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hepatocellular carcinoma ( hcc ) is one of the most common cancers worldwide , where it represents the third cause of cancer - related death . because of differences in risk factors , it ranges from 5.5 to 14.9 per 100,000 individuals , but it may reach 100 per 100,000 in some regions of africa and south east asia . ...	hepatocellular carcinoma ( hcc ) is the third cause of cancer - related death worldwide . curative options for hcc are limited and exclusively available for patients carrying an early stage hcc . in advanced stages , traditional chemotherapy proved to be only marginally effective or even toxic . thus , the identifi...
however , the incidence of btc appears to be increasing worldwide over the last few decades , particularly in latin america and east asia ( 1 ) . btc is currently the sixth leading cause of cancer - related mortality in japan , and patients with btc have a poor prognosis ( 2 ) . however , the majority of patients a...	a 68-year - old woman was referred to our hospital with increased levels of biliary enzymes . on imaging , the patient was diagnosed with unresectable intrahepatic biliary tract cancer ( btc ) with invasion of the portal vein and para - aortic lymph node metastasis ( ct3n1m1 , cstage ivb ) and underwent endoscopic bi...
amyotrophic lateral sclerosis ( als ) is a devastating neurodegenerative disease which affects both motor function and extramotor systems . according to the revised el escorial criteria for the diagnosis of als , the presence of signs for the affection of both upper motor neurons ( umns ) in the primary motor cortex an...	amyotrophic lateral sclerosis ( als ) , also known as lou gehrig disease , is a chronic degenerative neurologic disease and is characterized by the selective involvement of the motor system . usually , patients present with upper motor neuron ( umn ) and lower motor neuron compromise . degeneration of the umn in th...
	the valid extrapolation of carcinogenesis data from one species to another depends , in part , on strong similarities of the metabolic and cellular mechanisms involved in the carcinogenic process and similarities in the nature and behavior of the various lesions that appear during the development of neoplasia between t...
a 34-year - old man with painless right scrotal swelling , first noticed four months earlier , was admitted to our hospital . the patient had no history of scrotal trauma , voiding difficulty , other genitourinary diseases or weight loss . physical examination showed that the right side of the scrotum was noticeabl...	we report a case of adult granulosa cell tumor arising in the scrotal tunics . the patient was a 34-year - old man who presented with right scrotal swelling , first noticed four months previously . under the initial clinical impression of epididymoorchitis , antibiotic treatment was instituted but there was no respon...
as the most common aneurysm , abdominal aortic aneurysm ( aaa ) mainly occurs in middle - aged or elderly people , and shows an increasing trend worldwide . with the transition of demographic distribution toward an aging society , the incidence of aaa in china is also increasing . although having a benign nature , aa...	backgroundas the most common type of aneurysm , abdominal aortic aneurysm ( aaa ) has an unfavorable prognosis due to the high frequency of rupture . studies have indicated a close relationship between the pathogenesis and progression of aaa and abnormal serum lipid levels . atp - binding cassette transport protein...
fibrosarcoma is a tumor of mesenchymal cell origin that is composed of malignant fibroblasts in a collagenous background . it can occur as a soft tissue mass or as a primary or secondary bone tumor . the sarcomas as a group differ from malignant epithelial neoplasms by their typical occurrence in relatively younger...	fibrosarcoma is a malignant tumor of fibroblasts . at one time , it was considered one of the most common soft tissue sarcomas . however , the diagnosis of fibrosarcoma is made much less frequently today because of the recognition and separate classification of other spindle cell lesions that have similar microscopic...
	the intraband exciton dynamics of molecular aggregates is a crucial initial step to determine the possibly coherent nature of energy transfer and its implications for the ensuing interband relaxation pathways in strongly coupled excitonic systems . in this work , we fully characterize the intraband dynamics...
diabetes mellitus is a common noncommunicable disease in india , as well as the rest of the world . it has emerged as a major public health problem , with low- and middle - income countries facing the greatest burden . as of 2013 , india ranks second in the list of diabetes among people aged 2079 years next only to...	introduction : diabetes is a lifestyle disease which requires a multipronged approach for its management , wherein patient has an important role to play in terms of self - care practices , which can be taught to them by educational programs . to develop such an educational program , a baseline assessment of knowledge a...
	key clinical messagediagnosing hsp can be difficult , especially when abdominal symptoms precede the onset of characteristic palpable purpura ( chen mj et al . 2005 , world gastroenterol . , 11 , 2354 ) . therefore , it is necessary to consider the possibility of hsp in patients with prolonged strong abdominal p...
regulated upon activation normal t - cell expressed and secreted ( rantes ) is a key signaling cytokine involved in initiation of physiologic inflammation ( conti et al . , 1999 ) as well as in many pathologic inflammatory conditions including endometriosis ( oral et al . , 1996 ) . rantes has been shown to be respon...	this study was performed to investigate the effect of peroxisome proliferators activated receptor- ( ppar- ) ligand , pioglitazone , on production of regulated upon activation normal t - cell expressed and secreted ( rantes ) and in vitro fertilization ( ivf ) outcome in infertile patients with endometriosis . sixty ...
the deletion of long arm of chromosome 5 ( del(5)(q32 ) ) is a very rare event in acute lymphoblastic leukemia ( all ) and has not been analyzed extensively . the del ( 5)(q ) is associated with 20 - 30% of mds , either as the sole identifiable abnormality , or in combination with one or more additional abnormalities...	del(5)(q ) is a common chromosomal abnormality with favourable prognosis in myelodysplastic syndrome ( mds ) and acute myeloid leukemia ( aml ) . however , del(5)(q ) is also seen rarely in acute lymphoblastic leukemia ( all ) and its significance remains poorly understood . we present here , a case report of diagn...
because of the improved culture methods ( 8,9 ) and sensitive nucleic acid amplification assays ( naaas ) ( 1014 ) developed in recent years , kingella kingae , a gram - negative coccobacillus of the neisseriaceae family , is increasingly recognized as an invasive pathogen of early childhood . the organism is a frequ...	during the past decade , transmission of the bacterium kingella kingae has caused clusters of serious infections , including osteomyelitis , septic arthritis , bacteremia , endocarditis , and meningitis , among children in daycare centers in the united states , france , and israel . these events have been characteriz...
dopamine receptors and dopamine signaling have been implicated in various neurological and psychiatric disorders including parkinson 's disease , schizophrenia , and drug abuse [ 13 ] . dopamine receptors are divided into two subfamilies , the gs - coupled d1 and d5 receptors and the gi / o - coupled d2 , d3 , and d4...	chronic dopamine receptor activation is implicated in several central nervous system disorders . although acute activation of gi - coupled d2 dopamine receptors inhibits adenylyl cyclase , persistent activation enhances adenylyl cyclase activity , a phenomenon called heterologous sensitization . previous work revea...
gestational trophoblastic neoplasia ( gtn ) comprises a spectrum of malignant tumors derived from the trophoblast including the invasive mole ( i m ) , the choriocarcinoma ( ch ) , the placental site trophoblastic tumor ( pstt ) and the epithelioid trophoblastic tumor ( ett ) . pstt is a rare entity with less than 30...	highlightsrare case of pstt limited to the vagina presenting eight years after last pregnancy and four years after hysterectomydifferential diagnosis with other vaginal tumors can be challenging but it is critical because behavior and management are different.stage-adapted management is proposed and surgery is the main...
the most common symptoms leading to a diagnosis are dysmenorrhoea , pelvic pain , and reduced fertility . it is a very prevalent disease affecting up to 10% of the reproductive - aged female population . currently , the most widely accepted theory is the implantation theory : retrograde menstruation can result in v...	endometriosis is characterised by the growth of ectopic lesions at multiple locations outside the uterine cavity and may be considered a collection of distinct but related conditions . the exact aetiology of endometriosis is still not clear although a role for inflammation is increasingly accepted . we therefore in...
there are basically three variants of primary localized cutaneous amyloidosis ( plca ) : macular , papular ( lichenoid ) and nodular forms [ 1 , 2 , 3 ] . in macular and papular plca , cytokeratins serve as the amyloid precursors , and these variants are limited to the dermis [ 1 , 2 , 3 , 4 ] . in contrast , the rare ...	a 79-year - old man presented with a large tumor on the left side of his head , which had grown over 5 years . regional lymph nodes were impalpable and computed tomography revealed no signs of bone infiltration . histology showed that the entire dermis was filled with amorphous eosinophilic material . immunohisto...
the book of judith is a deuterocanonical book of the septuagint and catholic and eastern orthodox christian old testament of the bible . it narrates the story of the beautiful jewish widow judith who saved her city of bethulia from the siege of holofernes , a general of the assyrian king nebuchadnezzar . according to...	judith was a legendary hebrew heroine who beheaded the general holofernes and saved the children of israel from destruction by the assyrian army . in the book of judith , which is still present in the catholic and orthodox christian bibles , judith is presented as an illustrious woman who defeated the enemy using her...
patterning of the nervous system requires neurons to extend axons to targets that are often at great distances from their cell bodies . polarity information can be provided to growing axons by gradients of attractive or repulsive guidance cues that stimulate different signal transduction pathways in growth cones to g...	summarythe unc-5 receptor mediates axon repulsion from unc-6/netrin through unc-40 dependent ( unc-5+unc-40 ) and independent ( unc-5-alone ) signaling pathways . a requirement for unc-40 dependent signaling has been shown in long - range repulsion from unc-6/netrin , however , the mechanisms used to regulate disti...
generally , in automatic titration procedure based on flow injection analysis process , the volume of the titrant solution delivered has been determined considering both flow rate and time interval elapsed while the titration was run [ 13 ] . in principle , it has been admitted that the flow rate was constant a...	in this work , an automatic device to deliver titrant solution into a titration chamber with the ability to determine the dispensed volume of solution , with good precision independent of both elapsed time and flow rate , is proposed . a glass tube maintained at the vertical position was employed as a container for t...
thyroid nodules are commonly diagnosed in adults ; however , they are rare cases in pediatrics . depending on the iodine intake , they have been ranged from 19 to 35% in adults by ultrasonography ( us ) and from 0.2 to 5.1% in children [ 2 , 3 ] . cancer risk of a thyroid nodule is significantly greater in childr...	the clinical and pathological presentation of thyroid nodules among younger and adult patients was compared in an iodine - deficient ( i d ) region . data of 3,010 consecutive patients younger than 20 years and 3,010 patients older than 20 years were compared . the proportion of nodular goiters ( 22.8% versus 39.3% )...
pleomorphic adenoma is a frequent benign neoplasm in the head and neck region and accounts for 70% of all salivary gland tumors . 65% of the tumors arise in the parotid gland , and only 35% involve the minor glands . its origin in the maxillary antrum is an extremely rare phenomenon as , involvement of the upper re...	pleomorphic adenoma is the most common benign neoplasm of salivary gland origin involving both major and minor glands . though parotid is the most common site of origin , it has been reported to arise from various unusual locations . incidence of its origin in the respiratory tract is extremely rare , and the occur...
type 2 diabetes is a major independent risk factor for cvd , and this increased risk is partly attributed to abnormalities in lipid and lipoprotein metabolism as a consequence of hyperglycaemia and insulin resistance [ 14 ] . people with diabetes have a greater than twofold increase in the risk of cvd , and this risk...	dietary guidelines for the treatment of type 2 diabetes advocate the regular consumption of nuts and seeds . key lipid abnormalities associated with diabetes include raised ldl - c , vldl - c , and tag concentrations and decreased concentrations of hdl - c . the fatty acid profiles of nuts and seeds differ and may ...
pancreatic cancer is a major cause of cancer - related mortality worldwide as it ranks as the 5th leading cause of death , with an annual incidence in certain countries of approximately 20,00040,000 cases and poor mortality rates . owning to the high frequency of local extension and/or metastatic disease at the time ...	introduction . there has been limited reporting on the use of hepatic - directed therapy in liver dominant hepatic metastases arising from pancreatic cancer . methods . an irb - approved prospective multi - institutional treatment registry of 885 patients undergoing 1458 treatments for primary or secondary cancers ...
numerous large - scale clinical trials have demonstrated that statins ( 3-hydroxy-3-methylglutaryl - coenzyme a [ hmg - coa ] reductase inhibitors ) substantially reduce cardiovascular ( cv ) morbidity and mortality in both primary and secondary prevention of cv disease ( cvd ) . a meta - analysis of individual data ...	objective : statins are still underused for the prevention of cardiovascular disease ( cvd ) in china . hence , we conducted a systemic review on the pharmacology , clinical efficacy , and adverse events of atorvastatin , as well as on patient adherence.data sources : we conducted a systemic search in pubmed with the...
cancer of the nasal cavity and the paranasal sinuses , referred to as sinonasal cancer ( snc ) , is relatively uncommon in the general population , accounting for less than 1% of all neoplasms and less than 4% of those arising in the head and neck region [ 13 ] . snc incidence is around 1 100,000 person - years in...	we examined occupational exposures among subjects with sinonasal cancer ( snc ) recorded in a population - based registry in the lombardy region , the most populated and industrialized italian region . the registry collects complete clinical information and exposure to carcinogens regarding all snc cases occurring in...
maintaining or increasing soil organic carbon ( soc ) storage in croplands has been promoted as a win win strategy by enhancing soil productivity and increasing the terrestrial c stock , thereby mitigating greenhouse gas ( ghg ) emissions in agriculture ( lal 2004a ) . crop management may have great potential for ...	summaryan inventory of topsoil soil organic carbon ( soc ) content in household farms was performed in a village from a red earth region in jiangxi province , china in 2003 . in this region , the farmland managed by each household is fragmented , consisting of several plots of land that are not necessarily adjacent t...
a prospective study conducted at our hospital involved 41 pregnant women who bore a total of 41 fetuses and visited our department for level - ii obstetric us . gestational age ranged from 12 to 37 ( mean , 25 ) weeks : for nine , it was 10 - 20 weeks ; for 23 , 21 - 30 weeks ; and for the remaining nine , more than ...	objectiveto determine the usefulness of tissue harmonic imaging ( thi ) and pulse - inversion harmonic imaging ( pihi ) in the evaluation of normal and abnormal fetuses.materials and methodsforty - one pregnant women who bore a total of 31 normal and ten abnormal fetuses underwent conventional ultrasonography ( cus ) ,...
glaucoma is a multifactorial , progressive optic neuropathy characterized by retinal ganglion cell death , the loss of visual field , and excavation of the optic nerve head . glaucoma , the second leading cause of preventable blindness , is usually caused by the effects of elevated intraocular pressure ( iop ) . as e...	backgroundthe purpose of this work was to look into the effects of infliximab on wound healing in experimental glaucoma filtration surgery and to compare the antifibrotic effects of this agent to that of mitomycin - c ( mmc).methodstwenty - eight male new zealand white rabbits were randomly assigned to four groups , ea...
it has been well known that about half of the patients with lung cancer have metastases at the time of initial diagnosis . the common sites of distant metastases are the bone , liver , adrenal glands , and lymph nodes . the clinical symptoms of the metastases of bone , liver , and lymph nodes usually occur relative...	although intestinal metastases from lung cancer are not rare at postmortem studies , the development of clinically significant symptoms from the gastrointestinal metastases is very unusual . we report a case of small intestinal hemorrhage leading to intestinal perforation secondary to metastases from a large cell car...
primary aldosteronism ( pa ) has been traditionally considered a rare cause of hypertension ( 1 ) . however , recent studies have shown a higher prevalence , ranging between 5% - 20 % among hypertensive patients ( 2 ) . moreover , recent studies have demonstrated a higher frequency of cardiovascular complications i...	backgroundrecent studies have revealed a higher rate of cardiovascular complications in primary aldosteronism ( pa ) compared to patients with essential hypertension ( eh ) . asymmetric dimethylarginine ( adma ) is a marker of endothelial dysfunction that could contribute to increased cardiovascular risk in patients ...
the term primitive neuroectodermal tumors ( pnets ) were coined by hart and earle in 1973 . these are a group of malignant neoplasms derived from the primitive neural crest and are highly malignant and mainly exist in the central nervous system ( cns ) , chest wall , lower extremities , trunk , kidney , orbit , and r...	primitive neuroectodermal tumors ( pnets ) are aggressive childhood malignancies and are difficult to treat . primary intraspinal pnets are rare . these patients have poor prognosis with short survival time even after surgery and chemoradiation . as there are no standard guidelines exist for the management of the...
a total of 38 patients with chronic painful dpn ( neuropathy total symptom score 6 > 4 and < 16 ) for at least 6 months with stable glycemic control ( a1c < 11% ) were assessed . those with persistent pain , despite an adequate trial of tricyclic antidepressants , were recruited . three modalities of pain ( super...	objectiveto assess the efficacy of sativex , a cannabis - based medicinal extract , as adjuvant treatment in painful diabetic peripheral neuropathy ( dpn).research design and methodsin this randomized controlled trial , 30 subjects with painful dpn received daily sativex or placebo . the primary outcome measure was c...
complications during central venous catheter placement are uncommon and their incidence has decreased further with the use of ultrasound ( usg ) guidance for venous puncture . common vascular complications described during this procedure include common carotid artery ( cca ) injury leading to bleeding , dissection , ...	vascular injury during common jugular venous ( ijv ) access is a rare complication , usually involving injury to the common carotid artery . we describe a previously unreported complication of iatrogenic injury of ijv access involving a branch of the superior thyroid artery , and its endovascular management .
before the start of sample preparation one needs to program the automatic microwave tissue processor for electron microscopy ( leica em amw ; leica microsystems , vienna , austria ) with the following protocols ( table 1 ) for microwave assisted sample preparation for tem : table 1 . the different columns show ( fr...	investigations of ultrastructural changes induced by viruses are often necessary to clearly identify viral diseases in plants . with conventional sample preparation for transmission electron microscopy ( tem ) such investigations can take several days1,2 and are therefore not suited for a rapid diagnosis of plant vir...
in the development and patterning of embryonic and adult tissues , secreted signaling molecules of the wnt , fgf , hedgehog , and transforming growth factor ( tgf- ) families can act as morphogens to activate different transcriptional programs along a signaling gradient ( perrimon et al . , 2012 ) . ideas of how mo...	summarymorphogen signaling is critical for the growth and patterning of tissues in embryos and adults , but how morphogen signaling gradients are generated in tissues remains controversial . the morphogen nodal was proposed to form a long - range signaling gradient via a reaction - diffusion system , on the basis of ...
stickler syndrome alternately known as hereditary arthro - ophthalmopathy is an inherited disorder of collagen formation manifesting itself through a spectrum of ocular , orofacial , auditory , and musculoskeletal abnormalities.1,2 the disease is relatively uncommon , with a reported incidence of one in 7,5009,000 bi...	purposethe aim of the study was to present the long - term anatomical and visual outcomes of retinal detachment repair in patients with stickler syndrome.patients and methodsthis study is a retrospective , interventional , consecutive case series of patients with stickler syndrome undergoing retinal reattachment surger...
role of the p53 protein in regulation of cell cycle , cell growth and maintenance of genomic stability has been largely described . numerous alterations in p53 lead to neoplasmatic transformation . a rare familial li - fraumeni syndrome was associated with germline mutations in this gene . in families with li - fraum...	among many alterations within the tp53 gene the rs1042522 ( c72 g , p.pro72arg ) has been associated with numerous cancers , however the results differ between populations for opposite pro or arg alleles . similar thus inconclusive results are observed in ovarian cancer , which may suggest that the rs1042522 does not...
in modern society , chemicals are indispensable for everyday human life . numerous chemicals are used to maintain and improve the quality of life , including cosmetics , toiletries , detergents , air fresheners , agrochemicals such as pesticides and fertilizers , disinfectants , sterilizers , preservatives and industri...	objectiveskorea s act on the registration and evaluation of chemicals ( k - reach ) was enacted for the protection of human health and the environment in 2015 . considering that about 2000 new substances are introduced annually across the globe , the extent of animal testing requirement could be overwhelming unless reg...
ficoll - isolated mononuclear peripheral blood ( pb ) cells from healthy donors were stained with abs against the lin markers cd3 , cd19 and cd56 , as well as with hla - dr , cd14 , cd11c , cd141 , cd1c , cd303 and the indicated workshop abs ( table 1 ) . pdcs and two distinct myeloid dcs ( cd1c dcs , cd141 dcs ) wer...	dendritic cells ( dcs ) arise from hematopoietic stem cells and develop into a discrete cellular lineage distinct from other leucocytes . mainly three phenotypically and functionally distinct dc subsets are described in the human peripheral blood ( pb ) : plasmacytoid dcs ( pdcs ) , which express the key marker cd303...
the size class of meiofauna is generally defined as the portion of the community passing through a 1-mm sieve and being retained on a 32-m sieve . this community comprises protists and metazoan animals that remain small even as adults ( permanent meiofauna ) and animals that temporarily belong to this size class duri...	the abundance and higher taxonomic composition of epizooic metazoan meiobenthic communities associated with mussel and tubeworm aggregations of hydrocarbon seeps at green canyon , atwater valley , and alaminos canyon in depths between 1400 and 2800 m were studied and compared to the infaunal community of non - seep se...
age - related cataract is among the leading causes of severe visual impairment nowadays . with approximately 15 million cases performed annually , cataract extraction is one of the most frequent day - case procedures in medicine performed worldwide . anticipated demographic changes ( population growth in developing...	purpose . to evaluate and compare the efficacy of two different training methods in resident - performed phacoemulsification surgery . methods . 502 eyes of 467 patients who underwent resident - performed phacoemulsification were included in the study by reviewing their medical records . residents were allocated ...
tourette syndrome ( ts ) , also known as multiple transient tic disorder or combined vocal and multiple motor tics , is a type of chronic neuropsychiatric developmental disorder that occurs in children and adolescents . it is characterized by involuntary vocal tics and multiple motor tics of the head and body , parti...	background : tourette syndrome ( ts ) is a complex , heterozygous genetic disorder . the number of molecular genetic studies have investigated several candidate genes , particularly those implicated in the dopamine system . the dopamine d3 receptor ( drd3 ) gene has been considered as a candidate gene in ts . the...
perforation of acalculous gallbladder in association with enteric fever is extremely rare , especially in children . we report a rare case of enteric perforation of acalculous gallbladder in a 14-year - old boy , who presented with acute abdomen and responded very well after immediate surgical intervention . a 14-y...	introductiongallbladder perforation is a rare complication of acute calculous cholecystitis in adults . perforation of gallbladder due to enteric fever is extremely rare condition . pre - operative diagnosis is rarely made and mortality is high.presentation of casewe report a case of acalculous gallbladder perforat...
co - incidental aneurysms are detected almost seven times more frequently in patients with pituitary adenomas ( pa ) than in patients with other brain tumors2,12,19 ) . however , the vast majority of these aneurysms are located outside the sellar - region . aneurysms of the cavernous or supraclinoid carotid that en...	intra - cranial aneurysm can be incidental findings in patients with pituitary adenomas , and are usually located outside the pituitary region . however , the coexistence of intrasellar ( not intracranial ) aneurysms with pituitary adenomas is extremely rare . we report a patient with an incidental superior hypophy...
an operating microscope ( om ) has been considered as the mainstay in modern neurosurgery . it produces magnified images on the retina stereoscopically while providing detailed views of surgical anatomy . during the last two decades , neuroendoscopes are increasingly used in neurosurgery for intraventricular lesion...	an exoscope , high - definition video telescope operating monitor system to perform microsurgery has recently been proposed an alternative to the operating microscope . it enables surgeons to complete the operation assistance by visualizing magnified images on a display . the strong points of exoscope are the wide ...
evidence that continuing professional development impacts positively on patient and families outcomes is necessary to sustain an on - going investment in learning activities . in order to optimize the opportunities afforded by emerging web - based technology rural nurses need to develop and maintain their computer co...	background : the medical and nonmedical care of patients is the necessary skills in nursing profession . that it needs proper knowledge and attitude . hence , it is important to promote nurses knowledge and attitude by education based on need assessment . this study aimed to define the efficacy of a medical and non...
creativity is a very important psychological phenomenon that has attracted increased research interest in the cognitive neurosciences . at the same time , creativity is an extremely complex phenomenon that renders such research rather more difficult than studying a more basic cognitive process , such as attention or ...	because the cognitive neuroscientists have become increasingly interested in the phenomenon of creativity , the issue arises of how creativity is to be optimally measured . unlike intelligence , which can be assessed across the full range of intellectual ability creativity measures tend to concentrate on different sect...
	diyarbakir is the largest residential area in the southeastern anatolia of turkey . routine hbv vaccination has begun to be implemented by the ministry of health in turkey in 1998 . the purposes of this study were to detect the levels of hbv dna in patients with hbv in 2012 , and to compare the results of the year ...
the patient was male , aged 50 , 169 cm and 72 kg , and visited the hospital to undergo shoulder joint surgery with a damaged in the right rotator cuff . although he had diabetes that was diagnosed ten years before , he did not undergo treatment for it ; however , blood sugar level had been controlled . the patient...	the occurrence of severe hypotension and bradycardia , following placing to the beach chair position from supine during general anesthesia for repair of tendon injury of the rotator cuff of shoulder in a healthy 50 year - old man was described . the bezold - jarisch reflex , which is known to inhibit cardiovascular r...
adenosine triphosphate - binding cassette transporters , such as p - glycoprotein ( pgp ) , breast cancer resistance protein and multidrug resistance protein 4 have a pivotal role in controlling brain distribution of drugs . these transporters are expressed in the luminal membrane of brain capillary endothelial cells...	as p - glycoprotein ( pgp ) inhibition at the blood brain barrier ( bbb ) after administration of a single dose of tariquidar is transient , we performed positron emission tomography ( pet ) scans with the pgp substrate ( r)-[11c]verapamil in five healthy volunteers during continuous intravenous tariquidar infusion . ...
despite its potential for use in organic synthesis , applications of tmsccl3 ( tms = sime3 ) have been far narrower in scope than those of closely related tmscf3 ( ruppert prakash reagent).1 two reasons can be identified as the origins of this situation . firstly , all present literature preparations of tmsccl3 prov...	improved synthetic conditions allow preparation of tmsccl3 in good yield ( 70 % ) and excellent purity . compounds of the type nbu4x [ x = ph3sif2 ( tbat ) , f ( tetrabutylammonium fluoride , tbaf ) , oac , cl and br ] act as catalytic promoters for 1,4-additions to a range of cyclic and acyclic nitroalkenes , in th...
the ratio of copper ( cu ) to other dietary components ( e.g. , zinc ( zn ) , iron , sulfate , and molybdenum ) may be as important as the actual cu levels in the diet . cu / zn ratios may be important to the adequate metabolism of cholesterol , with low ratios resulting in hypercholesterolemia . previous studies h...	background : copper ( cu ) is essential both for its role in antioxidant enzymes , like cu / zinc ( zn ) superoxide dismutase ( sod ) and ceruloplasmin , as well as its role in lysyl oxidase , essential for the strength and integrity of the heart and blood vessels . with such a central role in cardiovascular health , c...
breast milk , the sole source of nourishment for newborns , has been under intense selective pressure over millions of years of evolution to meet the infant s needs to grow and survive . interestingly , the third most abundant chemical component class in human milk after lactose and lipids , human milk oligos...	human milk oligosaccharides ( hmos ) play a key role in shaping and maintaining a healthy infant gut microbiota . this article demonstrates the potential of combining recent advances in glycomics and genomics to correlate abundances of fecal microbes and fecal hmos . serial fecal specimens from two health...
autism and autism spectrum disorder ( asd ) are commonly used terms for a group of neurodevelopmental disorder that represents social deficits , communication difficulties , stereotyped or repetitive behaviors and cognitive delays1 , 2 . in general , the child with autism has not exhibited same symptom , but fe...	[ purpose ] the purpose of the present review is to discuss recent published articles in the understanding of efficacy of interventional exercise on autistic fragile x syndrome ( fxs ) with special emphasis on its significance in clinical application in patients . [ methods ] this review article was identified sc...
from july 2005 through october 2006 , a survey was conducted on 194 isolates of m. tuberculosis obtained from 194 patients with pulmonary tuberculosis ( tb ) ( 1 isolate per patient ) ( 1 ) . patients were recruited from the national hospital for pneumology and phtisiology in cotonou , benin , where most tb patients ...	using geographic information system and molecular tools , we characterized a possible outbreak of tuberculosis caused by mycobacterium tuberculosis beijing strain in 17 patients in cotonou , benin , during july 2005october 2006 . most patients lived or worked in the same area and frequented the same local drinking ba...
caebv infection was defined as 1 ) persistent or recurrent symptoms related to ebv infection for more than three months ; 2 ) high ebv genome levels in affected tissues or peripheral blood ; 3 ) chronic illness that could not be explained by other known disease processes at diagnosis , and 4 ) no specific underlying im...	backgroundepstein - barr virus ( ebv)-associated hemophagocytic lymphohistiocytosis ( hlh ) , ebv - positive systemic t - cell lymphoproliferative disease ( stlpd ) of childhood , and chronic active ebv ( caebv ) infection may develop after primary ebv infection . this study reviewed the clinicopathological spectrum ...
the impact of hai includes prolonged hospital stay , long - term disability , increased resistance of microorganisms to antimicrobials , massive additional financial burden , high costs for patients and their families , and excess deaths [ 1 - 3 ] . in october 2005 the world health organization ( who ) started the " cl...	summaryintroduction.hand decontamination with alcohol - based antiseptic agents is considered the best practise to reduce healthcare associated infections . we present a new method to monitor hand hygiene , introduced in a tertiary care pediatric hospital in northern italy , which estimates the mean number of daily h...
four decades after its introduction for joint arthroplasties , uhmwpe still represents the gold standard as an articulating counterface for arthroplasties , since it combines superior wear resistance along with high fracture toughness and biocompatibility compared to other polymers . it has been demonstrated that the...	wear debris related osteolysis is recognised as being the main cause of failure in joint replacements based on uhmwpe inserts . however , many solutions and new polyethylenes have been suggested in order to address this issue . this review discusses historical issues associated with uhmwpe , such as oxidation ,...
he had a 5-year history of schizophrenia and was previously partially controlled on risperidone 6 mg with trihexyphenidyl 4 mg in two equally divided doses daily in the last 2 years . then he was switched to amisulpride 200 mg twice daily , that initially controlled the akathisia and agitation symptoms . however , th...	amisulpride is a newer antipsychotic , which is very effective on its own , as well as augmenting other antipsychotic clozapine , which is an effective molecule for treatment resistant schizophrenia . in most cases , amisulpride is added on , in partial responders to clozapine . here a case is reported where clozapin...
bioconjugation of both the anti - icam-1 antibody and rat igg ( sigma , st . louis , mo ) to diethylenetriamine pentaacetic acid bisanhydride ( dtpaba ) and gadolinium chloride ( gdcl ) was performed according to a previously described procedure ( 19 ) . briefly , the anti - icam-1 antibody was purified from the cu...	objectiveto determine the utility of intercellular adhesion molecule ( icam)-1 antibody - conjugated gadolinium diethylenetriaminepentaacetic acid ( gd - dtpa - anti - icam-1 ) as a targeted contrast agent for the molecular magnetic resonance imaging ( mri ) in collagen - induced arthritis ( cia).materials and methodst...
leishmaniases are diseases with tegumentary or visceral forms that are caused by protozoans of the genus leishmania and are transmitted via insect vectors and affect more than 12 million people in tropical and subtropical areas of the world . leishmania ( leishmania ) amazonensis is one of the most prevalent species ...	leishmania ( leishmania ) amazonensis exhibits peculiarities in its interactions with hosts . because amastigotes are the primary form associated with the progression of infection , we studied the effect of insulin - like growth factor ( igf)-i on interactions between l. ( l. ) amazonensis amastigotes and macrophages...
because mf is the disease of old age , coincidence with pregnancy is rare and only few cases have been reported . until now there is controversy about the effect of pregnancy on progression of mf and some studies reported that pregnancy appeared to have no impact on the course of early mf , but according to our case ...	mycosis fungoides ( mf ) a cutaneous t - cell lymphoma , is a subgroup of non - hodgkin 's lymphomas , characterized by skin infiltration and occasionally systemic involvement . mf coincidence with pregnancy is rare . the effect of pregnancy on mf and the effect of this disease on pregnancy are still unknown . th...
we reviewed leptospirosis case investigation reports by hawaii department of health ( hdoh ) investigators submitted during 19992008 . these reports were ( and still are ) generated for all reported leptospirosis cases in the state . a standardized case investigation form was used , which includes demographic , epi...	although infrequently diagnosed in the united states , leptospirosis is a notable reemerging infectious disease throughout developing countries . until 1995 , when the disease was eliminated from the us list of nationally notifiable diseases , hawaii led the nation in reported annual incidence rates . leptospirosis...
corneal transplantation for corneal endothelial diseases is undergoing a paradigm shift from penetrating keratoplasty to endothelial keratoplasty.1 descemet s stripping automated endothelial keratoplasty ( dsaek ) , which is essentially endothelial keratoplasty that involves donor tissue preparation using an automated ...	backgroundthe purpose of this study was to compare endothelial cell counts after descemet s stripping automated endothelial keratoplasty ( dsaek ) and penetrating keratoplasty in asian eyes.methodsthis was a retrospective study of patients from our prospective singapore corneal transplant study cohort who received corn...
pterygium is an ocular lesion that is usually benign and is frequent in sunny countries . the intervention consists of the excision of the pterygium followed by the closing of the exeresis location . excimer laser , beta irradiation , and antimitotic molecules can be associated with this surgery.1 infectious compli...	the authors describe a case of keratomycosis that appeared after the exeresis of a pterygium . a 48-year - old patient had been referred with a red right eye associated with an abscess of the cornea along the ablation zone of the pterygium . the surgery had been performed a month beforehand . the abscess was 6 mm...
although the statistical - mechanical foundations of free - energy calculations were laid a long time ago , their practical applications became possible only with the advent of modern computers . from the inception of computer - based free - energy calculations it has been clear to theorists that direct boltzma...	in the host of numerical schemes devised to calculate free energy differences by way of geometric transformations , the adaptive biasing force algorithm has emerged as a promising route to map complex free - energy landscapes . it relies upon the simple concept that as a simulation progresses , a continuous...
food borne disease remains a significant problem in the united states , annually affecting millions of people . for example , the latest data reported by the centers for disease control and prevention ( cdc ) reveal that in 2007 there were 1096 outbreaks and 21,201 cases throughout the united states.1 these outbreaks...	food safety is an important public health issue in the u.s . eating at restaurants and other food service facilities increasingly has been associated with food borne disease outbreaks . food safety training and certification of food mangers has been used as a method for reducing food safety violations at food servi...
arthropods ( including insects and arachnids ) are often defined as pests , because they either compete with human consumption in agricultural or urban settings or transmit causal pathogens of disease . a large amount of investment is made into development of control tools for such pests . these tools can vary wide...	given the economic importance of insects and arachnids as pests of agricultural crops , urban environments or as vectors of plant and human diseases , various technologies are being developed as control tools . a subset of these tools focuses on modifying the behavior of arthropods by attraction or repulsion . ther...
various modalities , such as percutaneous nephrolithotomy ( pcnl ) , extracorporeal shock wave lithotripsy , and retrograde intrarenal surgery , are used to manage renal stone disease [ 1 - 3 ] . however , pcnl is regarded as the treatment of choice for most renal stones , especially for patients with a large renal sto...	purposeto compare surgical outcomes and complications after percutaneous nephrolithotomy ( pcnl ) under regional or general anesthesia.materials and methodsone hundred and one patients who underwent pcnl as a first - line treatment for kidney calculi between june 2004 and june 2013 were enrolled in this retrospective s...
the evaluation of motor function for duchenne muscular dystrophy ( dmd ) includes the 10-meter run , 6-minute walk test ( 6mwt ) , and the north star ambulatory assessment ( nsaa ) . these evaluation methods have also been used to determine the appropriate time to commence corticosteroid therapy for patients with...	[ purpose ] this study evaluated the effect of corticosteroid treatment on the daily activity of a patient with duchenne muscular dystrophy using an actigraph and examined whether this method produces the same results as the conventional motor - function evaluation methods . [ subject and methods ] a patient wi...
tourette syndrome ( ts ) is a childhood onset neuropsychiatric movement disorder characterized by multiple motor tics and one or more vocal / phonic tics.1,2 a duration of more than 1 year since the first tic and an onset before 18 years is also required for diagnosis.1,2 ts is associated with both simple and complex t...	this study addressed several questions relating to the core features of tourette syndrome ( ts ) including in particular coprolalia ( involuntary utterance of obscene words ) and copropraxia ( involuntary and inappropriate rude gesturing ) . a cohort of 400 ts patients was investigated . we observed that coprolalia o...
tuberculosis ( tb ) remains a worldwide health problem causing morbidity and mortality particularly in the developing and low - income countries . there are several reports of tb occurring during or following the treatment of malignant hemopathy and stem cell transplantation [ 1 , 2 , 3 ] . tb , especially the extr...	tuberculosis ( tb ) can present with various forms and can occasionally be mistaken for malignancy . hereby , we report a 53-year - old man diagnosed and treated for burkitt 's lymphoma in 2009 who achieved a complete remission confirmed by a computed tomography ( ct ) scan . during the follow - up 2 years later , he...
the accelerated global industrialisation trends during the past century have raised many concerns about the potential environmental health problems that might be caused as a result . in 2012 , it was estimated that seven million global deaths per year were attributed to air pollution.1 enhanced by the lack of strict ...	backgroundsohar industrial zone ( siz ) , oman , which started operating in 2006 , contains many industries that potentially affect the health of the local population . this study 's aim was to evaluate the health effects in a young population living near siz.methodspatient visits to state health clinics for acute re...
idiopathic megacolon is a rare and poorly understood clinical condition that usually presents as refractory abdominal distension and constipation . it includes idiopathic megarectum , idiopathic megacolon , or a combination of these disorders . among them , idiopathic megacolon without megarectum is the most uncommon...	idiopathic proximal hemimegacolon is a disorder characterized by bowel dilatation proximal to the splenic flexure . it is a very rare and therefore a poorly understood clinical entity . this report describes a case of idiopathic proximal hemimegacolon in a 44-year - old woman . the patient suffered from 2 episode...
road accidents and the related mass casualties are one of the challenges of the human society that threaten the health of people and impose huge costs on the states . developed countries have the largest number of victims due to road accident and is considered as one of the main causes of death . the degree of inju...	background : the aim of this study was to evaluate the effect of variables such as personality traits , driving behavior and mental illness on road traffic accidents among the drivers with accidents and those without road crash.methods:in this cohort study , 800 bus and truck drivers were recruited . participants wer...
insertion sequences ( is ) are short prokaryote transposable elements ( tes ) characterized by a simple structure , often consisting of a single transposase - encoding open reading frame flanked by terminal inverted repeats . because their proliferation can induce variation in genome size , activate and inactivate ge...	horizontal transfer of transposable elements ( tes ) plays a key role in prokaryote genome evolution . most tes do not encode the enzymatic machinery allowing them to transfer between host cells and it is widely assumed in the literature that horizontal transfer of prokaryote tes is mediated by other mobile genetic e...
chronic obstructive pulmonary disease ( copd ) is an airway inflammatory disease caused by inhalation of toxic particles , mainly cigarette smoking , and is now accepted as a disease associated with systemic characteristics.1 nutritional status is one of them . twenty - six percent to 70 percent of copd patients with...	background and objectivewhereas nutrition deficits are recognized as an expression of systemic inflammation in the elderly with diagnosed chronic obstructive pulmonary disease ( copd ) , if they occur in symptomatic elderly smokers , unfulfilled copd criteria are not confirmed.methodsrespiratory function , anthropometr...
in 1932 , crohn , ginzburg and oppenheimer first presented the clinical and pathologic features of a new disease which affected the terminal ileum . they described the disease as granulomatous inflammation associated with thickening of the bowel wall , and called the condition terminal ileitis . it later became a...	crohn s disease is a rare disease in korea , and only 45 cases have been reported during a 34 year from 1952 to 1985.the male to female ratio was about 1.3 to 1 with a slight preponderance of males . the age at diagnosis ranged from 8 to 72 ( mean 35.5 ) years , and the peak incidence occurred in the 3rd , 4th and 5t...
both registry data1 , 2 , 3 , 4 and secondary analyses of randomized controlled trials5 , 6 , 7 have suggested that the burden of anemia in patients presenting with acute coronary syndromes ( acs ) is significant . a recent metaanalysis of 27 studies including 233 144 patients has reported a prevalence of anemia in ...	backgroundwe aim to determine the prevalence of anemia in acute coronary syndrome ( acs ) patients and compare their clinical characteristics , management , and clinical outcomes to those without anemia in an unselected national acs cohort.methods and resultsthe myocardial ischemia national audit project ( minap ) regi...
with the advent of newer imaging modalities and their widespread availability , brain arteriovenous malformations ( avms ) are being increasingly diagnosed . even though microsurgery is advocated as the definitive treatment modality , radiosurgery is commonly performed , as an alternative to surgical resection in many ...	background : radiosurgery is an alternative to surgical resection of arteriovenous malformation ( avm ) . very few studies have addressed the concern of radiation injury to the brain and its attendant adverse effects on cognitive function.materials and methods : this prospective study included all patients who underw...
torus palatinus ( tp ) and torus mandibularis ( tm ) are two of the most common intraoral exostoses . other types of exostoses , affecting the palatal aspect of the maxilla ( palatal exostoses ) or the buccal aspects of the jaws ( buccal exostoses ) , are less commonly encountered . tp is a sessile nodule of the bo...	the aims of this study were to determine the prevalence , size , shape , and location of torus palatinus ( tp ) and torus mandibularis ( tm ) , and to assess their sex - related and age - related differences in the malay population . sixty - five subjects were assessed for the presence of both tori at the school of d...
epic - nl consists of the two dutch contributions to the epic study , the prospect - epic and morgen - epic cohorts . these cohorts were set up simultaneously in 19931997 and merged into one dutch epic cohort . the design and rationale of epic - nl are described elsewhere ( 16 ) . the prospect - epic study includes...	objectivedietary recommendations are focused mainly on relative dietary fat and carbohydrate content in relation to diabetes risk . meanwhile , high - protein diets may contribute to disturbance of glucose metabolism , but evidence from prospective studies is scarce . we examined the association among dietary total...
given the types of intermittent maximum effort needed during a team sport such as handball , it is important to evaluate performance by measuring variables such as muscle strength , velocity and resistance ( marques , 2010 ; michalsik et al . , 2013 ; pvoas et al . , the factors that determine performance in handball...	abstractthe aim of the present study was to identify different cluster groups of handball players according to their physical performance level assessed in a series of physical assessments , which could then be used to design a training program based on individual strengths and weaknesses , and to determine which of th...
this safe and inexpensive 4-aminoquinoline compound accumulates inside the digestive vacuole of the infected red blood cell . chloroquine resistance ( cqr ) was first reported in southeast asia and south america and has now spread to the vast majority of malaria - endemic countries . antimalarial drug resistance is...	chloroquine ( cq ) has been the mainstay of treatment of malaria for decades . this cost - effective and safe drug has become ineffective for treatment of falciparum malaria in many parts of the world due to development of resistance by the parasite . in addition cq is not gametocytocidal for p. falciparum and th...
a 69-year - old male complained of a 4 month history of a progressively enlarging , painless right groin swelling during routine urological review . he had been diagnosed with locally advanced prostate cancer 2 years previously , for which he had received radical radiotherapy ( 74gy/37 fractions ) and was on maintena...	soft - tissue sarcomas of the genitourinary tract account for only 12% of urological malignancies and 2.1% of soft - tissue sarcomas in general . a 69-year - old male complained of a 4 month history of a painless right groin swelling during routine urological review for prostate cancer follow - up . clinical examin...
chronic intestinal pseudo - obstruction ( cipo ) is a high - morbidity syndrome that develops as a consequence of altered intestinal motility , which results in clinical manifestations that resemble intestinal obstruction but in the absence of any physical obstructive process . cipo is one of the most important cause...	chronic intestinal pseudo - obstruction results in clinical manifestations that resemble intestinal obstruction but in the absence of any physical obstructive process . fabry disease is an x - linked lysosomal storage disease characterized by the dysfunction of multiple systems , including significant gastrointestina...
there have been conflicting reports on the role of ovary ( estrogen ) and testis ( testosterone ) in growth and cholesterol metabolism . our recent study ( lee et al . , 2008 ) demonstrated that a lower growth rate in female rats was due to estrogen , which induced secretion of the stress hormone cortisol . similar...	we conducted two studies to determine the effect of gender , gonadectomy ( gdx ) on growth and plasma cholesterol levels in pigs . in experiment 1 , five sham - operated and five gdx female landrace pigs ( 26 kg ) were allowed to have free access to water and feed up to market weight ( approximately 100 kg ) . body w...
	rodents are commonly used for inhalation toxicology studies , but until recently the nasal passages have often been overlooked or only superficially examined . the rodent nose is a complex organ in which toxicant - induced lesions may vary , depending on the test compound . a working knowledge of rodent nasal anato...
radiation pneumonitis is a dose - limiting complication for patients undergoing radiation therapy for lung cancer . the incidence of grade ii radiation pneumonitis is relatively low for prescribed standard doses up to 65 gy , but dose escalation is likely to increase the incidence of radiation pneumonitis . the dos...	purpose : lung perfusion scan provides a map of the spatial distribution of lung perfusion . this can be used to design radiation portals to spare functional lung ( fl ) , potentially reducing lung toxicity . the purpose of this study was to assess the utility of lung perfusion single photon emission computed tomogra...
polymicrogyria is a malformation of cortical development in which the process of normal cerebral cortical development is disturbed late in the stage of neuronal migration or early in the stage of cortical organization ; thus , it is considered a disorder of neuronal organization . as a result of these disturbances to t...	polymicrogyria is one of the most common malformations of cortical development . it has been known for many years and its clinical and mri manifestations are well described . recent advances in imaging , however , have revealed that polymicrogyria has many different appearances on mr imaging , suggesting that is ma...
according to lekholm and zarb,1 the bone density of the posterior maxilla is classified as type 4 bone , which means that a thin layer of cortical bone surrounds low - density trabecular bone . implants placed in soft bone or d4 bone require a longer healing period for better bone remodeling and maturation . a poor...	the displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone , resulting in soft tissue growth . this case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement...
weight loss among elderly patients is a common clinical problem . for patients with more than 4% weight loss , 2-year survival rate is less than 72% , and 3-year survival rate is less than 65% ( wallace et al 1995 ; wallace and schwartz 1997 ) . this manuscript will summarize the results of our studies and discuss ...	the aim is to review major clinical trials that have used megestrol acetate ( ma ) in the treatment of cachexia across several disease states . a review of general usage and potential side - effects are discussed . a theory that the newly approved nanocrystal formation of ma can better deliver this potent medication ...
cumulative trauma disorders ( ctds ) are defined as muscle , nerve , tendon , joint , cartilage , and spinal disc damages or disorders due to exposure to risk factors in the work environment1 . the common characteristics of ctds are that they arise or increase due to working and that they may lead to limitation...	[ purpose ] doner kebab is a food specific to turkey ; it is a cone - shaped meat placed vertically on a high stand . the doner kebab chefs stand against the meat and cut it by using both of their upper extremities . this work style may lead to recurrent trauma and correspondingly the upper extremity problems...
alzheimer 's disease ( ad ) is a multifactorial disorder leading to progressive memory loss and eventually death . one of the histopathological hallmarks of ad is the excessive accumulation of amyloid beta ( a ) peptides in the brain resulting in extracellular amyloid plaques [ 13 ] . amyloid peptides are natural c...	alzheimer 's disease ( ad ) is a multifactorial disorder leading to progressive memory loss and eventually death . in this study an appsweps1de9 ad mouse model has been analyzed using implantable video - eeg radiotelemetry to perform long - term eeg recordings from the primary motor cortex m1 and the hippocampal ca1 ...
the increasing adoption of laparoscopic or ( laparoscopic - assisted ) colorectal surgery as standard practice in colorectal cancer management has resulted in reduction in length of stay and improved patient experience . however , one complication , particular to laparoscopic but not to open surgery , is post - opera...	highlightswe encountered a peculiar case of surgical emphysema 3 days after an uneventful laparoscopic left colectomy.we reviewed the literature to ascertain the presence of similar episodes.albeit unable to determine the cause of the event , this is the first case of delayed emphysema after a laparoscopic colorectal p...
ectopic pregnancy ( ep ) is a term used for implantation of blastocyst outside the natural cavity of uterus ( 1 , 2 ) . the prevalence of ep has been doubled since 1960 and comprises 2% of pregnancies diagnosed at the first trimester ( 3 ) . in the developing countries like iran , 10% of women diagnosed with ep , c...	background : ectopic pregnancy ( ep ) is one of the most dangerous complications of pregnancy and without prompt diagnosis and treatment , it could become a major cause of maternal morbidity and mortality.objectives:in this randomized controlled study , we compared single and double dose of methotrexate ( mtx ) therapy...
research in personalized medicine seeks to achieve optimal clinical outcomes through the use of innovative biomarker discoveries to develop drugs that best suit a specific group of patients . to derive best - fit treatment options for a specific patient group , various signaling pathways are thoroughly analyzed to id...	personalized medicine promises patient - tailored treatments that enhance patient care and decrease overall treatment costs by focusing on genetics and -omics data obtained from patient biospecimens and records to guide therapy choices that generate good clinical outcomes . the approach relies on diagnostic and pro...
early age at menarche , the onset of menstrual periods in girls , is associated with increased risks of adverse health outcomes such as breast , ovarian , and endometrial cancer , hypertension , type 2 diabetes , and cardiovascular disease [ 1 , 2 ] . earlier age at menarche is also associated with increased risk for...	to infer the causal association between childhood bmi and age at menarche , we performed a mendelian randomisation analysis using twelve established bmi - increasing genetic variants as an instrumental variable ( iv ) for higher bmi . in 8,156 women of european descent from the epic - norfolk cohort , height was ...
the initiation of coagulation , especially in severe sepsis , is probably mediated by the induction of tissue factor ( tf ) expression by endotoxin . this leads to the activation of factor x , which then combines with factor va to convert prothrombin to thrombin . although thrombin is usually considered to have pur...	thrombin is a multifunctional protein , with procoagulant , inflammatory and anticoagulant effects . binding of thrombin to thrombomodulin results in activation of protein c and initiation of the activated protein c anticoagulant pathway , a process that is augmented by the endothelial cell protein c receptor ( epcr ...

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