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Preference and requests for smoke-free dining. This study looked at whether people prefer to sit in smoking or smoke-free areas when they go to cafés and restaurants. It also considered whether those who said they would prefer smoke-free dining made this known when booking or going to a restaurant. The sample was 2387 Victorians, randomly selected and interviewed in their own homes. Overall, 68 per cent of respondents said they would prefer a nonsmoking area, and only 11 per cent preferred a smoking area. Even among smokers, less than half (42 per cent) wanted to sit in a smoking area. Of those people who wanted smoke-free dining, only 45 per cent said they always made this known. The results demonstrate strong community desire for smoke-free dining, but also point to the need for restaurant managers or the dining public to take the initiative, or for legislative action to ensure the provision of smoke-free areas.

Why space is not one-dimensional: Location may be categorical and imagistic. In our commentary, we raise concerns with the idea that location should be considered a gestural component of sign languages. We argue that psycholinguistic studies provide evidence for location as a "categorical" element of signs. More generally, we propose that the use of space in sign languages comes in many flavours and may be both categorical and imagistic. In their target article, Goldin-Meadow & Brentari (G-M&B) discuss several observations suggesting that the use of space is imagistic and may not form part of the categorical properties of sign languages. Specifically, they point out that (1) the number of locations toward which agreeing verbs can be directed is not part of a discrete set, (2) event descriptions by users of different sign languages and hearing nonsigners exhibit marked similarities in the use of space, and (3) location as a phonological parameter is not categorically perceived by native signers. It should be noted that G-M&B acknowledge that categorical properties of location and movement may simply not have been captured yet because the proper investigative tools are not yet readily available.

Carbon-carbon bond cleavage and rearrangement of benzene by a trinuclear titanium hydride. The cleavage of carbon-carbon (C-C) bonds by transition metals is of great interest, especially as this transformation can be used to produce fuels and other industrially important chemicals from natural resources such as petroleum and biomass. Carbon-carbon bonds are quite stable and are consequently unreactive under many reaction conditions. In the industrial naphtha hydrocracking process, the aromatic carbon skeleton of benzene can be transformed to methylcyclopentane and acyclic saturated hydrocarbons through C-C bond cleavage and rearrangement on the surfaces of solid catalysts. However, these chemical transformations usually require high temperatures and are fairly non-selective. Microorganisms can degrade aromatic compounds under ambient conditions, but the mechanistic details are not known and are difficult to mimic. Several transition metal complexes have been reported to cleave C-C bonds in a selective fashion in special circumstances, such as relief of ring strain, formation of an aromatic system, chelation-assisted cyclometallation and β-carbon elimination. However, the cleavage of benzene by a transition metal complex has not been reported. Here we report the C-C bond cleavage and rearrangement of benzene by a trinuclear titanium polyhydride complex. The benzene ring is transformed sequentially to a methylcyclopentenyl and a 2-methylpentenyl species through the cleavage of the aromatic carbon skeleton at the multi-titanium sites. Our results suggest that multinuclear titanium hydrides could serve as a unique platform for the activation of aromatic molecules, and may facilitate the design of new catalysts for the transformation of inactive aromatics.

Effectiveness of Goal-Setting Telephone Follow-Up on Health Behaviors of Patients with Ischemic Stroke: A Randomized Controlled Trial. Adopting healthy behaviors is critical for secondary stroke prevention, but many patients fail to follow national guidelines regarding diet, exercise, and abstinence from risk factors. Compliance often decreases with time after hospital discharge, yet few studies have examined programs promoting long-term adherence to health behaviors. Goal setting and telephone follow-up have been proven to be effective in other areas of medicine, so this study evaluated the effectiveness of a guideline-based, goal-setting telephone follow-up program for patients with ischemic stroke. This was a multicenter, assessor-blinded, parallel-group, randomized controlled trial. Ninety-one stroke patients were randomized to either a control group or an intervention group. Intervention consisted of predischarge education and 3 goal-setting follow-up sessions conducted by phone. Data were collected at baseline and during the third and sixth months after hospital discharge. Six months after discharge, patients in the intervention group exhibited significantly higher medication adherence than patients in the control group. There were no statistically significant differences in physical activity, nutrition, low-salt diet adherence, blood pressure monitoring, smoking abstinence, unhealthy use of alcohol, and modified Rankin Scale (mRS) scores between the 2 groups. Goal-setting telephone follow-up intervention for ischemic stroke patients is feasible and leads to improved medication adherence. However, the lack of group differences in other health behavior subcategories and in themRS score indicates a need for more effective intervention strategies to help patients reach guideline-recommended targets.

Immunosuppression of EAMG by IVIG is mediated by a disease-specific anti-immunoglobulin fraction. Intravenous immunoglobulin (IVIG) administration has been beneficially used for the treatment of a variety of autoimmune diseases including myasthenia gravis (MG). We have demonstrated that IVIG administration in experimental autoimmune MG (EAMG) results in suppression of disease that is accompanied by decreased Th1 cell and B cell proliferation. Chromatography of pooled human immunoglobulins (IVIG) on immobilized IgG, isolated from rats with EAMG or from MG patients, results in a depletion of the suppressive activity of the IVIG. Moreover, reconstitution of the activity-depleted IVIG with the eluted minute IVIG fractions that had been adsorbed onto the EAMG- or MG-specific columns recovers the depleted immunosuppressive activity. This study supports the notion that the therapeutic effect of IVIG is mediated by an antigen-specific anti-immunoglobulin (anti-idiotypic) activity that is essential for its suppressive activity.

[Vitamin P in the nutrition of athletes]. Capillary resistance was examined in 1203 athletes, students of the Institute of Physical Culture. The examinees showed seasonal variations in capillary strength and in excretion of ascorbic acid with the urine. It is recommended that the diet of athletes be supplemented with vitamins C and P during winter season. Both vitamins were demonstrated to interfere with the effect of sports exercise affecting capillary walls. The vitamins can be used for raising the efficacy of ski training and improving the results during competition. It is also advisable that the diet be supplemented with vitamin P daily dose of 50-60 mg given with rutin, which is best combined with 100 mg of ascorbic acid.

Diagnosis and documentation of central nervous system dysfunctions with craniocorpography after surgical removal of acoustic neurinomas. Among other tests, craniocorpography (CCG) was performed in 21 patients after acoustic neurinoma surgery. After surgery, 17 patients (81%) had a developing vestibular compensation or an already normal CCG pattern; 3 patients (14%) had signs of persisting central nervous system dysfunction, either localized to the brain stem or in combination with a cerebellar dysfunction, and 1 patient showed a delayed but sufficient compensation after removal of a neurinoma that compressed central nervous system structures. Brain stem and cerebellar dysfunctions caused by tumor compression demonstrated a better vestibular compensation than dysfunctions caused by surgical manipulation, despite no evidence of cerebellar alteration. As an adjunct to complete neuro-otologic and neurologic examinations CCG could become a useful tool in the topodiagnosis of central nervous system dysfunctions after acoustic neurinoma surgery and therefore in the documentation and follow-up process of these patients.

Reversal of cancer cachexia in rats by cimaterol and supplemental nutrition. The anabolic beta 2-agonist cimaterol was used in conjunction with supplemental nutrition to reverse cancer-induced cachexia and malnutrition in tumor-bearing rats. Cimaterol was administered to tumor-bearing rats receiving total parenteral nutrition or enteral nutrition for 10 days, beginning 2 weeks after subcutaneous transplantation of methylcholanthrene sarcoma. A significant increase occurred in both muscle weight and muscle protein in animals receiving cimaterol in conjunction with either enteral or parenteral feeding, compared to food fed tumor-bearing animals. Muscle protein content was increased significantly by 16% in cimaterol-treated rats maintained on parenteral nutrition and by 11% in cimaterol-treated enterally fed rats compared with the respective tumor-bearing controls. Urinary concentrations of 3-methylhistidine, an estimation of muscle turnover or catabolism, were significantly reduced in both tumor-bearing groups treated with cimaterol compared to 3-methylhistidine levels of the untreated tumor-bearing groups. The anabolic effects of cimaterol were expressed in the presence of a large tumor burden resulting in reversal of muscle depletion and muscle breakdown regardless of the route of supplemental nutrition. Thus, beta 2-agonists may be considered as a possible therapy for cancer cachexia.

Burkholderia pseudomallei strain type, based on pulsed-field gel electrophoresis, does not determine disease presentation in melioidosis. Melioidosis, the infection due to Burkholderia pseudomallei, may present with a spectrum of severity and may affect any site in the body. Differential strain virulence and tropism suggested by previous studies would have implications for virulence and vaccine work. We explored clinical correlations using pulsed-field gel electrophoresis (PFGE) typing in a well-characterised clinical collection. Two methods of analysis were used based on band-based similarity values: first, a conventional cluster analysis formed by the unweighted paired group mean analysis, and second, an analysis of the distribution of the "within-group" and "between-group" Dice coefficient. Clinical isolates from 114 cases of melioidosis occurring in the Northern Territory, Australia were studied; 71 strain types were defined with a Simpson's index of 0.91. No correlation was found between strain type and disease severity or site of melioidosis on presentation, with no differences in similarity values found when comparing within and between-groups. In particular, isolates from patients with neurological melioidosis were not clustered. There was evidence of geographical localisation. This study suggests that the variation in strain type may not be as important as host and environmental factors in determining the pattern of disease.

Sphincterotomy: long-term complications and warning signs. Transurethral sphincterotomy is a commonly performed operation in spinal cord injury patients. Sixty-three patients who have had transurethral sphincterotomy were evaluated at our spinal cord injury unit for the risk and possible predictors of long-term outcome associated with this procedure. In addition to history and physical examination, all patients had urine culture, blood urea and creatinine, intravenous pyelogram and/or KUB with renal ultrasound, 4 channel videourodynamics, voiding cystourethrogram, and cystocopy when indicated. Their mean age was 53 years, and their level of injury was cervical 32, thoracic 25, and lumbar 6. The mean time since injury was 27 years (3-50), and the mean follow-up since their last sphincterotomy was 11 years (2-30). The mean number of sphincterotomies was 1.74 (1-4). Urine culture revealed bacteruria (asymptomatic) in 48 and sterile urine in 15 patients. Renal function was normal in 61 patients and abnormal in 2 patients. Videourodynamics revealed detrusor hyperreflexia in 60, detrusor areflexia in 3, abnormal detrusor compliance in 9, and detrusor sphincter dyssynergia in 34 patients. The mean Leak point pressure was 36.4 cm H2O (5-100), and the mean maximum detrusor pressure was 54.7 cm H2O (12-100). Nineteen (30%) patients had significant upper tract complications including; renal calculi, atrophic kidney, vesicoureteral reflux, and renal scarring with impaired renal function. Fifty percent of upper tract complications developed more than 2 years after sphincterotomy. Thirty patients had lower tract complications including; recurrent symptomatic urinary tract infection, bladder stones, urethral diverticulum, urethral stricture, bladder neck stenosis, and recurrent epididymitis.(ABSTRACT TRUNCATED AT 250 WORDS)

[A study on producing areas of Chinese flos Dendranthematis]. To probe into the cultural environment and changes of producing areas of different species of Chinese Flos Dendranthematis. On-the-spot investigation and literature study. A clearer idea has been gained on the geographical distribution, growing environment and changes of producing areas of Gongju, Hangju, Chuju, Boju, Huaiju and Jiju. Different environments fit for the growth of different species of Flos Dendranthematis. The present study provides some valuable information on the cultivation and development of Chinese Flos Dendranthematis.

Evaluation of single and joint effect of metabolites isolated from marine sponges, Fasciospongia cavernosa and Axinella donnani on antimicrobial properties. The biochemical mechanisms that marine sponges have developed as a chemical defense to protect themselves against micro and subsequent macrobiofouling process might comprise a potential alternative for the preventing attack of biofilm forming bacteria. The present study investigated the antimicrobial activity of a series of major secondary metabolites isolated from the sponges Fasciospongia cavernosa and Axinella donnani against fouling bacteria. Secomanoalide (1), dehydromanoalide (2) and cavernosine (3) have been isolated from F. cavernosa. Their structures were determined by MS, (1)H NMR spectra analyses and by comparison with those reported in the literature. The most promising activity was exhibited by the metabolites from A. donnani, that is, cerebroside (5) against three strains Aeromonas hydrophila subsp. salmonicida A449 and Erythrobacter litoralis. Our investigation revealed that combined metabolites 1, 2 and 3 retained strong activity but individual metabolite had moderate activity indicating that activity probably results from synergistic interactions between multiple compounds. The antibacterial screening of compounds 3, 5 and synergistic effect of 1-3 against fouling bacteria has been studied for the first time. Further, isolation of manoalide related compounds and their synergistic screening can be accelerated for the development of new biofilm inhibitors.

Oral manifestations associated with HIV infection: evaluation, assessment, and significance. During the course of HIV disease, oral lesions frequently are the initial manifestation of underlying immune deterioration. Typically, these lesions are readily accessible and lend themselves to being examined. Therefore, it is important to perform oral examinations routinely both in dental and medical settings. The recognition and treatment of these early signs of immune suppression may have a significant impact on the survival and the quality of life of HIV-infected patients. This article briefly discusses the HIV epidemic and common intraoral manifestations associated with HIV disease progression.

Transforming growth factor beta1-induced heat shock protein 27 activation promotes migration of mouse dental papilla-derived MDPC-23 cells. Transforming growth factor beta1 (TGFbeta1) regulates cellular functions including cell growth, differentiation, angiogenesis, migration, and metastasis. The TGFbeta1 signal transduction pathways are mostly undefined in mouse dental papilla-derived MDPC-23 cells. In this study, we investigated TGFbeta1-induced migration focusing on heat shock protein 27 (Hsp27) activation. Cellular responses mediated by TGFbeta1 in MDPC-23 cells were measured by Western blot and MTT assays. Cell migration was determined by counting migrated cells using the chemotaxis cell migration assay. TGFbeta1 induced cell migration and increased the phosphorylation of Hsp27 and p38 MAPK in MDPC-23 cells. However, TGFbeta1 did not affect Akt/NF-kappaB signaling to regulate the migration of MDPC-23 cells. Inhibiting p38 MAPK with SB203580 blocked TGFbeta1-induced Hsp27 activation and cell migration. Hsp27 phosphorylation followed by p38 MAPK activation was required for TGFbeta1-induced migration, and Hsp27 itself contributed to MDPC-23 cell migration.

Evaluation of optimal duration of chemotherapy in favorable-prognosis disseminated germ cell tumors: a Southeastern Cancer Study Group protocol. Four courses of PVP16B (cisplatin plus etoposide [VP-16] plus bleomycin) has been standard chemotherapy for disseminated germ cell tumors at Indiana University and the Southeastern Cancer Study Group (SECSG) since 1984. We began a random prospective phase III study in patients with favorable-prognosis (minimal and moderate extent) disseminated germ cell tumors comparing four courses of PVP16B over 12 weeks to the identical dose PVP16B administered in three courses over 9 weeks. The categories of minimal and moderate disease constitute approximately two thirds of all disseminated germ cell tumors that require chemotherapy. One hundred eighty-four patients entered this trial, and all patients have a minimal follow-up of 1 year. Overall, 106 of 107 (99%) minimal extent and 73 of 77 moderate patients (95%) achieved an initial disease-free status (NED), confirming the favorable prognostic categories. Eighty-six of 88 patients (98%) randomized to three courses and 93 of 96 randomized to four courses (97%) of PVP16B achieved disease-free status. There have been ten relapses (5%), with five on each arm. Currently, 81 of 88 (92%) and 88 of 96 (92%) patients randomized to three v four courses of PVP16B are continuously disease-free. This study confirms the high cure rate with PVP16B in favorable-prognosis germ cell tumors. The deletion of the fourth course of PVP16B significantly reduces the toxicity, cost, and inconvenience of this curative regimen. We conclude that three courses of PVP16B is the preferred regimen for favorable-prognosis germ cell tumors.

A synthetic decursin analog with increased in vivo stability suppresses androgen receptor signaling in vitro and in vivo. Targeting androgen receptor (AR) signaling with agents distinct from current antagonist drugs remains a rational approach to the prevention and treatment of prostate cancer (PCa). Our previous studies have shown that decursin and isomer decursinol angelate (DA), isolated from the Korean medicinal herb Angelica gigas Nakai, interrupt AR signaling and possess anti-PCa activities in vitro. In the LNCaP PCa cell model, these pyranoccoumarin compounds exhibit properties distinct from currently used antagonists (e.g., Casodex). However, both are rapidly de-esterified to decursinol, a partial AR agonist. We report here that a synthetic decursin analog, decursinol phenylthiocarbamate (DPTC), has greater in vivo stability than the parent compounds. DPTC-decursinol conversion was undetectable in mice. Furthermore, in LNCaP cells, DPTC decreased prostate specific antigen (PSA) expression, down-regulated AR abundance and mRNA and inhibited AR nuclear translocation. The effect of DPTC on AR and PSA mRNA and protein abundance was also observed in VCaP cells expressing wild type AR. DPTC inhibited growth of both PCa cell lines through G(1) cell cycle arrest and apoptosis, as did decursin and DA. Furthermore, i.p. administration of DPTC for 3 weeks suppressed the expression of AR target genes probasin and Nkx3.1 in mouse prostate glands. Overall, our data suggest that DPTC represents a prototype lead compound for development of in vivo stable and active novel decursin analogs for the prevention or therapy of PCa.

Effects of ocean-acidification-induced morphological changes on larval swimming and feeding. Reduction in global ocean pH due to the uptake of increased atmospheric CO(2) is expected to negatively affect calcifying organisms, including the planktonic larval stages of many marine invertebrates. Planktonic larvae play crucial roles in the benthic-pelagic life cycle of marine organisms by connecting and sustaining existing populations and colonizing new habitats. Calcified larvae are typically denser than seawater and rely on swimming to navigate vertically structured water columns. Larval sand dollars Dendraster excentricus have calcified skeletal rods supporting their bodies, and propel themselves with ciliated bands looped around projections called arms. Ciliated bands are also used in food capture, and filtration rate is correlated with band length. As a result, swimming and feeding performance are highly sensitive to morphological changes. When reared at an elevated P(CO2) level (1000 ppm), larval sand dollars developed significantly narrower bodies at four and six-arm stages. Morphological changes also varied between four observed maternal lineages, suggesting within-population variation in sensitivity to changes in P(CO2) level. Despite these morphological changes, P(CO2) concentration alone had no significant effect on swimming speeds. However, acidified larvae had significantly smaller larval stomachs and bodies, suggesting reduced feeding performance. Adjustments to larval morphologies in response to ocean acidification may prioritize swimming over feeding, implying that negative consequences of ocean acidification are carried over to later developmental stages.

[An investigational study of acne treatment in France]. Acne is one of the main reasons for dermatological consultation. Management may seem standardized, in particular for mild to moderate juvenile facial acne, where topical treatments are used for mild cases and topical treatments associated with systemic antibiotics are used for moderate cases. The aim of this investigational study was to evaluate current treatment approaches for mild to moderate acne patients by French dermatologists in private practice. During this study, more than 252 dermatologists practising in over 144 French cities were asked about their preferred treatments (other than isotretinoin) for young acne patients. A questionnaire containing information about patient characteristics, disease severity and the prescribed therapy was completed by dermatologists at baseline and 2 months later. In total, 3145 acne patients were analyzed. This study showed that in 53% of cases, dermatologists prescribed several topical treatments (up to three) associated with one or several systemic therapies (up to three), in addition to a cosmetic product. In 51% of cases, dermatologists prescribed only application of a dermatological cosmetic product for patients with very mild acne; in 41% of cases, a single treatment, especially a topical treatment, was prescribed for patients with mild acne, and in 59 and 64% of cases, two treatments (a combination of local and systemic therapy) were prescribed respectively for patients with moderate and severe acne. This study demonstrated the complexity of management of acne patients by dermatologists, particularly in the case of mild to severe acne. Most notably, such therapeutic complexity raises the question of compliance, a key factor in successful treatment.

Enhancement of various non-specific immune effector functions in mice by local injection of aclacinomycin A adsorbed onto activated carbon particles (ACR-CH). Local injections of aclacinomycin A adsorbed onto activated carbon particles (ACR-CH) augmented the cytotoxic activities of regional lymph node cells for 7 days. In contrast NK-activity was only slightly augmented by injections of aclacinomycin A (ACR) solution or activated carbon suspension. The effects were found in lymphocytes from all regions tested. NK-activity could only be detected when both adherent and non-adherent cells were present. The cell number of L3T4+ cells in each type of lymph node tested increased, and subset analysis of the lymphocyte subpopulations revealed an increase in the ratio of L3T4+/Lyt2+ cells, suggesting that the ACR-CH selectively increased and stimulated L3T4+ cells. Enhanced capacity of lymph node cells to produce cytokines, tumor necrosis factor (TNF) and interleukin-1 (IL-1) upon restimulation (with LPS) in vitro in the ACR-CH treated group was found. From these results, it appears that the new dosage form of aclacinomycin A, ACR-CH, with superior therapeutic efficacy against lymph node metastases, can also enhance the immune response of regional lymph node cells. The findings reported here will be valuable in the establishment of novel chemoimmunotherapeutic protocols using ACR-CH.

Egg envelopes in diplopods, a comparative ultrastructural study. By means of electron microscopy two types of egg envelope have been described in representatives of two diplopod subclasses, the Chilognatha and the Pselaphognatha. The vitelline envelope appears on the oocyte surface in early previtellogenesis and persists till ovulation. In its thin and filamentous structure it resembles basement membranes. During vitellogenesis electron dense material is deposited on filamentous scaffolding which fills the space between the oolemma and the vitelline envelope. As a result, the thick and spongy or filamentous chorion is formed. In the present study it has been shown that regardless of the type of oogenesis (solitary-the Chilognatha, or follicular-the Pselaphognatha) both envelopes in diplopods are produced by the oocyte itself, and although completely different in structure and time of appearance, they must be both considered as primary.

Rapid desensitization of central beta-adrenoceptors in rat after subacute treatment with imipramine and calcium entry blockers. The subcutaneous (s.c.) administration of isoprenaline to rats produced a dose-dependent increase in water drinking which was effectively antagonized by propranolol. This dipsogenic response was significantly inhibited after the intraperitoneal (i.p.) administration of imipramine (15 mg/kg/day), together with either of the following calcium entry blockers, for four days: diltiazem (15 mg/kg/day), verapamil (10 mg/kg/day), nifedipine (10 mg/kg/day) or nicardipine (15 mg/kg/day). Simultaneous injection of the inhibitor of the synthesis of serotonin, p-chlorophenylalanine (200 mg/kg/day, i.p.), did not affect this attenuation of the isoprenaline-induced response. Similarly, the selective 5-HT2 receptor agonist, 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane (DOM) or the 5-HT2 receptor antagonist, ketanserin, had no significant effect on the attenuation of isoprenaline-induced drinking behaviour. The inhibition of isoprenaline-induced drinking, was, however, effectively attenuated after treatment of the animals with 6-hydroxydopamine (2.5 micrograms) or clonidine (30 micrograms), injected intracerebroventricularly (i.c.v.). These results indicate that the calcium entry blockers accelerate the desensitization of central beta-adrenoceptors possibly by an action on central adrenoceptors of the rat.

Effect of ovariectomy on plasma LH, FSH, estradiol, and progesterone and medial basal hypothalamic LHRH concentrations old and young rats. Resting plasma concentrations of LH, FSH, estradiol, and progesterone and medial basal hypothalamic concentrations of LHRH (MBH-LHRH) were measured by RIA in 8- to 12-month-old female rats which had begun to exhibit constant estrous (CE) or prolonged diestrous (PD) vaginal smear patterns and compared to young cycling rats on proestrus, estrus, or diestrus. In addition, we examined the effect of ovariectomy on these hormonal profiles. Old CE rats have normal plasma LH, FSH and progesterone concentrations, but exhibit elevated estradiol levels and decreased MBH-LHRH concentrations compared to young cycling rats on the day of estrus. Ovariectomy results in an attenuated rise in plasma LH and FSH and a much lesser decrease in MBH-LHRH when compared to young rats, despite comparable steroid changes. Old PD rats have normal LH and FSH levels,but have elevated estradiol and progesterone concentrations and decreased MBH-LHRH levels when compared to young rats on the day of diestrus. Ovariectomy causes a normal decrease in MBH-LHRH; however, the increased gonadotropin levels are significantly less than seen in young controls.

Glucocorticoid receptors in circulating lymphocytes of premature infants and newborns. The number and affinity of glucocorticoid receptors in lymphocytes of newborns and prematures were determined by a whole cell 3H-dexamethasone binding assay. Mean receptor numbers were, 1758 +/- 245/cell in cord blood, 2758 +/- 307/cell in mature newborns and 2025 +/- 485/cell in prematures. Three of the premature babies died with hyaline membrane disease (HMD). They had not been treated prenatally with dexamethasone and no specific binding was measurable in their lymphocytes, suggesting that the lack of receptors might be one of the causes of HMD.

Molecular assembly of cystic fibrosis transmembrane conductance regulator in plasma membrane. Based on electrophysiological measurements, it has been argued that the active form of cystic fibrosis trans-membrane conductance regulator (CFTR) Cl(-) channel is a multimer. It has also been demonstrated that this multimerization is likely due to PDZ domain-interacting partners. Here we demonstrate that although CFTR in vitro can self-associate into multimers, which depends on PDZ-based interactions, this may not be the case in cell membrane. Using chemical cross-linking, we demonstrated that CFTR exists as a higher order complex in cell membrane. However, this higher order complex is predominantly CFTR dimers, and the PDZ-interacting partners (Na(+)/H(+) exchanger regulatory factor-1 (NHERF1) and NHERF2) constitute approximately 2% of this complex. Interestingly solubilizing membrane expressing CFTR in detergents such as Triton X-100, Nonidet P-40, deoxycholate, and SDS tended to destabilize the CFTR dimers and dissociate them into monomeric form. The dimerization of CFTR was tightly regulated by cAMP-dependent protein kinase-dependent phosphorylation and did not depend on the active form of the channel. In addition, the dimerization was not influenced by either the PDZ motif or its interacting partners (NHERF1 and NHERF2). We also demonstrated that other signaling-related proteins such as Gbeta and syntaxin 1A can be in this higher order complex of CFTR as well. Our studies provide a deeper understanding of how the CFTR assembly takes place in native cell membrane.

Temporal winner-take-all networks: a time-based mechanism for fast selection in neural networks. Winner-take-all (WTA) networks frequently appear in neural network models. They are primarily used for decision making and selection. As an alternative to the conventional activation-based winner-take-all mechanisms (AWTA), we present a time-based temporal-winner-take-all mechanism with O(n) space complexity and roughly O(log n) time complexity. The mechanism exploits systematic and stochastic differences between time delays within different units and connections. The TWTA and the AWTA networks are shown to be logically equivalent, but the TWTA mechanism may be more suitable than the latter for various selection tasks, especially the selection of an arbitrary unit from a set (e.g., as in unit recruitment). TWTA avoids various problems with conventional WTA, notably the difficulty of making it converge rapidly over a large range of conditions. Here we report a probabilistic analysis of the TWTA mechanism along with experimental data obtained from numerous massively parallel simulations of the TWTA mechanism on the connection machine.

A community program for the control of cardiovascular risk factors: a preliminary evaluation of the effectiveness of the CHAD program in Jerusalem. A community program for the control of cardiovascular risk factors, the CHAD program, was instituted in a family practice in western Jerusalem in 1971. The effectiveness of the program was evaluated by comparing the findings of community surveys conducted in 1970 and 1975 and by comparing the changes with those observed in an adjacent control neighborhood. This paper reports the findings among men aged 35 years and above. In the community exposed to the program there was a decrease in mean systolic and disatolic pressures, in the prevalence of hypercholesterolemia, and in the prevalence of cigarette smoking. The changes in blood pressures and smoking habits were significantly greater than those observed in the control population. In the control population (only) there was a small increase in mean body weight and a decrease in reported physical activity. The findings suggest that it is possible for a program that operates and through primary health care to have an appreciable influence upon cardiovascular risk factors in the community.

[Long-term efficacy of radiotherapy on children with nasopharyngeal carcinoma]. Nasopharyngeal carcinoma (NPC) in children is a particular type of NPC with poor prognosis. This study was to analyze long-term treatment efficacy, and relevant factors influencing prognosis of NPC in children. From Jan. 1975 to Dec. 1995, 47 children,7-14 years old, with NPC diagnosed by pathology received radiotherapy in our hospital. Radiation doses were 52-74 Gy/6-13 weeks [(64.68+/-5.68) Gy] in nasopharynx, and 46-73 Gy/5-13 weeks [(57.77+/-5.86) Gy] in neck; 21 received 1-3 cycles of chemotherapy (cisplatin, bleomycin, 5-fluoroucil, vincristine, and cyclophosphamide) before radiotherapy. Survival rate was calculated by Kaplan-Meier method, and analyzed by log-rank test with SPSS 10.0 software. The 1, 3, 5-year survival rates of 47 patients were 72.3%, 53.2%, and 40.4%, respectively. Clinical stage (P=0.046), mode of biopsy (P=0.024), radiation dose in nasopharynx (P=0.049), and short-term efficacy (P=0.005) correlated with prognosis of these patients. The average height of 15 male children with NPC who survived for more than 5 years was (161.5+/-1.23) cm. Among 3 female children with NPC who survived for more than 5 years, 2 had menstruation disturbance. Clinical stage, mode of biopsy, radiation dose in nasopharynx, short-term efficacy may influence prognosis of NPC in children. Radiation-induced long-term sequelae of NPC in children should not be overlooked.

Formation of PGD(2) Contributes to the Anti-aggregatory Efficacy of ZD1542, a Thromboxane A(2) Synthase Inhibitor and TP Receptor Antagonist, in Human Whole Blood. The aim of this study was to determine the contribution of increased PGD(2) formation to the anti-aggregatory action of a thromboxane A(2) (TXA(2)) synthase inhibitor and TP receptor antagonist (ZD1542) against collagen-induced human platelet aggregation in citrated whole blood using the prostaglandin (PG) DP receptor antagonists AH6809 and 868C84. ZD1542 (1 μM) was markedly more effective than aspirin (1 mM) against collagen-induced aggregation (73 vs 52% inhibition respectively), and formation of both PGI(2) and PGD(2) was evident in the presence of ZD1542. Added PGD(2) (30 nM) inhibited aggregation to a similar extent as did ZD1542 (68% inhibition) and the antiaggregatory action of PGD(2) was abolished, both by AH6809 (50 μM) and by 868C84 (0.5 μM). AH6809 significantly reduced the antiaggregatory efficacy of ZD1542, but did not modify the efficacy of aspirin. In contrast, 868C84 had little effect on the antiaggregatory efficacy of ZD1542 whereas 868C84 in combination with aspirin inhibited platelet aggregation more markedly than did aspirin alone. These findings indicate that formation of PGD(2) contributes to the antiaggregatory action of ZD1542 against collagen-induced human platelet aggregation. However, results obtained with the DP receptor antagonist 868C84 were inconclusive since 868C84 has a limited inhibitory effect against collagen-induced human platelet aggregation which is independent of eicosanoid formation.

The adult life course and homosexual identity in midlife gay men. The meaning of homosexual identity as shaped by the adult life course is poorly described in the lives of gay men. In particular, the transition from young adulthood to middle age raises questions of how homosexual identity is redefined as gay men alter their participation in gay sexual culture, experience change in sexual desire and activity, and revise broader psychosocial identity as influenced by psychological and socialization processes related to aging. In addition, the HIV epidemic and historical change in social tolerance of homosexuality have shaped the experience of sexual identity among the generation of currently middle-aged gay men in the United States. A perspective that integrates sociocultural, historical, and psychosocial factors is thus needed to understand thesubjective meaning of homosexual identity as it is experienced in midlife. In this paper I have described exploratory research on the meaning of homosexual identity in the life trajectories of middle-aged men. Such meanings reflect available social and cultural pathways for change in midlife homosexual identity, as well as individual psychological attributes and idiosyncrasies of life history. These findings have heuristic value in further refinement of models of homosexual identity maintenance and support a more inclusive view of the life course that considers the effects of sexual orientation on adult identity.

Characterization of two different forms of mitogen-activated protein kinase kinase induced in polymorphonuclear leukocytes following stimulation by N-formylmethionyl-leucyl-phenylalanine or granulocyte-macrophage colony-stimulating factor. Incubation of polymorphonuclear leukocytes with chemoattractants, granulocyte-macrophage colony-stimulating factor (GM-CSF), or phorbol 12-myristate 13-acetate (PMA) activated both mitogen-activated protein kinase kinase (MAPKK) and mitogen-activated protein kinase (MAPK). Activation by chemoattractants was rapid and transient, being maximal by 1 min and decreasing by 10 min. The order of efficacy was formyl-met-leu-phe > C5a > > LTB4 > interleukin 8 > platelet-activating factor. In contrast, activation by GM-CSF or PMA was slow and sustained being maximal at 5 min and with little decrease by 30 min. Sustained MAPK activation required continuous activation of the MAPKK. The MAPKK induced by N-formylmethionyl-leucyl-phenylalanine, GM-CSF, or PMA was resolved into two forms by anion exchange chromatography (Mono Q). Both corresponded to a 45-kDa MAPKK antigen by Western blotting and were inactivated by serine/threonine protein phosphatase 2A. Rechromatography of both forms after dephosphorylation resulted in the antigen's eluting slightly earlier on the Mono Q gradient than when in the active state. However, the two peaks remained separate, suggesting that they are not merely different phosphoforms of the same enzyme. The MAPK cascade is a signaling pathway common to many polymorphonuclear leukocyte stimulants, which may be activated transiently or in a sustained manner.

In search of counterurbanisation: some evidence from Devon on the relationship between patterns of migration and motivation. "The term counterurbanisation is frequently used to describe the redistribution of a population away from major cities and metropolitan areas and towards more rural areas. The widespread nature of this phenomenon has attracted much attention, yet the concept remains relatively under-developed, and even the basic definition lacks rigour. It is not surprising, therefore, that there has been a lack of cumulative evidence as to the extent of the process and little agreement as to its significance. In essence, ambiguity surrounds the types of movement that should be admitted, the necessary motives for movement and the appropriate measures for both. This paper offers some preliminary suggestions for a more structured approach to the problem. It draws on original survey data from Devon [England], a county which has experienced substantial net in-migration, both to examine the contribution of three alternative definitions of counterurbanisation and to consider how these issues relate to motivation."

beta-amyloid load is not influenced by the severity of cardiovascular disease in aged and demented patients. This study was conducted to analyze the association between reported risk factors for Alzheimer's disease, apolipoprotein E epsilon4 allele, and cardiovascular disease and neuropathological changes essential for the diagnosis of Alzheimer's disease. Our data are based on clinical and postmortem evaluations of a cohort of nondemented (n=118) and demented (n=107) individuals. A cardiovascular index was calculated at autopsy to estimate the extent of cardiovascular disease. Neuropathological lesions such as senile/neuritic plaques, neurofibrillary tangles, beta-amyloid load, cerebral amyloid angiopathy, and the load of paired helical filaments were determined. The aforementioned neuropathological lesions did not show any positive significant correlation with cardiovascular index. In contrast, the extent of Alzheimer's lesions was significantly higher in those nondemented and demented patients carrying the apolipoprotein E epsilon4 allele than in those without this allele. Our results demonstrate that the apolipoprotein E epsilon4 allele, but not cardiovascular disease, indeed influences the extent of Alzheimer's lesions seen in the brain tissue of demented patients as well as asymptomatic controls.

N-Alkenyl-2-aziridinylmethyl radicals and N-alkenylaminyl radicals in cascade cyclizations to pyrrolizidines and indolizidines. [reaction: see text] The radical cascade cyclizations of N-alkenyl-2-aziridinylmethyl radicals to pyrrolizidines and indolizidines were examined using density functional theory (DFT) calculations. A large preference for cyclization to pyrrolizidines was found. These predictions corroborated very well with experimental results, leading to an efficient synthesis of pyrrolizidines. No radical cascade cyclization to indolizidines could be performed in practice as only ring opening of N-alkenyl-2-aziridinylmethyl radicals to N-allyl-N-alkenylamines occurred.

Lifetime dose-response relationships for mammary tumor induction by a single administration of N-methyl-N-nitrosourea. Dose-response relationships for the induction of mammary tumors by a single i.v. injection of N-methyl-N-nitrosourea (MNU) were studied. At 50 days of age, groups of 20 virgin female Sprague-Dawley rats received single doses of 50, 45, 40, 35, 30, 25, 20, 15, or 10 mg MNU per kg body weight; a group of 10 control rats received 0.85% NaCl solution only. Animals were observed for the appearance of mammary tumors over their life span or until 600 days after carcinogen administration. Both malignant and benign mammary tumors appeared in all groups; however, malignant tumors appeared earlier and at a faster rate than did benign tumors. Incidence of cancer and number of cancers per animal increased with increasing MNU dose; the latent period for cancer increased with decreasing dose. The number of benign tumors induced as a percentage of total tumors increased with decreasing dose, ranging from approximately 10% in groups receiving more than 30 mg MNU per kg to 58% in the group receiving 10 mg/kg. Foci of metastatic mammary carcinoma were found in lungs of animals in several MNU dose groups. Data from the present study indicate that a single i.v. administration of MNU induces mammary cancer in a dose-related fashion, with little toxicity and a short latent period; induced cancers metastasize to distant sites. The single-dose MNU model thus appears to be superior to both the 7,12-dimethylbenz(a)anthracene and multiple-dose MNU models, particularly for use in studies of modification of mammary carcinogenesis.

Health problems in the extraterrestrial environment. Space travel imposes unique stress on humans. Through a review of the literature, psychophysiologic alterations associated with space flight are identified. A role for space nursing is proposed.

Effect of vitamin D deficiency and 1,25-dihydroxycholecalciferol treatment on epidermal calcium-binding protein (ECaBP) RNA activity. We have previously reported that the amount of epidermal calcium binding protein (ECaBP) in the skin decreases in the absence of vitamin D. Since vitamin D influences epidermal differentiation, and the synthesis of ECaBP may vary with cell differentiation, it was necessary to know whether vitamin D acts directly on the translational or post-translational level of ECaBP synthesis or indirectly by its action on epidermopoiesis. The cell-free translation technique was used to demonstrate the presence of mRNA coding for ECaBP. The activity of this mRNA has been evaluated in the skin of vitamin D-fed and in vitamin D-deficient rats with or without treatment with 1,25-dihydroxycholecalciferol (1,25(OH)2D3). Vitamin D deficiency decreased the ECaBP mRNA activity. The latter was selectively increased in animals given a single dose of 1,25(OH)2D3. These results suggest that 1,25(OH)2D3 stimulates the production of ECaBP mRNA or stabilizes this mRNA.

Drug-induced pure red cell aplasia. Pure red cell aplasia (PRCA) is an uncommon hematologic disorder characterized by the absence of erythroblasts in otherwise normal bone marrow. It is commonly an autoimmune disorder sometimes associated with a congenital error. It may also be acquired in association with thymomas, hematologic malignancies, human parvovirus B19 infection, drugs, and other disease states. Thirty drugs have been implicated as causative in PRCA, but most literature reports describe only one or two patients. Data evaluating possible mechanisms of drug-induced PRCA are extremely limited, with conflicting results from different investigators. The criteria we used were at least five patients reported, reports from at least three separate investigators, and a minimum of one case of probable causality or better using a published assessment scale. With these criteria, phenytoin, azathioprine, and isoniazid had sufficient evidence of causality. All three are documented causes of PRCA and should be considered in any case of selective erythrocyte aplasia.

Hyperxanthinemia interferes with serum uric acid determinations by the uricase method. Serum xanthine concentrations as high as 148 mg/L were noted after treatment of a patient with Burkitt's lymphoma who was receiving allopurinol. These markedly above-normal values for xanthine led to spuriously low values for serum uric acid as measured by the uricase method. Rapid tumor lysis in patients who are receiving allopurinol may lead to marked hyperxanthinemia, which in turn may obscure hyperuricemia in such patients when the uricase method is used for uric acid analysis. In such situations, uric acid concentrations should be measured by the phosphotungstate colorimetric assay.

Nuclear localization of growth hormone receptor: another age of discovery for cytokine action? The conventional view of cytokine signaling is that receptors transmit information to the nucleus without leaving the plasma membrane. However, accumulating data suggest that some membrane receptors may signal by dissociating from the plasma membrane and translocating to the nucleus, where they direct the transcriptional machinery. One example is the growth hormone receptor (GHR), which has been observed in the nuclei of various normal and neoplastic tissues. Waters and colleagues now present new mechanistic data describing how GHR might localize to the nucleus and influence gene transcription. These findings may have implications for the way we think about cytokine signaling.

Axon viability and mitochondrial function are dependent on local protein synthesis in sympathetic neurons. (1) Axons contain numerous mRNAs and a local protein synthetic system that can be regulated independently of the cell body. (2) In this study, cultured primary sympathetic neurons were employed, to assess the effect of local protein synthesis blockade on axon viability and mitochondrial function. (3) Inhibition of local protein synthesis reduced newly synthesized axonal proteins by 65% and resulted in axon retraction after 6 h. Acute inhibition of local protein synthesis also resulted in a significant decrease in the membrane potential of axonal mitochondria. Likewise, blockade of local protein transport into the mitochondria by transfection of the axons with Hsp90 C-terminal domain decreased the mitochondrial membrane potential by 65%. Moreover, inhibition of the local protein synthetic system also reduced the ability of mitochondria to restore axonal levels of ATP after KCl-induced depolarization. (4) Taken together, these results indicate that the local protein synthetic system plays an important role in mitochondrial function and the maintenance of the axon.

Plexin-B1 is a target of miR-214 in cervical cancer and promotes the growth and invasion of HeLa cells. Plexin-B1, the receptor for Sema4D, has been reported to trigger multiple and sometimes opposing cellular responses in various types of tumor cells. It has been implicated in the regulation of tumor-cell survival, proliferation, angiogenesis, invasion and metastasis. However, the plexin-B1 gene expression and its regulatory mechanism in cervical cancer remain unclear. The present study shows that plexin-B1 is over-expressed in cervical tumor tissues compared to normal cervical tissues by immunohistochemistry, Western blotting and quantitative RT-PCR. The expression of plexin-B1 is significantly associated with cervical tumor metastasis and invasion according to the analysis of the clinicopathologic data. Plexin-B1 also promotes proliferation, migration and invasion in human cervical cancer HeLa cells. We also found that the plexin-B1 levels are inversely correlated with miR-214 amounts in both cervical cancer tissues and HeLa cells. And miR-214 expression level is also associated with metastasis and invasion of cervical tumor. Furthermore, we demonstrate that plexin-B1 is inhibited by miR-214 through a miR-214 binding site within the 3'UTR of plexin-B1 in HeLa cells. Ectopic expression of miR-214 could inhibit the proliferation capacity, migration and invasion ability of HeLa cells. Our findings suggest that plexin-B1, a target of miR-214, may function as an oncogene in human cervical cancer HeLa cells.

Myeloperoxidase - A bridge linking inflammation and oxidative stress with cardiovascular disease. Myeloperoxidase (MPO) is a member of the superfamily of heme peroxidases that is mainly expressed in neutrophils and monocytes. MPO-derived reactive species play a key role in neutrophil antimicrobial activity and human defense against various pathogens primarily by participating in phagocytosis. Elevated MPO levels in circulation are associated with inflammation and increased oxidative stress. Multiple lines of evidence suggest an association between MPO and cardiovascular disease (CVD) including coronary artery disease, congestive heart failure, arterial hypertension, pulmonary arterial hypertension, peripheral arterial disease, myocardial ischemia/reperfusion-related injury, stroke, cardiac arrhythmia and venous thrombosis. Elevated MPO levels are associated with a poor prognosis including increased risk for overall and CVD-related mortality. Elevated MPO may signify an increased risk for CVD for at least 2 reasons. First, low-grade inflammation and increased oxidative stress coexist with many metabolic abnormalities and comorbidities and consequently an elevated MPO level may represent an increased cardiometabolic risk in general. Second, MPO produces a large number of highly reactive species which can attack, destroy or modify the function of every known cellular component. The most common MPO actions relevant to CVD are generation of dysfunctional lipoproteins with an increased atherogenicity potential, reduced NO availability, endothelial dysfunction, impaired vasoreactivity and atherosclerotic plaque instability. These actions strongly suggest that MPO is directly involved in the pathophysiology of CVD. In this regard MPO may be seen as a mediator or an instrument through which inflammation promotes CVD at molecular and cellular level. Clinical value of MPO therapeutic inhibition remains to be tested.

Internal derangement in the temporomandibular joint of juveniles with clinical signs of TMD : MRI-assessed association with skeletal and dental classes. The aim of this study was to investigate possible correlation of specific skeletal or dental class in children and adolescents with clinical signs of temporomandibular dysfunction (TMD) with the severity of internal derangement (ID) of the temporomandibular joint. Based on MRI images, the ID of 232 juvenile temporomandibular joints in 116 patients were retrospectively recorded. The distribution of the ID stages within the skeletal and dental classes was compared by means of the χ 2 test. Excluding the comparison between skeletal Class I (S I) and skeletal Class II (S II; p < 0.05), no statistically significant differences in the distribution of the ID stages were found between the skeletal classes (p > 0.05). No statistically significant differences were found when comparing the distribution of the ID stages between the dental classes (p > 0.05). According to these findings, there is no skeletal or dental class that is related to higher degrees of internal derangement in the TMJs of children and adolescents presenting clinical signs of TMD. Therefore, it is not possible to draw conclusions about the severity of the ID in relation to the dental and skeletal class in symptomatic juvenile TMJs.

Combination of obesity with hyperglycemia is a risk factor for the presence of vertebral fractures in type 2 diabetic men. Although patients with type 2 diabetes show no bone mineral density (BMD) reduction, fracture risks are known to increase. It is unclear why the patients have an increased risk of fracture despite sufficient BMD. We investigated the relationships of body mass index (BMI), HbA(1c), and urinary C-peptide (uC-peptide) versus BMD, bone metabolic markers, serum adiponectin, and prevalent vertebral fracture (VF). A total of 163 Japanese type 2 diabetic men were consecutively recruited, and radiographic and biochemical data were collected. BMI was positively correlated with BMD at the whole body, lumbar spine, and femoral neck (P < 0.05) and negatively correlated with osteocalcin and urinary N-terminal cross-linked telopeptide of type-I collagen (uNTX) (P < 0.01). HbA(1c) was negatively correlated with osteocalcin (P < 0.01) but not BMD at any site. Subjects were classified into four groups based on BMI and HbA(1c) (group LL BMI < 24 and HbA(1c) < 9, group LH BMI < 24 and HbA(1c) > or = 9, group HL BMI > or = 24 and HbA(1c) < 9, group HH BMI > or = 24 and HbA(1c) > or = 9). Serum adiponectin, osteocalcin, and uNTX were lower and the incidence of VF was higher despite sufficient BMD in the HH group. Multivariate logistic regression analysis adjusted for age, duration of diabetes, uC-peptide, and estimated glomerular filtration rate showed that the HH group was associated with the presence of a VF and multiple VFs (odds ratio [OR] = 3.056, 95% confidence interval [CI] 1.031-9.056, P = 0.0439, and OR = 5.415, 95% CI 1.126-26.040, P = 0.0350, respectively). Combination of obesity with hyperglycemia was a risk factor for VF despite sufficient BMD in diabetic men.

Cardiovascular pleiotropic actions of DPP-4 inhibitors: a step at the cutting edge in understanding their additional therapeutic potentials. Dipeptidyl peptidase 4 (DPP-4) is a serine protease enzyme expressed widely in many tissues, including the cardiovascular system. The incretin hormones such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) are released from the small intestine into the vasculature during a meal, and these incretins have a potential to release insulin from pancreatic beta cells of islets of Langerhans, affording a glucose-lowering action. However, both incretins are hurriedly degraded by the DPP-4. Inhibitors of DPP-4, therefore, enhance the bioavailability of GLP-1 and GIP, and thus have been approved for better glycemic management in patients afflicted with type 2 diabetes mellitus (T2DM). Five different DPP-4 inhibitors, often called as 'gliptins', namely sitagliptin, vildagliptin, saxagliptin, linagliptin and alogliptin have been approved hitherto for clinical use. These drugs are used along with diet and exercise to lower blood sugar in diabetic subjects. T2DM is intricately related with an increased risk of cardiovascular disease. Growing body of evidence suggests that gliptins, in addition to their persuasive anti-diabetic action, have a beneficial pleiotropic action on the heart and vessels. In view of the fact of cardiovascular disease susceptibility of patients afflicted with T2DM, gliptins might offer additional therapeutic benefits in treating diabetic cardiovascular complications. Exploring further the cardiovascular pleiotropic potentials of gliptins might open a panorama in impeccably employing these agents for the dual management of T2DM and T2DM-associated perilous cardiovascular complications. This review will shed lights on the newly identified beneficial pleiotropic actions of gliptins on the cardiovascular system.

Morphology of experimental actinomycotic abscess in mice with Dermatophilus-like microorganisms from porcine tonsil. Experimental infection in mice with Dermatophilus (D.) congolensis-like microorganisms was carried out, intraperitoneally and subcutaneously. This strain had been isolated from porcine tonsil and reported to be different in some morphological and biological points from D. congolensis. Macroscopic examination revealed multiple abscesses in the peritoneal cavities, or subcutaneous abscesses after the intraperitoneal or subcutaneous injection respectively. Histopathologic examination revealed the characteristic arrangement of the neutrophils surrounding the bacterial colony and peripheral macrophages in the abscess lesions. The lesions contained many microorganisms which showed wide range of the characteristic morphologic variation such as: mycelial elements, coccoid elements and large coccoid elements with transverse or longitudinal septa. Chlamydospore-like elements were sometimes found in the microcolonies in early lesions. The morphology of the lesions and the microorganisms was compared with those of other bacteria including D. congolensis.

Relation of counterregulatory responses to hypoglycemia in type I diabetics. We compared counterregulatory metabolic and hormonal responses in 8 normal controls with responses in 16 Type I (insulin-dependent) diabetics, 7 of whom had had repeated attacks of severe hypoglycemia, in an effort to determine whether these responses are related to the occurrence of hypoglycemia in the latter group. In response to insulin-induced hypoglycemia, peak values for glucose production (5.7 +/- 0.5 vs. 2.5 +/- 0.3 mg per kilogram of body weight per minute) (P less than 0.0001), glucagon (195 +/- 26 vs. 93 +/- 18 pg per milliliter) (P less than 0.0001), and growth hormone (63 +/- 8 vs. 37 +/- 5 ng per milliliter) (P less than 0.006) were significantly higher in the controls than in the diabetics. However, peak values for glucose production, glucagon, epinephrine, norepinephrine, cortisol, and growth hormone were similar in the diabetics with and without clinical hypoglycemia. Thus, with the present dose and method of insulin administration we were unable to predict the presence of severe hypoglycemic reactions in a group of Type I diabetics. Although deficient counterregulatory hormone responses are important in the pathogenesis of hypoglycemic reactions, we conclude that other factors in the daily lives of such patients also play a major part in determining whether reactions will occur.

A collaborative approach to minimally invasive direct coronary artery bypass. Minimally invasive direct coronary artery bypass (MIDCAB) graft is a surgical technique that is becoming more widely accepted. Through a collaborative effort--interhospital and intrahospital--surgical team members at two hospitals in Kentucky made significant improvements on the MIDCAB procedure that positively influenced patient outcomes (e.g., less time in intensive care, shorter hospital stays, fewer complication, cost savings to the patients and institutions). This article reviews those collaborative efforts and outcomes.

Individual differences in the sedating effects of ethanol. Twenty-four healthy, normal-sleeping, males aged 21-35 were screened for basal levels of sleepiness using the Multiple Sleep Latency Test (MSLT). Twelve subjects had basal average daily sleep latencies of less than or equal to 6 min (sleepy) and 12 had latencies of greater than or equal to 16 min (alert) on the MSLT. Subjects consumed either ethanol (0.75 mg/kg) or placebo at 0900-0930 after spending 8 hr time in bed (TIB) the previous night. Sleep latency was measured at 1000, 1200, 1400, and 1600 hr. Divided attention performance and the Stanford Sleepiness Scale (SSS) were assessed at 1100 hr. Breath ethanol concentration (BEC) was determined prior to each latency test. Ethanol decreased average daily sleep latency, divided attention scores and SSS ratings. There were individual differences in the sedating and impairing effects of ethanol, related to subjects' basal level of sleepiness/alertness. The alert subjects exhibited longer sleep latencies and higher performance scores after ethanol administration than the sleepy subjects after placebo. Subjectively the groups had a similar level of sleepiness on placebo and were similarly sedated with ethanol.

Flexor pollicis longus rebalancing: a modified technique for Wassel IV-D thumb duplication. To report a modified reconstructive technique for Wassel type IV-D thumb duplication that preserves and transfers the flexor pollicis longus (FPL) from the removed radial portion. We analyzed the hands of 16 patients (average age, 2 y) with Wassel IV-D thumb duplication. Patients were treated with ablation of the radial thumb and reconstruction of the ulnar thumb by a series of soft tissue procedures, including FPL rebalancing. The postoperative range of motion and the alignment at the metacarpophalangeal and interphalangeal joints of the affected thumbs were compared with the preoperative measurements. Of 16 cases, 14 were observed for an average of 29 months. Motion at the interphalangeal joint and alignment at metacarpophalangeal and interphalangeal joints showed improvement after surgery. According to the Japanese Society for Surgery of the Hand scoring system, the results were excellent in 2 cases, good in 11, and fair in 1. A disadvantage of this technique proved to be restricted interphalangeal joint motion with an extension lag that averaged 14°. The FPL rebalancing technique with soft tissue stabilization of the metacarpophalangeal and interphalangeal joints can establish dynamic rebalance of the bifurcated FPL tendon in Wassel IV-D duplicated thumb. It shows excellent results in alignment and joint stability. The long-term results are under evaluation. Therapeutic IV.

Rhabdomyosarcoma of the penis. We report a case of rhabdomyosarcoma of the penis, which was treated with local excision and chemotherapy.

Effects of cryolipolysis on abdominal adiposity of women. BACKGROUND: The cryolipolysis is on the spotlight as a non-invasive method which reduces fat layer thickness with no damage to surrounding tissues. This study aims to verify the effectiveness of cryolipolysis in the reduction of localized adiposity in women. This is an experimental study, without a control group, with pre- and post- treatment evaluation through a single application on the lower abdominal area. Research conducted in the period from July to December 2015 at the University Potiguar. A group of 15 women, age between 25-50 years. The cryolipolysis was used in the following parameters: temperature (-7 degree C); suction power (30 kPa), and application time (60 min). After the cryolipolysis was performed, a follow-up of 2 months was conducted to verify the changes related to weight, body circumference, fat layer thickness, which were evaluated by ultrasonography and photogrammetry. From data analysis, the reductions observed on perimeter (p=0.03) and ultrasonography (p=0.03) showed significant results, considering p <0.05. As of body weight results (p=0.57), the average value varied during the study; however, at the end of the research, no significant weight increase or decrease was reported, as it is known that this method does not interfere with this variable. Additionally, quantitative data were satisfactory. The photogrammetry analysis showed that cryolipolysis positively affected subjects' results. A change in body contouring, especially in individuals with lower body mass, reinforces the idea that the parameters must be suitable for individual needs.

[Applied phoniatry. IV. Rhinophony (author's transl)]. Rhinophony, which is a change of vocal sound, can appear as a major symptom in many peripheral or central disorders of childhood, adolescence and adulthood. Its investigation, aetiology and management from various points of view are discussed. These are considered broadly as rhinophony aperta (palatal paralysis, functional rhinophony aperta, congenitally short palate); as rhinophony clausa (organic in origin, functional nasal speech); and mixed types of rhinophony. Typical phoniatric problems related to cleft lip and palate are also presented.

[Prevalence of chronic obstructive pulmonary disease (COPD) and other pulmonary diseases among participants of the program of early detection and prevention of COPD]. Chronic obstructive pulmonary disease (COPD) is one of the most frequent chronic diseases and the sixth leading cause of death in the world. The cigarette smoking is the most important cause of the disease and therefore, that COPD is preventable. Programmes detecting COPD in its preclinical phase using spirometry with successful smoking cessation prevent disease progression. The aim of the study was to assess the prevalence of COPD and other pulmonary diseases among participants of the program of early detection and prevention of COPD. The program was held in 2002 and carried out by eleven health care institutions. Active smokers over 40 insured in the Fund were offered free spirometry, chest x ray, individual and group behavioural therapy to stop smoking, and chest physician's examination for patients with diagnosed pathology. The results confirm high detection of COPD and other diseases and confirm the efficacy of targeted screening for early detection of COPD and other diseases.

Beyond despair and disengagement: a transactional model of personality development in later life. It is argued that ego analytic, disengagement, and symbolic interaction theories of personality share an insufficient consideration of the dynamics of the interaction between developmental and social forces transpiring during the aging period. An alternative, transactional model is proposed, positing that the effects of the environment to which the elderly person is subject are the product of: (1) the people and settings comprising that environment and (2) the manner in which the individual acts upon and is acted upon by these people and settings. The model highlights the need for research in which present behavioral and environmental events assume as much importance as past ones.

Apoptotic Effect of Galbanic Acid via Activation of Caspases and Inhibition of Mcl-1 in H460 Non-Small Lung Carcinoma Cells. Galbanic acid (GBA), a major compound of Ferula assafoetida, was known to have cytotoxic, anti-angiogenic and apoptotic effects in prostate cancer and murine Lewis lung cancer cells; the underling apoptotic mechanism of GBA still remains unclear so far. Thus, in the present study, the apoptotic mechanism of GBA was investigated mainly in H460 non-small cell lung carcinoma (NSCLC) cells because H460 cells were most susceptible to GBA than A549, PC-9 and HCC827 NSCLC cells. Galbanic acid showed cytotoxicity in wild EGFR type H460 and A549 cells better than other mutant type PC-9 and HCC827 NSCLC cells. Also, GBA significantly increased the number of Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) positive cells and sub G1 population in H460 cells. Western blotting revealed that GBA cleaved poly (ADP-ribose) polymerase (PARP), activated Bax and caspase 9, attenuated the expression of Bcl-2, Bcl-x(L), and Myeloid cell leukemia 1 (Mcl-1) in H460 cells. However, interestingly, overexpression of Mcl-1 blocked the ability of GBA to exert cytotoxicity, activate caspase9 and Bax, cleave PARP, and increase sub G1 accumulation in H460 cells. Overall, these findings suggest that GBA induces apoptosis in H460 cells via caspase activation and Mcl-1 inhibition in H460 cells as a potent anticancer agent for NSCLC treatment.

[Factors affecting the prognosis of invasive pulmonary fungal infections after kidney transplantation: analysis of the ten-year single-center data]. To investigate the factors affecting the prognosis of invasive pulmonary fungal infection (IPFI) in patients after kidney transplantation. This retrospective study involved 80 concurrent patients with IPFI after receiving kidney transplantation in Zhujiang Hospital from January 1, 2000 to April 1, 2010. Fourteen factors including age, gender, pathogens, body temperature on day 5, renal insufficiency, mechanical ventilation, and clinical pulmonary infection score (CPIS) on day 5 were analyzed by univariate analysis and multivariate Logistic regression analysis to identify the factors related to the prognosis. Univariate analysis showed that a normal body temperature on day 5 of antifungal treatment (P=0.024), fasting high blood glucose (P=0.001), renal insufficiency (P=0.002), malnutrition (P=0.018), time of infection after transplantation (P=0.046), low CPIS on day 5 (P=0.000) and mechanical ventilation (P=0.000) all affected the prognosis of the patients. Logistic regression analysis showed that renal insufficiency (OR=18.096), mechanical ventilation (OR=130.7) and low CPIS on day 5 (OR=0.011) were independent prognostic factors, among which the low CPIS on day 5 was a protective factor. Timely and adequate empirical therapy and renal replacement therapy, along with adjusted anti-fungal therapy protocol according to the CPIS score on day 5, may improve the prognosis of IPFI after kidney transplantation.

The protease inhibitor atazanavir triggers autophagy and mitophagy in human preadipocytes. The association between HAART and lipodystrophy is well established, but lipodystrophy pathogenesis is still poorly understood. Drugs, and in particular protease inhibitors, accumulate in adipose tissue affecting adipocyte physiology and gene expression by several mechanisms. Recent studies have identified autophagy as another process affected by these classes of drugs, but no studies have been performed in adipose cells. SW872 preadipocytic human cell line was used to evaluate changes induced by amprenavir (APV), ritonavir (RTV), or atazanavir (ATV), all used at 10-200 μmol/l. A subline was stably transfected with murine stem cell virus (pMSCV)-enhanced green fluorescent protein (EGFP)-LC3 plasmid (to obtain a fluorescent LC3 protein) and treated with ATV at different doses. The distribution of LC3 and the colocalization of mitochondria, lysosome, and autophagosome were assessed by confocal microscopy. Transmission electron microscopy of ATV-treated cells was also performed. The cellular content of lysosomes was assessed using Lysotracker Green; apoptosis was evaluated by annexin V/propidium iodide staining, and mitochondrial superoxide anion (mtO2) was analyzed by mitoSOX red. Lysosomes, apoptosis, and mtO2 were studied by flow cytometry and multispectral imaging flow cytometry. In SW872 cells, RTV caused massive apoptosis, more than autophagy, whereas APV was almost ineffective. ATV induced both apoptosis (high doses) and autophagy (low doses). ATV-treated cells displayed LC3-specific punctae, suggesting the formation of autophagosomes that enclosed mitochondria, as revealed by electron microscopy. At low doses, ATV promoted mitochondrial superoxide generation, whereas at high doses, it induced mitochondrial membrane depolarization. Autophagy/mitophagy can be considered a mechanism triggered by ATV in SW872 preadipocytes.

Lasting Improvement of Patient-Reported Outcomes 6 Months After Patellofemoral Pain Rehabilitation. Hip- and knee-muscle-strengthening programs are effective in improving short-term patient-reported and disease-oriented outcomes in individuals with patellofemoral pain (PFP), but few to no data exist on moderate- to long-term postrehabilitative outcomes. The first purpose of the study was to assess differences in pain, function, strength, and core endurance in individuals with PFP before, after, and 6 mo after successful hip- or knee-muscle-strengthening rehabilitation. The second purpose was to prospectively follow these subjects for PFP recurrence at 6, 12, and 24 mo postrehabilitation. For 24 mo postrehabilitation, 157 physically active subjects with PFP who reported treatment success were followed. At 6 mo postrehabilitation, pain, function, hip and knee strength, and core endurance were measured. At 6, 12, 18, and 24 mo, PFP recurrence was measured via electronic surveys. Sixty-eight subjects (43%) returned to the laboratory at 6 mo. Regardless of rehabilitation program, subjects experienced significant improvements in pain and function, strength, and core endurance pre- to postrehabilitation and maintained improvements in pain and function 6 mo postrehabilitation (Visual Analog Scale/Pain-pre 5.12 ± 1.33, post 1.28 ± 1.14, 6 mo 1.68 ± 2.16 cm, P < .05; Anterior Knee Pain Scale/Function-pre 76.38 ± 8.42, post 92.77 ± 7.36, 6 mo 90.27 ± 9.46 points, P < .05). Over the 24 mo postrehabilitation, 5.10% of subjects who responded to the surveys reported PFP recurrence. The findings support implementing a hip-or knee-muscle-strengthening program for the treatment of PFP. Both programs improve pain, function, strength, and core endurance in the short term with moderate- and long-term benefits of improved pain and function and low PFP recurrence.

Laparoscopy in the critically ill. Laparoscopy was evaluated in critically ill patients with suspected acute cholecystitis, mesenteric ischemia, or gastrointestinal perforation. We studied laparoscopy to assess its utility, accuracy, and effect on cardiopulmonary stability. Twenty-six surgical ICU patients with possible abdominal sepsis underwent laparoscopy. Nineteen were post cardiac surgery; the remainder had other diagnoses. Video laparoscopy was performed with hemodynamic monitoring and inotropic support as needed. Eight patients had bedside laparoscopy. Fifteen patients had suspected acute cholecystitis. Laparoscopy was positive in 10; four had open cholecystectomy, four laparoscopic cholecystectomy, and two tube cholecystostomy. Nine patients had suspected mesenteric ischemia; laparoscopy was positive in five, revealing cirrhosis in two and ischemic bowel in three. Two patients had suspected perforated viscus with colonic perforation in one and one false negative. There were no adverse hemodynamic events. Laparoscopy can be performed safely in critically ill patients. It is useful in patients with acute cholecystitis and in patients who are post cardiac surgery with refractory lactic acidosis in whom a diagnosis of mesenteric ischemia is considered.

The features in IgA-dominant infection-related glomerulonephritis distinct from IgA nephropathy: a single-center study. IgA-dominant infection-related glomerulonephritis (IgA-IRGN) is a unique form of IRGN, which needs to be distinguished from IgA nephropathy (IgAN). Thirteen patients with IgA-IRGN (IgA-IRGN group) and 122 with IgAN (IgAN group) were selected from 1788 patients who underwent kidney biopsy between 2000 and 2015 in Kitano Hospital. Data selected included clinical and serological parameters; light and electron microscope findings; immunofluorescence findings; and prognostic parameters like renal and overall survival and creatinine increase by > 50%. In addition, a 26-patient IgAN cohort (matching-IgAN), matching with IgA-IRGN group with respect to age, sex, estimated glomerular filtration rate (eGFR), and proteinuria was segregated for comparison. Compared to IgAN group, IgA-IRGN group were older, had lower hemoglobin, higher CRP, lower eGFR, heavier proteinuria, lower serum albumin, and higher serum IgG and IgA levels (p < 0.05). Endocapillary hypercellularity, deposition of immune complexes along the glomerular capillary wall, and subendothelial and subepithelial electron dense deposits were more frequently observed (p < 0.05); and they were more susceptible to renal dysfunction and poorer prognosis. After propensity score-matching, serum albumin was significantly lower in the IgA-IRGN group. Significantly subendothelial and subepithelial deposits were frequently observed in this group. Matching-IgAN group showed relatively advanced sclerotic lesions with more global sclerosis and fibrous crescent. Local inflammation involved glomerular capillary wall in IgA-IRGN, in contrast to relatively chronic and sclerotic renal lesion in IgAN, might result in poorer prognosis in former, even under indistinguishable condition of deteriorated renal function and proteinuria.

rpoB gene sequencing and spoligotyping of multidrug-resistant Mycobacterium tuberculosis isolates from India. Multi drug-resistant Mycobacterium tuberculosis (MDR TB) has been well studied in outbreaks in settings of low endemicity in developed countries. However, the characteristics of MDR TB in the community with high endemicity such as India have not been well investigated. Mutations in the 81-bp rifampicin resistance-determining region of the rpoB gene were analyzed by DNA sequencing of 187 M. tuberculosis clinical isolates (149 resistant and 38 sensitive) from different parts of India. 146-Point mutations and two insertions were found in 146 of 149 resistant isolates in seven codons. The most common mutations were in codons 531 (59%), 526 (22%), and 516 (11.5%). Mutations were not found in three (2%) of the resistant isolates. N-terminal sequencing in these isolates showed no mutation at codon V176. None of the drug-susceptible isolates showed any mutation in the 437-bp rpoB gene segment sequenced. Genotypic analysis revealed a total of 80 different spoligotypes. A unique pattern was found in 65 (43.6%) isolates, whereas 84 (56.4%) were in 15 clusters. Comparison with an international spoligotype database showed ST26, Delhi type (18.1%), ST1, Beijing type (9.4%), and ST11 (5.4%), as the most common. The majority of isolates in the Beijing genotype (13/14) were associated with mutation 531TTG and similar drug-resistance patterns while other major clusters showed that the nature and frequency of occurrence of mutations in the rpoB gene were independent of spoligopatterns.

The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. The present study was designed to investigate the interaction between platelet indices, inflammatory markers and disease activity in rheumatoid arthritis (RA) subjects. The effects of anti-TNF-alpha therapy and conventional treatment on platelet indices were also compared. We studied 97 patients with RA (19 men, 78 women: mean age 51 years) and 33 age and sex-matched healthy subjects as a control group. All RA patients were administered conventional therapy. After 3 months of therapy, 35 subjects who had high disease activity score (DAS28 > 5.1) were grouped as non-responders and were administered infliximab as a TNF-alpha blocker at the standard intravenous dose. Responders to the conventional therapy and non-responders were also compared. At baseline white blood cell (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet count and mean platelet volume (MPV) were significantly higher in patients with RA. Mean platelet volume was positively correlated with DAS28 score (r = 0.27; p = 0.007). These markers of inflammation and platelet indices were substantially decreased after therapy. The reductions were similar in responders to conventional therapy and non-responders (TNF alpha group). In conclusion, we found that MPV was correlated with inflammatory markers and disease activity in patients with RA. Both anti-TNF-alpha and conventional therapy decreases markers of inflammation and platelet indices. MPV can reflect both disease activity and response to treatment.

Western blotting analysis in patients with MS using human brain vessels as antigen. Serum samples from patients suffering from multiple sclerosis, other neurological diseases and normal controls were screened by "western blotting" for antibody directed against proteins of human brain vessels purified from a post mortem brain. A small number of sera contained autoantibodies against some of the proteins of the brain vessels, particularly in patients suffering from MS, epilepsy and migraine. The significance of these results is discussed.

Characterization of psoralen-oleic acid cycloadducts and their possible involvement in membrane photodamage. By UVA irradiation of an ethanol solution of psoralen and oleic acid, four main photoproducts have been isolated and characterized: two have cis,cis structure; the other two are trans,cis. The same adducts have been isolated from the photoreaction of psoralen with beta-oleoyl-gamma-stearoyl-1-alpha-phosphatidylcholine followed by enzymatic hydrolysis with phospholipase A2. The four isomers stimulate protein kinase C to almost the same extent.

Predictive index for long-term survival after retransplantation of the liver in adult recipients: analysis of a 26-year experience in a single center. To develop a prognostic scoring system for risk stratification of patients with hepatic graft failure (GF) undergoing retransplants of the liver (ReLT) and improve patient selection. Retransplantation of the liver remains controversial because of inferior outcomes compared with the primary orthotopic liver transplantation (OLT) and raises concerns of inappropriate utilization of a scarce donor organ resource. Data on risk stratification of ReLT patients for long-term survival outcomes are limited. We conducted an analysis from our prospective database of 466 adults' ReLT between February 1984 and September 2010. Mean follow-up was 3 years. Each independent predictor for allograft failure was assigned risk score (RS) points of 1 or 2, proportional to the corresponding parameter estimate under the Cox model: Predictive index category (PIC) 1, RS = 0; PIC II, RS = 1 to 2; PIC III, RS = 3 to 4; and PIC IV, RS = 5 to 12. Eight risk factors predictive for GF after ReLT included recipient age greater than 55 years, Model for End-Stage Liver Disease score greater than 27, history of prior OLT greater than 1, pre-ReLT requirement for mechanical ventilation, serum albumin less than 2.5 g/dL, donor age greater than 45 years, intraoperative requirement of packed red blood cell transfusion greater than 30 units, and performance of ReLT between 15 and 180 days from the prior OLT. Five-year GF-free survival was significantly higher in PIC I (65%) than in PIC II (53%), PIC III (43%), and PIC IV (20%) groups (P < 0.001). This risk-stratification model was highly predictive of long-term outcome after liver retransplantation in adult recipients. This formula provides a practical guide for selection of candidates for retransplantation of the liver that can lead to improved patient outcomes and optimal utilization of a scarce resource.

Fine regulation of cellulose dissolution and regeneration by low pressure CO2 in DMSO/organic base: dissolution behavior and mechanism. In this study, the fine regulation of the dissolution and regeneration of microcrystalline cellulose (MCC) using very low pressure (0-0.2 MPa) CO2 in a mixed solvent of dimethyl sulfoxide (DMSO) and 1,8-diazabicyclo-[5.4.0]-undec-7-ene (DBU) at a very low temperature (30 °C) was achieved. The solubility of MCC in DMSO/DBU (weight ratio of DMSO WDMSO = 0.90) could reach 9.0% at 30 °C and under CO2 pressure of 0.2 MPa. A similar phenomenon was observed in the mixed solvent DMSO/1,1,3,3-tetramethylguanidine (TMG). Moreover, ATR-FTIR, NMR, UV-Vis, TGA, XRD and DFT computational analyses were used to investigate the dissolution mechanism. It was concluded that in the mixed solvent (DMSO and organic base), DMSO helped to dissociate ion-pairs into free ions by balancing the concentration of free ions and the number of hydrogen bonds at WDMSO = 0.90. Interactions between CO2 and the solvent mixture were explored, and the results indicate that the optimum CO2 pressure not only promotes the formation of ionic bonds but also accelerates the formation of covalent bonds. In this way, these interactions prevent the MCC molecules from aggregating and facilitate the dissolving of MCC. This study gives a thorough insight into the dissolution mechanism and specificity of MCC in the CO2-DMSO/organic base solvent system, which could be helpful for the utilization and transformation of cellulose.

Minimum Excess Weight Required for Obesity Surgery: how far can we go? The classical indication for obesity surgery, in terms of excess weight, included only patients with an excess weight of 100% or 45 kg. This review challenges this classic indication. Sixty-four out of 170 patients treated with a biliopancreatic diversion had an excess weight below 80%. The specific weight-related complications, reoperations and results are compared with patients above 80% excess weight. The different groups are comparable in complications and results.

Radionuclide detection of multiple soft tissue metastases of osteosarcoma masquerading as bone metastasis. The aim of this work was to report an unusual case of multiple soft tissue metastases of osteosarcoma detected using bone scan and confirmed by CT scan. A 15-year-old patient with a history of osteogenic sarcoma presented with fatigue and loss of appetite in addition to a painless swelling of the distal left lower extremity. Bone scan and chest CT scan were performed for restaging purposes. The bone scan revealed multiple bone metastases and suspected tumor recurrence in the left lower extremity in addition to multiple extraosseous hot spots. The latter findings were assessed as ossified soft tissue metastases after considering the performed CT scan. This case showed the double role of bone scan in osteosarcoma in simultaneously assessing the bone status and tumor spread in soft tissue. The benefit of a comparison of bone scan findings with other modalities was also demonstrated.

[Glutathione-dependent regulation of platelet aggregation with neutrophils and tumor cells]. It is shown that in the presence of reduced glutathione at low concentrations (1-5 microM) the extent of platelet aggregation with neutrophils increases and the lag period of platelet aggregation induced by tumor cells decreases. At the same time in the presence of reduced glutathione at high concentration (3 mM) the extent of platelet aggregation with neutrophils decreases, and the lag period of platelet aggregation induced by tumor cells increases. It is established that glutathione-dependent regulation of the intercellular contact formation between platelets and neutrophils depends on the ratio of glutathione oxidized and reduced forms: at fixed total glutathione concentration of 5 microM, increase of glutathione redox potential from -175 mV to 0 mV led to reduction in platelet aggregation with neutrophils. Thus, it is shown for the first time, that GSH has priming effect on the platelet aggregation with neutrophils and tumor cells, which may contribute to the regulation of inflammatory diseases and cancer.

Synthesis of some substituted aminophenazones of possible therapeutic interest. Synthesis of four different series of compounds having the phenazone moitety was accomplished, in the hope that one or more of the prepared compounds might possess pharmacological activity. These compounds may contain a hydrazone, an acid hydrazide, certain basic residues, or disubstituted urea structure.

Outcome of heparin-treated patients with acute cerebral venous sinus thrombosis: influence of the temporal pattern of intracerebral haemorrhage. The influence of temporal patterns of intracerebral haemorrhage (ICH) on the outcome of heparin-treated patients with cerebral venous sinus thrombosis (CVST) has not been examined systematically. Temporal patterns of ICH and their influence on survival without disability (modified Rankin Scale score ≤1 point) at hospital discharge were examined in 141 consecutive hospital-admitted patients with acute CVST who were treated with intravenous unfractionated heparin. Of all 141 patients (median age 40 years; 73% women), 59 (42%) had ICH at the time of diagnosis (early ICH). Of these, seven (12%) subsequently had extension of ICH and 13 (22%) had additional ICHs at other locations (delayed ICH). Of 82 patients without early ICH, nine (11%) later had delayed ICH. After a median hospital stay of 26 days, 107 patients (76%) were discharged without disability. Patients with early ICH were less likely to survive without disability until discharge than those without early ICH [63% vs. 85%; risk ratio (RR) 0.73; P = 0.005]. The association was attenuated after adjusting for age, sex and impaired consciousness on admission (RR 0.83; P = 0.03). Taking temporal patterns of ICH into account, early ICH with subsequent complication (extension or delayed ICH) had a larger influence on survival without disability (RR 0.57; 95% confidence interval 0.35-0.95) than early ICH without complications (RR 0.78; 95% confidence interval 0.67-0.91). Heparin-treated CVST patients were less likely to survive without disability when ICH was present on admission. This association may largely be driven by subsequent extension of haemorrhage or additionally occurring delayed haemorrhage.

Intra-arterial papaverine treatment for cerebral vasospasm: our experience and review of the literature. We described the techniques and efficacy of intra-arterial papaverine hydrochloride infusion (IA-PAP) for symptomatic vasospasm due to aneurysmal subarachnoid hemorrhage based on our experience and review of the literature. Angiographic improvement occurred almost always, but only 50% of patients who presented with acute symptoms showed remarkable clinical improvement after the first, second, or third IA-PAP. Recurrent vasospasm after IA-PAP frequently occurred and this seems to be an apparent source of controversy regarding its efficacy. Review of the literature indicates that IA-PAP may be most effective in combination with percutaneous transluminal angioplasty. Further controlled studies should be conducted regarding papaverine's true efficacy including most effective papaverine concentration and rate of infusion, maximum total dose, site of infusion, timing of treatment, and selection of patients.

Drug-induced congenital defects: strategies to reduce the incidence. Approximately 1% of congenital anomalies relate to pharmacological exposure and are. in theory, preventable. Prevention consists of controlled administration of drugs known to have teratogenic properties (e.g. retinoids, thalidomide). When possible, prevention could take the form of the use of alternative pharmacological therapies during the pre-conception period for certain specific pathologies, selecting the most appropriate agent for use during pregnancy [e.g. haloperidol or a tricyclic antidepressant instead of lithium; anticonvulsant drug monotherapy in place of multitherapy; propylthiouracil instead of thiamazole (methimazole)], and substitution with the most suitable therapy during pregnancy (e.g. insulin in place of oral antidiabetics; heparin in place of oral anticoagulants; alpha-methyldopa instead of ACE inhibitors). Another strategy is the administration of drugs during pregnancy taking into account the pharmacological effects in relation to the gestation period (e.g. avoidance of chemotherapy during the first trimester, avoidance of nonsteroidal anti-inflammatory drugs in the third trimester, and avoidance of high doses of benzodiazepines in the period imminent to prepartum).

Differential anatomical responses to elevated CO2 in saplings of four hardwood species. To determine whether an elevated carbon dioxide concentration ([CO(2)]) can induce changes in the wood structure and stem radial growth in forest trees, we investigated the anatomical features of conduit cells and cambial activity in 4-year-old saplings of four deciduous broadleaved tree species - two ring-porous (Quercus mongolica and Kalopanax septemlobus) and two diffuse-porous species (Betula maximowicziana and Acer mono) - grown for three growing seasons in a free-air CO(2) enrichment system. Elevated [CO(2)] had no effects on vessels, growth and physiological traits of Q. mongolica, whereas tree height, photosynthesis and vessel area tended to increase in K. septemlobus. No effects of [CO(2)] on growth, physiological traits and vessels were seen in the two diffuse-porous woods. Elevated [CO(2)] increased larger vessels in all species, except B. maximowicziana and number of cambial cells in two ring-porous species. Our results showed that the vessel anatomy and radial stem growth of Q. mongolica, B. maximowicziana and A. mono were not affected by elevated [CO(2)], although vessel size frequency and cambial activity in Q. mongolica were altered. In contrast, changes in vessel anatomy and cambial activity were induced by elevated [CO(2)] in K. septemlobus. The different responses to elevated [CO(2)] suggest that the sensitivity of forest trees to CO(2) is species dependent.

Effects of a nine-month occupational intervention on health-related quality of life. The aim of this study was to evaluate the effectiveness of vocationally outpatient oriented rehabilitation on an intervention group, compared with a control group that did not take part in the intervention. The groups were compared for health-related quality of life (HRQoL) by the quantitative indicator RAND 36. Data were obtained by a self-report at baseline and at nine months follow-up. Differences between base-line and follow-up were analyzed within group and between the groups. The study population consisted of 751 municipal employees aged between 26 and 64 years; an intervention with 463 women and 115 men ( n = 578), and a control group with 138 women and 35 men ( n = 173). In this study we focused on those who had answered to all questions in RAND 36, thus 581 remained. Of these, 388 were in the intervention group (mean age 49.0 years) and 110 in the control group (mean age 48.4 years). Intervention was based on cognitive behavioral therapy. Participants in the 9-month outpatient intervention group showed statistically significant increase in all eight RAND 36 areas. Most improvement was seen in the psychosocial functioning index ( p = 0.002). Although there were no statistically significant changes in RAND 36 components in the control group, difference in changes between groups were seen in energy and fatigue ( p < 0.001), social functioning ( p = 0.032) and general health perceptions 0.027 in favor of the intervention group. The results suggest that a cognitive behavioral intervention as an early rehabilitation program is effective in increasing employees' quality of life, as measured by RAND 36.

Novel GABAA receptor alpha subunit is expressed only in cerebellar granule cells. GABA (gamma-aminobutyric acid), the major inhibitory neurotransmitter in the vertebrate brain, mediates neuronal inhibition by opening a chloride channel integral to the GABAA receptor. This action is potentiated by both benzodiazepine and barbiturate drugs. Since the isolation of cDNAs encoding GABAA receptor alpha 1 and beta 1 subunits, a further eight subunits have been identified. These subunits show GABAA receptor heterogeneity, unpredicted from classical pharmacological studies. I now report the isolation of a mouse cDNA clone encoding a novel GABAA receptor alpha subunit. The striking feature of this subunit is its regional distribution in the mouse brain. Northern hybridization and in situ hybridization experiments demonstrate that the subunit mRNA is expressed only in cerebellar granule cells. This is the first demonstration of the exclusive presence of a neuroreceptor subtype in a single neuronal cell type.

Primary solitary eosinophilic granuloma of the brain and postoperative radiotherapy: a clinical case. A case of solitary eosinophilic granuloma (EG) of the brain in a 53-year-old woman is presented. The tumor developed in the anterior cranial fossa causing destruction of the skull basis and the retrobulbar space, accompanied by vision impairment. The tumor was partially excised and the patient was irradiated postoperatively with 40 Gy 6 MV x-rays, followed by 10 cycles of chemotherapy. Follow-up computed tomography (CT) showed no response at 30 Gy and no progression during chemotherapy. Attention is drawn to cases of EG indolent in growth but resistant to radiation and chemotherapy.

Health-related physical fitness and quality of life in men with congenital hypogonadotropic hypogonadism. Congenital hypogonadotropic hypogonadism is a rare disorder characterised by impaired testosterone secretion since birth, and represents a valuable model for studying the effects of testosterone replacement therapy (TRT) in humans. This cross-sectional study aimed to investigate all health-related physical fitness (HRPF) components and quality of life in a series of eight men with hypogonadotropic hypogonadism under regular TRT. The study group was compared to a control group of 16 healthy subjects paired for age, body mass index and physical activity. Body composition, aerobic capacity, muscular strength and endurance, and joint flexibility were evaluated in two different 7-day interval time points, based on the pharmacokinetics of testosterone in the hypogonadal group. Quality of life was assessed by the WHOQOL-brief questionnaire. Both groups had similar performances in all HRPF components evaluated, independently of plasma testosterone levels (p > .05). Quality of life was also similar in the four domains analysed (p > .05). The results of this pilot study suggest that regular testosterone replacement was efficient in providing HRPF and quality of life in a series of congenitally hypogonadal men to levels like those observed in healthy men. In addition, acute fluctuations in plasma testosterone did not correlate with changes in muscle strength and endurance.

Involvement of NMDA receptors in non-convulsive epilepsy in WAG/Rij rats. The involvement of the NMDA receptor in spontaneous non-convulsive epilepsy was studied by intracerebroventricular injections of APH and NMDA in WAG/Rij rats. The WAG/Rij rat strain is recognized as an animal model for human absence epilepsy. EEG registrations showed that APH (5 nmol/5 microliters; 25 nmol/5 microliters; 50 nmol/5 microliters) causes a dose-dependent decrease in the number and mean duration of the spike-wave discharges, while NMDA (50 pmol/5 microliters; 500 pmol/5 microliters; 5 nmol/5 microliters) induces a dose-dependent increase in the number. The effects of NMDA (5 nmol/5 microliters) can be blocked completely by APH (50 nmol/5 microliters). These results suggest an involvement of the NMDA receptor in experimental non-convulsive epilepsy, observed in the WAG/Rij model.

Long-term function and morphology of intestinal autografts and allografts in outbred dogs. Although small bowel transplantation (SBTx) has become a clinical option, there have been few studies of long-term function and histopathology of intestinal grafts. Unrelated mongrel dogs received autologous (n = 4) or allogeneic (n = 11) orthotopic SBTx under oral cyclosporine. Intestinal graft function and routine/immunohistopathology of full-thickness intestine were studied. Six allograft and all isograft recipients had comparable body weight gain and are currently alive (> 420 days). Five allograft recipients were sacrificed because of significant body weight loss and malnutrition at a median of 119 days. Analyses of intestinal function in long-surviving recipients revealed marginal reduction of D-xylose/cyclosporine absorption, intestinal transit time, in vitro muscle contractility, and mucosal enzyme activity compared with normal dogs. However, these changes were insignificant and no statistical difference was seen between auto and long-surviving allografts. In histopathological analysis, long-surviving allografts had normal mucosa with submucosal, muscularis propria, and perineural (Auerbach's plexus) inflammation. Five allorecipients with malnutrition had mucosal atrophy/erosion and significantly reduced intestinal absorption and motility. Thus, denervated intestinal allografts are able to efficiently digest and absorb nutrients to support life. Results also indicate that these allografts experienced low-grade chronic rejection as evidenced in the submucosa and muscle layers, despite the lack of clinical symptoms.

Chest tube-delivered bupivacaine improves pain and decreases opioid use after thoracoscopy. This study compared a simplified method of intrapleural bupivacaine administration with traditional analgesic therapy to decrease postoperative pain and opioid usage in patients after thoracoscopy. Thirty patients who had non-rib-spreading thoracoscopic operations under general anesthesia were prospectively randomized to no local anesthetic infusion (control), intermittent bolus (30 mL every 6 hours), or continuous infusion (5 mL/h). Bupivacaine (0.25%) was delivered through the pleural infusion channel of a specially designed single silicone 28F chest tube. Total intravenous fentanyl patient-controlled analgesia (boluses with basal rate) infused in the first 24 hours postoperatively was the designated primary study end point. Escalations of analgesic therapy, including ketorolac administration, were standardized across all groups. Nurses assessed pain control at onset and every 6 hours by visual analog pain scales (VAPS, 100 mm). VAPS were repeated 10 minutes later to assess any opioid or bupivacaine bolus effects. No study-related adverse events occurred. Compared with controls, pooled VAPS scores and 24-hour fentanyl consumption were significantly lower for the intermittent and continuous administration groups (1753 vs 1180 vs 1177 microg/24 h, respective median; p = 0.04) Early (6-hour) VAPS analgesic responses were more certain for intermittent (10 of 10) and continuous (10 of 10) patients than controls (7 of 10, p = .04). Five continuous patients successfully maintained VAPS scores below 20 mm throughout the study vs 3 intermittent and 2 controls (p = .045). Intermittent or continuous intrapleural bupivacaine infused through the chest tube reliably reduces postoperative pain and 24-hour opioid usage in thoracoscopy patients.

Effectiveness of pharmacist-administered diabetes mellitus education and management services. To evaluate the effectiveness of pharmacist-administered diabetes mellitus education and management services on selected diabetes performance measures. Additional goals were to compare outcomes with goals specified for patients with diabetes by the National Committee for Quality Assurance (NCQA) and identify areas for improvement. One-year observational study. Three university-based primary care clinics. One hundred ninety-one patients with diabetes. Intervention. Pharmacist-provided diabetes education and management services. Each patient was assessed for hemoglobin A1c (A1C) values, blood pressure, low-density lipoprotein cholesterol (LDL) levels, and aspirin use at baseline and at 1 year after enrollment. Cost avoidance comparators were calculated for those patients with reductions in A1C of at least 1%. Average A1C at 1 year was 7.8% (range 4.5-13.9%) versus 9.5% (range 5.4-19%) at baseline (change -1.7%, p<0.05). Seventy-two patients (38%) experienced a 1% or greater reduction in A1C. Average blood pressure decreased over the study period from 141/79 to 135/75 mm Hg (p=0.007), but average LDL levels did not change to a statistically significant extent (114 to 112 mg/dl, p>0.05). Aspirin use increased from 34% at baseline to 73% at 1 year (p<0.0001). The program achieved the A1C and LDL values required to qualify for NCQA diabetes recognition. Based on an estimated savings of $820 for each 1% decrease in A1C, cost avoidance was calculated as $59,040. Diabetes management services from clinical pharmacists achieved significant improvements in A1C values, blood pressure, and aspirin use. Continued efforts in diabetes education and management are needed to further improve clinical, economic, and humanistic outcomes.

Development of scales to assess patients' perception of physicians' cultural competence in health care interactions. This study describes the development of scales to measure patients' perception of physicians' cultural competence in health care interactions and thus contributes to promoting awareness of physician-patient intercultural interaction processes. Surveys were administrated to a total of 682 participants. Exploratory factor analyses were employed to assess emergent scales and subscales to develop reliable instruments. The first two phases were devoted to formative research and pilot study. The third phase was devoted to scale development, which resulted in a five-factor solution to measure patient perception of physicians' cultural competence for patient satisfaction.

Epigenetic regulation identifies RASEF as a tumor-suppressor gene in uveal melanoma. Recently, a segregation study in families with uveal and cutaneous melanoma identified 9q21 as a potential locus harboring a tumor-suppressor gene (TSG). One of the genes in this area, RASEF, was then analyzed as a candidate TSG, but lack of point mutations and copy number changes could not confirm this. In this study, the RASEF gene was investigated for potential mutations and gene silencing by promoter methylation in uveal melanoma. Eleven uveal melanoma cell lines and 35 primary uveal melanoma samples were screened for mutations in the RASEF gene by high-resolution melting-curve and digestion analysis. Expression of RASEF was determined by real-time RT-PCR in all cell lines and 16 primary uveal melanoma samples, and the methylation status of the promoter of the RASEF gene was analyzed and confirmed by direct sequencing. Mutation screening revealed a known polymorphism (R262C; C-->T) in exon 5 of the RASEF gene that displayed a normal frequency (54%). Of the primary uveal melanomas, 46% presented a heterozygous genotype, and 10 (91%) of 11 cell lines showed a homozygous genotype. Melting-curve analysis indicated loss of heterozygosity in at least two primary tumors. Low RASEF expression in the cell lines and primary tumors correlated with methylation of the RASEF promoter region. Homozygosity and methylation of the RASEF gene in primary tumors were associated with decreased survival (P = 0.019). Homozygosity, in combination with methylation, appears to be the mechanism targeting RASEF in uveal melanoma, and allelic imbalance at this locus supports a TSG role for RASEF.

[Composition and niche of the existing herbaceous plants in the water-level-fluctuating zone of the Three Gorges Reservoir Area, China]. To understand the usages of available resource by dominant plants, their niches and the mechanisms of inter-specific competition and co-existence in the water level fluctuation zone, we studied the spatial distributions and niche characteristics of existing dominant herbaceous species at a typical water-level-fluctuation site of the Three Gorges Reservoir Area, Zigui. The results showed that there were 39 herb species in total, which belonged to 18 families and 32 genera. Gramineae, Compositae, Polygonaceae and Euphorbiaceae were the dominant families. Cynodon dactylon, Setaria viridis, Bidentis tripartitae and Digitaria chrysoblephara were the dominant species, with high importance value and niche breadth. In addition, at 145-155 m, 155-165 m and 165-175 m altitude section, the three major species, expressing the highest ecological niche breadth, which were in order of C. dactylon ＞ Polygonum lapathifolium ＞ S. viridis, S. viridis ＞ D. chrysoblephara ＞ C. dactylon, and S. viridis ＞ B. tripartitae ＞ P. orientale, respectively. The niche overlap of the species between the different altitudes zone was relatively high. The species which had a broad niche could co-exist with those occupying narrow niche. The niche overlap could not be determined by niche breadth lonely. Furthermore, after seven times of water level fluctuations, most of the species were annual herbs, and the degree of niche differentiation was low in the area. Due to scarce resources and unstable habitats, the inter-specific competition was strong, and the vegetation was at the primary successional stage.

[Role of the vitreous in retinal neovascularization evaluated by a comparison of central retinal vein occlusion and branch retinal vein occlusion]. Thirty three patients (33 eyes) with central retinal vein occlusion (CRVO) and 80 patients (81 eyes) with branch retinal vein occlusion (BRVO) were studied in an attempt to investigate the role of the vitreous in the formation of retinal neovascularization. All these eyes had some areas of capillary nonperfusion confirmed by fluorescein angiography and no scatter photocoagulation before the first examination. The incidence of new vessels at the optic disc (NVD) in CRVO was not significantly different from that in BRVO. However, the incidence of new vessels elsewhere (NVE) in CRVO was significantly less than that in BRVO. Follow-up vitreous examination of 36 cases while they had not developed NVD and/or NVE showed a higher incidence of posterior vitreous detachment from the mid-peripheral retina (MP-PVD) in CRVO than in BRVO. On the other hand, there was no statistically significant difference in the incidence of posterior vitreous detachment from the optic disk (D-PVD) between CRVO and BRVO. The high incidence of MP-PVD in CRVO may explain the low incidence of NVE in CRVO.

PQQ as redox shuttle for quinoprotein glucose dehydrogenase. The role of pyrroloquinoline quinone (PQQ) as a redox shuttle between an electrode and the active site of soluble quinoprotein glucose dehydrogenase (sGDH) from Acinetobacter calcoaceticus has been investigated using both electrochemical and spectrophotometric methods. Reversible redox behavior of PQQ was observed at cystamine-modified gold electrodes. sGDH is able to reduce free PQQ, i.e. PQQ that is not bound to the enzyme and therefore could act as a mediator between the enzyme and the cystamine-modified electrode. The second order rate constants for the reduction of PQQ by sGDH are 6 x 10(3) M(-1) S(-1) and 64 M(-1) S(-1) in the absence and in the presence of calcium ions, respectively. Similarly, the interaction with a second redox protein is realized via the PQQ shuttle. Using DC voltammetry, the reduction rate of cytochrome c (cyt c) by PQQH2 was determined to be on the order of 10(4) M(-1) S(-1)

Recovery between Work Shifts among Emergency Medical Services Clinicians. Shift workers regularly report sleep problems, fatigue, and the need for recuperative rest between shifts (intershift recovery). We sought to characterize intershift recovery among emergency medical services (EMS) workers and the role of worker demographics and work-related factors. We combined cross-sectional survey data from two studies of EMS shift workers who completed standardized instruments, including the Occupational Fatigue Exhaustion Recovery (OFER) scale. A multivariable regression identified demographic and work factors most strongly associated with intershift recovery. Mean intershift recovery among 450 EMS workers varied by clinical setting, general health status, length of work shift, sleep quality score, fatigue score, and daytime sleepiness. Recovery was better for EMS workers who report greater satisfaction with their schedule, higher for shift schedules >12 hours, and lowest for individuals who usually work 12-hour shifts. In this sample of EMS workers, greater recovery between shifts is associated with satisfaction with scheduling and longer shift length. There were weaker associations of recovery with health status, sleep quality, and workplace fatigue. Future studies should address the relationship of intershift recovery with time off between shifts, workload, and workplace safety and performance.

Effects of two synaptic activators, calcium and ethanol, on MEPP distribution in time. Miniature end-plate potentials (MEPPs) were recorded intracellularly from sartorius muscle of Rana esculenta. Tracings were divided into time bins whose duration approximated one-fifth of the mean interval between consecutive potentials. The observed number of bins containing 0, 1, 2, ... MEPPs was compared, by the X2 test, with the number calculated from the Poisson equation. MEPP timing was analyzed in the absence as well in the presence of Ca2+ (1 mM, 2.5 MM, and 15 mM). In half of the experiments, 0.5% ethanol was added to the bathing solution. In the absence of Ca2+, MEPP timing fitted the Poisson predictions. On adding Ca2+, the fit became poor and MEPPs showed the tendency to cluster. At 15 mM Ca2+, no experiment proved to be Poissonian. Though increasing the frequency of MEPPs similarly to Ca2+, ethanol maintained a Poissonian release of transmitter at any concentration of Ca2+. It is suggested that ethanol masks the effects of Ca2+ on MEPP timing by also inducing the discharge of transmitter outside the Ca2+-dependent sites of exocytosis in the presynaptic membrane.

Transfer students' personality types and their academic performance in a graduate-entry dental school. The study was designed to identify how different types of transfer student personality would be constituted in Seoul National University School of Dentistry (SNU SD) and delve into what personal types were often observed more competent in academic performance. Among 40 students who transferred to SNU SD in 2004, 15 students voluntarily participated in completing the Myers-Briggs type indicator (MBTI; GS form); then, it was tested whether or not their MBTI types would be dependent upon their final grades. In addition, another 32 out of the 50 students who were enrolled through a traditional pre-den system served as a control group. It was mainly found that ISTJ type was the most typical one for those transfer dental students as well as for other native dental students who excelled in their academic performance. The noticeable majority of transfer students were Introverted (67%), Sensing (80%), Thinking (86%), and Judging (80%), with S-J pattern being statistically significant. SNU SD has been in a rebuilding process in terms of student/outcome centered dental education to have it up to the global standards. For this reason, it is ultimately a crucial part of that process to understand what personality types of the dental students with different backgrounds in major are observed and thus recognize how to support their learning according to different patterns of individual personality.

FDG PET/CT of Infection: Should It Replace Labeled Leukocyte Scintigraphy of Inpatients? OBJECTIVE. The purpose of this study was to compare the sensitivity, specificity, and helpfulness to referring clinicians of labeled leukocyte scintigraphy versus FDG PET/CT in inpatients with suspected infection. MATERIALS AND METHODS. In this retrospective study, labeled leukocyte scintigraphy and FDG PET/CT examinations performed from 2009 to 2017 for suspected infection in inpatients were identified. Sensitivity, specificity, and helpfulness of PET/CT versus labeled leukocyte scintigraphy were calculated by means of a mixed generalized linear model. Number of yearly tests and radiopharmaceutical costs were also assessed. RESULTS. Fifty-seven patients (30 men, 27 women; median age, 65 years; range, 21-91 years) underwent whole-body labeled leukocyte scintigraphy. Forty-two patients (30 male patients, 12 female patients; median age, 62.5 years; range, 12-91 years) underwent PET/CT for suspected infection. Labeled leukocyte scintigraphy was 66.7% sensitive, whereas the sensitivity of PET/CT was 89.7% (p = 0.0485). The higher sensitivity of PET/CT did not come at a cost to specificity, which was 73.3% as opposed to 76.9% for labeled leukocyte scintigraphy (p = 0.8050). The odds of a positive study being helpful increased 4.6-fold for PET/CT versus labeled leukocyte scintigraphy (p = 0.0412). From 2009 to 2011, 33 labeled leukocyte scintigraphic examinations were performed versus two PET/CT examinations; and from 2012 to 2014, 16 labeled leukocyte scintigraphic versus 22 PET/CT examinations; from 2015 to 2017, eight labeled leukocyte scintigraphic versus 18 PET/CT examinations. The cost of labeled leukocytes increased between 2009 and 2017, but that of FDG decreased. By 2017, a labeled leukocyte radiopharmaceutical dose was approximately 10 times the cost of an FDG dose. CONCLUSION. PET/CT was more sensitive than and as specific as labeled leukocyte scintigraphy for identifying a source of infection in inpatients, and it was more helpful to referring clinicians. Use of PET/CT increased over time and was associated with substantial savings in radiopharmaceutical cost.

Bioaccumulation, distribution and metabolism of BDE-153 in the freshwater fish Carassius auratus after dietary exposure. Polybrominated diphenyl ethers (PBDEs) are of great environmental concern due to bioaccumulation and biomagnification in different food chains. However, significant biotransformation of some congeners via reductive debromination has been observed during in vivo and in vitro laboratory exposures. Little is known about the fate of 2,2',4,4',5,5'-hexabromodiphenyl ether (BDE-153) in fish. In the present study, crucian carp (Carassius auratus) were exposed to BDE-153 at a concentration of 10μg/g in food for 28 days. BDE-153 and its metabolites in different tissues were identified and quantified using gas chromatography coupled with tandem mass spectrometry and ultra-high performance liquid chromatography coupled with tandem mass spectrometry. In addition to eight debrominated metabolites, four oxidative metabolites were detected 4'-hydroxy-2,2',4,5'-tetra-BDE, 6-hydroxy-2,2',4,4'-tetra-BDE, 2,4-dibromophenol and 2,4,6-tribromophenol. With regard to the concentrations of BDE-153 and the major metabolites, the contribution order of different tissues was bile>brain>liver>gill>muscle. The highest concentrations of BDE-153 and metabolite 2,2',4,4'-tetrabromodiphenyl ether were detected in bile at 808ng/g and 157ng/g, respectively. Our results suggested that three possible metabolic pathways of BDE-153 occurred in crucian carp via dietary exposure: debromination, hydroxylation and cleavage of the diphenyl ether bond. These findings indicated evidence of the bioavailability of BDE-153 from food in the form of debrominated metabolites and oxidative metabolites in freshwater fish, which is critical to understanding the complete risks associated with PBDE bioaccumulation and metabolism in humans and wildlife.

Orlistat augments postprandial increases in glucagon-like peptide 1 in obese type 2 diabetic patients. Orlistat leads to improved glycemic control in obese type 2 diabetic patients, which is attributed to decreased insulin resistance associated with weight loss. Glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) are gut hormones that are secreted in response to food intake, and they both stimulate insulin secretion. Orlistat decreases fat absorption and increases intestinal fat content, which may lead to increased secretion of these peptides. In this pilot study, we tested the hypothesis that increased levels of these intestinal hormones may be involved in the improvement of postprandial hyperglycemia observed previously with orlistat in type 2 diabetic patients. A total of 29 type 2 diabetic patients, who were not taking insulin or alpha-glucosidase inhibitors, were enrolled in the study. On a crossover and single-blind design, after an overnight fasting, the patients received 120-mg orlistat or placebo capsules, followed by a standard 600-kcal mixed meal that contained 38% fat. At baseline and 60 min after the meal, blood samples were obtained for the measurement of GLP-1, GIP, insulin, C-peptide, triglycerides, free fatty acids, and glucose. All measured parameters increased significantly in response to the mixed meal compared with baseline, both with orlistat or placebo. When compared with the placebo, the orlistat administration resulted in a significantly enhanced postprandial increase in GLP-1 and C-peptide levels and attenuated the postprandial rise in glucose and triglycerides. The results of this study suggest that apart from decreasing insulin resistance as a result of weight loss, orlistat may increase postprandial GLP-1 levels, thereby enhancing the insulin secretory response to the meal and blunting the postprandial rise in glucose in type 2 diabetic patients. Increased GLP-1 levels, which lead to decreased food intake, may also contribute to the weight loss that is associated with the use of this drug.

[A dynamic study of myocardial perfusion using radioisotope analysis of coronary blood flow during auricular stimulation]. Reproductibility of the radiocardiographic method using 42 Potassium has been verified. Coronary blood flow has so been measured in 50 control subjects and coronary heart disease patients, at steady state and during auricular pacing at 150 beats per minute. In control subjects group, under auricular packing coronary blood flow increases by a mean value of 15%; on the other hand it decreases by a mean value of 32% in coronary heart disease patients bearing obvious coronarography lesions. The cardiac output coronary fraction increases by a mean value of 27% in the control subjects group; it remains unchanged in coronary heart disease patients. On the contrary this coronary fraction increases in a significant way after functional aortocoronary bypass.

The use of medetomidine/fentanyl combinations in dogs. The sedative effects of medetomidine at doses of 20 and 40 micrograms/kg im given alone or followed 16-18 min later by fentanyl (2 micrograms/kg iv) was investigated in 6 bitches of mixed breeds. The higher dose of medetomidine alone caused the greater degree of sedation, but two bitches were only lightly sedated with either dose. Side effects noted in some cases included apparent pain on injection, vomiting on induction of sedation, bradycardia, slowing of respiratory rate, cyanosis and muscular twitching. The intravenous injection of fentanyl caused a marked increase in depth of sedation in all animals, inducing a condition similar to neuroleptanaesthesia in which the eyes were rotated downward and the pedal reflex abolished. Slight twitching and sensitivity to sound occurred immediately after fentanyl injection, but this was transient. The cardiopulmonary effects of medetomidine (40 micrograms/kg im) followed 20 min later by either fentanyl (2 micrograms/kg iv) or a saline placebo were investigated in 4 beagle dogs. Medetomidine caused bradycardia, hypotension and reduced respiratory rate, inducing an intermittent respiratory pattern. The iv injection of fentanyl did not further alter the heart or respiratory rate or blood pressure. However there was a small but significant decrease in arterial oxygen tension and rise in arterial carbon dioxide tension. indicating some respiratory depression. We conclude that the use of intravenous fentanyl to dogs already sedated with medetomidine could prove useful in clinical cases where the initial sedation with medetomidine has proved inadequate.

Evaluation of the drug effect and rational use of antiseptic drugs in outpatient and emergency department of hospital. With the popularization and application of antiseptic drugs, the abuse of antiseptic drugs and various unreasonable applications have also become a serious medical problem. The prescriptions of antibiotics in our hospital were randomly selected for statistical analysis. Further, we analyzed the various situations of the use of antibiotics in outpatient department, and calculated the DDDs of different drugs based on the defined daily dose (DDD). The results showed that there were 403 unreasonable prescriptions, accounting for 24.9% of the drug prescriptions. The main problems of irrational prescriptions were unsuitable drugs, non indications and improper frequency of administration, which accounted for 27.1%, 21.3% and 18.3%. It is suggested that the quality department of the hospital should strengthen the special training for rational use of antimicrobial agents, intervene in time and effectively, and gradually change post evaluation into prevention and intervention in advance.

Comparison of oral administration of lomustine and prednisolone or prednisolone alone as treatment for granulomatous meningoencephalomyelitis or necrotizing encephalitis in dogs. To compare oral administration of lomustine and prednisolone with oral administration of prednisolone alone as treatment for granulomatous meningoencephalomyelitis (GME) or necrotizing encephalitis (NE) in dogs. Retrospective cohort study. 25 dogs with GME and 18 dogs with NE (diagnosis confirmed in 8 and 5 dogs, respectively). Records of dogs with GME or NE were reviewed for results of initial neurologic assessments and clinicopathologic findings, treatment, follow-up clinicopathologic findings (for lomustine-treated dogs), and survival time. Dogs with GME or NE treated with lomustine and prednisolone were assigned to groups 1 (n = 14) and 3 (10), respectively; those treated with prednisolone alone were assigned to groups 2 (11) and 4 (8), respectively. Prednisolone was administered orally every 12 hours to all dogs. In groups 1 and 3, mean lomustine dosage was 60.3 mg/m², PO, every 6 weeks. Median survival times in groups 1 through 4 were 457, 329, 323, and 91 days, respectively (no significant difference between groups 1 and 2 or between groups 3 and 4). Within the initial 12 months of treatment, median prednisolone dosage was reduced in all groups; dosage reduction in group 1 was significantly larger than that in group 2 at 6, 9, and 12 months. Combination treatment most frequently caused leukopenia, but had no significant effect on liver enzyme activities. In dogs with GME and NE, oral administration of lomustine and prednisolone or prednisolone alone had similar efficacy. Inclusion of lomustine in the treatment regimen was generally tolerated well.

Vancomycin-sensitive and vancomycin-resistant enterococcal infections in the ICU: attributable costs and outcomes. To determine the economic and clinical outcomes associated with infection with vancomycin-resistant Enterococcus (VRE) and to compare these outcomes to those associated with infection with vancomycin-sensitive Enterococcus (VSE). During a 3-month, prospective, cohort study of 117 high-risk, critically ill patients we collected complete clinical and demographic and ICU cost data from all patients during their ICU stays. After adjusting for variables in a stepwise multiple regression model VRE infections were associated with a median attributable increased ICU cost per patient of $33,251 (38,088 euros) and an increased length of hospital stay (LOS) of 22 days, while VSE infections were associated with an increased cost of $21,914 (25,102 euros) and an increased LOS of 27 days. The effect of VRE and VSE infections were not significantly different. Over the entire cohort the attributable cost per ICU patient day associated with VRE infection was $304 (348 euros). The attributable cost of ICU care associated with VRE infection is $33,251 (38,088 euros) and per ICU patient day was $304 (348 euros). VRE and VSE infections do not differ in associated cost of ICU care, LOS, or mortality. Any VRE control strategy is be cost-effective if the overall cost per ICU patient-day is less than $304 (348 euros).

Novel ultrasonic-modified MnOx/TiO2 for low-temperature selective catalytic reduction (SCR) of NO with ammonia. A novel ultrasonic-modified MnO(x)/TiO(2) catalyst was prepared and compared with two different kinds of MnO(x)/TiO(2) catalysts in the process of low-temperature selective catalytic reduction of NO with NH(3). The physicochemical properties of the catalysts were studied by using various characterization techniques, such as Brunauer-Emmett-Teller (BET) surface measurement, X-ray diffraction (XRD), high-resolution transmission electron microscope (HRTEM), and in situ Fourier transform infrared spectroscopy (in situ FT-IR). The ultrasonic-modified process introduced ultrasound in the solution impregnation step of traditional impregnation method for MnO(x)/TiO(2) catalyst preparation. In this study, ultrasonic process significantly improved the dispersion behavior and surface acid property of manganese oxide on TiO(2) as well as the catalytic activity, especially at temperature below 120°C. The NO conversion could reach 90% at 100°C. For the novel ultrasonic-modified catalyst, the combination analysis of XRD and HRTEM confirmed that manganese oxide was in a highly dispersed state and Ti and Mn had strong interaction. Furthermore, in situ FT-IR studies revealed that there were significant amounts of Lewis acidity and high Mn atom concentration on the surface of the novel catalysts.