title stringlengths 0 1.13k | abstract stringlengths 1 15.7k | PMID int64 22 36.5M |
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Super-resolution microscopy by nanoscale localization of photo-switchable fluorescent probes. | A new form of super-resolution fluorescence microscopy has emerged in recent years, based on the high accuracy localization of individual photo-switchable fluorescent labels. Image resolution as high as 20 nm in the lateral dimensions and 50 nm in the axial direction has been attained with this concept, representing an order of magnitude improvement over the diffraction limit. The demonstration of multicolor imaging with molecular specificity, three-dimensional (3D) imaging of cellular structures, and time-resolved imaging of living cells further illustrates the exciting potential of this method for biological imaging at the nanoscopic scale. | 18,809,508 |
Comparison of three different concentrations of ropivacaine for postoperative patient-controlled thoracic epidural analgesia after upper abdominal surgery. | Previous studies have reported the comparable efficacy of ropivacaine/fentanyl for patient-controlled epidural analgesia (PCEA). In our hospital, three different concentrations of ropivacaine solution (0.1%, 0.15%, 0.2%) in combination with 1 microg/mL fentanyl were available for PCEA. As some studies have reported a much higher incidence of motor block and opioid-related side effects with 0.2% ropivacaine in combination with 4 microg/mL fentanyl, it was our intent to analyze the data of our patients who had received PCEA after upper abdominal surgery. In addition to comparing the analgesic effects and the incidence of motor block and opioid-related side effects of these three different ropivacaine/fentanyl solutions, we also evaluated the workload of our pain staff. The main purpose of our study was to determine which of these three regimens of ropivacaine was most satisfactory with the least workload for the pain service staff. In total, 33 patients who had received PCEA after upper abdominal surgery were included in the analysis. The number of patients in each ropivacaine/fentanyl group was 11 (group 1, 0.1% ropivacaine; group 2, 0.15%; group 3, 0.2%). The PCEA device was programmed to deliver a patient-controlled bolus of 2 mL with a lockout time of 20 minutes and background infusion of 5 mL/hr for 72 hours. Visual analog scale (VAS) pain scores, adverse events and the extent of sensory or motor block were recorded 12, 36 and 60 hours after surgery. The total volume of analgesic solution consumed and the frequency of requisite attendance by pain service staff were also recorded. There were no differences among the three groups regarding total consumption. In group 1, VAS scores during ambulation and cough 12 hours postoperatively were significantly higher than in the other two groups (p < 0.05). There was no motor block. Four patients in group 3 suffered from loss of temperature sensation. The overall incidence of adverse events was less than 40%. Both thoracic epidural 0.15% and 0.2% ropivacaine provide effective postoperative pain control in combination with fentanyl without motor block. A 0.15% ropivacaine-1 microg/mL fentanyl solution is preferable considering the lower incidence of adverse events. | 18,809,519 |
Spontaneous intracranial hypotension treated by epidural blood patches. | We present a case of spontaneous intracranial hypotension (SIH) diagnosed from the clinical symptoms and magnetic resonance imaging brain scans. After failure of conservative treatment, and lack of identification of the cerebrospinal fluid leak site, the headache was managed successfully and simply with two applications of an epidural blood patch (EBP). The strategy of our management for the patient was as follows: (1) application of an EBP to the lumbar epidural space initially and manipulating it into the proximity of the possible leak site; (2) a greater volume of autologous blood was injected at the second attempt of EBP; and (3) the patient was required to lie flat for at least 2 hours after the procedure. Better management of SIH is still developing. Traditionally, SIH is initially managed by conservative treatment. However, recent studies have shown that the success rate in arresting SIH after weeks or months of conservative treatment is not quite satisfactory. Hence, the EBP has proven to be more effective in treating SIH patients. Early EBP application may offer immediate relief of clinical symptoms. The role of the EBP in treating SIH patients should have greater emphasis and its application is worth recommendation. | 18,809,524 |
Increasing walking in college students using a pedometer intervention: differences according to body mass index. | The researchers assessed the effectiveness of a pedometer intervention and differences in walking behaviors according to body mass index (BMI). Two hundred ninety college students completed the intervention from January to February 2005. Participants wore pedometers 5 days per week for 12 weeks and completed questionnaires assessing demographic information. The authors calculated daily step averages for weeks 1, 6, and 12. They then classified students as underweight (UW), normal weight (NW), or overweight/obese, by BMI. The authors analyzed data using repeated-measures analysis of variance. The average number of daily steps increased from week 1 to week 6 (p < .001) and week 12 (p = .002). UW participants reported the fewest steps at each time point, but the difference was significant only when compared with NW participants (p = .03). These results support the effectiveness of a pedometer intervention to increase walking in college students. Health benefits other than weight management should be emphasized to maximize the effects for all students. | 18,809,532 |
Psychosocial factors and low back pain among college students. | The authors evaluated psychosocial factors of stress and their effects on the prevalence of low back pain (LBP) among a population of college students in a major university in Colorado. This was a nested cross-sectional study of 973 respondents who completed the National College Health Assessment survey. The authors evaluated a subset of questions pertaining to psychosocial stressors against the presence of LBP. The annual prevalence of LBP among the population studied was 42.8%. The stressful psychosocial variables of feeling very sad, exhausted, and overwhelmed were associated with the prevalence of LBP. The prevalence of LBP among this younger population is significant and understudied. | 18,809,536 |
Dichotomous metabolism of Enterococcus faecalis induced by haematin starvation modulates colonic gene expression. | Enterococcus faecalis is an intestinal commensal that cannot synthesize porphyrins and only expresses a functional respiratory chain when provided with exogenous haematin. In the absence of haematin, E. faecalis reverts to fermentative metabolism and produces extracellular superoxide that can damage epithelial-cell DNA. The acute response of the colonic mucosa to haematin-starved E. faecalis was identified by gene array. E. faecalis was inoculated into murine colons using a surgical ligation model that preserved tissue architecture and homeostasis. The mucosa was exposed to haematin-starved E. faecalis and compared with a control consisting of the same strain grown with haematin. At 1 h post-inoculation, 6 mucosal genes were differentially regulated and this increased to 42 genes at 6 h. At 6 h, a highly significant biological interaction network was identified with functions that included nuclear factor-kappaB (NF-kappaB) signalling, apoptosis and cell-cycle regulation. Colon biopsies showed no histological abnormalities by haematoxylin and eosin staining. Immunohistochemical staining, however, detected NF-kappaB activation in tissue macrophages using antibodies to the nuclear localization sequence for p65 and the F4/80 marker for murine macrophages. Similarly, haematin-starved E. faecalis strongly activated NF-kappaB in murine macrophages in vitro. Furthermore, primary and transformed colonic epithelial cells activated the G2/M checkpoint in vitro following exposure to haematin-starved E. faecalis. Modulation of this cell-cycle checkpoint was due to extracellular superoxide produced as a result of the respiratory block in haematin-starved E. faecalis. These results demonstrate that the uniquely dichotomous metabolism of E. faecalis can significantly modulate gene expression in the colonic mucosa for pathways associated with inflammation, apoptosis and cell-cycle regulation. | 18,809,545 |
Molecular epidemiology and antimicrobial susceptibilities of 273 exfoliative toxin-encoding-gene-positive Staphylococcus aureus isolates from patients with impetigo in Japan. | The molecular epidemiology and antimicrobial susceptibilities of 273 Staphylococcus aureus isolates positive for the exfoliative toxin-encoding gene obtained from patients with impetigo in Japan in 2006 were studied. The mecA gene was detected in 74 meticillin-resistant S. aureus (MRSA) and 23 meticillin-susceptible S. aureus (MSSA) isolates. All isolates with the staphylococcal cassette chromosome (SCC) mec were classified into type IV (92.8%, 90/97) or V (7.2%, 7/97). The ET-encoding gene etb was found primarily in strains with mecA (87.7%, 71/81), whilst eta (86.6%, 161/186) was detected mainly in strains without mecA. The chromosomal enterotoxin-encoding gene cluster egc was found in 83.0% of strains with eta, whilst no enterotoxin-encoding gene was detected in strains with only etb. PFGE showed that each strain carrying eta, etb and etd could be classified into distinct groups. The susceptibility profiles of MRSA to antimicrobial agents excluding beta-lactams were similar to those of MSSA. Gentamicin- and clarithromycin-resistant strains were frequently found for both MRSA and MSSA. The aminoglycoside-resistance gene aacA-aphD was detected in 97.3% of MRSA and 85.4% of MSSA. Additionally, the macrolide-resistance gene ermA or ermC was detected in 67.6% of MRSA and 71.4% of MSSA. Therefore, these results suggest that SCCmec types IV or V have spread, particularly in MSSA carrying etb in the community. | 18,809,554 |
Glyceraldehyde-3-phosphate dehydrogenase regulates endothelin-1 expression by a novel, redox-sensitive mechanism involving mRNA stability. | The regulation of the synthesis of the endothelial-derived vasoconstrictor endothelin-1 (ET-1) is a complex process encompassing transcriptional as well as mRNA stability mechanisms. We have described recently the existence of a mechanism for the control of ET-1 expression based on the mRNA-destabilizing capacity of specific cytosolic proteins through interaction with AU-rich elements (AREs) present in the 3' untranslated region of the gene. We now identify glyceraldehyde-3'-phosphate dehydrogenase (GAPDH) as a protein which binds to the AREs and is responsible for the destabilization of the mRNA. Oxidant stress alters the binding of GAPDH to the mRNA and its capacity to modulate ET-1 expression, a phenomenon occurring through specific S glutathionylation of the catalytically active residue Cys 152. Finally, we provide data consistent with a role for GAPDH in mRNA unwinding, yielding this molecule more prone to degradation. In contrast, S-thiolated GAPDH appears unable to modify mRNA unwinding, thus facilitating enhanced stability. Taken together, these results describe a novel, redox-based mechanism regulating mRNA stability and add a new facet to the panoply of GAPDH cellular homeostatic actions. | 18,809,573 |
Role of the Caenorhabditis elegans Shc adaptor protein in the c-Jun N-terminal kinase signaling pathway. | Mitogen-activated protein kinases (MAPKs) are integral to the mechanisms by which cells respond to physiological stimuli and a wide variety of environmental stresses. In Caenorhabditis elegans, the stress response is controlled by a c-Jun N-terminal kinase (JNK)-like mitogen-activated protein kinase (MAPK) signaling pathway, which is regulated by MLK-1 MAPK kinase kinase (MAPKKK), MEK-1 MAPK kinase (MAPKK), and KGB-1 JNK-like MAPK. In this study, we identify the shc-1 gene, which encodes a C. elegans homolog of Shc, as a factor that specifically interacts with MEK-1. The shc-1 loss-of-function mutation is defective in activation of KGB-1, resulting in hypersensitivity to heavy metals. A specific tyrosine residue in the NPXY motif of MLK-1 creates a docking site for SHC-1 with the phosphotyrosine binding (PTB) domain. Introduction of a mutation that perturbs binding to the PTB domain or the NPXY motif abolishes the function of SHC-1 or MLK-1, respectively, thereby abolishing the resistance to heavy metal stress. These results suggest that SHC-1 acts as a scaffold to link MAPKKK to MAPKK activation in the KGB-1 MAPK signal transduction pathway. | 18,809,575 |
Dissection of the molecular defects caused by pathogenic mutations in the DNA repair factor XPC. | XPC is responsible for DNA damage sensing in nucleotide excision repair (NER). Mutations in XPC lead to a defect in NER and to xeroderma pigmentosum (XP-C). Here, we analyzed the biochemical properties behind mutations found within three patients: one amino acid substitution (P334H, XP1MI, and GM02096), one amino acid incorporation in a conserved domain (697insVal, XP8BE, and GM02249), and a stop mutation (R579St, XP67TMA, and GM14867). Using these mutants, we demonstrated that HR23B stabilizes XPC on DNA and protects it from degradation. XPC recruits the transcription/repair factor TFIIH and stimulates its XPB ATPase activity to initiate damaged DNA opening. In an effort to understand the severity of XP-C phenotypes, we also demonstrated that single mutations in XPC perturb other repair processes, such as base excision repair (e.g., the P334H mutation prevents the stimulation of Ogg1 glycosylase because it thwarts the interaction between XPC and Ogg1), thereby leading to a deeper understanding of the molecular repair defect of the XP-C patients. | 18,809,580 |
Adjuvant paclitaxel plus carboplatin compared with observation in stage IB non-small-cell lung cancer: CALGB 9633 with the Cancer and Leukemia Group B, Radiation Therapy Oncology Group, and North Central Cancer Treatment Group Study Groups. | Adjuvant chemotherapy for resected non-small-cell lung cancer (NSCLC) is now accepted on the basis of several randomized clinical trials (RCTs) that demonstrated improved survival. Although there is strong evidence that adjuvant chemotherapy is effective in stages II and IIIA NSCLC, its utility in stage IB disease is unclear. This report provides a mature analysis of Cancer and Leukemia Group B (CALGB) 9633, the only RCT designed specifically for stage IB NSCLC. Within 4 to 8 weeks of resection, patients were randomly assigned to adjuvant chemotherapy or observation. Eligible patients had pathologically confirmed T2N0 NSCLC and had undergone lobectomy or pneumonectomy. Chemotherapy consisted of paclitaxel 200 mg/m(2) intravenously over 3 hours and carboplatin at an area under the curve dose of 6 mg/mL per minute intravenously over 45 to 60 minutes every 3 weeks for four cycles. The primary end point was overall survival. Three hundred-forty-four patients were randomly assigned. Median follow-up was 74 months. Groups were well-balanced with regard to demographics, histology, and extent of surgery. Grades 3 to 4 neutropenia were the predominant toxicity; there were no treatment-related deaths. Survival was not significantly different (hazard ratio [HR], 0.83; CI, 0.64 to 1.08; P = .12). However, exploratory analysis demonstrated a significant survival difference in favor of adjuvant chemotherapy for patients who had tumors > or = 4 cm in diameter (HR, 0.69; CI, 0.48 to 0.99; P = .043). Because a significant survival advantage was not observed across the entire cohort, adjuvant chemotherapy should not be considered standard care in stage IB NSCLC. Given the magnitude of observed survival differences, CALGB 9633 was underpowered to detect small but clinically meaningful improvements. A statistically significant survival advantage for patients who had tumors > or = 4 cm supports consideration of adjuvant paclitaxel/carboplatin for stage IB patients who have large tumors. | 18,809,614 |
An investigation of the effects of music on anxiety and pain perception in patients undergoing haemodialysis treatment. | This study aimed to investigate the effects of preferred music listening on anxiety and pain perception in patients undergoing haemodialysis. A two group experimental design was used. Sixty people diagnosed with end stage renal failure undergoing haemodialysis treatment participated in this study. Preferred music listening was applied as an intervention. Anxiety and pain were measured pre-test and post-test. The control group scored significantly higher in state anxiety than the experimental group and experienced significantly higher pain intensity in post-test phase. Findings provide experimental evidence to support the effectiveness of preferred music listening in medical settings. | 18,809,642 |
Communicating about self and others within an online support group for women with breast cancer and subsequent outcomes. | Research suggests communicating too much about one's self within an online support group may amplify breast cancer patients' focus on their own problems and exacerbate negative emotions while focusing on others may have the opposite effects. This study explored how pronoun usage within an online support group was associated with subsequent mental health outcomes. There were 286 patients recruited into the study who filled out the pre-test and 231 completed post-tests four months later with survey measures including breast cancer-related concerns and negative emotions. Messages were analyzed using a program counting first person and relational pronouns. A positive relationship was found between use of first person pronouns and negative emotions. | 18,809,644 |
Peer crowd identification and indoor artificial UV tanning behavioral tendencies. | In this study, the relation between peer crowd identification and indoor tanning behavioral tendencies was examined. Participants were 174 undergraduate students at a large university in the USA. Results indicated peer crowd identification was significantly associated with indoor artificial UV tanning behavioral tendencies (attitudes, normative beliefs, past year use and intentions) independent of gender and skin type. Participants who identified with the popular peer crowd were at the greatest risk for indoor tanning UV exposure while identification with the brain crowd was protective against such behavior. The findings are discussed in terms of implications for future skin cancer intervention efforts. | 18,809,645 |
Diabetes mellitus: considerations for dentistry. | The connection between oral health and systemic health is bidirectional; systemic illnesses, especially metabolic disorders, affect oral health, and it appears that oral health may affect systemic health. In this review, the authors outline the basic principles behind diabetes mellitus (DM) and provide some tips to help dentists manage the care of patients with DM better in general practice. DM negatively affects all microvasculature beds, and the soft tissues and bones supporting the teeth are susceptible. There is also strong evidence that the presence of periodontal disease is associated with increased cardiovascular morbidity in patients with DM. DM is a chronic, systemic metabolic disorder in which the orosystemic connection is becoming more understood. DM is a relatively common condition and, thus, is one that practicing dentists may encounter frequently. | 18,809,649 |
The Toxoplasma gondii dense granule protein GRA7 is phosphorylated upon invasion and forms an unexpected association with the rhoptry proteins ROP2 and ROP4. | The obligate intracellular parasite Toxoplasma gondii infects warm-blooded animals throughout the world and is an opportunistic pathogen of humans. As it invades a host cell, Toxoplasma forms a novel organelle, the parasitophorous vacuole, in which it resides during its intracellular development. The parasite modifies the parasitophorous vacuole and its host cell with numerous proteins delivered from rhoptries and dense granules, which are secretory organelles unique to the phylum Apicomplexa. For the majority of these proteins, little is known other than their localization. Here we show that the dense granule protein GRA7 is phosphorylated but only in the presence of host cells. Within 10 min of invasion, GRA7 is present in strand-like structures in the host cytosol that contain rhoptry proteins. GRA7 strands also contain GRA1 and GRA3. Independently of its phosphorylation state, GRA7 associates with the rhoptry proteins ROP2 and ROP4 in infected host cells. This is the first report of interactions between proteins secreted from rhoptries and dense granules. | 18,809,661 |
Filamin B mediates ICAM-1-driven leukocyte transendothelial migration. | During inflammation, the endothelium mediates rolling and firm adhesion of activated leukocytes. Integrin-mediated adhesion to endothelial ligands of the Ig-superfamily induces intracellular signaling in endothelial cells, which promotes leukocyte transendothelial migration. We identified the actin cross-linking molecule filamin B as a novel binding partner for intracellular adhesion molecule-1 (ICAM-1). Immune precipitation as well as laser scanning confocal microscopy confirmed the specific interaction and co-localization of endogenous filamin B with ICAM-1. Importantly, clustering of ICAM-1 promotes the ICAM-1-filamin B interaction. To investigate the functional consequences of filamin B binding to ICAM-1, we used small interfering RNA to reduce filamin B expression in ICAM-1-GFP expressing HeLa cells. We found that filamin B is required for the lateral mobility of ICAM-1 and for ICAM-1-induced transmigration of leukocytes. Reducing filamin B expression in primary human endothelial cells resulted in reduced recruitment of ICAM-1 to endothelial docking structures, reduced firm adhesion of the leukocytes to the endothelium, and inhibition of transendothelial migration. In conclusion, this study identifies filamin B as a molecular linker that mediates ICAM-1-driven transendothelial migration. | 18,809,679 |
Interaction between the C termini of Alg13 and Alg14 mediates formation of the active UDP-N-acetylglucosamine transferase complex. | The second step of eukaryotic N-linked glycosylation in endoplasmic reticulum is catalyzed by an UDP-N-acetylglucosamine transferase that is comprised of two subunits, Alg13 and Alg14. The interaction between Alg13 and 14 is crucial for UDP-GlcNAc transferase activity, so formation of the Alg13/14 complex is likely to play a key role in the regulation of N-glycosylation. Using a combination of bioinformatics and molecular biological methods, we have undertaken a functional analysis of yeast Alg13 and Alg14 proteins to elucidate the mechanism of their interaction. Our mutational studies demonstrated that a short C-terminal alpha-helix of Alg13 is required for interaction with Alg14 and for enzyme activity. Electrostatic surface views of the modeled Alg13/14 complex suggest the presence of a hydrophobic cleft in Alg14 that provides a pocket for the Alg13 C-terminal alpha-helix. Co-immunoprecipitation assays confirmed the C-terminal three amino acids of Alg14 are required for maintaining the integrity of Alg13/Alg14 complex, and this depends on their hydrophobicity. Modeling studies place these three Alg14 residues at the entrance of the hydrophobic-binding pocket, suggesting their role in the stabilization of the interaction between the C termini of Alg13 and Alg14. Together, these results demonstrate that formation of this hetero-oligomeric complex is mediated by a short C-terminal alpha-helix of Alg13 in cooperation with the last three amino acids of Alg14. In addition, deletion of the N-terminal beta-strand of Alg13 caused the destruction of protein, indicating the structural importance of this region in protein stability. | 18,809,682 |
Transient high glucose causes persistent epigenetic changes and altered gene expression during subsequent normoglycemia. | The current goal of diabetes therapy is to reduce time-averaged mean levels of glycemia, measured as HbA1c, to prevent diabetic complications. However, HbA1c only explains <25% of the variation in risk of developing complications. Because HbA1c does not correlate with glycemic variability when adjusted for mean blood glucose, we hypothesized that transient spikes of hyperglycemia may be an HbA1c-independent risk factor for diabetic complications. We show that transient hyperglycemia induces long-lasting activating epigenetic changes in the promoter of the nuclear factor kappaB (NF-kappaB) subunit p65 in aortic endothelial cells both in vitro and in nondiabetic mice, which cause increased p65 gene expression. Both the epigenetic changes and the gene expression changes persist for at least 6 d of subsequent normal glycemia, as do NF-kappaB-induced increases in monocyte chemoattractant protein 1 and vascular cell adhesion molecule 1 expression. Hyperglycemia-induced epigenetic changes and increased p65 expression are prevented by reducing mitochondrial superoxide production or superoxide-induced alpha-oxoaldehydes. These results highlight the dramatic and long-lasting effects that short-term hyperglycemic spikes can have on vascular cells and suggest that transient spikes of hyperglycemia may be an HbA1c-independent risk factor for diabetic complications. | 18,809,715 |
Lis1 and Ndel1 influence the timing of nuclear envelope breakdown in neural stem cells. | Lis1 and Ndel1 are essential for animal development. They interact directly with one another and with cytoplasmic dynein. The developing brain is especially sensitive to reduced Lis1 or Ndel1 levels, as both proteins influence spindle orientation, neural cell fate decisions, and neuronal migration. We report here that Lis1 and Ndel1 reduction in a mitotic cell line impairs prophase nuclear envelope (NE) invagination (PNEI). This dynein-dependent process facilitates NE breakdown (NEBD) and occurs before the establishment of the bipolar spindle. Ndel1 phosphorylation is important for this function, regulating binding to both Lis1 and dynein. Prophase cells in the ventricular zone (VZ) of embryonic day 13.5 Lis1(+/-) mouse brains show reduced PNEI, and the ratio of prophase to prometaphase cells is increased, suggesting an NEBD delay. Moreover, prophase cells in the VZ contain elevated levels of Ndel1 phosphorylated at a key cdk5 site. Our data suggest that a delay in NEBD in the VZ could contribute to developmental defects associated with Lis1-Ndel1 disruption. | 18,809,722 |
Ryk cooperates with Frizzled 7 to promote Wnt11-mediated endocytosis and is essential for Xenopus laevis convergent extension movements. | The single-pass transmembrane protein Ryk (atypical receptor related tyrosine kinase) functions as a Wnt receptor. However, Ryk's correlation with Wnt/Frizzled (Fz) signaling is poorly understood. Here, we report that Ryk regulates Xenopus laevis convergent extension (CE) movements via the beta-arrestin 2 (betaarr2)-dependent endocytic process triggered by noncanonical Wnt signaling. During X. laevis gastrulation, betaarr2-mediated endocytosis of Fz7 and dishevelled (Dvl/Dsh) actually occurs in the dorsal marginal zone tissues, which actively participate in noncanonical Wnt signaling. Noncanonical Wnt11/Fz7-mediated endocytosis of Dsh requires the cell-membrane protein Ryk. Ryk interacts with both Wnt11 and betaarr2, cooperates with Fz7 to mediate Wnt11-stimulated endocytosis of Dsh, and signals the noncanonical Wnt pathway in CE movements. Conversely, depletion of Ryk and Wnt11 prevents Dsh endocytosis in dorsal marginal zone tissues. Our study suggests that Ryk functions as an essential regulator for noncanonical Wnt/Fz-mediated endocytosis in the regulation of X. laevis CE movements. | 18,809,723 |
Directed induction of anterior and posterior primitive streak by Wnt from embryonic stem cells cultured in a chemically defined serum-free medium. | Formation of the primitive streak (PS) is the initial specification step that generates all the mesodermal and endodermal tissue lineages during early differentiation. Thus, a therapeutically compatible and efficient method for differentiation of the PS is crucial for regenerative medicine. In this study, we developed chemically defined serum-free culture conditions for the differentiation of embryonic stem (ES) cells into the PS-like cells. Cultures supplemented with Wnt showed induction of expression of a PS marker, the brachyury gene, followed by induction of the anterior PS markers goosecoid and foxa2, a posterior PS marker, evx1, and the endoderm marker sox17. Similar differentiation of PS by Wnt was also observed in human ES cells. Moreover, we revealed that the activation of the Wnt canonical pathway is essential for PS differentiation in mouse ES cells. These results demonstrated that Wnt is an essential and sufficient factor for the induction of the PS-like cells in vitro. These conditions of induction could constitute the initial step in generating therapeutically useful cells of the definitive endoderm lineage, such as hepatocytes and pancreatic endocrine cells, under chemically defined conditions. | 18,809,738 |
Elevated fluoride products enhance remineralization of advanced enamel lesions. | Caries prevention might benefit from the use of toothpastes containing over 1500 ppm F. With few clinical studies available, the aim of this pH-cycling study was to investigate the dose response between 0 and 5000 ppm F of de- and remineralization of advanced (> 150 microm) enamel lesions. Treatments included sodium and amine fluoride, and a fluoride-free control. Mineral uptake and loss were assessed from solution calcium changes and microradiographs. Treatments with 5000 ppm F both significantly enhanced remineralization and inhibited demineralization when compared with treatments with 1500 ppm F. Slight differences in favor of amine fluoride over sodium fluoride were observed. The ratio of de- over remineralization rates decreased from 13.8 to 2.1 in the range 0 to 5000 ppm F. As much as 71 (6)% of the remineralized mineral was calculated to be resistant to dissolution during subsequent demineralization periods. With 5000-ppm-F treatments, more demineralizing episodes per day (10 vs. 2 for placebo) would still be repaired by remineralization. | 18,809,748 |
Characterization and quantification of clonal heterogeneity among hematopoietic stem cells: a model-based approach. | Hematopoietic stem cells (HSCs) show pronounced heterogeneity in self-renewal and differentiation behavior, which is reflected in their repopulation kinetics. Here, a single-cell-based mathematical model of HSC organization is used to examine the basis of HSC heterogeneity. Our modeling results, which are based on the analysis of limiting dilution competitive repopulation experiments in mice, demonstrate that small quantitative but clonally fixed differences of cellular properties are necessary and sufficient to account for the observed functional heterogeneity. The model predicts, and experimental data validate, that competitive pressures will amplify small clonal differences into large changes in the number of differentiated progeny. We further predict that the repertoire of HSC clones will evolve over time. Last, our results suggest that larger differences in cellular properties have to be assumed to account for genetically determined differences in HSC behavior as observed in different inbred mice strains. The model provides comprehensive systemic and quantitative insights into the clonal heterogeneity among HSCs with potential applications in predicting the behavior of malignant and/or genetically modified cells. | 18,809,760 |
Homozygous deletion of HFE produces a phenotype similar to the HFE p.C282Y/p.C282Y genotype. | Hemochromatosis is predominantly associated with the HFE p.C282Y homozygous genotype, which is carried by approximately 1 person in 200 in Northern European populations. However, p.C282Y homozygosity is often characterized by incomplete penetrance. Here, we describe the case of a woman who had a major structural alteration in the HFE gene. Molecular characterization revealed an Alu-mediated recombination leading to the loss of the entire HFE gene sequence. Although homozygous for the HFE deleted allele, the woman had a phenotype similar to that seen in most women homozygous for the common p.C282Y mutation. Contrasting with previously reported results in Hfe knockout and Hfe knockin mice, our report gives further evidence that progression of the disease depends on modifying factors. | 18,809,761 |
Northcroft Memorial Lecture 2007. A century of progress: advances in orthodontics since the foundation of the British Society for the Study of Orthodontics. | The British Orthodontic Society invites outstanding contributors from the field of Orthodontics to give the guest lecture in memory of George Northcroft. In 2007 the guest lecturer was Professor Murray C. Meikle. The article that follows was presented as the Northcroft Memorial Lecture 2007 at the British Orthodontic Conference, Harrogate, UK, 24th September 2007. | 18,809,781 |
A comparison of plaster, digital and reconstructed study model accuracy. | To evaluate the accuracy and reproducibility of a three-dimensional (3D) optical laser-scanning device to record the surface detail of plaster study models. To determine the accuracy of physical model replicas constructed from the 3D digital files. A method comparison study using 30 dental study models held in the Orthodontic Department, School of Dentistry, Cardiff University. Each model was captured three-dimensionally, using a commercially available Minolta VIVID 900 non-contact 3D surface laser scanner (Konica Minolta Inc., Tokyo, Japan), a rotary stage and Easy3DScan integrating software (TowerGraphics, Lucca, Italy). Linear measurements were recorded between landmarks, directly on each of the plaster models and indirectly on the 3D digital surface models, on two separate occasions by a single examiner. Physical replicas of two digital models were also reconstructed from their scanned data files, using a rapid prototyping (RP) manufacturing process, and directly evaluated for dimensional accuracy. The mean difference between measurements made directly on the plaster models and those made on the 3D digital surface models was 0.14 mm, and was not statistically significant (P = 0.237). The mean difference between measurements made on both the plaster and virtual models and those on the RP models, in the z plane was highly statistically significant (P <0.001). The Minolta VIVID 900 digitizer is a reliable device for capturing the surface detail of plaster study models three-dimensionally in a digital format but physical models of appropriate detail and accuracy cannot be reproduced from scanned data using the RP technique described. | 18,809,782 |
Neighborhood income, health insurance, and prehospital delay for myocardial infarction: the atherosclerosis risk in communities study. | Outcomes following an acute myocardial infarction (AMI) are generally more favorable if prehospital delay time is minimized. We examined the association of neighborhood household income (nINC) and health insurance status with prehospital delay among a weighted sample of 9700 men and women with a validated, definite, or probable AMI in the Atherosclerosis Risk in Communities (ARIC) community surveillance study (1993-2002). Weighted multinomial regression with generalized estimation equations was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) and to account for the clustering of patients within census tracts. Low nINC was associated with a higher odds of long vs short delay (OR, 1.46; 95% CI, 1.09-1.96) and medium vs short delay (OR, 1.43; 95% CI, 1.12-1.81) compared with high nINC in a model including age, sex, race, diabetes, hypertension, presence of chest pain, arrival at the hospital via emergency medical service, distance from residence to hospital, study community, and year of AMI event. Meanwhile, compared with patients with prepaid insurance or prepaid plus Medicare, patients with Medicaid were more likely to have a long vs short delay (OR, 1.87; 95% CI, 1.10-3.19) and a medium vs short delay (OR, 1.76; 95% CI, 1.13-2.74). Both low nINC and being a Medicaid recipient are associated with longer prehospital delay. Reducing socioeconomic and insurance disparities in prehospital delay is critical because excess delay time may hinder effective care for AMI. | 18,809,814 |
Trade-offs in cervical cancer prevention: balancing benefits and risks. | New screening and vaccination technologies will provide women with more options for cervical cancer prevention. Because the risk of cervical cancer diminishes with effective routine screening, women may wish to consider additional attributes, such as the likelihood of false-positive results and diagnostic procedures for mild abnormalities likely to resolve without intervention in their screening choices. We used an empirically calibrated simulation model of cervical cancer in the United States to assess the benefits and potential risks associated with prevention strategies differing by primary screening test, triage test for abnormal results (cytologic testing, human papillomavirus [HPV] DNA test), and screening frequency. Outcomes included colposcopy referrals, cervical intraepithelial neoplasia (CIN) types 1 and 2 or 3, lifetime cancer risk, and quality-adjusted life expectancy. Across strategies, colposcopy referrals and diagnostic workups varied 3-fold, although diagnostic rates of CIN 2 or 3 were similar and 95% of positive screening test results were for mild abnormalities likely to resolve on their own. For a representative group of a thousand 20-year-old women undergoing triennial screening for 10 years, we expect 1038 colposcopy referrals (7 CIN 2 or 3 diagnoses) from combined cytologic and HPV DNA testing and fewer than 200 referrals (6-7 CIN 2 or 3 diagnoses) for strategies that use triage testing. Similarly, for a thousand 40-year-old women, combined cytologic and HPV DNA testing led to 489 referrals (9 CIN 2 or 3), whereas alternative strategies resulted in fewer than 150 referrals (7-8 CIN 2 or 3). Using cytologic testing followed by triage testing in younger women minimizes both diagnostic workups and positive HPV test results, whereas in older women diagnostic workups are minimized with HPV DNA testing followed by cytologic triage testing. Clinically relevant information highlighting trade-offs among cervical cancer prevention strategies allows for inclusion of personal preferences into women's decision making about screening and provides additional dimensions to the construction of clinical guidelines. | 18,809,815 |
Cost-effectiveness of HIV monitoring strategies in resource-limited settings: a southern African analysis. | Although the number of infected persons receiving highly active antiretroviral therapy (HAART) in low- and middle-income countries has increased dramatically, optimal disease management is not well defined. We developed a model to compare the costs and benefits of 3 types of human immunodeficiency virus monitoring strategies: symptom-based strategies, CD4-based strategies, and CD4 counts plus viral load strategies for starting, switching, and stopping HAART. We used clinical and cost data from southern Africa and performed a cost-effectiveness analysis. All assumptions were tested in sensitivity analyses. Compared with the symptom-based approaches, monitoring CD4 counts every 6 months and starting treatment at a threshold of 200/muL was associated with a gain in life expectancy of 6.5 months (61.9 months vs 68.4 months) and a discounted lifetime cost savings of US $464 per person (US $4069 vs US $3605, discounted 2007 dollars). The CD4-based strategies in which treatment was started at the higher threshold of 350/microL provided an additional gain in life expectancy of 5.3 months at a cost-effectiveness of US $107 per life-year gained compared with a threshold of 200/microL. Monitoring viral load with CD4 was more expensive than monitoring CD4 counts alone, added 2.0 months of life, and had an incremental cost-effectiveness ratio of US $5414 per life-year gained relative to monitoring of CD4 counts. In sensitivity analyses, the cost savings from CD4 count monitoring compared with the symptom-based approaches was sensitive to cost of inpatient care, and the cost-effectiveness of viral load monitoring was influenced by the per test costs and rates of virologic failure. Use of CD4 monitoring and early initiation of HAART in southern Africa provides large health benefits relative to symptom-based approaches for HAART management. In southern African countries with relatively high costs of hospitalization, CD4 monitoring would likely reduce total health care expenditures. The cost-effectiveness of viral load monitoring depends on test prices and rates of virologic failure. | 18,809,819 |
Effects of social disruption on physical parameters, corticosterone concentrations, and immune system in two genetic lines of White Leghorn layers. | Farm management practices such as increasing group size and mixing of unfamiliar chickens may cause social disruption and affect bird well-being. To examine genetic-associated physical and physiological differences in response to social disruption, 2 strains of White Leghorn hens were used in the study [i.e., HGPS (line selected for high group production and survivability) and DXL (DeKalb XL commercial line)]. Social disruption was created when hens were 50 wk of age by increasing group size from 4 hens (control) to 8 hens (experimental) per cage and providing an unstable social environment by moving 2 hens weekly between cages within the same line (experimental hens only). At 58 wk of age, hens were feather-scored. After euthanization, BW and the right adrenal gland weight were collected (n = 10 per treatment). Adrenal gland weight was adjusted for BW, and adjusted adrenal weight was used for analysis. Plasma corticosterone was quantified using RIA. The T-lymphocytes (CD4+ and CD8+) were measured using flow cytometry. Results showed that average feather cover score was greater for DXL hens than HGPS hens in both the unstressed (P < 0.05) and stressed treatment (P < 0.01). There was no difference in BW in DXL and HGPS hens between the control and the social disruption treatments. However, the relative adrenal weight of HGPS hens tended to be lower than control hens after social disruption (0.05 > P < 0.10). Plasma corticosterone was significantly lower in both strains following social disruption (P < 0.01). The T-lymphocyte ratio (CD4+:CD8+) was greater in HGPS hens than DXL hens post social disruption (P < 0.05). The data indicate that the 2 strains of hens reacted differently in terms of the adrenal system and immunity in response to social disruption. Hens selected for longevity with docile behaviors and high productivity, such as HGPS hens, provide a useful tool for improving animal well-being. | 18,809,855 |
Effects of liquid aluminum chloride additions to poultry litter on broiler performance, ammonia emissions, soluble phosphorus, total volatile Fatty acids, and nitrogen contents of litter. | Recent studies have shown that the use of aluminum sulfate [alum, Al2(SO4)3.14H2O] and aluminum chloride (AlCl3) additions to animal manures are more effective than other chemicals in reducing ammonia (NH3) emissions and P solubility. Although the use of Al2(SO4)3.14H2O has been intensively used in the poultry industry for many years, no research has been conducted to evaluate the effect of liquid AlCl3 on these parameters. The objectives of this study were to determine the effects of applying liquid AlCl3 to poultry litter on 1) broiler performance, 2) NH3 fluxes, and 3) litter chemical characteristics, including soluble reactive P, total volatile fatty acids, and N content. Eight hundred broiler chicks were placed into 16 floor pens (50 birds/pen) in a single house for 6 wk. Liquid AlCl3 treatments were sprayed on the litter surface at rates of 100, 200, and 300 g of liquid AlCl3/kg of litter; un-treated litter served as controls. At the 2 lower rates, liquid AlCl3 treatments tended to improve weight gain and feed intake but had no effect on feed conversion or mortality, whereas the higher rate (300 g/kg of litter) had a negative effect on intake. Application of 100, 200, and 300 g of liquid AlCl3 reduced NH3 fluxes by 63, 76, and 76% during the 6-wk period, respectively, compared with the controls. Liquid AlCl3 additions reduced litter soluble reactive P contents by 24, 30, and 36%, respectively, at the low, medium, and high rates. Total volatile fatty acid contents (odor precursors) in litter were reduced by 20, 50, and 51%, respectively, with 100, 200, and 300 g of liquid AlCl3/kg of litter. Liquid AlCl3 additions increased total N, inorganic N, and plant available N contents in litter. These results indicate that liquid AlCl3 additions at the lower rates can provide significant positive environmental benefits to broiler operations. | 18,809,856 |
Effects of prelay 6/85-strain Mycoplasma gallisepticum inoculation alone or in conjunction with the inoculation of F-strain Mycoplasma gallisepticum during lay on the blood characteristics of commercial egg-laying hens. | The effects of 6/85-strain Mycoplasma gallisepticum (6/85MG) inoculation alone or in conjunction with F-strain M. gallisepticum (FMG) overlays and their timing on the blood characteristics of commercial egg-laying hens were investigated. Control birds received sham inoculations at 10 wk of age. Birds in a second treatment group were inoculated with 6/85MG at 10 wk of age, those in a third treatment group were inoculated with 6/85MG at 10 wk followed by an overlay inoculation of FMG at 22 wk, and those in a fourth treatment group were inoculated with 6/85MG at 10 wk followed by an overlay inoculation of FMG at 45 wk. Parameters investigated at 24, 32, 43, and 47 wk were hematocrit, plasma total protein, and serum calcium, triglycerides, and cholesterol. No significant treatment effects were noted for hematocrit, serum triglycerides, or serum cholesterol. However, at wk 32, plasma protein was greater in birds that received 6/85MG at 10 wk or 6/85MG at 10 wk and FMG at 22 wk in comparison to controls. Also, at wk 47, serum calcium concentration was greater in birds that received 6/85MG at 10 wk and FMG at 45 wk compared with controls and those that received 6/85MG at 10 wk and FMG at 22 wk. These results suggest that the prelay inoculation of pullets with 6/85MG may subsequently elevate plasma protein, and in conjunction with an FMG overlay at 45 wk, may increase serum calcium concentrations in laying hens. | 18,809,862 |
Corn expressing an Escherichia coli-derived phytase gene: comparative evaluation study in broiler chicks. | The efficacy of corn expressing an Escherichia coli-derived gene (corn-based phytase; CBP) and an E. coli-derived microbial phytase (expressed in Pichia pastoris) sprayed onto a wheat carrier (Quantum) was comparatively evaluated in two 14-d broiler chicken studies. In experiment 1, a total of 288 seven-day-old male broiler chicks were grouped by weight into 8 blocks of 6 cages, with 6 birds per cage, and used to measure growth performance, bone mineralization, and nutrient utilization. In experiment 2, a total of 192 seven-day-old male broiler chicks were used, with 4 birds per cage. Six dietary treatment groups were randomly allotted to the cages within each of 8 blocks. The corn-soybean meal-based diets used in each study consisted of a positive control adequate in P and Ca; a negative control (NC) low in P and Ca (no added inorganic P); the NC supplemented with 3,630, 36,300, or 363,000 phytase units (FTU) of CBP/kg; and the NC + 3,630 FTU of Quantum/kg. Growth performance and bone mineralization criteria were reevaluated in the second broiler study. Data from the 2 experiments were combined because there was no diet x experiment interaction and analyzed as a randomized complete block design. Weight gain decreased (P < 0.05) with a reduction in dietary P and Ca in the NC diet. Weight gain, feed efficiency, and percentage of tibia ash of birds fed 3,630 FTU/kg of either CBP or Quantum phytase were not different. There was a quadratic response (P < 0.01) to CBP supplementation of the NC diets in weight gain of the broiler chicks. Feed intake increased quadratically (P < 0.01) with CBP supplementation of the NC diets, but CBP supplementation of the NC diets did not affect feed efficiency. Tibia ash of birds fed the positive control diet was greater (P < 0.01) than that of birds fed the NC diet. There was a quadratic response (P < 0.01) to CBP supplementation of the NC diets in tibia ash of the broiler chicks. Birds fed supplemental phytase had greater (P < 0.01) ileal and total tract P and Ca digestibility than birds fed the NC diet. Data from the study suggest that E. coli phytase expressed in corn is efficacious in P-deficient broiler chick diets for the improvement of growth performance and indices of P utilization, which would minimize the need for supplemental P in broiler diets. | 18,809,864 |
Factors affecting intestinal health in poultry. | The gastrointestinal (GI) tract has the most extensive exposed surface in the body and is constantly exposed to a wide variety of potentially harmful substances. The GI tract acts as a selective barrier between the tissues of the bird and its luminal environment. This barrier is composed of physical, chemical, immunological, and microbiological components. A wide range of factors associated with diet and infectious disease agents can negatively affect the delicate balance among the components of the chicken gut and, as a result, affect health status and production performance of birds in commercial poultry operations. Phasing out of antibiotic growth promoters from poultry diets in Europe and recent moves toward reduction or removal of these compounds in other parts of the world including North America will likely change the microbial profile of the GI tract environment in commercial poultry. This paper reviews the GI tract from developmental, immunological, and microbial standpoints and then discusses factors that can affect health status of this system. Necrotic enteritis and coccidiosis and their interactions, and possible consequences of antibiotic growth promoter removal from poultry diets with respect to these diseases, are discussed in more detail. | 18,809,868 |
Distinct sets of alphabeta TCRs confer similar recognition of tumor antigen NY-ESO-1157-165 by interacting with its central Met/Trp residues. | Naturally acquired immune responses against human cancers often include CD8(+) T cells specific for the cancer testis antigen NY-ESO-1. Here, we studied T cell receptor (TCR) primary structure and function of 605 HLA-A*0201/NY-ESO-1(157-165)-specific CD8 T cell clones derived from five melanoma patients. We show that an important proportion of tumor-reactive T cells preferentially use TCR AV3S1/BV8S2 chains, with remarkably conserved CDR3 amino acid motifs and lengths in both chains. All remaining T cell clones belong to two additional sets expressing BV1 or BV13 TCRs, associated with alpha-chains with highly diverse VJ usage, CDR3 amino acid sequence, and length. Yet, all T cell clonotypes recognize tumor antigen with similar functional avidity. Two residues, Met-160 and Trp-161, located in the middle region of the NY-ESO-1(157-165) peptide, are critical for recognition by most of the T cell clonotypes. Collectively, our data show that a large number of alphabeta TCRs, belonging to three distinct sets (AVx/BV1, AV3/BV8, AVx/BV13) bind pMHC with equal antigen sensitivity and recognize the same peptide motif. Finally, this in-depth study of recognition of a self-antigen suggests that in part similar biophysical mechanisms shape TCR repertoires toward foreign and self-antigens. | 18,809,922 |
In vitro and in vivo validation of ligA and tarI as essential targets in Staphylococcus aureus. | A conditional expression system has been developed using the isopropyl-beta-d-thiogalactopyranoside (IPTG)-inducible Pspac promoter to validate essential genes of Staphylococcus aureus in vivo. The system has been applied to prove the essentiality of ligA and to evaluate the function of tarI, which was found to be essential in vitro but not in vivo. | 18,809,938 |
Sonographic differentiation of thyroid nodules with eggshell calcifications. | The purpose of this study was to assess the role of known suspicious sonographic findings and to find other additional sonographic findings to differentiate benign and malignant thyroid nodules with "eggshell" calcifications. Our Institutional Review Board approved this retrospective study, and informed consent was not required. We reviewed sonographic findings of thyroid nodules in 795 patients who underwent thyroid surgery in our institution between August 2006 and February 2007. Ninety-three thyroid nodules with eggshell calcifications in 92 patients were included in this study. Each lesion was evaluated for known suspicious sonographic criteria, including marked hypoechogenicity, irregular or microlobulated margins, and a taller-than-wide shape, as well as 2 additional sonographic findings: a hypoechoic halo and disruption of eggshell calcifications (halo and disrupted calcification rim). The sensitivity and specificity based on the sonographic criteria were calculated and compared among the 2 types of criteria. Among the 93 thyroid nodules, 59 were malignant and 34 were benign. The halo and disrupted calcification rim showed higher sensitivity (62.7% and 76.3%, respectively) than any of the known suspicious sonographic criteria (40.7%, 35.6%, and 55.9%). The combination of both the halo and the disrupted calcification rim showed significantly higher sensitivity (93.2%) than the combination of the known suspicious sonographic criteria (78%; P < .05), although both had the same specificity (64.7%). In thyroid nodules with eggshell calcifications but no other calcifications, the findings of a peripheral halo and disruption of the eggshell calcifications may be more useful sonographic predictors of malignancy than hypoechogenicity, microlobulated margins, and a taller-than-wide shape. | 18,809,952 |
Biomechanical modelling of a direct vertebral translation instrumentation system: preliminary results. | Many new spine instrumentation concepts were introduced in recent years, like the incremental direct vertebral translation. The objective was to develop a biomechanical model in order to analyze the biomechanics of this instrumentation system. The patient-specific spine model was built using the 3D reconstruction based on bi-planar radiographs of a scoliotic patient (thoraco-lumbar Cobb: 49 degrees ). The mechanical properties were derived from literature, experiments on cadaver spines and patient's side bending radiographs. Each screw construct was modelled by four rigid bodies connected each other by kinematic joints. The screw-vertebra flexible joint was represented by 3 experimentally derived non-linear springs, and the rods by non-linear flexible elements. The correction manoeuvres were simulated by lowering the rod, tightening the crimps (incremental segmental translation) and applying secondary correction manoeuvres (direct vertebra derotation, compression, distraction and construct tightening). The simulations showed that the system allows a good force distribution among implants. The long post pushing and pulling contributed, to a great extent, to a global correction in the coronal plane, while the crimp tightening had more important effect in the sagittal plane. The preliminary results illustrated the effectiveness of local correction by a direct vertebra translation technique. Our next step is to validate the model and compare the performance of this strategy with other spinal instrumentation systems. | 18,810,013 |
Clinical and postural behaviour of scoliosis during daily brace weaning hours. | What happens to scoliosis when the brace is daily weaned is not described in the literature, even if this can have a significant clinical impact. Our aim was to evaluate the postural and clinical changes at brace weaning. We developed a pre-post trial in 10 adolescent idiopathic scoliosis female patients 12.6 years old, with 42.8+/-7.4 degrees Cobb curves. more than 30 degrees Cobb; TLSO worn at least 20 hours/day. Patients have been divided according to the hours of brace wearing per day: group 23H (6 patients, 23 hours per day) and group 20H (20-21 hours per day). We evaluated the patients at brace weaning and every hour per 4 hours, clinically (Bunnell degrees, hump and plumbline distances through usual clinical instruments) and posturally (scoliosis degree), by means of a non-ionising instrument that allow a 3D reconstruction of the spine. Paired ANOVA and t-test were used for statistical analysis. Group 23H showed statistically significant variations in 1 to 3 hours in all clinical parameters, and a tendency to progression of scoliosis. Group 20H did not show any statistically significant variation in 4 hours, a part from slight improvements. These results could be explained in terms of scoliosis reactions to usual/unusual daily load on the spine. Moreover, these data show the possible existence of the "concertina effect" due to brace weaning, and the importance of standardizing clinical examination with respect to the daily brace weaning hours. | 18,810,041 |
Congenital scoliosis - presentation of three severe cases treated conservatively. | In view of the very limited data about conservative treatment of patients with congenital scoliosis (CS) available, early surgery is suggested already in mild cases with formation failures in the first three years of life. It is common sense that patients with failures of segmentation will not benefit from conservative treatment at all and the same applies to failures of formation with curves of >50 degrees in infancy. Two patients with rib synostosis denied surgery before entering the pubertal growth spurt. These patients have been treated conservatively with braces and Scoliosis In-Patient Rehabilitation (SIR) and now are beyond the pubertal growth spurt. One patient with a formation failure and a curve of >50 degrees lumbar has been treated with the help of braces and physiotherapy from 1.6 years on and is still under treatment now at the age of 15 years. Severe decompensation was prevented in the two patients with failure of segmentation, however a severe thoracic deformity is evident with underdeveloped lung function and severe restrictive ventilation disorder. The patient with failure of formation is well developed, now without cosmetic or physical complaints although his curve progressed at the end of the growth spurt due to final mal-compliance. Failures of segmentation should be advised to have surgery before entering the pubertal growth spurt. In case they deny, conservative treatment can at least in part be beneficial. For patients with failures of formation conservative treatment should be suggested in the first place because long-term outcomes of early surgery beyond pubertal growth spurt are not yet revealed. | 18,810,043 |
Rolling to a lift. | A dynamic method to kneel and return to standing has been suggested. An amalgamation of principles and experiences has encouraged the advent of rolling to a lift. The method is applicable for patients with at least fair trunk control. J Orthop Sports Phys Ther 1982;4(2):118-119. | 18,810,102 |
Calculation of lsokinetic Rehabilitation Velocities for the Knee Extensors. | The aim of this study was to evaluate the validity of a method which provides for the calculation of the isokinetic speed of knee rehabilitation. The results indicated that, for the sampled population, the method produced validity coefficients (r = 0.98; r = 0.94) in the excellent range. Therefore, it was concluded that the utilization of this method may be appropriate in knee cases where the torque transmitting capacity of the capsule, ligaments, and tendons are in question. J Orthop Sports Phys Ther 1982;4(1):32-35. | 18,810,113 |
Trunk Testing Using a Prototype Cybex II lsokinetic Dynamometer Stabilization System. | This pilot study represents Cybex II isokinetic dynamometer trunk testing on 160 subjects (98 males, 62 females). A prototype apparatus which provides stabilization in the standing (functional) position was used in the testing. The testing protocols were performed first for trunk flexion and then trunk extension. The protocols consisted of two isometric tests for 5 seconds at 0 degrees trunk angle and 45 degrees trunk angle followed by three repetitions each at the isokinetic speeds of 30, 60, 90, and 120 degrees per second. Peak torque values were measured for the isometric tests. lsokinetic data interpretation consisted of: peak torque, time rate of tension development, range of motion where peak torque occurred, and total work performed. The ratios of trunk flexors to extensors at each test were also calculated. The conclusion from this pilot study is that the use of an isokinetic testing of trunk musculature and establishing normative data provide clinically useful guidelines for sports screening, industrial medicine screening, and objective parameters for discharging patients with trunk dysfunction. J Orthop Sports Phys Ther 1982;3(4):164-170. | 18,810,123 |
lontophoresis for Treatment of Shinsplints*. | It was hypothesized that shinsplints are the result of muscle inflammation induced by overuse; thus, as an inflammatory response, the application of an antiinflammatory medication to the involved muscles would eliminate the pain of shinsplints. The application of hydrocortisone by iontophoresis was effective in the elimination of shinsplint pain in 18 cases of shinsplints involving four male and eight female athletes. J Orthop Sports Phys Ther 1982;3(4):183-185. | 18,810,124 |
Academics versus Teachers: A Dilemma in Physical Therapy Education. | "These excerpts from the text of the Advisory Council on Physical Therapy Education, October 22, 1981, express the concerns of many clinical and research physical therapists about the current trends in physical therapy education. Although Dr. Rose makes a controversial assumption that effective educators need no formal training in educational process, I believe Dr. Rose's comments deserve our attention." Dennis L. Hart, MPA. PT J Orthop Sports Phys Ther 1982;3(4):160-163. | 18,810,125 |
Physical therapy evaluation of the shoulder complex in athletes. | A systematic approach is presented for evaluating the shoulder complex in athletes. The evaluation is divided into two parts: the subjective and objective examinations. The evaluation will determine the severity of the injury, the irritability of injury, and the structural involvement, and provide objective data for designing a comprehensive program of rehabilitation. J Orthop Sports Phys Ther 1982;3(3):108-120. | 18,810,134 |
Electromyographic Analysis of the Lower Extremity during Pedaling*. | EMG activity in the gluteus maximus, rectus femoris, biceps femoris, vastus lateralis, gastrocnemius, and anterior tibialis muscles was studied in six healthy male subjects. Each subject pedaled against changes in workload, pedaling rates, and different weight flywheels, with and without toe clips and from both sitting and standing positions. All the muscles tested were shown to be active at workloads greater than 300 kilograms per minute. In addition, the amplitude of the EMG signals increased with increasing workloads. No real differences in muscle activity timing were found between the light and heavy flywheels or between the competitive and noncompetitive cyclists. Standing while pedaling produced increased activity in the rectus femoris and vastus lateralis at high rpm and low workloads. J Orthop Sports Phys Ther 1981;2(4):163-170. | 18,810,152 |
A case study: application of ultrasound to determine a stress fracture of the fibula. | A female with a diagnosis of acute ankle sprain was evaluated for physical therapy treatment. Although radiological evidence was negative, the patient's history and symptoms suggested a stress fracture of the fibula. Application of ultrasound intensified the pain when directed to a specific point on the fibula. At a later date, subsequent radiological evidence indicated a stress fracture at the point of maximum sensitivity to ultrasound. J Orthop Sports Phys Ther 1981;2(3):134-136. | 18,810,154 |
The straight-leg-raising test: a review*. | A positive unilateral straight-leg-raising sign is routinely interpreted as indicative of a "disc lesion. " A review of the literature was undertaken in an attempt to more clearly illustrate the mechanisms and results of the straight-leg-raising test. It was found that a positive straight-leg-raising test has minimal value in differentiating a patient with herniated disc from other patients with love back pain and sciatica. J Orthop Sports Phys Ther 1981;2(3):117-133. | 18,810,158 |
Sports medicine centers in the United States: the personnel, patients, and services. | Sports medicine in the United States is a rapidly expanding field. The movement of the public into organized and informal recreation and sports has stimulated the growth and sophistication of sports medicine. In the last 35 years, sports-related injuries have received unprecedented interest. Numerous sports medicine centers (SMC) have been established to meet the increased demand for a specialized approach to the treatment of sports injuries. Three main functions of SMC's have been reported: 1) research into the causes of and possible prevention of sports injuries; 2) sports medicine education for physicians, medical students, allied medical professionals, coaches, and the public; and 3) care of the injured athlete including the areas of prevention, diagnosis, treatment, and rehabilitate.In the latter half of 1978, this investigator surveyed SMC's in the United States to identify the status of selected aspects of the operations and approaches to sports medical treatment at these centers and also to provide a profile of sports medicine centers. A listing of SMC's was generated and a specially constructed survey instrument was mailed to 85 centers. Of the centers identified for this study, 71 (83.5%) responded with either a completed survey or a letter of explanation. Of those 71 responding, 56 (79%) met criteria established for inclusion in the study. These criteria were that the SMC: 1) specialized in the care of athletic injuries, and 2) had a patient population presenting primarily participant sports-related injuries.J Orthop Sports Phys Ther 1980;1(4):222-225. | 18,810,170 |
On conversion reactions. | This article discusses the symptomatology of conversion reactions along with Freudian, behavioral, and holistic perspectives on their etiology. Factors influencing the incidence of conversion reactions and clues for identifying the disorder are presented.J Orthop Sports Phys Ther 1980;1(4):200-204. | 18,810,171 |
Dysfunction of the sacroiliac joint and its treatment*. | A very common but frequently overlooked cause of pain in the low back is a result of leaning forward without adequately supporting the anterior pelvis. This allows the innominates to rotate slightly downwards on the sacrum with fixation and an apparent increase in the length of the legs, which in turn irritates the sciatic nerve. This commonly occurs bilaterally but may occur on just one side. Flexion of the innominate(s) on the sacrum restores function to the sacroiliac joint, causes an apparent shortening of the legs and gives excellent relief of pain in the low back and sciatic pain.J Orthop Sports Phys Ther 1979;1(1):23-35. | 18,810,188 |
Translabyrinthine approach for vestibular schwannomas: operative technique. | For large vestibular schwannomas (VSs) for which removal is the primary therapy, the goals are complete tumor resection and maintenance of normal neurological function. The authors analyzed their results about facial nerve preservation, extent of resection and complications following resection of large VSs via a widened translabyrinthine approach. Between 1991 and 2001, 110 patients with a unilateral large VS (Koos stage IV) were operated on using the same technique in the same institution. The main steps of the operative technique were detailed and the clinical outcomes analyzed and compared with the results that were extracted from matched series in the literature. The main postoperative complications were cerebrospinal fluid leakage through the scalp wound in 4%, cerebrospinal fluid rhinorrhea in 4% requiring surgical revision in 3%. One percent of meningitis, 1% of posterior fossa hematoma and 4% of transient lower cranial nerve palsies were observed. There was no death related to the surgery. Total tumor removal was achieved in 85% of cases, near-total in 11% and subtotal in 4% of cases. Sixty-two percent of patients obtained normal to near-normal facial function (House-Brackmann grades 1 and 2). The authors suggest that the translabyrinthine approach is a suitable route for the safe removal of large VSs. | 18,810,201 |
Tissue changes after radiosurgery for vestibular schwannomas. | The specific effects of radiosurgery on brain tumor tissue are not well understood. We review several approaches that have been used to address this issue. Correlating the radiobiology of radiosurgery with the radioclinical outcome may help to understand these tissue changes. In vivo imaging investigations are usually performed with MRI, but the use of functional and metabolic imaging, such MR spectroscopy, positron emission tomography or single-photon emission computed tomography may provide additional information on the effects of radiosurgery. Finally, histological observations represent an invaluable source of information, when systematically analyzed in their clinical context. | 18,810,206 |
Hearing preservation after complete microsurgical removal in vestibular schwannomas. | To evaluate and present the treatment strategy and hearing preservation in a recent series of vestibular schwannoma cases. A retrospective analysis of 200 patients operated consecutively over a 3 year period was performed. Patient records, operative reports, including data from the electrophysiological monitoring, follow-up audiometric examinations, and neuroradiological findings were analyzed. The anatomical integrity of the cochlear nerve was preserved in 75.8% of the cases. When only patients with preserved preoperative hearing were included, the rate was 84%. The overall rate of functional hearing preservation was 51%. It was highest in small tumors--60% in class T1 and 72% in class T2. In tumors extending to and compressing the brain stem, preservation of some hearing was possible in up to 43%. Vestibular schwannomas are benign lesions whose total removal leads to definitive healing of the patient. The goal of every surgery should be functional preservation of all cranial nerves. Using the retrosigmoid approach with the patient in the semi-sitting position, hearing preservation is possible even for large schwannomas. | 18,810,211 |
Economic evaluation alongside a phase II, multi-centre, randomised controlled trial of very early rehabilitation after stroke (AVERT). | The effectiveness and costs of very early rehabilitation after stroke are unknown. This study assessed the cost effectiveness of very early mobilisation in addition to standard care (VEM) compared with standard care alone (SC). Cost-effectiveness analysis alongside a phase II, multi-centre, randomised controlled trial (RCT) with blinded outcome assessments. Less than 24 h after stroke, patients were recruited from two stroke units and randomised to receive VEM or SC. The intervention continued until discharge or 14 days, whichever was sooner. The efficacy measure was a dichotomised modified Rankin Scale (mRS) at 3 months with mRS < or =2 representing good outcome. Costs were determined from medical records and patient interviews at 3, 6 and 12 months. National average (where available) or local costs were applied for the reference year 2004. Differences in mean total costs at 3 and 12 months were tested using t test assuming unequal variances. An incremental cost-effectiveness ratio was calculated and probabilistic uncertainty analysis was undertaken. The sample consisted of 38 VEM and 33 SC patients. A trend for good outcome with VEM compared to SC was found (adjusted OR 4.10, 95% CI 0.99-16.88, p = 0.051). Patients receiving VEM incurred significantly less costs at 3 months (AUD 13,559) compared with SC (AUD 21,860; p = 0.02). This difference in mean per patient total cost persisted at the 12-month assessment (VEM: AUD 17,564; SC: AUD 29,750; p = 0.03). VEM was found to be a 'dominant' (more effective, less cost) intervention when compared to SC at 3 months. These findings provide preliminary evidence that VEM is likely to be cost-effective. A large RCT is currently underway to confirm the cost effectiveness of VEM. | 18,810,233 |
Sex differences in stroke. | Increasing evidence suggests that sex differences exist in the etiology, presentation, treatment, and outcome from stroke. The reasons for these sex disparities are becoming increasingly explored, but large gaps still exist in our knowledge. Experimental studies over the past several years have demonstrated intrinsic sex differences both in vivo and in animal models which may have relevance to our understanding of stroke in clinical populations. A greater understanding of the differences and similarities between males and females with respect to the risk factors, pathophysiology, and response to stroke will facilitate the design of future clinical trials and enhance the development of treatment strategies to improve stroke care in both sexes. This article reviews the current literature on sex differences in stroke with an emphasis on the clinical data, incorporating an analysis of bench research as it pertains to the bedside. | 18,810,232 |
Cerebellomedullary cerebrospinal fluid collection in the dog. | Analysis of cerebrospinal fluid (CSF) can be a valuable diagnostic tool. This column describes cerebellomedullary CSF collection in the dog. | 18,810,263 |
Metagenomic analysis of lysogeny in Tampa Bay: implications for prophage gene expression. | Phage integrase genes often play a role in the establishment of lysogeny in temperate phage by catalyzing the integration of the phage into one of the host's replicons. To investigate temperate phage gene expression, an induced viral metagenome from Tampa Bay was sequenced by 454/Pyrosequencing. The sequencing yielded 294,068 reads with 6.6% identifiable. One hundred-three sequences had significant similarity to integrases by BLASTX analysis (e < or =0.001). Four sequences with strongest amino-acid level similarity to integrases were selected and real-time PCR primers and probes were designed. Initial testing with microbial fraction DNA from Tampa Bay revealed 1.9 x 10(7), and 1300 gene copies of Vibrio-like integrase and Oceanicola-like integrase L(-1) respectively. The other two integrases were not detected. The integrase assay was then tested on microbial fraction RNA extracted from 200 ml of Tampa Bay water sampled biweekly over a 12 month time series. Vibrio-like integrase gene expression was detected in three samples, with estimated copy numbers of 2.4-1280 L(-1). Clostridium-like integrase gene expression was detected in 6 samples, with estimated copy numbers of 37 to 265 L(-1). In all cases, detection of integrase gene expression corresponded to the occurrence of lysogeny as detected by prophage induction. Investigation of the environmental distribution of the two expressed integrases in the Global Ocean Survey Database found the Vibrio-like integrase was present in genome equivalents of 3.14% of microbial libraries and all four viral metagenomes. There were two similar genes in the library from British Columbia and one similar gene was detected in both the Gulf of Mexico and Sargasso Sea libraries. In contrast, in the Arctic library eleven similar genes were observed. The Clostridium-like integrase was less prevalent, being found in 0.58% of the microbial and none of the viral libraries. These results underscore the value of metagenomic data in discovering signature genes that play important roles in the environment through their expression, as demonstrated by integrases in lysogeny. | 18,810,270 |
Rapid and quantitative detection of the microbial spoilage in milk using Fourier transform infrared spectroscopy and chemometrics. | Microbiological safety plays a very significant part in the quality control of milk and dairy products worldwide. Current methods used in the detection and enumeration of spoilage bacteria in pasteurized milk in the dairy industry, although accurate and sensitive, are time-consuming. FT-IR spectroscopy is a metabolic fingerprinting technique that can potentially be used to deliver results with the same accuracy and sensitivity, within minutes after minimal sample preparation. We tested this hypothesis using attenuated total reflectance (ATR), and high throughput (HT) FT-IR techniques. Three main types of pasteurized milk - whole, semi-skimmed and skimmed - were used and milk was allowed to spoil naturally by incubation at 15 degrees C. Samples for FT-IR were obtained at frequent, fixed time intervals and pH and total viable counts were also recorded. Multivariate statistical methods, including principal components-discriminant function analysis and partial least squares regression (PLSR), were then used to investigate the relationship between metabolic fingerprints and the total viable counts. FT-IR ATR data for all milks showed reasonable results for bacterial loads above 10(5) cfu ml(-1). By contrast, FT-IR HT provided more accurate results for lower viable bacterial counts down to 10(3) cfu ml(-1) for whole milk and, 4 x 10(2) cfu ml(-1) for semi-skimmed and skimmed milk. Using FT-IR with PLSR we were able to acquire a metabolic fingerprint rapidly and quantify the microbial load of milk samples accurately, with very little sample preparation. We believe that metabolic fingerprinting using FT-IR has very good potential for future use in the dairy industry as a rapid method of detection and enumeration. | 18,810,291 |
Towards quantitatively reproducible substrates for SERS. | There is a need for a method to facilitate the development of novel, reproducible colloidal surface-enhanced Raman scattering (SERS) substrates to encourage the use of SERS in applied studies. In this study we show for the first time that by using suitably designed SERS experiments in conjunction with multivariate analysis of variance (MANOVA), an objective assessment of colloidal SERS reproducibility can be made. This is demonstrated with the analyte cresyl violet, but could be extended to any analyte of interest for which reproducible SERS data are needed. | 18,810,294 |
Utilization of inpatient care before and after hip fracture: a population-based study. | Evaluation of hospitalizations in a 70+ population showed that hip fractures (HF) were associated with a significant increase in the utilization of inpatient care for a lengthy period. Hospital days attributable to several diagnostic classes still exceeded both prefracture and population levels in the second year after HF. The goal was to assess effects of HF on the inpatient care utilization. The study covered HF patients and the 70+general population (26,000) living in Central Finland. Hospitalization data categorized by the ICD-10 main classes were obtained from the nationwide discharge register. In 2002-2003, 498 residents (mean age 82 SD 7, 74.9% women) of the study area sustained HF. Among them, the number of hospital days was 23, 107, and 52 per person-year in the prefracture, first and second postfracture year, respectively. In the 70+ general population, the number was constantly 11 per year. The age- and gender-adjusted rate ratio of hospital days between the two groups was 1.30 (95% CI 1.27 to 1.32), 6.91 (95% CI 6.85 to 7.00), and 3.61 (95% CI 3.55 to 3.67) for the prefracture, first and second postfracture year, respectively. Hospital days due to injuries were more prevalent in the HF group throughout the period. Moreover, excess of days was seen in six other diagnostic classes in the first and in four classes in the second postfracture year. Hospital days in HF patients still exceeded both the prefracture and population levels in the second year after HF. Days attributable to several other causes than HF itself became also more prevalent indicating that HF can steeply decrease patients' coping capacity and launch a cascade of impairments in the function of different organ systems. | 18,810,302 |
The timing of ovulation with respect to sexual swelling detumescence in wild olive baboons. | Baboon researchers commonly use the timing of sexual swelling detumescence to infer the timing of ovulation. These estimates are then used for a variety of purposes, including the interpretation of male and female behaviour, assessment of likely paternity, and the calculation of gestation lengths. Although captive studies have measured the timing of ovulation with respect to detumescence, this has not been measured in wild baboons. Here, we use observational data on female sexual swellings, and hormonal data measured from faeces, to investigate the timing of ovulation with respect to detumescence in wild olive baboons. Our data show similar variability in the timing of ovulation with respect to detumescence as that produced by captive studies, although there are some notable differences, including the absence of any ovulations measured on or after the day of swelling detumescence. We discuss the importance of our results for baboon researchers using swellings to infer ovulation as part of their studies. | 18,810,314 |
Sporadic hemiplegic migraine: report of a case with clinical and radiological features. | A case of visual hallucination, headache and left hemiparesis is reported. The patient had a history of recurrent attacks of similar semiology for the previous 15 years. MRI brain revealed a cortical hyperintensity on T2W, FLAIR and diffusion weighted imaging (DWI) in the right cerebral hemisphere with a normal ADC (apparent diffusion coefficient) map and MR angiogram. Detailed workup for MELAS was negative. A diagnosis of sporadic hemiplegic migraine was made and he was managed conservatively. He made a gradual complete recovery over 2 weeks. He was discharged on flunarizine for prophylaxis and has remained asymptomatic over the ensuing 4 months. This interesting condition is reviewed and discussed herein. | 18,810,316 |
Evaluation of MR markers that predict survival in patients with newly diagnosed GBM prior to adjuvant therapy. | Purpose Glioblastoma Multiforme (GBM) is the most common and lethal primary brain tumor in adults. The goal of this study was to test the predictive value of MR parameters in relation to the survival of patients with newly diagnosed GBM who were scanned prior to receiving adjuvant radiation and chemotherapy. Methods The study population comprised 68 patients who had surgical resection and were to be treated with fractionated external beam radiation therapy and chemotherapy. Imaging scans included anatomical MRI, diffusion and perfusion weighted imaging and (1)H MRSI. The MR data were acquired 3-5 weeks after surgery and approximately 1 week before treatment with radiation therapy. The diffusion, perfusion and spectroscopic parameter values were quantified and subjected to proportional hazards analysis that was adjusted for age and scanner field strength. Results The patients with larger lesion burden based upon volumes of anatomic lesions, volume of CNI2 (number of voxels within the T2 lesion having choline to NAA index >2), volume of CBV3 (number of pixels within the T2 lesion having relative cerebral blood volume >3), and volume of nADC1.5 (number of pixels within the T2 lesion having normalized apparent diffusion coefficient <1.5) had a higher risk for poor outcome. High intensities of combined measures of lactate and lipid in the T2 and CNI2 regions were also associated with poor survival. Conclusions Our study indicated that several pre-treatment anatomic, physiological and metabolic MR parameters are predictive of survival. This information may be important for stratifying patients to specific treatment protocols and for planning focal therapy. | 18,810,326 |
Chromosomal changes characterize head and neck cancer with poor prognosis. | It is well established that genetic alterations may be associated to prognosis in tumor patients. This study investigates chromosomal changes that predict the clinical outcome of head and neck squamous cell carcinoma (HNSCC) and correlate to characteristic clinicopathological parameters. We applied comparative genomic hybridization (CGH) to tissue samples from 117 HNSCC patients scheduled for radiotherapy. Genomic aberrations occurring in more than five patients were studied for impact on locoregional progression (LRP)-free survival. p values were adjusted by the Hochberg-Benjamini procedure and significant aberrations and clinical variables subjected to a stepwise backwards Cox proportional model. Significant alterations were further analyzed by array-CGH and fluorescence in situ hybridization (FISH). In multivariate survival analysis gains on 1q and 16q predict reduced LRP-free survival independently from known prognostic factors. Cluster analysis separated the HNSCC cases into two groups (cluster 1 and 2) that are characterized by significant differences for imbalances in 13 chromosomal regions. Moreover, it became apparent that cluster 1 correlates to nonanemic patients, while cluster 2 represents predominantly anemic cases. Array-CGH pinpoints 16q24.3 to be the region of interest on chromosome 16 which was further verified by FISH analysis where an increased copy number of FANCA, a member of the Fanconi anemia/breast cancer pathway, could be identified. This study demonstrates that chromosomal gains on 1q and 16q as well as chromosomal loss on 18q represent prognostic markers in HNSCC and that these alterations may explain to some extent the dismal course of a subgroup of patients. | 18,810,378 |
Medical simulation: a tool for recognition of and response to risk. | The use of simulation and team training has become an excellent tool to reduce errors in high-risk industry such as the commercial airlines and in the nuclear energy field. The health care industry has begun to use similar tools to improve the outcome of high-risk areas where events are relatively rare but where practice with a tactical team can significantly reduce the chance of bad outcome. There are two parts to this review: first, we review the rationale of why simulation is a key element in improving our error rate, and second, we describe specific tools that have great use at the clinical bedside for improving the care of patients. These cross different (i.e. medical and surgical) specialties and practices within specialties in the health care setting. Tools described will include the pinch, brief/debriefing, read-backs, call-outs, dynamic skepticism, assertive statements, two-challenge rules, checklists and step back (hold points). Examples will assist the clinician in practical daily use to improve their bedside care of children. | 18,810,414 |
The art of communication: strategies to improve patient and information flow : radiology perspective. | The art of communication involves understanding the needs of the person with whom one is interacting. The radiologist must be an expediter and a consultant. Face-to-face, eyeball-to-eyeball communication is almost always best. Nonverbal communication must be aligned with verbal principles. The radiologist must build trust to have successful communication and fulfill the role of a consultant who adds value to a child's health care. This occurs most easily by increased visibility and face-to-face discussion. | 18,810,421 |
Extended MRI findings of intersection syndrome. | The symptoms and physical findings of intersection syndrome have been well described in the clinical medical literature. However, the magnetic resonance imaging (MRI) findings in patients with intersection syndrome of the forearm have only recently been described in a small number of patients. We review our experience with imaging of intersection syndrome, describe previously unreported MRI findings, and emphasize modifications to MRI protocols for its evaluation. Institutional review board approval was obtained for this retrospective review of patients with MRI findings consistent with intersection syndrome of the forearm during the period from January 2004 to September 2006. Six patients were identified, three males and three females, with an average age of 39.3 years. The MRI examinations were reviewed to assess signal abnormalities within and adjacent to the first and second dorsal extensor tendon compartments (DETC): tendinosis, peritendinous edema or fluid, muscle edema, subcutaneous edema, and juxtacortical edema. The overall longitudinal extent of signal alterations was measured as well as the distance from Lister's tubercle to the crossover of the first and second DETC. Review of the MRIs showed increased intrasubstance tendon signal suggesting tendinosis in two of the six patients, peritendinous edema or fluid in all six patients, muscle edema in five of the six patients, and subcutaneous edema in three of the six patients. Juxtacortical edema was seen in one patient. Peritendinous edema or fluid extended distally beyond the radiocarpal joint in three of the six patients. The average distance from Lister's tubercle to the crossover of the first and second DETC was 3.95 cm, in keeping with recently published data. Intersection syndrome is an uncommon MRI diagnosis. In addition to the previously described MRI findings of edema adjacent to the first or second DETC, possibly with proximal extension and subcutaneous edema, we have identified additional abnormalities: tendinosis, muscle edema, and juxtacortical edema. In addition, our review shows that first and second DETC signal abnormalities in patients with intersection syndrome are not necessarily limited to the site of crossover but can extend distally beyond the radiocarpal joint. As standard wrist protocols may not include the area of intersection between the first and second DETC, coverage may need to be extended to the mid-forearm. | 18,810,435 |
[Molecular pathogenesis. Its importance in targeted therapy in colorectal cancer]. | Colorectal cancer has the second highest mortality of all cancers in Germany. In spite of advances in surgical and chemotherapeutic treatment, efficient new therapies need to be developed. In recent years, advances have been achieved by novel targeted therapies that are specifically directed against altered signaling pathways of malignant cells. Colorectal cancers represent a heterogeneous tumor entity, and response to targeted therapies varies individually. About 15% of colorectal carcinomas are characterized by a deficient DNA mismatch repair system and microsatellite instability (MSI). These MSI cancers apparently have a decreased sensitivity to chemotherapy and frequently show evidence of a pronounced anti-tumoral immune response of the host. This immune response is likely to be mediated by a high number of tumor-specific antigens generated during MSI tumorigenesis. Interventions specifically targeting these antigens may be the basis for novel therapeutic strategies in MSI colorectal cancer and will be evaluated in clinical trials. | 18,810,440 |
Immunophenotyping without antibodies. New perspectives for lymphoma characterization. | Accurate classification of haematological malignancies is a prerequisite for their correct diagnosis, prognosis and therapy. Clear classification of lymphomas is often hindered by the limited number of available cell surface protein markers that are suitable for immunophenotyping. A systematic and quantitative analysis of cell surface proteins is thus required to identify new protein markers on lymphoma subtypes in an unbiased and discovery-driven approach. Nine Hodgkin and non-Hodgkin B cell lines of diffuse large cell type and mediastinal type were investigated by cell surface capture (CSC) technology, a mass spectrometry-based method to identify cell surface glycoproteins. Selected proteins are verified by antibody-based methods, including flow cytometry and immunohistochemistry on cell line arrays. A total of 747 predicted transmembrane proteins were identified from all cell lines, including 142 CD (cluster of differentiation) annotated proteins. A group of differentially expressed cell surface glycoproteins between Hodgkin and non-Hodgkin B cell lines was revealed via quantitative CSC technology. In addition to classical and expected CD molecules such as CD20 and CD30, less frequently expressed molecules such as CD2 on Hodgkin lymphoma (HL) cell lines were identified by CSC and verified by immunohistochemistry in cell lines and primary lymphoma tissue. A panel of CSC-identified differentiation glycoprotein candidates is currently under investigation on tissue microarrays (TMAs) from patient samples. | 18,810,443 |
Thymic enlargement in a patient with juvenile idiopathic arthritis during etanercept therapy. | Tumor necrosis factor (TNF) alpha inhibitors are effective in the treatment of inflammatory rheumatic diseases. Despite their effectiveness, anti-TNF drugs have some drawbacks such as severe adverse effects including infections and possibly lymphoproliferative disorders. In this report we described a case of juvenile idiopathic arthritis patient who developed thymic enlargement (true thymic hyperplasia), mediastinal lymphadenopathy and pleurisy associated with systemic symptoms under Etanercept treatment. The clinical presentation was highly suggestive of malignancy and the patient underwent diagnostic mediastinoscopy with biopsy. | 18,810,448 |
Risk factors for nephrolithiasis in children. | The aim of this study is to evaluate the clinical outcome in children with urinary calculi, to detect risk factors for nephrolithiasis in childhood. This retrospective study comprised 62 pediatric nephrolithiasis patients who have come for routine follow-up visits between the dates of January 2002-August 2006 (48% girls and 52% boys). The mean age of the patients was 8.8 +/- 4.5 years (1-16 years). Hypercalciuria was found in 25 (40%) patients. The mean urinary calcium excretion for hypercalciuric patients was 5.7 +/- 1.2 mg/kg (4.8 mg/kg per day). In our hypercalciuric patients 15 (60%) children had abdominal or flank pain, seven (28%) patients macroscopic hematuria and three (12%) dysuria. Hypocitraturia is the second important risk factor for nephrolithiasis. Urinary calcium excretion showed a positive correlation with the stone size (r = 0.482, P = 0.043). A positive correlation was found between recurrent urinary tract infection (UTI) and hypercalciuria (r = 0.528, P = 0.017). Urinary citrate excretion showed a negative correlation with recurrent UTI (r = -0.503, P = 0.024). Hyperuricaciduria, hyperoxaluria were found to have no effect on the stone size and UTI of the patients. Stones were disintegrated with ESWL in two patients, endoscopic interventions were used in one patient and two underwent an open surgical procedure. All children with nephrolithiasis should have a metabolic screen. Children with a positive family history and consanguinity should be followed carefully with respect to metabolic abnormalities. | 18,810,456 |
Primary Burkitt lymphoma presenting as a solitary rectal polyp in a child. | Non-Hodgkin lymphoma (NHL) accounts for approximately 60% of all lymphomas in children and adolescents. It represents 8-10% of all malignancies in children aged between 5 and 19 years. Primary rectal lymphoma in childhood is extremely rare. This report focuses on the importance of considering the possibility of malignancy in rectal polyps. We report a 5-year-old girl with fresh rectal bleeding who was admitted in our clinic. In physical exam, we found a single pedicled polyp on the posterior wall of the rectum. Surgical removal under general anesthesia involved polyp and its pedicle. Dimensions of the extirpation material were 1.5 x 1.0 x 0.8 cm. Histopathological examination and immunohistochemistry study of the polyp revealed a high-grade B-cell lymphoma (Burkitt lymphoma). These studies also showed lymphoma cells on the surgical border. The patient was referred to pediatric oncology center for chemotherapy. Primary rectal lymphoma in childhood is extremely rare; therefore, the possibility of malignancy in rectal polyps should be considered in the pediatric patients. | 18,810,465 |
Deposit of glass fragments during femtosecond laser penetrating keratoplasty. | To evaluate femtosecond laser interaction with the applanation lens during pre-programmed penetrating keratoplasty corneal cuts. Three different-shaped penetrating keratoplasty dissections were performed on edematous corneas from bank eyes using a clinical femtosecond laser system (Intralase FS60) with energies higher than 2 microJ, and the "depth into glass" parameter at 50 microm, which is defined as the length over which the laser interacts with the glass of the applanation cone in contact with the cornea. Additional full-thickness corneal incisions were obtained with an experimental laser source with technical characteristics similar to the clinical laser. Following cutting, tissue sections were examined by optical microscopy (OM), transmission electron microscopy (TEM), and electron energy loss spectroscopy (EELS). After the procedure, the cones were examined by optical and scanning electron microscopy (SEM). A control was obtained by repeating the procedures and stopping the laser at the cornea-lens interface. OM and TEM analysis of the tissue showed the presence of solid particles of a maximum dimension of 1.5 mum on the epithelium and the anterior stroma, regardless of the laser system used to cut. The EELS technique revealed their composition as silicon dioxide. We believe that the fragments originate from the applanation cone, which is machined by the laser interacting with the glass in contact with cornea. This is consistent with the structures observed on the lens by OM and SEM. Radial and circumferential tracks on the surface of the lens are visible, corresponding to the laser path in penetrating keratoplasty protocols. No particles were found in the control samples. When performing penetrating keratoplasty corneal cuts by infra-red femtosecond laser, the applanation lens in contact with the cornea is machined by the laser depending on the system parameters. As a consequence, microscopic glass fragments are created, which may remain in the tissue. This unwanted effect can be avoided by stopping the procedure at the lens-cornea interface. | 18,810,479 |
Epigenetic deregulation of the human Oct4 promoter in mouse cells. | To examine whether the epigenetic status of the human Oct4 promoter is similarly regulated in mouse cells, we engineered a human bacterial artificial chromosome to express green fluorescent protein under the control of the hOct4 promoter and stably integrated it into mouse embryonic stem cells (mESCs), NIH3T3, and 293T cells. The hOct4 promoter is unmethylated in mESCs and it undergoes methylation during retinoic acid-induced differentiation. However, the hOct4 promoter is demethylated in NIH3T3 cells even though it is fully methylated in 293T cells. Methylation status of the hOct4 promoter is associated with green fluorescent protein expression at transcription level. Our findings indicate that the hOct4 promoter is differently regulated in mouse cells. | 18,810,488 |
Antiparasitic activity of biochanin A, an isolated isoflavone from fruits of Cassia fistula (Leguminosae). | The fractionation through bioguided antileishmanial activity of the dichloromethane extract of Cassia fistula fruits (Leguminosae) led to the isolation of the active isoflavone biochanin A, identified by spectroscopic methods. This compound showed 50% effective concentration (EC(50)) value of 18.96 microg/mL against promastigotes of Leishmania (L.) chagasi. The cytotoxicity of this substance against peritoneal macrophages resulted in an EC(50) value of 42.58 microg/mL. Additionally, biochanin A presented an anti-Trypanosoma-cruzi activity, resulting in an EC(50) value of 18.32 microg/mL and a 2.4-fold more effectiveness than benznidazole. These results contribute with novel antiprotozoal compounds for future drug design studies. | 18,810,492 |
Artificial neural network models of relationships between Alternaria spores and meteorological factors in Szczecin (Poland). | Alternaria is an airborne fungal spore type known to trigger respiratory allergy symptoms in sensitive patients. Aiming to reduce the risk for allergic individuals, we constructed predictive models for the fungal spore circulation in Szczecin, Poland. Monthly forecasting models were developed for the airborne spore concentrations of Alternaria, which is one of the most abundant fungal taxa in the area. Aerobiological sampling was conducted over 2004--2007, using a Lanzoni trap. Simultaneously, the following meteorological parameters were recorded: daily level of precipitation; maximum and average wind speed; relative humidity; and maximum, minimum, average, and dew point temperature. The original factors as well as with lags (up to 3 days) were used as the explaining variables. Due to non-linearity and non-normality of the data set, the modelling technique applied was the artificial neural network (ANN) method. The final model was a split model with classification (spore presence or absence) followed by regression for spore seasons and logx+1 transformed Alternaria spore concentration. All variables except maximum wind speed and precipitation were important factors in the overall classification model. In the regression model for spore seasons, close relationships were noted between Alternaria spore concentration and average and maximum temperature (on the same day and 3 days previously), humidity (with lag 1) and maximum wind speed 2 days previously. The most important variable was humidity recorded on the same day. Our study illustrates a novel approach to modelling of time series with short spore seasons, and indicates that the ANN method provides the possibility of forecasting Alternaria spore concentration with high accuracy. | 18,810,504 |
Candida albicans adhesion to composite resin materials. | The adhesion of Candida albicans to dental restorative materials in the human oral cavity may promote the occurrence of oral candidosis. This study aimed to compare the susceptibility of 14 commonly used composite resin materials (two compomers, one ormocer, one novel silorane, and ten conventional hybrid composites) to adhere Candida albicans. Differences in the amount of adhering fungi should be related to surface roughness, hydrophobicity, and the type of matrix. Cylindrical specimens of each material were made according to the manufacturers' instructions. Surface roughness R (a) was assessed by perthometer measurements and the degree of hydrophobicity by computerized contact angle analysis. Specimens were incubated with a reference strain of C. albicans (DMSZ 1386), and adhering fungi were quantified by using a bioluminometric assay in combination with an automated plate reader. Statistical differences were analyzed by the Kruskal-Wallis test and Mann-Whitney U test. Spearman's rank correlation coefficients were calculated to assess correlations. Median R (a) of the tested composite resin materials ranged between 0.04 and 0.23 microm, median contact angles between 69.2 degrees and 86.9 degrees . The two compomers and the ormocer showed lower luminescence intensities indicating less adhesion of fungi than all tested conventional hybrid composites. No conclusive correlation was found between surface roughness, hydrophobicity, and the amount of adhering C. albicans. | 18,810,508 |
The universal trend of amino acid gain-loss is caused by CpG hypermutability. | Understanding the cause of the changes in the amino acid composition of proteins is essential for understanding the evolution of protein functions. Since the early 1970s, it has been known that the frequency of some amino acids in protein sequences is increasing and that of others is decreasing. Recently, it was found that the trends of amino acid changes were similar in 15 taxa representing Bacteria, Archaea, and Eukaryota. However, the cause of this similarity in the trend of the gains and losses of amino acids continued to be debated. Here, we show that this trend of the gain and loss of amino acids can be simply explained by CpG hypermutability. We found that the frequency of amino acids coded by codons with TpG dinucleotides and those with CpA dinucleotides is increasing, while that of amino acids coded by codons with CpG dinucleotides is decreasing. We also found that organisms that lack DNA methyltransferase show different trends of the gain and loss of amino acids. DNA methyltransferase methylates CpG dinucleotides and induces CpG hypermutability. The incorporation of CpG hypermutability into models of protein evolution will improve studies on protein evolution in different organisms. | 18,810,523 |
Phylogenetic placement of pentatomid stink bug gut symbionts. | Insect bacterial symbionts are ubiquitous, however, only a few groups of host families have been well studied in relation to their associations with microbes. The determination of the phylogenetic relationships among bacteria associated with different species within an insect family can provide insights into the biology and evolution of these interactions. We studied the phylogenetic placement of vertically transmitted bacterial symbionts associated with the posterior midgut (crypt-bearing) region of pentatomid stink bugs (Hemiptera, Pentatomidae). Our results demonstrate that different host species carried one major bacterium in their midgut. Phylogenetic analyses of the 16S rRNA gene sequences obtained from the midgut of stink bugs placed all symbionts in a clade with Erwinia and Pantoea species, both plant-associated bacteria. Results indicate that symbiont monophyly occurs among recently diverged taxa (e.g., within a genus) but does not occur in the Pentatomidae. Results suggest that these vertically transmitted symbionts are occasionally replaced by other taxonomically similar bacteria over evolutionary time. Our findings highlight how the evolutionary history of hemipteran symbionts in unexplored host families may have unpredictable levels of complexity. | 18,810,535 |
Superior mesenteric artery syndrome: diagnosis and treatment strategies. | Superior mesenteric artery (SMA) syndrome is an unusual cause of vomiting and weight loss resulting from the compression of the third part of the duodenum by the SMA. Various medical and psychiatric conditions may result in the initial rapid weight loss which causes narrowing of the aortomesenteric angle. The vomiting and obstructive syndrome is then self-perpetuated regardless of the initiating factors. The young age and nonspecific symptoms often lead to a delay in diagnosis. A series of eight cases is presented reviewing the presentation, investigations, surgical treatment by division of duodenum and duodenojejunostomy, and outcomes. SMA syndrome is a well-described entity which must be considered as a cause of vomiting associated with significant weight loss in young adults. Surgical treatment should be allied with psychological assessment to treat any underlying psychosocial abnormality. | 18,810,558 |
Pyogenic complications of Crohn's disease, evaluation, and management. | The principal by which treatment of pyogenic complications anorectal disease is guided should rely heavily on small procedure with medical management of rectal disease and limitation of proctectomy. Management of pyogenic complications of abdominal Crohn's by an elective approach after percutanea drainage of abscess and nutritional repletion should prevent long term complication even when its patient is receiving immune suppressive therapy. | 18,810,560 |
Changes of the metabolism of the colon cancer cell line SW-480 under serum-free and serum-reduced growth conditions. | Serum of animal origin, like foetal calf serum (FCS), is used as a standard supplement for media to cultivate mammalian cells, mostly due to its growth-supporting properties. Unfortunately, animal serum has many disadvantages like the risk of contamination, high costs, fluctuations within the composition of different batches and the high amount of foetuses, which have to be harvested. To avoid all this, it is necessary to provide alternatives, which combine as many positive properties of the animal serum as possible but do not influence the cellular metabolism negatively. Today, several serum-free complete media as well as serum substitutes are commercially available. In the present study, a serum substitute, a serum-reduced medium and a serum-free medium were evaluated concerning their influence on the metabolism on the colon cancer cell line SW-480. The evaluation of morphological changes of the cells was done by microscopic analysis whereas differences in the volatile metabolome were analysed by solid phase micro extraction (SPME) followed by gas chromatography/mass spectrometry (GC/MS). | 18,810,564 |
In vitro study of haematoporphyrin monomethyl ether-mediated sonodynamic effects on C6 glioma cells. | To study the cytotoxicity induced by haematoporphyrin monomethyl ether (HMME)-mediated sonodynamic therapy (SDT) on C6 glioma cells. The potent photosensitizer HMME was used as the sensitizer. Rat C6 glioma cells were incubated with HMME (10 microg/mL) in the dark for 2 h and then subjected to ultrasound treatment at 1.0 MHz and 0.5 W/cm2 for 2 min. The growth inhibition rate at different time points after SDT was determined by MTT assay. The apoptotic rate and cell circle profiles were examined with flow cytometry. Fine structures were observed with transmission electron microscope (TEM). The sonodynamic effect on the glioma cells was also studied in the absence or presence of various reactive oxygen species (ROS) scavengers. The growth inhibition rate of C6 glioma cells after SDT significantly increased. SDT also increased the apoptosis and proliferation rate (APR). TEM examination showed the morphological features of apoptosis or necrosis. The addition of NaN(3) showed a strong protective effect again SDT. Our data indicated that SDT could kill C6 glioma cells in vitro and possibility through induction of apoptosis and necrosis. Singlet oxygen ((1)O2) may play an important role in SDT. | 18,810,596 |
Conservative treatment of ruptured vertebrobasilar dissecting aneurysm. | Ruptured vertebrobasilar dissecting aneurysm is usually treated surgically because rebleeding negatively affects outcome. However, the risk of rebleeding decreases markedly once several hours have passed from the initial bleeding. Moreover, surgery-related complications are not rare. We describe seven patients with ruptured vertebrobasilar dissecting aneurysm. To prevent rebleeding during the acute stage, we treated all seven patients conservatively with fentanyl instead of emergency surgery. During the follow-up period (mean 20 months), no patient suffered rebleeding. Conservative treatment with fentanyl administration may be a good option for management of ruptured vertebrobasilar dissecting aneurysm during the acute stage. | 18,810,598 |
The use of the MacCAT-CA with adolescents: an item response theory investigation of age-related measurement bias. | Despite the application of the MacCAT-CA to juveniles, questions been raised regarding the appropriateness of this tool for adolescents. The current study tested for age-related measurement bias using data from the MacArthur Juvenile Adjudicative Competence Study (n = 1393). Five of the MacCAT-CA items showed age-related measurement bias (i.e., DIF) for adolescents aged 11-15, and three items showed DIF for adolescents aged 16-17. Several items (e.g., understanding of juries) were more difficult for adolescents than adults matched at the same latent level of capacity, suggesting that these items might underestimate adolescents' legal capacities. Contrary to expectations, there was little evidence of age-related measurement bias on the Appreciation scale. The use of the MacCAT-CA in research and clinical settings is discussed. | 18,810,614 |
Comparison of atrial fibrillation inducibility by electrical stimulation of either the extrinsic or the intrinsic autonomic nervous systems. | To study the effects of bilateral vagosympathetic nerve stimulation (VNS) and ganglionated plexi stimulation (GPS) on atrial refractoriness and inducibility of atrial fibrillation (AF). Studies were performed in fourteen adult mongrel dogs anesthetized with Na-pentobarbital, 30 mg/kg. VNS was achieved by insertion of wires into the left and right VN trunks. An octapolar catheter was attached to contact the right superior pulmonary vein (RSPV) and other octapolar catheter electrodes were sutured to the right atrial (RA) free wall and appendage (RAA). GPS was performed via a plaque electrode sutured to the fat pad containing the anterior right (AR) GP. VNS and GPS were matched to decrease heart rate by approximately 50%. Programmed stimulation delivered from the RSPV or RAA at 2x, 4x and 10x threshold (TH) allowed the determination of atrial refractory period (ARP) and the AF inducibility. The latter was quantitated by the cumulative window of vulnerability (WOV), i.e., the longest minus the shortest coupling interval during which AF was induced at 2x, 4x, 10x, TH combined. Programmed electrical stimulation at the RSPV showed that the ARP was significantly shorter for both VNS and GPS than baseline (baseline, 113 +/- 22 ms; VNS, 94 +/- 26 ms; GPS, 85 +/- 31 ms) but there was no significant difference in ARP between VNS and GPS. In contrast, the cumulative WOV was significantly wider with GPS (39 +/- 36 ms) than either the baseline state (1 +/- 1 ms) or with VNS (14 +/- 26 ms), p < 0.05. Moreover, pacing from RAA showed a significantly greater cumulative WOV for VNS (33 +/- 36 ms) vs both baseline and GPS (1 +/- 4 ms and 15 +/- 26 ms, respectively, p < 0.05). The heart rate slowing caused by GPS and VNS was not significantly different, 82 +/- 11/min vs 82 +/- 7/min. These data indicate a distinct functional separation of autonomic nerve innervation to the atria from the extrinsic and intrinsic nervous systems. AF is more liable to occur due to intrinsic nerve stimulation at the PVs whereas peripheral atrial sites are more readily inducible for AF due to the extrinsic neural input. | 18,810,624 |
Dissecting "gaydar": accuracy and the role of masculinity-femininity. | "Gaydar" is the ability to distinguish homosexual and heterosexual people using indirect cues. We investigated the accuracy of gaydar and the nature of "gaydar signals" conveying information about sexual orientation. Homosexual people tend to be more sex atypical than heterosexual people in some behaviors, feelings, and interests. We hypothesized that indicators of sex atypicality might function as gaydar signals. In Study 1, raters judged targets' sexual orientation from pictures, brief videos, and sound recordings. Sexual orientation was assessed with high, though imperfect, accuracy. In Study 2, different raters judged targets' sex atypicality from the same stimuli. Ratings of sexual orientation from Study 1 corresponded highly with targets' self-reports of sex atypicality and with observer ratings of sex atypicality from Study 2. Thus, brief samples of sex-atypical behavior may function as effective gaydar signals. | 18,810,629 |
Vesico-vaginal fistula: report of 220 cases. | To present the major causes, diagnosis, indications, and basic principles of surgical treatment of vesico-vaginal fistulas (VVF). From 1978 to 2004, 235 surgical procedures in 220 women with vesico-vaginal fistulas were performed at the Clinical Center of Serbia, Urological Clinic, due to primary or recurrent VVF. There were 220 primary procedures: 129 transvesical approaches (TVES), 59 transvaginal repairs (TVAG), and 32 transperitoneal approaches with flap interposition (TPA). Transvesical approach was the most common procedure in the early period (1978-1993) and less frequent in the late period (1994-2004). The main causes of VVF were hysterectomy for benign conditions (62.7%), hysterectomy for malignant conditions (30.4%), cesarean section (5.9%), and obstetric injuries (0.9%). There was no perioperative mortality. There were fifteen recurrent fistula formations: twelve after the first operation and three after the second. The recurrence rates between the procedures were comparable: TVES 6.6%, TVAG 6.4%, and TPA 5.4%. The total recurrence rate of 6.4% did not differ significantly between various procedures. However, TVAG is less invasive and suitable for uncomplicated cases, whereas TPA should be recommended for great and recurrent VVF. | 18,810,652 |
Symbiosis between microorganisms from kombucha and kefir: Potential significance to the enhancement of kombucha function. | Gluconacetobacter sp. A4 (G. sp. A4), which had strong ability to produce d-saccharic acid 1, 4 lactone (DSL), was the key functional bacteria isolated from the kombucha preserved. This paper investigated the interaction between G. sp. A4 and ten different strains of lactic acid bacteria (LAB) obtained from kefir. The result suggested that the LAB promoted DSL production of G. sp. A4 to different extents, ranging from 4.86% to 86.70%. Symbiosis between G. sp. A4 and LAB was studied. LAB's metabolites, xylitol, and acetic acid, were utilized by G. sp. A4, and it promoted the growth of G. sp. A4 and yield of DSL. Therefore, in developing starter cultures for kombucha fermentation process, a mixed flora of LAB and G. sp. A4 would be the optimal combination. | 18,810,658 |
Metaanalysis of tirilazad mesylate in patients with aneurysmal subarachnoid hemorrhage. | Tirilazad is a non-glucocorticoid, 21-aminosteriod that inhibits lipid peroxidation. It had neuroprotective effects in experimental ischemic stroke and reduced angiographic vasospasm after experimental subarachnoid hemorrhage (SAH). Five randomized clinical trials of tirilazad were conducted in patients with SAH. We performed a meta-analysis of these trials to assess the effect of tirilazad on unfavorable outcome, symptomatic vasospasm, and cerebral infarction after SAH. Data from 3,797 patients were analyzed and modeled using random effect and Mantel-Haenszel meta-analyses and multivariable logistic regression to determine the effect of tirilazad on clinical outcome, symptomatic vasospasm, and cerebral infarction. Clinical outcome was assessed 3 months after SAH using the Glasgow outcome scale, and symptomatic vasospasm was defined by clinical criteria with laboratory and radiological exclusion of other causes of neurological deterioration. The five trials were randomized, double-blind, and placebo-controlled. Tirilazad did not significantly decrease unfavorable clinical outcome on the GOS (odds ratio [OR] 1.04, 95% confidence interval [CI] 0.89-1.20) or cerebral infarction (OR 1.04, 95% CI 0.89-1.22). There was a significant reduction in symptomatic vasospasm in patients treated with tirilazad (OR 0.80, 95% CI 0.69-0.93). There was no heterogeneity across the five trials. Tirilazad had no effect on clinical outcome but did decrease symptomatic vasospasm in five trials of aneurysmal SAH. The dissociation between clinical outcome and symptomatic vasospasm deserves further investigation. | 18,810,661 |
Palliative surgical bypass for pancreatic and peri-ampullary cancers. | The optimal method of palliation for patients with unresectable pancreatic and peri-ampullary cancer (PAC) is controversial with surgical bypass or endoscopic stenting, each having advantages and disadvantages. We analysed short term outcomes and survival for all patients undergoing surgical palliative bypass procedures. All patients undergoing palliative surgical bypass for unresectable PAC from Aug 1999 to July 2007 were identified from our database. Outcomes analysed were peri-operative morbidity, mortality, and overall survival with comparisons from contemporaneous literature. One hundred eight patients (median age 65 (range 36-86) years; male = 61) had palliative surgical bypass procedures for unresectable PAC. Patients underwent combined biliary and gastric bypass (n = 81, 75%), gastric bypass alone (n = 24, 22.2%) or biliary bypass alone (n = 3, 2.8%). Overall mortality was 6.5% and the morbidity was 15.7%. Median hospital stay was 11 (range 4-54) days. Median survival was 6 (95% confidence interval (CI) = 4.3-7.6) months. No re-explorations for recurrent biliary or gastric obstruction were required. Contemporaneous literature review showed similar results. Surgical bypass performed in a specialist pancreatic center can offer effective palliation for unresectable PAC, with satisfactory outcomes. | 18,810,668 |
Probiotic Escherichia coli Nissle 1917 (EcN) for successful remission maintenance of ulcerative colitis in children and adolescents: an open-label pilot study. | Since about 20 % of patients with ulcerative colitis (UC) are children and adolescents there is a need for therapeutic options custom-tailored to the children's needs. E. coli Nissle 1917 (EcN) as an evidence-based probiotic alternative to mesalazine (5-ASA) in adult UC remission maintenance is a promising agent for such a therapy. The present open-labelled pilot study was undertaken to investigate the clinical benefit of EcN for maintenance therapy in young UC patients. 34 patients with UC in remission aged between 11 and 18 years were allocated either to EcN (2 capsules o. d., n = 24) or 5-ASA (median 1.5 g/d, n = 10) and observed over one year. As a result, the relapse rate was 25 % (6 / 24) in the EcN group and 30 % (3 / 10) in the 5-ASA group. Data on the patients' global health and development were favourable and no serious adverse events were reported. In conclusion, maintenance therapy for UC with the probiotic EcN is effective also in young patients. | 18,810,672 |
[An unusual cause of severe abdominal pain]. | A 33-year-old previously healthy man was admitted to the hospital with a 6-day history of diffuse abdominal pain and constipation. He was afebrile, looked unwell with a pale skin and displayed an elevated blood pressure. He had no peritoneal sign, and bowel sounds were normal. Blood tests were remarkable for a hematocrit of 26 % and mean cell volume of 83 fl, bilirubin levels were slightly elevated. Abdominal radiographs, abdominal ultrasound and computed tomography showed stool throughout the colon with a non-specific bowel gas pattern. Moreover, colonoscopy and gastroscopy provided no information on the underlying cause of the patient's severe pain. He was treated with fluids and spasmolytic drugs until the result of the urinary porphyrin level was received, which showed an elevated concentration of 1608 microg/d. Consequently, the plasma lead concentration was determined showing an elevated level of 92.3 microg/d. The examination of blood slides revealed erythrocytes with basophile stippling. On physical examination, a bluish discoloration could be seen along the gums. After starting the detoxication therapy with DMPS - 1800 mg p. o. for the first two days followed by 600 mg DMPS daily - the complaints disappeared. In spite of an extensive anamnestic exploration the source of the lead intoxication could not be found until now. | 18,810,673 |
Photophysical and duplex-DNA-binding properties of distamycin dimers based on 4,4'- and 2,2'-dialkoxyazobenzenes as the core. | Distamycin-based tetrapeptide (1) was covalently tethered to both ends of the central dihydroxyazobenzene moiety at either the 2,2' or 4,4' positions. This afforded two isomeric, distamycin-azobenzene-distamycin systems, 2 (para) and 3 (ortho), both of them being photoisomerizable. Illumination of these conjugates in solution at approximately 360 nm induced photoisomerization and the time course of the process was followed by UV/Vis and (1)H NMR spectroscopy. The kinetics of the thermal reversion at various temperatures of cis to trans isomers of the conjugates obtained after photoillumination were also examined. This afforded the respective thermal-activation parameters. Both the molecular architecture and the location of the substituent around the core azobenzene determined the rate and activation-energy barrier for the cis-to-trans back-isomerization of these conjugates in solution. Duplex-DNA binding of the conjugates and the changes in DNA-binding efficiency upon photoisomerization was also examined by CD spectroscopy, thermal denaturation studies, and a Hoechst displacement assay. The conjugate 2 showed higher DNA-binding affinity and a greater change in the DNA-binding efficiency upon photoisomerization compared with its 2,2'-disubstituted counterpart. The experimental findings were substantiated by using molecular-docking studies involving each conjugate with a model duplex d[(GC(AT)(10)CG)](2) DNA molecule. | 18,810,740 |
Spontaneous resolution of chiral polyoxometalate-based compounds consisting of 3D chiral inorganic skeletons assembled from different helical units. | Four enantiomerically pure 3D chiral POM-based compounds, [Ni(2)(bbi)(2)(H(2)O)(4)V(4)O(12)]2 H(2)O (1 a and 1 b) and [Co(bbi)(H(2)O)V(2)O(6)] (2 a and 2 b) (bbi=1,1'-(1,4-butanediyl)bisimidazole) based on the achiral ligand, different vanadate chains, and different metal centers have been synthesized by hydrothermal methods. Single-crystal X-ray diffraction analyses revealed that 1 a and 1 b, and 2 a and 2 b, respectively, are enantiomers. In 1 a and 1 b two kinds of vanadate chains with different screw axes link Ni cations to generate 3D chiral inorganic skeletons, which are connected by the achiral bbi ligands to form complicated 3D 3,4-connected chiral self-penetrating frameworks with (7(2)8)(7(2)8(2)9(2))(7(3)8(2)10) topology. They represent the first examples of chiral self-penetrating frameworks known for polyoxometalate (POM) systems. Contrary to 1 a and 1 b, in 2 a and 2 b the vanadate chains link Co(II) cations to generate 3D chiral inorganic skeletons, which are assembled from two kinds of heterometallic helical units of opposite chirality along the c axes. The chiral inorganic skeletons are connected by bbi to form 3D 3,4-connected chiral POM-based frameworks with (6(2)8)(2)(6(2)8(2)10(2)) topology. It is believed that the asymmetrical coordination modes of the metal cations in 1 a-2 b generate the initial chiral centers, and that the formation of the various helical units and the hydrogen bond interactions are responsible for preservation of the chirality and spontaneous resolution when the chirality is extended into the homochiral 3D-networks. This is the first known report of chiral POM-based compounds consisting of 3D chiral inorganic skeletons being obtained by spontaneous resolution upon crystallization in the absence of any chiral source, which may provide a rational strategy for synthesis of chiral POM-based compounds by using achiral ligands and POM helical units. | 18,810,744 |
Crohnology: a tale of time and times and inflammatory bowel diseases. | Time, times and timing are key words in inflammatory bowel diseases (IBD). The leitmotif of this issue of World Journal of Gastroenterology is time. We have asked experts to review on the epidemiology of these diseases over time, the changes in innate immunity that could be present in the first time, and then the timing of key treatments. The correct time of using azathioprine, mercaptopurine, infliximab, cyclosporine and surgery are reviewed. We have chosen experts with not only great clinical expertise but also personal interest in clinical and basic investigation. Our goal in this monograph is to get an idea not only of the present but of the immediate future in some of the key management issues in IBD. To this end, we think that the authors are the most adequate. | 18,810,763 |
Treatment of severe steroid refractory ulcerative colitis. | Although systemic steroids are highly efficacious in ulcerative colitis (UC), failure to respond to steroids still poses an important challenge to the surgeon and physician alike. Even if the life time risk of a fulminant UC flare is only 20%, this condition is potentially life threatening and should be managed in hospital. If patients fail 3 to 5 d of intravenous corticosteroids and optimal supportive care, they should be considered for any of three options: intravenous cyclosporine (2 mg/kg for 7 d, and serum level controlled), infliximab (5 mg/kg IV, 0-2-6 wk) or total colectomy. The choice between these three options is a medical-surgical decision based on clinical signs, radiological and endoscopic findings and blood analysis (CRP, serum albumin). Between 65 and 85% of patients will initially respond to cyclosporine and avoid colectomy on the short term. Over 5 years only 50% of initial responders avoid colectomy and outcomes are better in patients naive to azathioprine (bridging strategy). The data on infliximab as a medical rescue in fulminant colitis are more limited although the efficacy of this anti tumor necrosis factor (TNF) monoclonal antibody has been demonstrated in a controlled trial. Controlled data on the comparative efficacy of cyclosporine and infliximab are not available at this moment. Both drugs are immunosuppressants and are used in combination with steroids and azathioprine, which infers a risk of serious, even fatal, opportunistic infections. Therefore, patients not responding to these agents within 5-7 d should be considered for colectomy and responders should be closely monitored for infections. | 18,810,767 |
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