest a potential clinical benefit of this combination therapy for non-resectable pancreatic cancer patients as the first line therapy. Further exploration of this approach is warranted.

Pure stress leakage symptomatology: is it safe to discount detrusor instability? To determine whether the combination of a urological history and urinary diary, with rigorous selection criteria, can be used to define a group of women on whom urodynamic assessment is unnecessary prior to offering surgery for urinary stress incontinence. Retrospective review of the urodynamic records of women attending for assessment between January 1992 and December 1996. Urodynamic Department, Southmead Hospital, Bristol. 5193 women who attended the urodynamic clinic during the five year study period. Self-completion of a urinary diary in the preceding week before urodynamic assessment and a detailed urological history before undergoing cystometry by all women in the study period. Data were entered onto a computer database. Women reporting stress incontinence in the absence of bladder filling symptoms, with a normal urinary diary showing daytime frequency of seven times or less and nocturia of no more than once, had the results of their filling cystometry analysed. Of 5193 women, 555 had symptoms of pure stress incontinence and a normal urinary diary. Incontinence was confirmed objectively in 81%, with 9% having incontinence secondary to detrusor instability; 5% had detrusor instability as the sole cause of their incontinence with 4% having a mixed picture of detrusor instability incontinence and urethral sphincter weakness. Genuine stress incontinence cannot be diagnosed reliably from a urological history, even when rigorous selection criteria are used in combination with a normal urinary diary. Without cystometry, incontinence secondary to detrusor instability will be missed.

Renal functional reserve in diabetic patients without clinical nephropathy: comparisons with renal morphology. The acute effect of a protein loading test (1.5 g kg-1) on glomerular filtration rate (GFR) was examined in 10 Type 1 diabetic patients without clinical nephropathy to evaluate the renal functional reserve. GFR was measured before (baseline) and after (test) ingestion of the protein load. Two groups of diabetic patients were distinguished: those who exhibited normal renal reserve equal to that in healthy individuals (change in GFR 35 +/- 17 (+/- SD)%) and those who had no renal reserve (change in GFR -20 +/- 20%). These groups did not differ in the duration and control of diabetes nor in the level of urinary albumin excretion. However baseline GFR was 120 +/- 34 and 209 +/- 46 ml min-1 in diabetic patients with and without renal reserve, respectively. Renal morphology revealed hilar glomerular lesions composed of severely expanded mesangium only in diabetic patients without renal reserve. Minimal structural nephropathy was observed in those who exhibited normal renal reserve. We suggest that the impaired response of GFR to protein loading precedes other subclinical manifestations of renal lesions in diabetic patients.

Topical hydrogen peroxide and the safety of ocular tissues. Hydrogen peroxide is an effective and commonly used contact lens disinfectant that is also used as a preservative in certain ocular medications. We describe the effects of hydrogen peroxide on the cornea and anterior chamber following its topical application via a contact lens or as drops. The conditions for interaction of hydrogen peroxide with corneal and palpebral tissues and its accumulation within the aqueous humor are detailed. Values are given for thresholds at which hydrogen peroxide in specified concentrations, volumes, locations, and durations of exposure can cause ocular pain, swelling of the corneal stroma, damage to the endothelium, and penetration of the compound to the anterior chamber. The cornea and the palpebral tissues, together with the tear film, form a highly effective barrier and detoxifying system that, except under extreme, accidental circumstances, prevents both extra- and intraocular damage from use of hydrogen peroxide in contact lens care or in medications.

Too late smart: farmers' adoption of self-protective behaviors in response to exposure to hazardous noise. Farmers are exposed to hazardous noise from equipment and livestock and experience high rates of noise-induced hearing loss (NIHL); however, their use of hearing protection devices (HPDs) is low. The purpose of this study was to describe farmers' personal experiences using HPDs, influencing others' use of HPDs, and overcoming barriers to the use of HPDs. A purposive sample of farmers who reported a high frequency of HPD use was selected for face-to-face interviews. Findings indicated that farmers have frequent exposure to hazardous noise. They described their motivation to adopt protective behaviors to avoid hearing loss, noise annoyance, or tinnitus. Many tried to influence others' use of HPD, particularly family members. These farmers have developed a variety of methods to ensure convenient access to HPDs when needed, and have developed effective techniques for overcoming common barriers to protection. Findings from this study will be used to form the foundation for future studies aimed at developing and testing an intervention to increase HPD use and decrease rates of NIHL among farmers.

Generation of high-density DNA markers from yeast artificial chromosome DNA by single unique primer-polymerase chain reaction. We have developed a method for the whole sequence amplification of yeast artificial chromosome (YAC) DNA excised from preparative pulsed-field gel electrophoresis using single unique primer-polymerase chain reaction procedures. We used seven contiguous YAC clones, which span 2 Mbp of the Huntington disease gene region on 4p16.3, to amplify the YAC DNAs. The average size of the amplified DNA was approximately 300 bp long, and 12 DNA markers located on the YAC clones positively hybridized with these amplified products, implying that the sequences of the YAC clones were comprehensively amplified by our procedures. These amplified YAC DNAs greatly facilitate the characterization of YAC clones, leading to the detailed analysis of the defined chromosomal region.

Familial Mediterranean fever-associated diseases in children. MEditerranean FeVer (MEFV) gene encodes for the pyrin protein and a mutated pyrin is associated with a prolonged or augmented inflammation. Hence, various diseases were reported to be associated with familial Mediterranean fever (FMF) or carriers of MEFV mutations. However, systematic evaluation of all associated diseases in children with FMF has not been done previously. The aim of this study was to investigate the frequency and type of FMF-associated diseases in children. Files of FMF patients who had been seen in two reference hospitals in Ankara, in the last two years, were retrospectively evaluated. Patients with FMF and concomitant diseases were included to the study. Among 600 FMF patients, 77 were found to have a concomitant disease (12.8%). Thirty patients (5%) had vasculitis; 21 (3.5%) had juvenile idiopathic artritis (JIA); 7 (1.16%) had inflammatory bowel disease (IBD) and 19 had other diseases including 5 patients with isolated sacroiliitis. Overall, 13 (2.17%) patients had sacroiliitis in our cohort. The most frequent mutation was M694V/M694V (44%) and 81% of the patients had at least one M694V mutation. Majority of the patients (74%) developed associated diseases while they were not receiving colchicine therapy. Certain inflammatory diseases including vasculitis, chronic arthritis and IBD were more frequently detected in patients with FMF during childhood. M694V mutation is a susceptibility factor for associated diseases. In countries where FMF is prevalent, clinicians dealing with FMF and other inflammatory diseases should be aware of these associations.

Lectin-affinity chromatography for downstream processing of MDCK cell culture derived human influenza A viruses. The presented study aims on the development of a capture step for the purification of cell culture derived influenza viruses using lectin affinity chromatography. Human influenza A/Puerto Rico/8/34 virus produced in Madin Darby canine kidney cells have been chosen as a model. The influenza A virus envelop possesses two viral glycoproteins: hemagglutinin and neuraminidase. Oligosaccharides of theses glycoproteins can be targeted as affinity ligands using specific lectins. First, lectins have been screened via lectin blots and spin columns. Adequate lectins have been chosen based on published glycan structures of hemagglutinin. The most specific binding was achieved via the galactose specific Erythrina cristagalli and Euonymus europaeus lectins. Second, the chromatographic separations characteristics of these lectins have been further determined via FPLC. These experiments revealed that the rate of hemagglutinin glycan binding to the ligands was higher with the E. europaeus compared to the E. cristagalli lectin. Third, viral recoveries in addition to the total protein and host cell DNA have been balanced in a series of E. europaeus lectin chromatography runs. The total protein and dsDNA content in the product fraction of the affinity chromatography was reduced from the starting conditions to 21% and 0.1%, respectively. The average viral recovery in the product fraction was 97%. SDS-PAGE analysis indicated that the majority of the eluted proteins were of viral origin. The reproducibility and column stability was confirmed in up to 25 runs applying six different virus product batches.

Methods for the study of the metabolism of radiolabeled monoclonal antibodies by liver and tumor. Methods for elucidating the mechanisms by which radiolabeled antibodies are taken up and accumulated in tumor and liver are reviewed. These include the use of isolated perfused rat livers, RES blockade using dextran sulfate, single and double labeled antibodies, micropore chambers for the accumulation of the interstitial fluid, and in vitro tissue culture studies of antibody metabolism. Each method has its utility, examples of which will be discussed along with the methods' limitations. All of the methods have value in furthering our understanding of the metabolism of monoclonal antibodies both in vivo and in vitro. Use of these procedures to create a greater understanding of radiolabeled antibody metabolism, hopefully, will result in improved clinically useful agents for diagnosis and therapy.

Preliminary study on the microbiology of Campylobacter pyloridis and gastric histopathology. Biopsy samples were taken endoscopically from the antral-mucosa of 693 patients with peptic ulcer and chronic gastritis presenting dyspepsia symptoms. Campylobacter pyloridis cultures were positive in 59 of 98 (60.2%) cases and histopathologically the organisms were found in 411 of 693 cases (59.3%). Pathologically, Campylobacter pyloridis was positive in 273 out of 300 patients with chronic superficial gastritis (91.0%), in 102 of 249 patients with chronic atrophic gastritis (40.9%), in 36 out of 144 patients with chronic atrophic gastritis with intestinalization or dysplasia (25.0%). We found that there was a significant association between the presence of Campylobacter pyloridis and chronic superficial gastritis, also the degree of lymphocyte infiltration showed a strong inverse association with the presence of Campylobacter pyloridis, suggesting that a local immune response might exert an important action in the eradication of this organism. These findings support the view that Campylobacter pyloridis, may be etiologically related to chronic gastritis and peptic ulceration, even though its role still remains to be determined.

Hypoxic vasoconstriction in rat pulmonary and mesenteric arteries. Hypoxic vasoconstriction was investigated in isolated pulmonary and mesenteric arteries of the rat. Experiments were performed on large (approximately 2 mm pulmonary, approximately 0.8 mm mesenteric) and small (100-350 microns) arteries. Hypoxia [oxygen partial pressure (PO2) approximately 33 mmHg] elicited a biphasic response in arteries precontracted with prostaglandin F2 alpha (10 microM). A transient contraction reaching a peak within 2-3 min was observed in both large and small pulmonary and mesenteric arteries (phase 1). In pulmonary arteries, this was followed by a slowly developing contraction over 45 min (phase 2). In mesenteric arteries, there was no phase 2 but instead a profound relaxation. Mechanical disruption of the endothelium had no significant effect on phase 1 in preconstricted large pulmonary arteries but reduced phase 1 in small arteries by 40%. Phase 2 was abolished in both large and small arteries. Inhibition of endothelium-derived relaxing factor synthesis or cyclooxygenase pathways had no effect on either phase. Verapamil substantially reduced phase 1 but abolished phase 2. In conclusion, we have found a clear biphasic response to hypoxia in pulmonary arteries of the rat, but, in contrast to some previous reports, phase 1 was only partially dependent on the endothelium, whereas phase 2 was entirely dependent on the endothelium. Small and large arteries had qualitatively similar responses. These results are consistent with the involvement of at least two mechanisms for hypoxic vasoconstriction, one of which may involve release of an as yet unidentified endothelium-derived constrictor factor.

Gastrointestinal endometriosis. Incidence and indications for resection. Of 1573 consecutive patients with endometriosis diagnosed at laparoscopy or celiotomy, 85 patients (5.4%) had gastrointestinal involvement and 11 patients (0.7%) required bowel resection due to recurrent gastrointestinal symptoms (usually obstructive in nature) and/or suspicion of malignancy. Of 63 patients with gastrointestinal involvement at sites other than the appendix, who did not undergo bowel resection, only two patients had gastrointestinal symptoms at the time of diagnosis (neither patient had obstructive symptoms); follow-up has revealed that only one patient subsequently developed significant gastrointestinal symptoms. Fifteen patients had appendiceal endometriosis, but none had symptoms suggestive of appendicitis. Indications for resection of gastrointestinal endometriosis include the presence of clear-cut obstructive symptoms or the inability to exclude malignancy. The absence of gastrointestinal symptoms appears to be predictive of the absence of clinically significant intestinal endometriosis, and bowel resection is not indicated in the asymptomatic patient. Appendiceal endometriosis appears to be an incidental finding and one that is not clinically important.

Synthesis and preliminary biological evaluation of potent and selective 2-(3-alkoxy-1-azetidinyl) quinolines as novel PDE10A inhibitors with improved solubility. We report the discovery of a novel series of 2-(3-alkoxy-1-azetidinyl) quinolines as potent and selective PDE10A inhibitors. Structure-activity studies improved the solubility (pH 7.4) and maintained high PDE10A activity compared to initial lead compound 3, with select compounds demonstrating good oral bioavailability. X-ray crystallographic studies revealed two distinct binding modes to the catalytic site of the PDE10A enzyme. An ex vivo receptor occupancy assay in rats demonstrated that this series of compounds covered the target within the striatum.

Mutual benefits. Hospital-business wellness partnerships yield. Hospitals and employers see a strong business case for developing wellness partnerships.