title stringlengths 0 1.13k | abstract stringlengths 1 15.7k | PMID int64 22 36.5M |
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Doppler analysis and placental nitric oxide synthase expression during fetal growth restriction. | To assess placental nitric oxide (NO) metabolism related to changes in the uteroplacental circulation during fetal growth restriction (FGR). The resistance index (RI) from the uterine arteries and pulsatility index (PI) from the umbilical artery were determined by Doppler analysis in 15 patients with FGR and 12 healthy controls, before elective cesarean section. Inducible (iNOS) and endothelial (eNOS) NO synthase expression were measured in placental samples. Immunohistochemistry was performed for iNOS location in the placenta. During FGR, we observed a significant elevation of iNOS when compared with controls. Conversely, eNOS did not differ between the two groups. A negative correlation with eNOS (r = -0.85) and a positive correlation with iNOS (r = 0.91) was found correlating to umbilical PI. The iNOS proteins were reduced in syncytiotrophoblast cells and increased in endothelium in the FGR group compared to the controls. During FGR, placental iNOS expression is significantly increased; this increase possibly represents an adaptive physiological mechanism for overcoming a fetoplacental circulation deficiency. | 18,828,052 |
Comparison of ceftriaxone versus triple drug regimen in the prevention of cesarean section infectious morbidities. | To compare the effectiveness of single dose ceftriaxone versus multiple doses of ampiclox, gentamicin, and metronidazole to prevent infectious morbidity at elective cesarean section. This was a randomized clinical trial involving 200 pregnant women who had an elective cesarean section for various reasons during the study period. Outcome measures included endometritis, urinary tract infections, febrile morbidities, wound infections, duration of hospital stay, and cost of antibiotic therapy. Data were managed using SPSS. There was no statistically significant difference in the mean duration of hospital stay between the two groups, but a significant statistical difference was found in the mean cost of antibiotic treatment ($15 for the combination and $9 for ceftriaxone; p = 0.000), with the group of patients taking a single dose of ceftriaxone (ROPHEX) having a lower mean cost of treatment than those taking a combination of ampiclox, gentamicin, and metronidazole. The study groups did not differ significantly in the incidence of endometritis (14% versus 15%), urinary tract infection (11% versus 15%), wound infections (7% versus 8%), febrile morbidity (7% versus 6%), and peritonitis (0% versus 0%). Single dose ceftriaxone was as effective as a combination of ampiclox, gentamicin, and metronidazole in preventing post-elective cesarean section complications. | 18,828,055 |
Toward in silico approaches for investigating the activity of nanoparticles in therapeutic development. | The distinctive characteristics of nanoparticles (NPs), resulting from properties that arise at the nanoscale, are stimulating the use of these particles in the biomedical sector for diagnostic and therapeutic purposes. However, these same characteristics of NPs also underlie widespread concerns regarding potential toxic effects. Given the large number of NPs that are being developed for possible biomedical use, there is a need to develop rapid screening methods based on in silico methods. This feature review provides an overview of some of the main in silico methods that are already used in the assessment of chemicals. The current status of these methods, in terms of availability and applicability to NPs, and recommendations for further research, are highlighted. | 18,828,072 |
Living without a data management system. | The implementation of a typical electronic data capture (EDC) system for clinical trials - encompassing data entry, validation and reporting tools - involves modeling electronic case report forms (eCRFs) for data that will be entered by investigative trial sites, providing web access for the sites to enter the data, managing a 'cleaning and locking' process (in which any queries against the data are resolved), and transmitting the final data to SAS datasets. Other clinical data not included in CRFs, such as laboratory data, are typically handled in a separate clinical data management system; this information is not directly linked back to the trial sites and therefore is inaccessible for review. Thus, activities such as seeking site feedback on out-of-range laboratory values can only be performed by manually transcribing queries from the data management system into the EDC system. As the number of studies using EDC systems escalates and the number of studies gathering data on paper diminishes, the inefficiencies of handling data across different systems are becoming increasingly apparent. This article explores the opportunities, risks and technical requirements needed for an integrated EDC environment to enable a discontinuation of the use of older data management systems. | 18,828,073 |
The ansa subclavia: a review of the literature. | The ansa subclavia, subclavian loop, Vieussens' ansa or Vieussens' loop is a nerve cord that connects the middle cervical and inferior cervical sympathetic ganglia, forming a loop around the subclavian artery. The structure of the ansa subclavia is evolutionarily conserved from rats, guinea pigs, the porcine species and dogs to humans. A common application in physiological studies is to electrically stimulate the ansa subclavia in animal models as a robust protocol to modulate stimulatory cardiac sympathetic input. Despite a large number of physiological studies utilizing the ansa subclavia, only very brief descriptions have been devoted to it in standard anatomy texts. An extensive search found only one report in the English language literature concerning the anatomy of the ansa subclavia. The aim of this report, therefore, was to provide a comprehensive review of the clinical anatomy of the ansa subclavia and to discuss its potential physiological functions. | 18,828,096 |
The body constitution of patients and intubation scales as predictors of difficult intubation considered in relation to the experience of the intubator. | The aims of the study were to identify factors that may result in difficulties in intubation, and to compare the results obtained when an experienced and when a less experienced anaesthesiologist was involved. The 96 patients included in the study were evaluated for difficult intubation according to the following scales: Mallampati, upper lip bite test (ULBT) and Patil. The mobility of the cervical segments of the vertebral column, the distance between the jugular notch of the sternum and the chin and the anatomical constitution of the body were other factors that were taken into consideration. Statistical analysis was performed in order to identify factors that may result in difficulties in intubation for an experienced and for a less experienced anaesthesiologist. | 18,828,097 |
[Clearances in automated intermittent peritoneal techniques: a new formula to use morning blood sampling]. | According to the main guidelines, dialysis adequacy monitoring is fundamental in the management of patients on peritoneal dialysis. In order to avoid mistakes in the calculation of the peritoneal urea and creatinine clearance in patients on dialysis with intermittent techniques, the collection of blood samples about 6 hours after the end of the dialysis session is advised. In fact, because the creatinine and urea values at the end of dialysis (the morning values in NIPD) are the lowest, the resulting clearances could be overestimated. The mean values between the start and the end of the dialysis session are considered the gold standard. However, collecting a blood sample at 2.00 p.m. may be difficult and uncomfortable both for the nurse and the patient. In this paper we present two formulas (the first for urea and the second for creatinine) which, starting from the values at the end of dialysis, predict the values at the beginning of the session and consequently the mean values. The aim of this study was to validate the formulas by evaluating their capability to predict the mean urea and creatinine values when only end-of-dialysis blood sampling was performed. Statistical analysis was carried out using the Bland-Altman test. The two formulas proved able to predict the mean urea and creatinine values; the differences between the measured and calculated values were not statistically significant. | 18,828,118 |
[The Classics of Italian Nephrology: ''The physiopathological basis for the nosography and the classification of bilateral kidney diseases'' by Pio Bastai (1888-1975) and Massimo Crepet (1911-1994)]. | The paper ''I fondamenti fisiopatologici per la nosografia e la classificazione delle malattie renali bilaterali'' (The physiopathological basis for the nosography and the classification of bilateral kidney diseases'') by Pio Bastai (1888-1975) and Massimo Crepet (1911-1994) was presented at the 54th Congress of the Italian Society of Internal Medicine, which was held in October 1953 in Rome. In the report, the authors proposed their own classification of renal diseases based on a ''physopathological'' criterion and different from the classifications proposed by other authors of the period. According to Bastai and Crepet, renal diseases could be classified into arteriolopathies (either acute or chronic), capillary diseases (glomerulonephritides, including inflammatory and noninflammatory forms), renal diseases due to circulatory failure, nephropathies due to toxic substances, interstitial nephropathies, and idiopathic nephropathies. Of particular interest today is the part of the paper on the nosography of the so-called ''genuine glomerulonephrosis'' which, at variance with the view of the leading clinicians at the time, was placed among the inflammatory glomerulonephritides. In addition, the authors expressed their uncertainty about the existence of primary chronic interstitial nephropathies. Today, the paper by Bastai and Crepet shows how difficult it was to propose a classification of renal diseases in a period when the use of renal biopsy was still in its infancy. | 18,828,120 |
[Objectives of the low-protein diet]. | The prescription of low-protein diets to patients with chronic kidney disease has several objectives: to lower the dietary phosphorus load and circulating phosphorus and parathyroid hormone levels, and to improve the acid-base control and uremic symptoms while preserving the nutritional status. However, such objectives are always subordinate to the necessity of maintaining adequate calorie intake. An important target of any reduction of dietary protein intake is the delay of renal death and start of dialysis, as demonstrated by several methodologically sound studies and meta-analyses. However, no prospective study has yet confirmed the nephroprotective potential of low-protein diets repeatedly shown in animal models. Such negative results in human studies could be explained by their frequent methodological flaws, as well as by the modest actual reduction of protein intake compared with pre-study levels. The recent Cochrane meta-analysis confirmed that reducing dietary protein intake can delay renal death and dialysis. The Number-to-Treat estimate in the Cochrane meta-analysis (NNT=16) was even better than similar estimates in the statin prevention trials ''4S'' and ''WOSCOPS''. | 18,828,128 |
Nanoscale organization of CD4 molecules of human T helper cell mapped by NSOM and quantum dots. | CD4 molecule, the surface marker of T helper cell, has been confirmed to be the main cellular receptor for the human immunodeficiency viruses HIV-1, HIV-2 and SIV. Recent research demonstrated the importance of the spatial arrangement of CD4 on the cell membrane to its binding efficiency to virus. In this article, the combined near-field scanning optical microscopy (NSOM) and quantum dots (QDs) fluorescent labeling technology were performed to investigate the nanoscale organization of CD4 molecules with a spatial resolution about 100 nm. Simultaneous topographic image of the T helper cell and fluorescent image of QDs have been directly gained by NSOM/QDs-based system. Intensity- and size-distribution histograms of the QDs fluorescent spots verify that approximately 80% of the CD4 molecules are organized in nanosized domains randomly distributed on the cell surface. Intensity-size correlation analysis revealed heterogeneity in the molecular packing density of the domains. Our results also illustrated the combination of NSOM imaging and QDs labeling is an ultrasensitive, high-resolution technique to probe nanoscale organization of molecules on the cell surface. | 18,828,144 |
DFT-GIAO-NBO and 13C NMR study of the delta-syn-axial effect in 2,4-disubstituted adamantanes. | Six groups of diastereomeric 2,4-disubstituted adamantanes were studied with DFT-GIAO-NBO (natural orbital analysis) methods. The calculated (13)C chemical shifts reproduce well the experimental data. It was found that among all diastereomers, those bearing substituents in delta-syn-axial positions showed the largest overall deshielding, i.e. the sum of all (13)C chemical shifts [Sigmadelta((13)C)] was the greatest and also had the highest delocalization contribution to the molecular energy evaluated with NBO. The higher delocalization energy is proposed to be the origin of the deshielding delta-syn-axial effect. | 18,828,152 |
Analysis of mutant DNA polymerase gamma in patients with mitochondrial DNA depletion. | We studied six unrelated children with depletion of mitochondrial DNA (mtDNA). They presented with Leigh syndrome, infantile hepatocerebral mtDNA depletion syndrome, or Alpers-Huttenlocher syndrome. Several genes have been implicated in mtDNA depletion. Screening of candidate genes indicated that all six patients were compound heterozygous for missense mutations in the gene for the catalytic subunit of DNA polymerase gamma (POLG). Three of the identified mutations, c.3328C>T (p.H1110Y), c.3401A>G (p.H1134R), and c.3406G>A (p.E1136K), have not been reported earlier. To investigate the functional consequences of the mutations, we carried out a series of biochemical assays in cultured fibroblasts. These studies revealed that fibroblast cultures from the patients with infantile hepatocerebral mtDNA depletion syndrome progressively lost their mtDNA during culturing, whereas fibroblast cultures from patients presenting with Leigh syndrome or Alpers-Huttenlocher syndrome had reduced but stable levels of mtDNA. DNA polymerase gamma activity was below the normal range in all patient cultures, except for one; however, this culture showed low levels of the heterodimeric enzyme and poor DNA polymerase gamma processivity. Parental fibroblast cultures had normal catalytic efficiency of DNA polymerase gamma, consistent with the observation that all carriers are asymptomatic. Thus, we report the first patient with Leigh syndrome caused by POLG mutations. The cell culture experiments established the pathogenicity of the identified POLG mutations and helped to define the molecular mechanisms responsible for mtDNA depletion in the patients' tissues. The assays may facilitate the identification of those patients in whom screening for POLG mutations would be most appropriate. | 18,828,154 |
Regional variation in rural hospital charges due to ambulatory care sensitive conditions. | In this policy brief, we estimate and document the regional magnitudes of charges associated with hospitalizations due to ambulatory care sensitive conditions (ACSCs) in rural hospitals. This research will inform policy makers about the regional magnitudes of rural preventable hospitalizations and the associated potential savings in hospital resource utilization when rural patients receive timely and effective primary care. | 18,828,245 |
Coexisting congenital diaphragmatic hernia, esophageal atresia, and tracheoesophageal fistula: a case report and review of the literature. | Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) and congenital diaphragmatic hernia (CDH) are two relatively common neonatal conditions. The coexistence of the two conditions in the same newborn is extremely rare. This is a case report of a newborn with CDH and concurrent EA and TEF. Aspects of diagnosis and the literature on the subject are also reviewed. | 18,828,268 |
A comparative study between total contact casting and conventional dressings in the non-surgical management of diabetic plantar foot ulcers. | Of all non-traumatic amputations 50% occur in Diabetics, mostly as a final outcome of foot ulcers. A major biomechanical factor in the causation of foot ulcers in persons with diabetes mellitus is elevated peak plantar pressure. Offloading the ulcer area in the form of equalisation of pressure across the plantar surface can accelerate healing of the ulcer. Total contact casting is one such method of offloading, and this study attempts to investigate the advantages of the above method as compared to conventional dressings in the physiatric management of the depth--ischaemia grades 1A, 1B, 2A, 2B neuropathic plantar ulcers in a diabetic patient. The outcome measure was the time taken for complete resolution of the ulcers. Of the 29 patients in Category A treated with total contact casting involving a total of 39 foot ulcers, 36 healed, which was statistically significant (p < 0.05) as compared to 25 out of the 33 ulcers healing in Category B consisting of 26 patients treated by conventional dressings alone. Total contact casting is an effective, rapid, economical, ambulatory and outpatient--based method for the treatment of diabetic foot ulcers. | 18,828,342 |
[Mobilization and transformation of phosphorus from water-soil interface of flooded soil]. | Mobilization and transformation of phosphorus from water-soil interface of flooded agricultural soils is a concern, and it has been a leading cause of eutrophication of lakes and rivers. Using PVC soil trough, we modeled the mobilization and transformation of P, ferrous iron, ferric iron, dissolved organic carbon (DOC) between soil floodwater and porewater induced by flooding, and characterized the main factors that contributed to phosphorus release by using the principal component-partial least squares method. This study shows that flooding soils induced significant release of phosphate to the floodwater over a 54-d period. Cumulative phosphate content in floodwater was 16 times as much as in porewater. The changes that occurred among the inorganic P forms during flooding were also invested. Significant changes in the inorganic P fractions Fe-P, Al-P, Ca-P, and O-P occurred in soil during flooding. Typically, the Ca-P fraction was almost unchanged during flooding. The others decreased, and Fe-P contents during flooding decreased by 30.4%-72% of its initial value, which significantly contributed to the release of phosphate to floodwater and porewater. The major factors that affected the floodwater phosphate release were Eh, ferrous iron, ferric iron, and dissolved organic carbon (DOC). The factor that affected the porewater phosphate release was DOC. The predominant mechanism of DOC induced floodwater P release was ligand-enhanced dissolution, and that induced porewater P release was competitive sorption. Furthermore, ferric iron in porewater affected the porewater P release. | 18,828,360 |
[Inhibitory effect kinetics of nitrite acting as electron acceptor on anoxic phosphorus uptake and denitrification]. | Nitrite has been found in previous research an inhibitor on anoxic phosphorus uptake in enhanced biological phosphorus removal systems (EBPR). However, the inhibiting nitrite concentration reported varied in a large range and no kinetics study concerned on anoxic phosphorus uptake. This study investigates the nitrite inhibition on anoxic phosphorus uptake with sequencing batch reactor (SBR) in different concentrations of NO2- and under different pH gradient. The activated sludge was cultured with A2/O Oxidation Ditch pilot-scale reactor performing EBPR. The progress of SBR is as follows: the activated sludge was taken out an aerobic zone of the A2/O Oxidation Ditch to SBR, then phosphorus was released with acetate fed in anaerobic phase, subsequently phosphorus uptake proceeded with NO2- added in anoxic phase. It is pointed that not only NO2- but pH inhibited anoxic phosphorus uptake. The result indicated that (1) specific denitrification rate and specific phosphorus uptake rate correlated the original nitrite accord with Andrews's inhibition model under the constant pH. (2) If pH was in the range of 6.5 to 8.0, nitrite inhibited DPR much stronger when pH was less, vice versa. (3) Kinetics parameter was as follows: the max specific denitrification rate was 4.55 mg/(g x h), the half saturation constant of the denitrification process was 2.14 mg/L; and the max specific phosphorus uptake rate was 3.06 mg/(g x h), the half saturation constant of the phosphorus uptake process was 2.64 mg/L. | 18,828,369 |
[Control of shortcut nitrification in SBBR with adequate oxygen supply]. | At the high level of dissolved oxygen (DO) in sequencing batch biofilm reactor (SBBR), the approach and mechanism for realizing shortcut nitrification were researched. Landfill leachate was used as handling of object, the mainly environment parameters of the reactor were controlled as follow: DO 5 mg/L, pH 7.0, temperature 25 degrees C, adopted all drainage mode and 12-hour cycle influent. Through mathematical derivation and modeling analysis, determined free ammonia (FA), CO2 and HNO2 as the direct control factors, whereas the influent cycle time was the indirect one, shortcut nitrification was achieved effectively in SBBR. When the volume load of ammonia (NH4(+) -N) was 0.52 kg/(m3 x d) and NaHCO3 was 1.5 mg/L in the reactor, the shortcut nitrification effect was apparent as NH4(+) -N conversion rate was 89% and NO2(-) -N accumulation rate achieved 83% at the same time. With adequate oxygen supply, the key factors of achieving NO2(-) -N accumulation is FA concentration, and as the carbon source of ammonia-oxidizing bacteria, CO2 can upgrade the reactor performance further. | 18,828,367 |
[Degradation of simazine by O3/H2O2 system]. | The endocrine disrupter simazine was oxidized by O3/H2O2 and the reactive productions was analyzed by chromatography to assess the degradation efficiency of Simazine. The initial content of Simazine 2 mg/L was removed about 87.1% by O3H2O2 system when the O3 was dosed as 10.0 mg/L, the H2O2/O3 molar ratio was 0.70, the temperature was 26 degrees C and pH 7-8, which indicated Simazine could be conveniently removed by O3/H2O2 system in ordinary reactive condition. The simazine removal ratio in tap water was 10% more than it in purified water up to 86.9%. The removal of simazine was decreased when the content of humic acid (HA) was high, whereas it was increased while low content HA in water. Also, the removal efficiency was inhabited by hydrogen carbonate fairly. The deethyl-simazine (DES) was trapped by Gas Chromatography Mass Spectrum(GC-MS) which was also certificated by analyzing the Liquid Chromatography Mass Spectrum (LC-MS) of the products. The Ion Chromatography spectrum showed the existing of de-chloro-procedure and breakage of triazine ring. Which indicated the oxidizability of O3/H2O2 system was fairly strong. | 18,828,376 |
[Construction of a stable genetically engineered microorganism for degrading HCH & methyl parathion and its characteristics]. | A GEM designated as BHC-A-mpd, capable of simultaneously degrading of methyl parathion (MP) and HCH was successfully constructed by random insertion of a methyl parathion hydrolase gene (mpd) into chromosome of a HCH-degrading strain BHC-A with the mini-Tn-transposon system. The growth and degrading characteristics of BHC-A-mpd was compared with the original strain BHC-A, and the result showed that there was no difference in this two aspects, A600 nm of BHC-A-mpd in LB medium could reach 2.5 in logarithmic period, which was the same as that of the original strain BHC-A.BHC-A-mpd showed the same HCH-degrading ability as BHC-A and could degrade 5 mg/L of gamma-HCH in 10 h. BHC-A-mpd showed high genetica stability and could degrade many kinds of organophosphorus pesticides. All these results indicated that BHC-A-mpd was a promising GEM in bioremediation of MP and HCH co-contaminated environment. | 18,828,386 |
Patient risks, outcomes, and costs of voluntary HIV testing at five testing sites within a medical center. | The Centers for Disease Control and Prevention (CDC) recommends offering human immunodeficiency virus (HIV) testing to all patients in all high HIV-prevalence clinical settings. We evaluated programmatic aspects of HIV testing across multiple clinical settings within a single medical center. We analyzed programmatic data of HIV testing in the Urgent Care Center (UCC), inpatient floors, outpatient primary care, a non-clinical Drop-In Center, and Emergency Department (ED). HIV testing was by oral mucosal transudate, venous blood samples, or rapid testing fingersticks, with Western blot confirmation. We compared the sociodemographics and behavioral risks of individuals undergoing HIV testing across the five sites and estimated costs per person tested and per HIV-positive test result. From 2002 to 2004, 16,750 HIV tests were conducted, with 229 (1.4%) previously unreported HIV infections diagnosed among 16,696 valid test results. HIV-positive prevalence was 1.5% for the UCC, 1.5% at the Drop-In Center, 1.4% for primary care, 1.2% for inpatient, and 0.6% in the ED. Behavioral risks were most prevalent in the UCC and the Drop-In Center. The cost per test was lowest in the UCC and highest in the Drop-In Center. The cost per previously unreported HIV infection was lowest in the UCC ($1,980) and highest in the ED ($9,724). Although a significant number of HIV infections were identified, the number of tests performed represents < 10% of all clinical visits. Due to personnel and time constraints, offering HIV testing to patients hierarchically in some settings of a high-volume medical center merits evaluation. | 18,828,416 |
Mini-open reduction and intramedullary interlocking nailing of fracture shaft of tibia without an image intensifier. | Intramedullary interlocking tibial nailing is usually performed using an image intensifier. But being expensive, it is not available in the most of the hospitals of resource-poor countries of the world. The purpose of this study is to analyze the results of interlocking nailing without the use of an image intensifier. This is the retrospective study of 55 diaphyseal tibial fractures treated with minimally open reduction and internal fixation with interlocked intramedullary nail fixation. The proximal locking of the nail with the screws was made using external jig and for the distal locking direct visualization of the hole was carried out. There were 15 females and 40 males. The average age in years was 32 with a range of 18 to 64 years. The surgical approach was medial parapatellar. The average follow up period was 4 months. This period ranged from 3 months to 14 months. The union time in an average was 4 months. The complication mainly was distal screw loosening leading to valgus deformity and shortening in 1 case. It is, therefore, concluded that interlocking intramedullary nailing can be performed with proximal and distal locking accurately without the use of an image intensifier. | 18,828,436 |
High prevalence of intestinal zoonotic parasites in dogs from Belgrade, Serbia--short communication. | To identify areas of risk for canine-related zoonoses in Serbia, the aim of this study was to provide baseline knowledge about intestinal parasites in 151 dogs (65 household pets, 75 stray and 11 military working dogs) from Belgrade. The following parasites, with their respective prevalences, were detected: Giardia duodenalis (14.6%), Ancylostomatidae (24.5%), Toxocara canis (30.5%), Trichuris vulpis (47.0%) and Taenia-type helminths (6.6%). Of all examined dogs, 75.5% (114/151) were found to harbour at least one parasite species. Of these, mixed infections with up to four species per dog occurred in 44.7% (51/114). Infections with all detected species were significantly higher (p < 0.05) in military working (100%) and stray dogs (93.3%) versus household pets (50.8%). Among all parasites, agents with zoonotic potential including Giardia, Ancylostomatidae and Toxocara were detected in 58.3% (88/151) of all examined dogs with a significant difference (p < 0.05) among the subgroups (100%, 62.7% and 46.2% for military working dogs, stray dogs and household pets, respectively). The high prevalence of zoonotic parasites registered in the dog population from a highly urban area in south-eastern Europe indicates a potential risk to human health. Thus, veterinarians should play an important role in helping to prevent or minimise zoonotic transmission. | 18,828,485 |
A hybrid body technique: does the pulse diagnostic cun guan chi method have Chinese-Tibetan origins? | This article investigates the medieval origins of the main pulse diagnostic method in contemporary Chinese medicine, sometimes known as san bu (three sectors) method, which requires physicians to examine the mai (vessels, vessel movements or pulse) on the wrist at the three locations cun guan chi (inch, gate, foot). The article provides evidence to suggest that this body technique grew out of an earlier Chinese one, the cun chi (inch-foot) method, which appears to have aimed at investigating the qualities of yin and yang in order to determine the condition of a patient by means of exploring fairly large areas of the patient's body surface with the palms. The article furthermore posits that the cun chi method was decisively transformed in medieval times, presumably due to the impact of early Tibetan pulse diagnostic practices: it became framed in a numerology of three and started advocating the use of the fingertips for sensing the pulse beats. The article, which draws on detailed textual analyses of medieval manuscripts, on visual evidence and also on psychophysical research, furthermore highlights how misunderstandings can constructively contribute to cultural communication. | 18,828,567 |
Spanish influenza in the heart of Europe. A study of a significant sample of the Basque population. | This article presents calculations and comparisons of mortality rates for influenza, for diseases of the respiratory system (with the exception of tuberculosis) and for all the causes of death, in 21 locations in the Basque Country (between Spain and France). The data were collected from all the entries in the death registers for the period between May 1918 and April 1919. The Spanish influenza pandemic affected this population sample to a varying extent. Depending on the characteristic of the different locations, the mortality rate varied between 2.2 and 19.7 per thousand for influenza, and between 7.5 and 25.7 per thousand for influenza and other diseases of the respiratory system. The mortality rate for the total population studied has been calculated to be 6.8 per thousand for Spanish influenza and 12.1 per thousand for influenza and other diseases of the respiratory system. The first wave of the pandemic (spring 1918) was benign like a seasonal influenza. The second wave (autumn 1918) was extremely virulent owing to the mutation of the virus in Europe during the summer. This article identifies one of the sites, on the border between France and Spain, from which the second wave of the Spanish flu spread. | 18,828,568 |
Electronic and vibrational relaxation of porphycene in solution. | The relaxation of electronically excited porphycene in acetonitrile solution has been studied by transient absorption spectroscopy supported by global analysis techniques. Three processes following the femtosecond pulse excitation to the S 2 state have been identified: the intramolecular vibrational redistribution on the time scale of tens of femtoseconds, the internal conversion S 2 right arrow-wavy S 1 (750 fs) and thermal equilibration of the molecule by energy exchange with the solvent (16 ps). The recorded transient absorption kinetics exhibit oscillations which have been assigned to the evolution of wavepackets in both S 1 and S 0 states. | 18,828,574 |
Mesoporous zirconium titanium oxides. Part 1: Porosity modulation and adsorption properties of xerogels. | A series of zirconium titanium oxide mesophases containing 33 atom % Zr have been prepared using carboxylic acids of different alkyl chain lengths (Cy ) from y=4-18 through organic-inorganic polymer phase segregation as the gel transition is approached. Thermal treatment of these transparent gels up to 450 degrees C eliminated the organic template, and domain coarsening occurred affording stable worm-hole mesoporous materials of homogeneous composition and pore diameters varying from about 3 to 4 nm in fine increments. With such materials, it was subsequently possible to precisely study the adsorption of vanadium oxo-anions and cations from aqueous solutions and, more particularly, probe the kinetics of intraparticle mass transport as a function of the associated pore dimension. The kinetics of mass transport through the pore systems was investigated using aqueous vanadyl (VO2+) and orthovanadate (VO3(OH)2-) probe species at concentrations ranging from 10 to 200 ppm (0.2 to 4 mmol/L) and pH values of 0 and 10.5, respectively. In the case of both of these vanadium species, the zirconium titanate mesophases displayed relatively slow kinetics, taking in excess of about 500 min to achieve maximum uptake. By using a pseudo-second-order rate law, it was possible to extract the instantaneous and overall rate of the adsorption processes and then relate these to the pore diameters. Both the instantaneous and overall rates of adsorption increased with increasing surface area and pore diameter over the studied pore size range. However, the equilibrium adsorption capacity increased linearly with pore diameter only for the higher concentrations and was independent of pore diameter for the lower concentration. These results have been interpreted using a model in which discrete adsorption occurs at low concentrations and is then followed by multilayer adsorption at higher concentration. | 18,828,619 |
An unlikely silk: the composite material of green lacewing cocoons. | Spiders routinely produce multiple types of silk; however, common wisdom has held that insect species produce one type of silk each. This work reports that the green lacewing ( Mallada signata, Neuroptera) produces two distinct classes of silk. We identified and sequenced the gene that encodes the major protein component of the larval lacewing cocoon silk and demonstrated that it is unrelated to the adult lacewing egg-stalk silk. The cocoon silk protein is 49 kDa in size and is alanine rich (>40%), and it contains an alpha-helical secondary structure. The final instar lacewing larvae spin protein fibers of approximately 2 microm diameter to construct a loosely woven cocoon. In a second stage of cocoon construction, the insects lay down an inner wall of lipids that uses the fibers as a scaffold. We propose that the silk protein fibers provide the mechanical strength of the composite lacewing cocoon whereas the lipid layer provides a barrier to water loss during pupation. | 18,828,638 |
Pharmacologic inhibition of platelet function: correlation between in vitro tests of platelet function and clinical outcomes. | Atherothrombosis continues to be a leading cause of death and disability despite advances in pharmacologic and procedural therapies. Antiplatelet agents have been extensively studied and validated to improve outcomes in multiple settings of cardiovascular disease. The emergence of the phenomenon of resistance to antiplatelet therapy resulted in the availability of platelet function tests to assess the effectiveness of these agents. Subsequent evaluations have shown considerable inter-individual variability in platelet inhibition in patients receiving antiplatelet agents. Several small studies showed that patients who were deemed 'resistant' to antiplatelet therapy by platelet function testing had adverse clinical outcomes. It is essential that ongoing investigations help delineate a standard definition of 'resistance' to antiplatelet therapy, which test of platelet function should be the gold standard, and what therapy, once identified, can help overcome resistance to the currently available antiplatelet agents. Data are needed to determine if outcomes can be improved by changes to existing antiplatelet therapy based on the results of platelet function tests. Alternatively, newer antiplatelet agents may prove effective in overcoming resistance; however, these agents also await validation in large-scale clinical trials. | 18,828,640 |
Compound eye development during caste differentiation in the termite Reticulitermes speratus (Isoptera: Rhinotermitidae). | We morphologically examined postembryonic compound eye development in Reticulitermes speratus (Kolbe) to understand developmental regulation during caste differentiation. The eye primordia were shown to exist from the larval stage. The number of ommatidia and compound eye size greatly increased over the course of imaginal development. Nymphoids (second-form reproductives) possessed a developed compound eye structure on the surface of the cuticle and thick optic nerves, but individual ommatidia were not clearly discriminated. However, in the line of apterous workers and soldiers, although the outer rim of the eye was observed from second-stage workers, there were few morphological differences among instars, including ergatoids (third-form reproductives). Both nymphoids and ergatoids are slightly physogastric and have highly developed reproductive organs. These results suggest that eye development in the apterous line could be strongly arrested and that there is a weak developmental correlation between the eyes and reproductive organs in R. speratus. | 18,828,656 |
Detection and changes in levels of testosterone during spermatogenesis in the freshwater planarian Bdellocephala brunnea. | It was reported recently that vertebrate-type steroids exist and control reproduction in several groups of invertebrates, including molluscs. Sexually reproductive freshwater planarians of the species Bdellocephala brunnea have a limited breeding season in their natural habitat. This phenomenon suggests that some endogenous reproductive hormones might play a role in vivo. However, to date, sex steroids such as androgen, estrogen, and progesterone have not been found in planarians. The goal of the present study was to determine whether androgen is present in sexual planarians such as B. brunnea. The presence of testosterone was detected by high-pressure liquid chromatography and, in sexually reproductive individuals in which no seminal vesicles were visible, the level of testosterone was about twice than that in individuals with visible seminal vesicles. An enzyme-linked immunosorbent assay revealed that the levels of testosterone during terminal spermatogenesis were three times higher than during the spermatocyte-building phase. Our results indicate that sexually reproductive freshwater planarians such as B. brunnea might have vertebrate-type steroids and show variation in testosterone levels during spermatogenesis. | 18,828,664 |
Birth size and breast cancer risk: re-analysis of individual participant data from 32 studies. | Birth size, perhaps a proxy for prenatal environment, might be a correlate of subsequent breast cancer risk, but findings from epidemiological studies have been inconsistent. We re-analysed individual participant data from published and unpublished studies to obtain more precise estimates of the magnitude and shape of the birth size-breast cancer association. Studies were identified through computer-assisted and manual searches, and personal communication with investigators. Individual participant data from 32 studies, comprising 22,058 breast cancer cases, were obtained. Random effect models were used, if appropriate, to combine study-specific estimates of effect. Birth weight was positively associated with breast cancer risk in studies based on birth records (pooled relative risk [RR] per one standard deviation [SD] [= 0.5 kg] increment in birth weight: 1.06; 95% confidence interval [CI] 1.02-1.09) and parental recall when the participants were children (1.02; 95% CI 0.99-1.05), but not in those based on adult self-reports, or maternal recall during the woman's adulthood (0.98; 95% CI 0.95-1.01) (p for heterogeneity between data sources = 0.003). Relative to women who weighed 3.000-3.499 kg, the risk was 0.96 (CI 0.80-1.16) in those who weighed < 2.500 kg, and 1.12 (95% CI 1.00-1.25) in those who weighed > or = 4.000 kg (p for linear trend = 0.001) in birth record data. Birth length and head circumference from birth records were also positively associated with breast cancer risk (pooled RR per one SD increment: 1.06 [95% CI 1.03-1.10] and 1.09 [95% CI 1.03-1.15], respectively). Simultaneous adjustment for these three birth size variables showed that length was the strongest independent predictor of risk. The birth size effects did not appear to be confounded or mediated by established breast cancer risk factors and were not modified by age or menopausal status. The cumulative incidence of breast cancer per 100 women by age 80 y in the study populations was estimated to be 10.0, 10.0, 10.4, and 11.5 in those who were, respectively, in the bottom, second, third, and top fourths of the birth length distribution. This pooled analysis of individual participant data is consistent with birth size, and in particular birth length, being an independent correlate of breast cancer risk in adulthood. | 18,828,667 |
Interconvertible lac repressor-DNA loops revealed by single-molecule experiments. | At many promoters, transcription is regulated by simultaneous binding of a protein to multiple sites on DNA, but the structures and dynamics of such transcription factor-mediated DNA loops are poorly understood. We directly examined in vitro loop formation mediated by Escherichia coli lactose repressor using single-molecule structural and kinetics methods. Small ( approximately 150 bp) loops form quickly and stably, even with out-of-phase operator spacings. Unexpectedly, repeated spontaneous transitions between two distinct loop structures were observed in individual protein-DNA complexes. The results imply a dynamic equilibrium between a novel loop structure with the repressor in its crystallographic "V" conformation and a second structure with a more extended linear repressor conformation that substantially lessens the DNA bending strain. The ability to switch between different loop structures may help to explain how robust transcription regulation is maintained even though the mechanical work required to form a loop may change substantially with metabolic conditions. | 18,828,671 |
Evaluation of perinuclear anti-neutrophilic cytoplasmic autoantibodies as an early marker of protein-losing enteropathy and protein-losing nephropathy in Soft Coated Wheaten Terriers. | To evaluate perinuclear anti-neutrophilic cytoplasmic autoantibody (pANCA) status in Soft Coated Wheaten Terriers (SCWTs) and SCWT-Beagle crossbred dogs and to correlate pANCA status of dogs with clinicopathologic variables of protein-losing enteropathy (PLE), protein-losing nephropathy (PLN), or both. 13 SCWTs and 8 SCWT-Beagle crossbred dogs in a research colony and a control group comprising 7 dogs with X-linked hereditary nephropathy and 12 healthy SCWTs > 9 years old. Samples were obtained from dogs in the research colony every 6 months. At each sample-collection time point, serum concentrations of albumin, globulin, creatinine, and urea nitrogen; fecal concentration of alpha-proteinase inhibitor; and urinary protein-to-creatinine ratios were determined and correlated with pANCA status. 20 of 21 dogs in the research colony had positive results for pANCAs at a minimum of 2 time points, and 18 of 21 dogs had definitive evidence of disease. None of the control dogs had positive results for pANCAs. A positive result for pANCAs was significantly associated with hypoalbuminemia, and pANCAs preceded the onset of hypoalbuminemia on an average of 2.4 years. Sensitivity and specificity for use of pANCAs to predict development of PLE or PLN were 0.95 (95% confidence interval, 0.72 to 1.00) and 0.8 (95% confidence interval, 0.51 to 0.95), respectively. Most dogs in this study affected with PLE, PLN, or both had positive results for pANCAs before clinicopathologic evidence of disease was detected. Thus, pANCAs may be useful as an early noninvasive test of disease in SCWTs. | 18,828,686 |
Flow cytometric evaluation of multidrug resistance proteins on grossly normal canine nodal lymphocyte membranes. | To demonstrate efficacy of flow cytometric evaluation of expression and activity of P-glycoprotein (P-gp) and multidrug resistance-associated protein (MRP) efflux pumps and characterize and correlate their expression and activity in grossly normal canine nodal lymphocytes. Nodal lymphocytes from 21 clinically normal dogs. Pump expression was assessed by use of fluorescent-labeled mouse antihuman P-gp (C494) and MRP1 (MRPm6) antibodies and expressed as median values (antibody value divided by isotype control value). The P-gp and MRP activities were assessed by measuring cellular retention of rhodamine 123 and 5(6)-carboxyfluorescein diacetate in the absence and presence of inhibitors (verapamil and PSC833 for P-gp, probenecid and MK-571 for MRP). Protein activity was expressed as median fluorescence of cells with inhibitors divided by that without inhibitors. Expression of P-gp was (mean +/- SEM) 50.62 +/- 13.39 (n = 21) and that of MRP was 2.16 +/- 0.25 (13). Functional activity was 1.27 +/- 0.06 (n = 21) for P-gp and both inhibitors and 21.85 +/- 4.09 (21) for MRP and both inhibitors. Function and expression were not correlated. Use of flow cytometry effectively assessed P-gp and MRP expression and activity in canine lymphocytes. Optimization of the flow cytometric assay was determined for evaluating activity and expression of these pumps in canine lymphoid cells. Evaluation of expression or activity may offer more meaning when correlated with clinical outcome of dogs with lymphoproliferative diseases. Cell overexpression of P-gp and MRP can convey drug resistance. | 18,828,688 |
Molecular mechanisms of traumatic brain injury in children. A review. | Despite advances in molecular biology and genetics, the precise pathophysiology of traumatic brain injury (TBI) in children is unknown. In this paper the authors review what is currently known about intra- and extracellular responses to pediatric TBI and relate these factors to future investigations. Although hyperemia and vascular congestion have long been thought to be the hallmarks of pediatric TBI, on a cellular level, calcium influx as well as modulation of local neurotransmitters appears to play a major role in its onset. Recent genetic and proteomic research has identified specific neurotrophic factors as well as apoptotic and antiapoptotic genes that appear to control the progression of inflammation and neuronal damage. The search for a therapeutic target will ultimately require a thorough understanding of these factors and their interplay on a proteomic, genomic, and neuromic level. | 18,828,704 |
Cerebral pressure autoregulation in traumatic brain injury. | An understanding of normal cerebral autoregulation and its response to pathological derangements is helpful in the diagnosis, monitoring, management, and prognosis of severe traumatic brain injury (TBI). Pressure autoregulation is the most common approach in testing the effects of mean arterial blood pressure on cerebral blood flow. A gold standard for measuring cerebral pressure autoregulation is not available, and the literature shows considerable disparity in methods. This fact is not surprising given that cerebral autoregulation is more a concept than a physically measurable entity. Alterations in cerebral autoregulation can vary from patient to patient and over time and are critical during the first 4-5 days after injury. An assessment of cerebral autoregulation as part of bedside neuromonitoring in the neurointensive care unit can allow the individualized treatment of secondary injury in a patient with severe TBI. The assessment of cerebral autoregulation is best achieved with dynamic autoregulation methods. Hyperventilation, hyperoxia, nitric oxide and its derivates, and erythropoietin are some of the therapies that can be helpful in managing cerebral autoregulation. In this review the authors summarize the most important points related to cerebral pressure autoregulation in TBI as applied in clinical practice, based on the literature as well as their own experience. | 18,828,705 |
Quantification of the association between intervertebral disk calcification and disk herniation in Dachshunds. | To quantify the association between intervertebral disk calcification and disk herniation in Dachshunds. Longitudinal study. 61 Dachshunds that had been radiographically screened for calcification of intervertebral disks at 2 years of age in other studies. Thirty-seven of the dogs had survived to the time of the present study and were > or = 8 years of age; 24 others had not survived. Radiographic examination of 36 surviving dogs was performed, and information on occurrence of disk calcification at 2 years of age were obtained from records of all 61 Dachshunds. Information on occurrence of disk herniation between 2 and 8 years of age was obtained from owners via questionnaire. Associations between numbers of calcified disks and disk herniation were analyzed via maximum likelihood logistic regression. Disk calcification at 2 years of age was a significant predictor of clinical disk herniation (odds ratio per calcified disk, 1.42; 95% confidence interval, 1.19 to 1.81). Number of calcified disks in the full vertebral column was a better predictor than number of calcified disks between vertebrae T10 and L3. Numbers of calcified disks at > or = 8 years of age and at 2 years of age were significantly correlated. Number of calcified disks at 2 years of age was a good predictor of clinical disk herniation in Dachshunds. Because of the high heritability of disk calcification, it is possible that an effective reduction in occurrence of severe disk herniation in Dachshunds could be obtained by selective breeding against high numbers of calcified disks at 2 years of age. | 18,828,719 |
Vitamin D receptor gene polymorphisms have negligible effect on human height. | Human height is a highly heritable trait, with genetic factors explaining up to 90% of phenotypic variation. Vitamin D levels are known to influence several physiological processes, including skeletal growth. The vitamin D receptor (VDR) gene has been reported as contributing to variation in height. A meta-analysis of 13607 adult individuals found a small but significant association with the rs1544410 (BsmI) polymorphism. In contrast, the meta-analysis found no effect in a sample of 550 children. Two recent studies reported variants with large effect on height elsewhere in VDR (rs10735810 [FokI] and rs7139166 [-1,521] polymorphisms). We genotyped large Caucasian samples from Australia (N = 3,906) and the Netherlands (N = 1,689) for polymorphisms in VDR. The Australian samples were twin families with height measures from 3 time points throughout adolescence. The Dutch samples were adult twins. We use the available family data to perform both within and between family tests of association. We found no significant associations for any of the genotyped variants after multiple testing correction. The (non-significant) effect of rs1544410 in the Australian adolescent cohort was in the same direction and of similar magnitude (additive effect 0.3 cm) to the effect observed in the published adult meta-analysis. An effect of this size explains approximately 0.1% of the phenotypic variance in height - this implies that many, probably hundreds, of such variants are responsible for the observed genetic variation. Our results did not support any role for two other regions (rs10735810, rs7139166) of VDR in explaining variation in height. | 18,828,731 |
Prediction of spontaneous preterm delivery in twin pregnancies by cervical length at mid-gestation. | The objective of our study was to evaluate the correlation of the cervical length at 20-25 weeks of gestation with the incidence of spontaneous preterm delivery in twins in a country with a high incidence of preterm delivery compared to other European countries. Cervical length was measured in 262 consecutive patients. Previous preterm delivery before 34 weeks of gestation, chorionicity, maternal age, body-mass-index, smoking habit and parity were recorded as risk factors for preterm delivery. Women who were symptomatic at 20-25 weeks and who delivered because of other reasons than spontaneous labour and preterm rupture of membranes or at term were excluded. The primary outcome was incidence of preterm birth before 34 weeks. Two hundred and twenty-three patients were analyzed. Thirty-two (14%) delivered before 34 weeks. There was a significant correlation between cervical length of less than 25 mm and spontaneous delivery before 34 weeks (50% vs. 13%, p = .007). In addition, logistic regression analysis found cervical length to be the only significant predictor of spontaneous delivery before 34 weeks (OR 1.084; 95% CI 1.015; 1.159; p = .017). We conclude that the risk of severe preterm delivery in twins is high. Cervical length at mid-gestation was the only predictor of delivery before 34 weeks. | 18,828,739 |
Evaluation of the immune response to a 2-dose measles vaccination schedule administered at 6 and 9 months of age to HIV-infected and HIV-uninfected children in Malawi. | The World Health Organization recommends that infants at high risk for developing measles before 9 months of age, including human immunodeficiency virus (HIV)-infected infants, receive measles vaccination (MV) at 6 and 9 months of age. Children born to HIV-infected mothers received MV at 6 and 9 months, and children of HIV-uninfected mothers were randomized to receive MV at 6 and 9 months, MV at 9 months, or routine MV without follow-up. Blood samples were obtained before and 3 months after each MV. Data were collected on adverse events for 21 days after each MV, at all clinic visits, on any hospitalization, and for subjects who died. HIV-infection status was determined by antibody assays and polymerase chain reaction; the presence of measles IgG was determined by EIA. Twenty-two hundred mother-infant pairs were enrolled. After the first and second doses of measles vaccine, respectively, the percentages of children who were measles seropositive were 59% (36 of 61) and 64% (29 of 45) among HIV-infected children, 68% (152 of 223) and 94% (189 of 202) among HIV-exposed but uninfected children, and 62% (288 of 467) and 92% (385 of 417) among HIV-unexposed children. Of 521 HIV-unexposed children vaccinated only at 9 months, 398 (76%) were measles seropositive at 12 months. No serious vaccine-related adverse events were identified. An early, 2-dose MV schedule was immunogenic, but a higher proportion of HIV-infected children remained susceptible to measles, compared with HIV-uninfected children (whether HIV exposed or HIV unexposed). | 18,828,743 |
Respiratory syncytial virus persistence in the lungs correlates with airway hyperreactivity in the mouse model. | Previous studies in mice showed that respiratory syncytial virus (RSV) infection was associated with RSV RNA persistence. This study was designed to characterize the significance of RSV RNA persistence and its relation to RSV-induced chronic airway disease. Mice were inoculated with live RSV, UV light-treated RSV, heat-inactivated RSV, or medium. Bronchoalveolar lavage fluid samples were obtained and lung specimens were harvested on days 1, 5, and 42 after inoculation to assess lung inflammation, lung mRNA expression of interleukin (IL)-4, IL-5, IL-15, and interferon (IFN)-gamma; RSV loads were assessed by culture and real-time polymerase chain reaction (PCR) and correlated with pulmonary function. During the acute phase of infection, RSV loads as indicated by culture and PCR were significantly higher in mice inoculated with live RSV. On day 42, RSV RNA remained detectable only in mice inoculated with live or UV light-treated RSV. Lung inflammation, IFN-gamma:IL-4 mRNA expression ratios, airway obstruction (AO), and airway hyperreactivity (AHR) were significantly increased in mice inoculated with live RSV. AO on day 5 and AHR on day 42 were significantly correlated with RSV RNA copy number in lung samples. Infection with live RSV induced acute and chronic airway disease that was associated with a predominantly Th-1 immune response and RSV RNA persistence that significantly correlated with pulmonary function abnormalities. | 18,828,742 |
The structure of clines with fitness-dependent dispersal. | Spatial models commonly assume that dispersal does not depend on environmental conditions or phenotype. For example, these assumptions underpin explanations for clines on the basis of a trade-off between dispersal and local adaptation. We reexamine clines when an individual's decisions over whether and where to disperse depend on its fitness. We compare fitness-dependent dispersal with cases where dispersal responds to juvenile survivorship only. Clines are steeper the more responsive dispersal is to environmental conditions for all dispersal behaviors that we consider. Clines eventually become stepped as the responsiveness of dispersal to environmental conditions is increased for half of the dispersal behaviors we consider, but smooth clines are maintained for the remaining cases. Smooth clines are maintained by the biased movement of individuals out of the hybrid zone when individuals move directionally in response to gradients in juvenile survivorship, which is a different mechanism to that maintaining smooth clines in classic cline theory. | 18,828,744 |
The effect of costimulatory and interleukin 2 receptor blockade on regulatory T cells in renal transplantation. | Regulatory T cells (Treg) are critical regulators of immune tolerance. Both IL-2 and CD28-CD80/CD86 signaling are critical for CD4(+)CD25(+)FOXP3(+) Treg survival in mice. Yet, both belatacept (a second-generation CTLA-4Ig) and basiliximab (an anti-CD25 monoclonal antibody) are among the arsenal of current immunotherapies being used in kidney transplant patients. In this study, we explored the direct effect of basiliximab and belatacept on the Tregs in peripheral blood both in the short term and long term and in kidney biopsies of patients with acute rejection. We report that the combined belatacept/basiliximab therapy has no long-term effect on circulating Tregs when compared to a calcineurin inhibitor (CNI)-treated group. Moreover, belatacept-treated patients had a significantly greater number of FOXP3(+) T cells in graft biopsies during acute rejection as compared to CNI-treated patients. Finally, it appears that the basiliximab caused a transient loss of both FOXP3(+) and FOXP3(-) CD25(+) T cells in the circulation in both treatment groups raising important questions about the use of this therapy in tolerance promoting therapeutic protocols. | 18,828,769 |
Severe renal vein stenosis of a kidney transplant with beneficial clinical course after successful percutaneous stenting. | A 51-year-old renal transplant recipient presented with marked renal function deterioration 13 months after renal transplantation. After exclusion of ureteral obstruction, transplant artery stenosis and acute rejection, the diagnosis of a severe renal vein stenosis was made by an MR scan. After angiographic confirmation of the stenosis, treatment was attempted with percutaneous stent angioplasty. The long-term clinical course was favorable, with marked improvement in renal function. Transplant renal vein stenosis is a rare, but potentially curable, cause of renal allograft functional deterioration. | 18,828,776 |
Long-term posaconazole treatment and follow-up of rhino-orbital-cerebral mucormycosis in a diabetic girl. | To demonstrate that the 2-yr clinical follow-up of our patient strongly suggests that long-term therapy with posaconazole (POS) is safe and beneficial in treatment and prevention of relapses of, otherwise fatal, central nervous system mucormycosis. Mucormycosis is a very rare opportunistic mycotic infection of diabetic children. We present the 30-month follow-up of a 12-yr-old girl affected by diabetic ketoacidotic coma, complicated by rhinocerebral mucormycosis and successfully treated with POS at the initial daily dose of 5 mg/kg t.i.d. with fatty food for 3 wk, followed by a daily dose of 10 mg/kg in four doses for 2 months and then 20 mg/kg/d in four doses for 16 months and in two doses for further 5 months. The previous amphotericin B, granulocyte colony-stimulating factor, hyperbaric oxygen and nasal and left maxillary sinus surgical debridement therapy was ineffective in stopping the progression of the infection to the brain. The patient improved within 10 d with reduced ocular swelling and pain, and 6 months after therapy stop, she is in good health and cultures are sterile. This article demonstrates that POS may be a useful drug in mucormycosis in children. We also strongly draw the attention to the main preventive procedure against invasive fungal infection that is the correct management of antidiabetic therapy that prevents the predisposing temporary neutrophils activity deficit, contributing to a better survival rate of diabetic children. | 18,828,793 |
S-adenosyl-L-methionine co-administration prevents the ethanol-elicited dissociation of hepatic mitochondrial ribosomes in male rats. | Chronic ethanol feeding to male rats has been shown to result in decreased mitochondrial translation, depressed respiratory complex levels and mitochondrial respiration rates. In addition, ethanol consumption has been shown to result in an increased dissociation of mitoribosomes. S-adenosyl-L-methionine (SAM) is required for the assembly and subsequent stability of mitoribosomes and is depleted during chronic ethanol feeding. The ability of dietary SAM co-administration to prevent these ethanol-elicited lesions was investigated. Male Sprague-Dawley rats were fed a nutritionally adequate liquid diet with ethanol comprising 36% of the calories according to a pair-fed design for 28 days. For some animals, SAM was supplemented in the diet at 200 mg/l. Liver mitochondria were prepared and mitoribosomes isolated. Respiration rates, ATP levels, respiratory complex levels, and the extent of mitoribosome dissociation were determined. Twenty-eight days of ethanol feeding were found to result in decreased SAM content, depressed respiration, and increased mitoribosome dissociation. No changes in mitochondrial protein content; levels of respiratory complexes I, III, and V; complex I activities; and ATP levels were detected. Co-administration of SAM in the diet was found to prevent ethanol-induced SAM depletion, respiration decreases and mitoribosome dissociation. Taken together, these findings suggest (1) that mitoribosome dissociation precedes respiratory complex depressions in alcoholic animals and (2) that dietary supplementation of SAM prevents some of the early mitochondrial lesions associated with chronic ethanol consumption. | 18,828,798 |
Alterations in ethyl alcohol pharmacokinetics during oral consumption of malt liquor beverages in African Americans. | Malt liquor (ML) beverages have become increasingly popular among urban minority groups, due partly to their inexpensive price and targeted advertising. We hypothesized that nonfermented by-products contained in ML beverages will alter the pharmacokinetics (PK) and pharmacodynamic (PD) effects of its ethanol content. In addition, we determined the effect of alcohol dehydrogenase (ADH) genotypes on the PK following consumption of ML beverages. The study was conducted in 31 healthy adult African-American social drinkers, mean +/- SD age of 22.3 +/- 1.3 years, and weight of 70.7 +/- 10.9 kg. Participants were administered ethanol, in randomized order, 2-weeks apart, in the form of oral ML beverage (6%v/v), or isocaloric solution of diet soda-ethanol (DS-Etoh) beverage (6%v/v). During each session the beverage was consumed over 4 minutes and breath alcohol concentrations (BrAC) as well as subjective and behavioral effects of ethanol were evaluated over 180 minutes. Pharmacokinetic parameters of ethanol were calculated using Michaelis-Menten elimination kinetics. The effect of ML and ADH genotype on PK was evaluated using the Wilcoxon rank-sum test and the Wilcoxon signed rank test, respectively. Results show a slower mean rate of absorption, K(a), (0.12 vs. 0.15 min(-1), p = 0.03) and a longer time to reach maximum concentration, T(max), (28 vs. 23 minute, p < 0.01) for the ML compared with DS-Etoh beverage. The ML beverage resulted in a larger area under the BrAC-time curve compared with DS-Etoh beverage (8.4 vs. 6.8 min g/dl, p = 0.02). There was no difference in the subjective PD effects between the 2 beverages. Results show that exposure to ethanol following the consumption of ML beverages is different compared to that following nonmalt beverages in African-Americans. These differences may be related to nonfermented by-products present in commercially available ML products. These PK differences do not appear to result in significant perceived alcohol PD changes, nor are they related to ADH genotype. | 18,828,806 |
Angiogenesis in newly augmented bone observed in rabbit calvarium using a titanium cap. | In our previous work using a rabbit experimental model, we identified the importance of using a rigid support device for augmenting the development of mineralized bone. In the early stage of healing, newly generated tissue has not filled occlusive spaces, and mineralized bone forms and tends to climb along the inner wall of a device. Even though the blood supply is critical for successful bone augmentation, few studies have been conducted on angiogenesis in augmented bone. The purpose of the present study was to evaluate a method for observing angiogenesis in newly augmented bone. The right and left sections of the calvarium of six adult male Japanese white rabbits were exposed. The cortical bone was penetrated, and custom-made, standardized, hemispherical titanium caps were fixed to the exposed bone. The caps on the right side of each rabbit were filled with granulated beta-tricalcium phosphate (beta-TCP). After a healing period of 1 month, the animals were injected with MICROFIL into the right and left common carotid arteries to form a three-dimensional cast of the vasculature, and the newly generated blood vessels in the augmented bone were observed. The newly generated blood vessels were observed entering the space beyond the existing calvarial bone. Furthermore, angiogenesis was seen to have occurred to a similar extent through the inter-granular beta-TCP in the right caps. These areas of angiogenesis were observed in a histological study with cross-sections. The results of the present study suggest that this observation method allows the examination of angiogenesis in hard tissue before the preparation of histological specimens. | 18,828,816 |
Maxillary sinus-floor elevation: an animal model. | To find an animal model for modified Caldwell-Luc procedure training. The animal model should have (1) a proper cortical thickness in the lateral wall; (2) a similar morphology and resistance of the Schneiderian membrane in humans; and, finally, (3) an oral approach. Twelve fresh heads (four Merino sheep, four Murciano-Granadina goats and four Large-White pigs). Two skulls from each of these species were also used. Several three-dimensional imagings from the skulls of each species were acquired using a C-arm. Two fresh heads of each species were used to perform the modified Caldwell-Luc procedure. Two fresh heads of each species were firstly frozen at -30 degrees C for 48 h and then sawed in blocks containing only the target region of the maxillary sinus. The average thickness was 2.03 mm in goat and sheep and 2.80 in pig. Releasing and elevation of the Schneiderian membrane from the sinus floor were easy in the three species. The approach of the maxillary sinus in sheep, goat and pig from the buccal vestibule required a previous surgical enlargement of the buccal vestibule. In conclusion, the cortical bone thickness and Schneider membrane characteristics in Merina sheep and Murciano-Granadina goat allow a perfect training for the modified Caldwell-Luc procedure. However, the approach from the oral cavity needs, in these species, a previous enlargement of the buccal vestibule. The excessive thickness of the cortical bone restricts the use of pigs for this technique. | 18,828,821 |
Adherence and invasion of Bacteroidales isolated from the human intestinal tract. | Members of the genera Bacteroides and Parabacteroides are important constituents of both human and animal intestinal microbiota, and are significant facultative pathogens. In this study, the ability of Bacteroides spp. and Parabacteroides distasonis isolated from both diarrhoeal and normal stools (n = 114) to adhere to and invade HEp-2 cells was evaluated. The presence of putative virulence factors such as capsule and fimbriae was also investigated. Adherence to HEp-2 cells was observed in 75.4% of the strains, which displayed non-localized clusters. Invasion was observed in 37.5% and 26% of the strains isolated from diarrhoeal and non-diarrhoeal stools, respectively. All strains displayed a capsule, whereas none of them showed fimbriae-like structures. This is the first report of the ability of Bacteroides spp. and P. distasonis to adhere to and invade cultured HEp-2 epithelial cells. | 18,828,854 |
An important step towards completing the rheumatoid arthritis cycle. | In the previous issue of Arthritis Research & Therapy data are presented showing that circulating immune complexes containing citrullinated fibrin(ogen) are present in anti-citrullinated protein antibody-positive rheumatoid arthritis patients, and that such immune complexes co-localize with complement factor C3 in the rheumatoid synovium. These results corroborate the idea that citrullination is intimately involved in the pathophysiology of rheumatoid arthritis and complete our model (the rheumatoid arthritis cycle) for the development and chronic nature of this disease. | 18,828,887 |
Therapeutic and prophylactic effect of intermittent preventive anti-malarial treatment in infants (IPTi) from Ghana and Gabon. | Intermittent preventive treatment in infants (IPTi) with sulphadoxine-pyrimethamine (SP) reduces the incidence of malaria episodes in young children. The exact mechanism by which the protective effect is mediated needs to be defined. This study aimed to investigate therapeutic, prophylactic, and possible exceeding effects of SP-based IPTi in two clinical trials. Protective efficacies from two IPTi trials performed in Kumasi, Ghana, and Lambaréné, Gabon, were assessed for overlapping time series of 61 days. For six-months periods after each of three IPTi doses a multivariate Poisson regression model with the respective cohort as co-variate was generated and effect modification of protective efficacy with time strata was evaluated by log-likelihood tests. Protective efficacies were not significantly different between the two study cohorts. Study-cohort corrected protective efficacy was highest for the first 61 days after each IPTi application and decreased continuously. For the first 61 days after IPTi-1, IPTi-2, and IPTi-3 the protective efficacy was 71%, 44%, and 43%, respectively. A reduction of the malaria incidence rate was detectable for the first 60, 30 and 40 days after IPTi-1, IPTi-2 and IPTi-3 drug application, respectively. After IPTi-3 a higher risk for malaria could be seen after day 60. This effect was mainly based on the overwhelming influence of the Kumasi cohort. The results suggest that SP-based IPTi mainly works through a therapeutic and prophylactic effect over 30 to 60 days after drug application and that a sustained effect beyond post-treatment prophylaxis might be very low. Data analysis from clinical trials NCT ID # 00206739 (Kumasi Trial) and NCT ID # 00167843 (Lambaréné Trial), http://www.clinicaltrials.gov. | 18,828,899 |
A new method to determine tissue specific tissue factor thrombomodulin activities: endotoxin and particulate air pollution induced disbalance. | Increase in tissue factor (TF) and loss in thrombomodulin (TM) antigen levels has been described in various inflammatory disorders. The functional consequences of such changes in antigen concentrations in the coagulation balance are, however, not known. This study was designed to assess the consequences of inflammation-driven organ specific functional properties of the procoagulant response. Tissue specific procoagulant activity was assessed by adding tissue homogenate to normal human pool plasma and recording of the thrombin generation curve. The new technique was subsequently applied on two inflammation driven animal models: 1) mouse lipopolysaccharide (LPS) induced endotoxemia and 2) spontaneously hypertensive rats exposed to environmental air pollution (particulate matter (PM). Addition of lung tissue from untreated animals to human plasma suppressed the endogenous thrombin potential (ETP) (175 +/- 61 vs. 1437 +/- 112 nM.min for control). This inhibitory effect was due to TM, because a) it was absent in protein C deficient plasma and b) lungs from TMpro/pro mice allowed full thrombin generation (ETP: 1686 +/- 209 nM.min). The inhibitory effect of TM was lost after LPS administration to mice, which induced TF activity in lungs of C57Bl/6 mice as well as increased the ETP (941 +/- 523 vs. 194 +/- 159 nM.min for control). Another pro-inflammatory stimulus, PM dose-dependently increased TF in the lungs of spontaneously hypertensive rats at 4 and 48 hours after PM exposure. The ETP increased up to 48 hours at the highest concentration of PM (1441 +/- 289 nM.min vs. saline: 164 +/- 64 nM.min, p < 0.0001), suggesting a concentration- and time dependent reduction in TM activity. Inflammation associated procoagulant effects in tissues are dependent on variations in activity of the TF-TM balance. The application of these novel organ specific functional assays is a useful tool to monitor inflammation-driven shifts in the coagulation balance within animal or human tissues. | 18,828,903 |
P-loop mutations and novel therapeutic approaches for imatinib failures in chronic myeloid leukemia. | Imatinib was the first BCR-ABL-targeted agent approved for the treatment of patients with chronic myeloid leukemia (CML) and confers significant benefit for most patients; however, a substantial number of patients are either initially refractory or develop resistance. Point mutations within the ABL kinase domain of the BCR-ABL fusion protein are a major underlying cause of resistance. Of the known imatinib-resistant mutations, the most frequently occurring involve the ATP-binding loop (P-loop). In vitro evidence has suggested that these mutations are more oncogenic with respect to other mutations and wild type BCR-ABL. Dasatinib and nilotinib have been approved for second-line treatment of patients with CML who demonstrate resistance (or intolerance) to imatinib. Both agents have marked activity in patients resistant to imatinib; however, they have differential activity against certain mutations, including those of the P-loop. Data from clinical trials suggest that dasatinib may be more effective vs. nilotinib for treating patients harboring P-loop mutations. Other mutations that are differentially sensitive to the second-line tyrosine kinase inhibitors (TKIs) include F317L and F359I/V, which are more sensitive to nilotinib and dasatinib, respectively. P-loop status in patients with CML and the potency of TKIs against P-loop mutations are key determinants for prognosis and response to treatment. This communication reviews the clinical importance of P-loop mutations and the efficacy of the currently available TKIs against them. | 18,828,913 |
Syndrome of arachnomelia in Simmental cattle. | The syndrome of arachnomelia is an inherited malformation mainly of limbs, back and head in cattle. At present the arachnomelia syndrome has been well known mainly in Brown Swiss cattle. Nevertheless, the arachnomelia syndrome had been observed in the Hessian Simmental population during the decade 1964-1974. Recently, stillborn Simmental calves were observed having a morphology similar to the arachnomelia syndrome. The goal of this work was the characterization of the morphology and genealogy of the syndrome in Simmental to establish the basis for an effective management of the disease. The first pathologically confirmed arachnomelia syndrome-cases in the current Simmental population appeared in the year 2005. By 2007, an additional 140 calves with the arachnomelia syndrome were identified. The major pathological findings were malformed bones affecting the head, long bones of the legs and the vertebral column. It could be shown that, with the exception of two cases that were considered as phenocopies, all of the paternal and about two-third of the maternal pedigrees of the affected calves could be traced back to one common founder. Together with the data from experimental matings, the pedigree data support an autosomal recessive mutation being the etiology of the arachnomelia syndrome. The frequency of the mutation in the current population was estimated to be 3.32%. We describe the repeated occurrence of the arachnomelia syndrome in Simmental calves. It resembles completely the same defect occurring in the Brown Swiss breed. The mutation became relatively widespread amongst the current population. Therefore, a control system has to be established and it is highly desirable to map the disease and develop a genetic test system. | 18,828,914 |
Changing dental caries and periodontal disease patterns among a cohort of Ethiopian immigrants to Israel: 1999-2005. | Dental epidemiology has indicated that immigrants and minority ethnic groups should be regarded as high risk populations on the verge of oral health deterioration. The objectives of this study were to measure the changing pattern of dental caries, periodontal health status and tooth cleaning behaviour among a cohort of Ethiopian immigrants to Israel between the years 1999-2005. Increment of dental caries and periodontal health status was recorded among a cohort of 672 Ethiopian immigrants, utilizing the DMFT and CPI indices. Data were gathered during 1999-2000 and five years later, during 2004-2005. Participants were asked about their oral hygiene habits in Ethiopia and in Israel five years since their immigration. Regarding dental caries, at baseline 70.1% of the examinees were caries-free, as compared to 57.3% after five years. DMFT had increased from 1.48 to 2.31. For periodontal health status, at baseline, 94.7% demonstrated no periodontal pockets (CPI scores 0-2) and 5.3% revealed periodontal pockets (CPI scores 3&4), compared to 75.6% and 24.4%, respectively after five years. At baseline, 74% reported cleaning their teeth exclusively utilizing chewing and cleaning sticks common in Ethiopia. After five years, 97% reported cleaning their teeth exclusively utilizing toothbrushes. The deterioration in the oral health status, especially the alarming and significant worsening of periodontal health status, among this immigrant group, emphasizes the need for health promotion and maintenance among immigrants and minority groups in changing societies. An "acclimatizing and integrating" model of oral health promotion among minority and immigrant groups is suggested. | 18,828,927 |
Integrating health economics modeling in the product development cycle of medical devices: a Bayesian approach. | Medical device companies are under growing pressure to provide health-economic evaluations of their products. Cost-effectiveness analyses are commonly undertaken as a one-off exercise at the late stage of development of new technologies; however, the benefits of an iterative use of economic evaluation during the development process of new products have been acknowledged in the literature. Furthermore, the use of Bayesian methods within health technology assessment has been shown to be of particular value in the dynamic framework of technology appraisal when new information becomes available in the life cycle of technologies. In this study, we set out a methodology to adapt these methods for their application to directly support investment decisions in a commercial setting from early stages of the development of new medical devices. Starting with relatively simple analysis from the very early development phase and proceeding to greater depth of analysis at later stages, a Bayesian approach facilitates the incorporation of all available evidence and would help companies to make better informed choices at each decision point. | 18,828,941 |
The relationship between antidepressant and analgesic responses: findings from six placebo-controlled trials assessing the efficacy of duloxetine in patients with major depressive disorder. | Debate continues regarding whether onset of analgesia is faster than antidepressant effect in antidepressants with both properties. Duloxetine hydrochloride (from here on referred to as duloxetine) is effective in both major depressive disorder and diabetic peripheral neuropathic pain. This post-hoc analysis of six placebo-controlled duloxetine trials in patients with major depressive disorder was designed to compare onset of antidepressant activity to pain relief. Duloxetine was administered at 40-120 mg/day versus placebo for up to 9 weeks in outpatient clinic settings. The primary depression measure was the HAMD(17) and pain severity was measured using visual analog scale (VAS) measuring overall pain, headache, back and shoulder pain, and pain while awake. The time course of improvement was profiled using repeated measures modeling and Kaplan-Meier product limit estimation. In all but one case, significant reductions in HAMD(17) and VAS scores were seen within 2 weeks of treatment. Median time to VAS response was consistently shorter across all VAS measures than that to HAMD(17) response in both placebo- and duloxetine-treated patients with at least modest levels of pain at study entry. Regression analyses consistently demonstrated little association between analgesic and antidepressant responses. Limitations of these findings include that the studies used in these analyses did not require the patients to enroll with any specific level of pain. Moreover, the type of pain exhibiting at presentation was not routinely identified; therefore, the impact of different pain types on these findings is unknown. Duloxetine's analgesic effect is independent of the drug's antidepressant effect. Additionally, faster onset of the analgesic effect appears to be a population-specific phenomenon that is unmodified in the presence of active agents. | 18,828,958 |
The effect of applying potassium chloride solutions at atmospheric pressure on the sensitivity of dentine in man. | To determine the effects of applying KCl solutions to exposed dentine at atmospheric pressure on pain evoked by probing and air blast stimuli in human subjects. The experiments were carried out on 24 premolars in 16 subjects (aged 16-30 years). A cavity (diameter 3mm, depth 3mm) was cut at the tip of the buccal cusp and etched with 35% orthophosphoric acid. The cavity was filled with 500, 250 mmol/l KCl or 500 mmol/l NaCl for 10 min, after which it was rinsed with normal saline. Each solution was tested in 8 teeth. Air blast and probing stimuli were applied to the exposed dentine prior to dentine treatment and at 0, 2, 5, 10, and 20 min after treatment. After each stimulus the subject indicated the intensity of the pain evoked on a visual analogue scale (VAS). In teeth treated with 250 or 500 mmol/l KCl, the mean VAS response to air blast stimuli was significantly decreased at 5 and 10 min after treatment. The mean VAS response to probing was significantly decreased 10 min after treatment with 500 mmol/l KCl. Otherwise there were no significant changes. Topical application to exposed dentine of solutions containing a high concentration of potassium ions at atmospheric pressure produce a temporary reduction in the sensitivity of dentine to air blast and probing stimuli. | 18,828,986 |
Quantitative analysis of EGFR affinity to immobilized glycolipids by surface plasmon resonance. | EGF-induced activation of EGFR tyrosine kinase is known to be inhibited by ganglioside GM3, its dimer, and other mimetics. However, details of the interaction, such as kinetic properties, have not yet been clarified. The direct interaction is now defined by the surface plasmon resonance (SPR) technique. To determine the affinity of EGFR for lyso-GM3 or lyso-GM3 mimetic, these glycolipid ligands were covalently immobilized onto a sensor chip, and binding affinities were investigated. Results of these studies confirmed the direct interaction of lyso-GM3 or its mimetic with EGFR. A strong interaction between EGFR and lyso-GM3 or its mimetic was indicated by increased binding of EGFR to glycolipid-immobilized surface, in an EGFR dose-dependent manner. | 18,828,994 |
Women with spontaneous 46,XX primary ovarian insufficiency (hypergonadotropic hypogonadism) have lower perceived social support than control women. | To test the hypothesis that women with spontaneous primary ovarian insufficiency differ from control women with regard to perceived social support and to investigate the relationship between perceived social support and self-esteem. Cross-sectional. Mark O. Hatfield Clinical Research Center, National Institutes of Health. Women diagnosed with spontaneous primary ovarian insufficiency (n = 154) at a mean age of 27 years and healthy control women (n = 63). Administration of validated self-reporting instruments. Personal Resource Questionnaire 85 and Rosenberg Self-Esteem Scale. Women with primary ovarian insufficiency had significantly lower scores than controls on the perceived social support scale and the self-esteem scale. The findings remained significant after modeling with multivariate regression for differences in age, marital status, and having children. There was a significant positive correlation between self-esteem scores and perceived social support in patients. We found no significant differences in perceived social support or self-esteem related to marital status, whether or not the women had children, or time since diagnosis. This evidence supports the need for prospective controlled studies. Strategies to improve social support and self-esteem might provide a therapeutic approach to reduce the emotional suffering that accompanies the life-altering diagnosis of spontaneous primary ovarian insufficiency. | 18,829,005 |
Role of glutathione S-transferase (GSTM1) gene polymorphism in development of uterine fibroids. | Glutathione S-transferase (GSTM1) plays an important role in the excretion of catechol estrogens and is therefore a candidate marker for fibroids. However, this case-control study demonstrated no association between GSTM1 polymorphism and the risk of leiomyoma in Brazilian women. | 18,829,006 |
Blood ghrelin, resistin, and adiponectin concentrations during the normal menstrual cycle. | To investigate changes of ghrelin, resistin, and adiponectin levels in the circulation during the normal menstrual cycle. Longitudinal study. The study was conducted at a university hospital. Eight healthy normally cycling women. The women were observed during a whole menstrual cycle. Daily blood samples were taken every morning, after overnight fasting, from day 2 of the cycle until the next menstrual period. Plasma acylated and unacylated ghrelin and serum resistin, adiponectin, FSH, LH, E(2), and P levels were measured in all blood samples. In all women serum FSH, LH, E(2), and P levels, normalized to the midcycle peak LH value, showed the typical changes of the normal menstrual cycle. Acylated and unacylated ghrelin, resistin, and adiponectin levels did not change significantly during the whole menstrual cycle. The present study shows for the first time that plasma ghrelin and serum resistin levels do not change significantly during the normal menstrual cycle. It is also confirmed that serum adiponectin levels remain stable throughout the cycle. It is suggested that ovarian steroid dynamics during the cycle have no effect on the secretion of these substances. | 18,829,017 |
Diminished ovarian reserve in a woman with a balanced 13;21 translocation. | To present the a case of decreased ovarian reserve in a patient with a balanced 13;21 translocation. Case report. Reproductive endocrinology and infertility practice in a university teaching hospital. A 33-year-old caucasian woman with primary infertility. Laboratory evaluation, hysterosalpingogram, karyotype analysis, semen analysis. Endocrinologic evaluation and genetic analysis. A diagnosis of decreased ovarian reserve based upon laboratory evaluation with concomitant findings of a balanced translocation between the long arms of chromosomes 13 and 21. A diagnosis of primary infertility secondary to decreased ovarian reserve of unknown etiology, but with karyotype evidence of a balanced autosomal translocation and a familial history of early menopause, suggested possible roles of autosomal genes in mechanisms of ovarian follicular attrition. | 18,829,026 |
Plasma asymmetric dimethylarginine, L-arginine and left ventricular structure and function in a community-based sample. | Increasing evidence indicates that cardiac structure and function are modulated by the nitric oxide (NO) system. Elevated plasma concentrations of asymmetric dimethylarginine (ADMA; a competitive inhibitor of NO synthase) have been reported in patients with end-stage renal disease. It is unclear if circulating ADMA and L-arginine levels are related to cardiac structure and function in the general population. We related plasma ADMA and L-arginine (the amino acid precursor of NO) to echocardiographic left ventricular (LV) mass, left atrial (LA) size and fractional shortening (FS) using multivariable linear regression analyses in 1919 Framingham Offspring Study participants (mean age 57 years, 58% women). Overall, neither ADMA or L-arginine, nor their ratio was associated with LV mass, LA size and FS in multivariable models (p>0.10 for all). However, we observed effect modification by obesity of the relations of ADMA and LA size (p for interaction p=0.04): ADMA was positively related to LA size in obese individuals (adjusted-p=0.0004 for trend across ADMA quartiles) but not in non-obese people. In our large community-based sample, plasma ADMA and l-arginine concentrations were not related to cardiac structure or function. The observation of positive relations of LA size and ADMA in obese individuals warrants confirmation. | 18,829,028 |
Analysis of fumonisins B(1), B(2) and B(3) in corn-based baby food by pressurized liquid extraction and liquid chromatography/tandem mass spectrometry. | A sensitive and reliable method using pressurized liquid extraction (PLE) and liquid chromatography (LC)/electrospray ionization (ESI) tandem mass spectrometry with a triple quadrupole (QqQ) analyzer has been developed for the analysis of fumonisin B(1) (FB(1)), fumonisin B(2) (FB(2)) and fumonisin B(3) (FB(3)) in corn-based baby foods. Influence of several extraction parameters that affect PLE efficiency such as temperature, pressure, solvent extraction, number of cycles and dispersant/clean-up agents were studied. The selected PLE operating method was: 3g of sample was packed into 11 ml stainless-steel cell and fumonisins were extracted with methanol at 40 degrees C, 34 atm in one cycle of 5 min at 60% flush. The analytes were ionized in ESI operating with positive ion mode and identified by selecting two monitoring transitions, permitting quantification and confirmation in a single injection. Recoveries ranged from 68% to 83% at fortification levels of 200 microg kg(-1) with relative standard deviation (RSD) from 4% to 12%. The limits of quantification were from 2 microg kg(-1) for FB(1) and FB(2), and 5 microg kg(-1) for FB(3), which are below the maximum residue level established by the European Union legislation in infant formulas. The proposed method was successfully applied to the analysis of twenty seven samples of baby food products collected from different markets, and one positive sample with a content of 15.9 microg kg(-1) for FB(1), 9.2 microg kg(-1)for FB(2) and 5.8 microg kg(-1) for FB(3) was obtained. Given the simplicity and potential of the proposed procedure, its application for safety control is recommended. | 18,829,034 |
Simultaneous coaxial thermal lens spectroscopy and retro-reflected beam interference detection for capillary electrophoresis. | A novel optical scheme, which accomplished simultaneous coaxial thermal lens spectroscopy and retro-reflected beam interference detection for capillary electrophoresis, has been described. By a special design, an adjustable pump laser waist relative to the probe laser waist was implemented, while some key elements for both detection modes were optimized. In either detection modes, certain preponderance compared with former reports was indicated. With both coaxial thermal lens spectroscopy and retro-reflected beam interference detection, the reported detection scheme combined high sensitivity and universal property for capillary electrophoresis detection. | 18,829,035 |
A small-angle X-ray scattering study of the structure of lysozyme-sodium dodecyl sulfate complexes. | The structure of lysozyme-sodium dodecyl sulfate (SDS) complexes in solution is studied using small-angle X-ray scattering (SAXS). The SAXS data cannot be explained by the necklace and bead model for unfolded polypeptide chain interspersed with surfactant micelles. For the protein and surfactant concentrations used in the study, there is only marginal growth of SDS micelles as they complex with the protein. Being a small and rather rigid protein, lysozyme can penetrate the micellar core which is occupied by flexible and disordered paraffin chains and also the shell occupied by the hydrated head groups. A partially embedded swollen micellar model seems appropriate and describes well the scattering data. The SAXS intensity profiles are analyzed by considering the change in the electron scattering length density of the micellar core and shell due to complexation with protein and treating the intermicellar interaction using rescaled mean spherical approximation (RMSA) for charged spheres. | 18,829,038 |
Cleaning using nanobubbles: defouling by electrochemical generation of bubbles. | Here we demonstrate that nanobubbles can be used as cleaning agents both for the prevention of surface fouling and for defouling surfaces. In particular nanobubbles can be used to remove proteins that are already adsorbed to a surface, as well as for the prevention of nonspecific adsorption of proteins. Nanobubbles were produced on highly oriented pyrolytic graphite (HOPG) surfaces electrochemically and observed by atomic force microscopy (AFM). Nanobubbles produced by electrochemical treatment for 20 s before exposure to bovine serum albumin (BSA) were found to decrease protein coverage by 26-34%. Further, pre-adsorbed protein on a HOPG surface was also removed by formation of electrochemically produced nanobubbles. In AFM images, the coverage of BSA was found to decrease from 100% to 82% after 50 s of electrochemical treatment. The defouling effect of nanobubbles was also investigated using radioactively labeled BSA. The amount of BSA remaining on a stainless steel surface decreased by approximately 20% following 3 min of electrochemical treatment and further cycles of treatment effectively removed more BSA from the surface. In situ observations indicate that the air-water interface of the nanobubble is responsible for the defouling action of nanobubbles. | 18,829,043 |
Antiemetic medications in children with presumed infectious gastroenteritis--pharmacoepidemiology in Europe and Northern America. | To investigate the prescription pattern of antiemetic medications in 0- to 9-year-old children with infectious gastroenteritis in several industrialized countries during 2005. We retrospectively retrieved data from 4 national and international databases (IMS MIDAS, IMS disease analyzer, WIdO databases). Between 2% and 23% of children with gastroenteritis (International Classification of Diseases code A08.X or A09) received prescriptions for antiemetic medications (United States, 23%; 95% CI, 15-31; Germany, 17%; 95% CI, 15-20; France, 17%; 95% CI, 14-19; Spain, 15%; 95% CI, 10-19; Italy, 11%; 95% CI, 7-16; Canada, 3%; 95% CI, 0-16; United Kingdom, 2%; 95% CI, 1-2). The antihistamines dimenhydrinate and diphenhydramine were most frequently used in Germany and Canada, whereas promethazine was prescribed preferentially in the United States. In France, Spain, and Italy, the dopamine receptor antagonist domperidone was preferred as antiemetic treatment. Ondansetron was used in a minor proportion of antiemetic prescriptions (Germany, Canada, Spain, and Italy, 0%; United States, 3%; United Kingdom, 6%). Antiemetic drugs are frequently used in children with gastroenteritis. In different industrialized countries, prescription of antiemetic medication varies considerably. Ondansetron, the only drug with evidence-based antiemetic efficacy, plays a minor role among antiemetic prescriptions. | 18,829,050 |
Five new consanguineous families with horizontal gaze palsy and progressive scoliosis and novel ROBO3 mutations. | Horizontal gaze palsy and progressive scoliosis (HGPPS) is an autosomal recessive neurologic disorder caused by homozygous or compound heterozygous mutations in the ROBO3 gene on chromosome 11. We clinically evaluated seven individuals with HGPPS from five previously unreported consanguineous families. We sequenced ROBO3 in all affected individuals, additional unaffected members of each family, and ethnic controls. All affected individuals had severe horizontal gaze restriction, progressive scoliosis, and lower brainstem hypoplasia on neuroimaging, the hallmarks of this syndrome. One individual experienced head trauma with a right subdural hematoma associated with a right hemiparesis, observations that confirm clinically for the first time that corticospinal tracts in HGPPS are uncrossed. We found five novel homozygous ROBO3 mutations (four missense mutations and one base deletion) distributed throughout the extracellular domain of the gene. The ROBO3 gene does not appear to have an obvious hot spot area for mutations; therefore, we recommend sequencing all exons and exon-intron boundaries in patients with clinical and/or radiologic features of HGPPS. | 18,829,051 |
[Nocardia brain abscess: features, therapeutic strategies and outcome]. | Nocardia species is an aerobic soil-saprophyte bacterium, responsible for rare opportunistic infections, mainly reported in immunocompromised patients. Nocardia brain abscess accounts for 1 to 2% of cerebral abscesses. Prognosis is poor. We describe clinical, radiological and bacteriological findings along with therapeutic aspects for five patients and review the literature on Nocardia cerebral abscess. The clinical features of Nocardia brain abscess are insidious and nonspecific, occurring frequently with a medical background of obvious or latent immunodeficiency; fever, if any, is observed subordinate to extracerebral nocardiosis. Computerized tomography scan and conventional magnetic resonance (MR) scan show lesions with a necrotic core and multilobed thick walls enhancing after injection of gadolinium or iodine. Abscesses are mainly located in the brain stem, basal ganglia and cerebral cortex of the frontal, parietal and occipital lobes; cerebellar and spinal locations are uncommon. MR diffusion-weighted imaging with calculation of apparent diffusion coefficient and proton MR spectroscopy can provide additional data for accurate differential diagnosis between abscess and other necrotic lesions, such as tumor and cyst formations. Bacteriological identification has progressed with advances in molecular microbiology: 16S rRNA sequencing, allowing a more rapid routine identification of Nocardia strains from clinical samples. Clinical management of patients with a Nocardia brain abscess relies upon early use of intravenous antibiotics adapted to the strains identified and their susceptibility. Most Nocardia strains display susceptibility to cotrimoxazol, amikacin and linezolid, but develop beta-lactamase activity. Early pus samples, obtained by biopsy or surgical resection, are needed to establish a certain bacteriological diagnosis and initiate appropriate intravenous antibiotics. | 18,829,055 |
Known knowns and known unknowns: risks associated with combination antithrombotic therapy. | Use of antiplatelet therapy in combination with oral anticoagulants remains controversial. The purpose of this article is to review current consensus recommendations for antithrombotic therapy, to evaluate risks for bleeding among patients taking combination antithrombotic therapy, and lastly to review single-center data from Kaiser Permanente Colorado detailing clinical outcomes associated with combination therapy. This was a retrospective, longitudinal pharmacoepidemiologic review. Adult patients receiving warfarin managed by a clinical pharmacy service who had documented antiplatelet (aspirin, clopidogrel, and/or dipyridamole) use (combination therapy cohort) or non-use (monotherapy cohort) were identified as of September 30, 2005. Utilizing integrated, electronic medical records, anticoagulation-related adverse events (death, hemorrhage, thrombosis) and coronary events were identified during a six-month follow-up (October 2005 through March 2006). Proportions of events were compared between cohorts. Independent associations between the cohorts and the outcomes were assessed with adjustment for potential confounding factors. Data from 2,560 monotherapy and 1,623 combination therapy patients were analyzed. Patients in the combination therapy cohort were more likely to have had anticoagulation-related hemorrhages (4.2% vs. 2.0%, unadjusted p<0.001). With adjustment, combined warfarin and antiplatelet use was independently associated with hemorrhagic (OR=2.75; 95% CI 1.44, 5.28) but not coronary (OR=0.99; 95% CI 0.37, 2.62) events. At the population level, the hemorrhagic risk associated with warfarin therapy combined with antiplatelet therapy appears to outweigh the benefits. These findings suggest that clinicians carefully consider risks and benefits when prescribing antiplatelet therapy for patients taking warfarin who do not meet evidence-based criteria for that approach. | 18,829,070 |
Induction of abortion with aglepristone significantly changed the expression of progesterone and estrogen receptors in canine endometrial stromal cells. | In the present study, resorption/abortion was induced between days 25 and 45 of gestation with aglepristone (group IRA, n=10). The aim was to observe the change in the distribution of progesterone (PR) and estrogen receptors (ER), in comparison to a group of spontaneous resorptions/abortions (group SRA, n=5), and a further group of normal healthy pregnant animals, ovariohysterectomized between days 25 and 45 of gestation (controls, n=7). The receptors were assessed by means of immunohistochemistry (IHC) and RT-PCR, at the placental and interplacental sites of the uterine horn as well as in the corpus uteri. Significant differences were observed between the controls on one side and the groups of resorption/abortion on the other side. The total scores of the progesterone receptors (TPR) in the placental and interplacental part of the uterine horn, was significantly lower in the endometrial stromal cells (ESC) of the control group than in those of the SRA- and IRA-group, respectively (placenta: 5.8 vs. 6.5 and 6.7, p<0.01; interplacental sites: 5.6 vs. 6.6 and 6.6, p<0.05). In contrary, the total scores of the estrogen receptors (TER) at interplacental sites and the corpus uteri, respectively, was significantly higher in the myometrial smooth muscle cells (MSMC) and the ESC (p<0.05) of the controls. We therefore conclude, that the here observed differences between groups point to an up-regulation of TPR- and a down-regulation of TER-scores in endometrial stromal cells at different uterine sites during resorption/abortion, which indicates a special role of these cells. | 18,829,094 |
Silk-functionalized titanium surfaces for enhancing osteoblast functions and reducing bacterial adhesion. | It would be ideal to have implants which can simultaneously inhibit bacterial adhesion and promote osteoblast functions. In this work, titanium surfaces were modified with poly(methacrylic acid) (P(MAA)) followed by immobilization of silk sericin. Firstly a trichlorosilane coupling agent, which is an atom transfer radical polymerization (ATRP) initiator, was immobilized on the oxidized titanium surface to facilitate the surface-initiated ATRP of methacrylic acid sodium salt (MAAS). The pendant carboxyl end groups of the grafted and partially protonated MAA chains were subsequently coupled with silk sericin via carbodiimide chemistry. The functionalized Ti surfaces were characterized by X-ray photoelectron spectroscopy, and assayed for osteoblast cell functions and bacterial adhesion. The covalently immobilized MAA brushes significantly reduce the adhesion of the two bacterial strains (Staphylococcus aureus and Staphylococcus epidermidis) tested. The silk sericin-immobilized surfaces, at the same time, promote osteoblast cells' adhesion, proliferation, and alkaline phosphatase activity. Thus, the P(MAA) and silk sericin functionalized Ti surfaces have potential applications combating biomaterial-centered infection and promoting osseointegration. | 18,829,101 |
Unbalanced whole-arm translocation der(5;19)(p10;q10) is a novel and recurrent cytogenetic aberration in myelodysplastic syndrome. | We describe here two cases of myelodysplastic syndrome (MDS) with a novel unbalanced translocation der(5;19)(p10;q10). Both patients had complex karyotypes including der(5;19) accompanied by an extra chromosome 19, resulting in deletion of the whole long arm of chromosome 5. Furthermore, these patients presented several common clinical and hematological characteristics: MDS subtypes as refractory anemia with excess of blasts (RAEB)-1 or RAEB-2, marked anemia and thrombocytopenia without neutropenia, leukoerythroblastosis, trilineage dysplasia with prominent dyserythropoiesis, CD7 expression in blasts, and association with abnormalities of chromosomes 6, 17 and 18. These findings indicate that der(5;19)(p10;q10) may play a crucial role in the pathogenesis of high-risk MDS as a rare but recurrent translocation. | 18,829,109 |
Proteolytic processing of polyphenol oxidase from plants and fungi. | Polyphenol oxidase (PPO), a metalloenzyme containing a type-3 copper center, is produced by many species of plants, fungi, and bacteria. There is great variability in the subunit molecular mass reported for PPO, even from a single species. In some cases, experimental evidence (usually protein sequencing by Edman degradation) indicates that the variability in molecular mass for PPO from a given species is the result of proteolytic processing at the N and/or C-termini of the protein. In order to identify specific sequence regions where proteolysis occurs in PPO from most species, the experimentally established N and C-termini of these proteolyzed enzymes were compared to the protein sequences of other PPOs for which the N and C-termini have not been established by protein sequencing methods. In all cases the N-terminal proteolysis sites were located prior to a conserved arginine residue, and the C-terminal proteolysis sites were located following a conserved tyrosine motif. Based on the sites of proteolysis, molecular masses were calculated for the enzymes, and the calculated values were used to rationalize the varying molecular masses reported in the literature. To determine the structural implications of N and C-terminal proteolysis, the proteolysis sites were related to the two available PPO structures: Ipomoea batatas catechol oxidase and Streptomyces castaneoglobisporus tyrosinase. A structural "core" region that appears to be essential for structural stability and enzymatic activity was identified. | 18,829,115 |
Whole brain atrophy rate predicts progression from MCI to Alzheimer's disease. | For both clinical and research reasons, it is essential to identify which mild cognitive impairment (MCI) subjects subsequently progress to Alzheimer's disease (AD). The prediction may be facilitated by accelerated whole brain atrophy exhibited by AD subjects. Iterative principal component analysis (IPCA) was used to characterize whole brain atrophy rates using sequential MRI scans for 102 MCI subjects from the Kuopio University Hospital. We modelled the likelihood of progression to probable AD, and found that each additional percent of annualized whole brain atrophy rate was associated with a higher odds ratio (OR) of progression (OR=1.30, p=0.01, 95% CI=1.05-1.60). Our study demonstrates an association between whole brain atrophy rate and subsequent rate of clinical progression from MCI to AD. These findings suggest that IPCA could be an effective brain-imaging marker of progression to AD and useful tool for the evaluation of disease-modifying treatments. | 18,829,136 |
[Disseminated arterial occlusions revealing bilateral venous thrombosis with paradoxical embolisms]. | Paradoxical embolism is a diagnosis of exclusion. Clinical triad associates deep venous thrombosis with or without pulmonary embolism, arterial embolism, and intracardiac communication with right-to-left shunt. The intracardiac communication is generally related to a patent foramen ovale (PFO). We report a 75-year-old patient, who presented with bilateral deep venous thrombosis of the legs, complicated by massive pulmonary embolism and paradoxical embolisms through a PFO. This resulted in cerebral, mesenteric, splenic and bilateral kidney infarctions. A promptly initiated anticoagulant treatment allowed a favourable outcome. | 18,829,139 |
Estimation of chromium(VI) sorption efficiency of novel regenerable p-tert-butylcalix[8]areneoctamide impregnated Amberlite resin. | The article describes a convenient synthesis and Cr(VI) extraction efficiency of a novel p-tert-butylcalix[8]areneoctamide impregnated Amberlite (XAD-4) resin. Using p-tert-butylcalix[8]arene macrocyclic building block, two strategies have been developed; i.e., derivatization of p-tert-butylcalix[8]arene framework with sophisticated ionophoric groups having efficiency to extract oxoanions from aqueous media and, impregnation of p-tert-butylcalix[8]arene derivative onto the polymeric support. Liquid-liquid and solid-liquid extraction experiments have been performed to evaluate the Cr(VI) extraction efficiency of both p-tert-butylcalix[8]arene derivative and the impregnated resin. From the results, it has been deduced that solid-phase extraction method is more convenient and efficient than liquid-liquid extraction process. The impregnated XAD-4 resin has been found regenerable with better extracting efficiency as compared to the simple p-tert-butylcalix[8]areneoctamide ionophore. | 18,829,160 |
Recycling of waste printed circuit boards: a review of current technologies and treatment status in China. | From the use of renewable resources and environmental protection viewpoints, recycling of waste printed circuit boards (PCBs) receives wide concerns as the amounts of scrap PCBs increases dramatically. However, treatment for waste PCBs is a challenge due to the fact that PCBs are diverse and complex in terms of materials and components makeup as well as the original equipment's manufacturing processes. Recycle technology for waste PCBs in China is still immature. Previous studies focused on metals recovery, but resource utilization for nonmetals and further separation of the mixed metals are relatively fewer. Therefore, it is urgent to develop a proper recycle technology for waste PCBs. In this paper, current status of waste PCBs treatment in China was introduced, and several recycle technologies were analyzed. Some advices against the existing problems during recycling process were presented. Based on circular economy concept in China and complete recycling and resource utilization for all materials, a new environmental-friendly integrated recycling process with no pollution and high efficiency for waste PCBs was provided and discussed in detail. | 18,829,162 |
Evaluation of persulfate oxidative wet scrubber for removing BTEX gases. | Soil vapor extraction (SVE) coupled with air sparging of groundwater is a method commonly used to remediate soil and groundwater contaminated with volatile organic petroleum contaminants such as gasoline. These hazardous contaminants are mainly attributable to the compounds-benzene, toluene, ethylbenzene, and xylenes (known collectively as BTEX). Exhaust gas from SVE may contain BTEX, and therefore must be treated before being discharged. This study evaluated the use of iron-activated persulfate chemical oxidation in conjunction with a wet scrubbing system, i.e., a persulfate oxidative scrubber (POS) system, to destroy BTEX gases. The persulfate anions can be activated by citric acid (CA) chelated Fe(2+) to generate sulfate radicals (SO(4)(*-), E degrees =2.4V), which may rapidly degrade BTEX in the aqueous phase and result in continuous destruction of the BTEX gases. The results show that persulfate activation occurred as a result of continuous addition of the citric acid chelated Fe(2+) activator, which readily oxidized the dissolved BTEX. Based on initial results from the aqueous phase, a suitable Fe(2+)/CA molar ratio of 5/3 was determined and used to initiate activation in the subsequent POS system tests. In the POS system, using persulfate as a scrubber solution and with activation by injecting Fe(2+)/CA activators under two testing conditions, varying iron concentrations and pumping rates, resulted in an approximate 50% removal of BTEX gases. During the course of the tests which in corporate activation, a complete destruction of BTEX was achieved in the aqueous phase. It is noted that no removal of BTEX occurred in the control tests which did not include activation. The results of this study would serve as a reference for future studies into the practical chemical oxidation of waste gas streams. | 18,829,165 |
Biodegradation of phenol by Pseudomonas putida immobilized in polyvinyl alcohol (PVA) gel. | Batch experiments were carried out to evaluate the biodegradation of phenol by Pseudomonas putida immobilized in polyvinyl alcohol (PVA) gel pellets in a bubble column bioreactor at different conditions. The bacteria were activated and gradually acclimatized to high concentrations of phenol of up to 300 mg/l. The experimental results indicated that the biodegradation capabilities of P. putida are highly affected by temperature, pH, initial phenol concentration and the abundance of the biomass. The biodegradation rate is optimized at 30 degrees C, a pH of 7 and phenol concentration of 75 mg/l. Higher phenol concentrations inhibited the biomass and reduced the biodegradation rate. At high phenol concentration, the PVA particle size was found to have negligible effect on the biodegradation rate. However, for low concentrations, the biodegradation rate increased slightly with decreasing particle size. Other contaminants such heavy metals and sulfates showed no effect on the biodegradation process. Modeling of the biodegradation of phenol indicated that the Haldane inhibitory model gave better fit of the experimental data than the Monod model, which ignores the inhibitory effects of phenol. | 18,829,170 |
HPA-axis regulation at in-patient admission is associated with antidepressant therapy outcome in male but not in female depressed patients. | A concatenation of data implicates a hyperactivity of the hypothalamus pituitary adrenal (HPA)-axis in the pathogenesis of depression and its normalization as a necessary predecessor of clinical response to antidepressant drugs. In addition, regulation of the HPA-axis has been shown to be dependent on sex hormones. We therefore investigated gender differences in HPA-axis regulation in depression and its normalization during remission of clinical symptoms. We used the combined dexamethasone suppression/CRH stimulation (Dex-CRH) test to evaluate the degree of HPA-axis dysregulation in 194 in-patients with unipolar depression from the Munich Antidepressant Response Signature (MARS) study at both admission and discharge. The Hamilton Depression (HAM-D) Rating Scale was used to monitor clinical response to antidepressant treatment. For both genders, we observed a normalization of HPA-axis dysregulation in remitters but not in non-remitters, both after 5 weeks of treatment and at discharge. The pattern of HPA-axis normalization with remission of depressive symptoms, however, showed gender-specific differences. In male patients, remission after 5 weeks of in-patient treatment was associated with a significantly higher cortisol response in the Dex-CRH test at admission. In female patients, 5-week remitters and non-remitters had a comparable cortisol response at admission. Cortisol response at admission was not correlated with gonadal steroid levels at this time point and the results were similar for pre-menopausal women vs. post-menopausal women. Gender-associated biological characteristics, likely independent of circulating gonadal steroids, thus seem to influence HPA-axis regulation in depression. In male patients, a single measure of HPA-axis dysregulation at admission may serve as a predictor of response to antidepressant treatment in addition to the previously reported repeated measure of the Dex-CRH test. | 18,829,172 |
A new probe for targeting drug delivery system. | Recently, TDDS (Targeting drug delivery system) plays an important role in enhancing the bioavailability and targeting of anti-tumor drugs. How to transport drugs quickly and precisely to their target sites of action has not been solved fundamentally. A large number of researches have identified artemisinin and its analogs have the merit of precisely targeting to cancer cell, and low side effects to healthy tissue. Thus, if these compounds could be attached to established anti-tumor drugs with probe, a novel targeting anti-tumor drugs will be put into practice in the future. The novel drugs delivery system will be a powerful weapon against cancer disease for their unique targeting. | 18,829,175 |
Stature and gender estimation using foot measurements. | In forensic investigation difficulties are being experienced in the stature and gender estimation of bodies dismembered in mass destruction. So as to eliminate these difficulties, new methods are being developed. The aim of this study is to develop formulae for estimation of the stature and gender through foot measurements when necessary. For this purpose, the length, width, malleol height, navicular height measurements of the right and left foot as well as stature have been taken from the 249 subjects who are attending Medical Faculty of Dokuz Eylul University and School of Physical Therapy and Rehabilitation in Turkey. In males, stature and foot measurements were higher than in females, and the difference between the average measures was significant. The highest correlation was observed in the right and left foot length for female, male and study (mix-gender group) groups when stature and foot measurement relations were evaluated. The lowest correlation was observed in foot width for the right foot in all groups but, differed in left foot measurements for each group. Formulae were obtained by using multiple regression analysis for stature estimation and logistic regression analysis for gender estimation. As a consequence, whilst stature estimation formulae, depending on the gender, allow 9-10 cm errors, those that are independent on the gender help make estimation with less than 4 cm errors. Gender estimation formula can help determine the gender with 95.6% accuracy via right foot measurements, and 96.4% accuracy via left foot measurements. In population similar to our subjects, stature and gender estimation can be made by using foot measurements. | 18,829,191 |
Deep vein thrombosis resolution is impaired in diet-induced type 2 diabetic mice. | Type 2 diabetes mellitus results in a procoagulant and thrombogenic state that could predispose diabetic individuals to develop venous thrombosis. We sought to determine whether diet-induced type 2 diabetes mellitus affects deep venous thrombosis (DVT) resolution in a murine model. C57Bl/6 mice were fed a low-fat or a high-fat diet (n = 10) for 10 weeks, after which DVT was created in the inferior vena cava (IVC) by a combination of low flow and endothelial damage. The IVC and thrombus were harvested at 1 and 2 weeks. Thrombus resolution and neovascularization were investigated through transfemoral angiography (n = 10), thrombus size (n = 4) and weight (n = 10), and nitric oxide synthase 3 immunoquantification (n = 4). Macrophage content was assessed by CD68 immunoreactivity (n = 4). The fibrinolytic system (urokinase plasminogen activator [uPA] and plasminogen activator inhibitor-1 [PAI-1]) was analyzed by Western immunoblotting (n = 6) and immunohistochemistry (n = 4). Total collagen was stained by Sirius red. Matrix metalloproteinases (MMP)-2 and MMP-9 activities were evaluated by zymography and their expressions by Western immunoblotting (n = 6) and immunohistochemistry (n = 4). Diabetic mice had significantly larger and heavier thrombi at 1 and 2 weeks (P < .05), threefold less neovascularization (P < .05), and 35-fold increase in macrophage content (P < .01), than control mice 2 weeks after surgery. IVC recanalization was documented in 90% of 2-week control mice and in 10% of 2-week diabetic mice (P < .01). Increased vein wall collagen and less uPA and more PAI-1 expressions with a decreased uPA/PAI-1 ratio (31%, P < .01) were documented at 2 weeks in diabetic mice. MMP-2 and MMP-9 activities and expressions were significantly increased in diabetic mice at 1 and 2 weeks (P < .05) compared with control mice. Diet-induced type 2 diabetes may impair DVT resolution through altered inflammatory, fibrinolytic, and MMP responses. | 18,829,216 |
Incidence of ipsilateral postoperative deep venous thrombosis in the amputated lower extremity of patients with peripheral obstructive arterial disease. | Patients undergoing amputation of the lower limb due to peripheral arterial disease (PAD) are at risk of developing deep venous thrombosis (DVT). Few studies in the research literature report the incidence of DVT during the early postoperative period or the risk factors for the development of DVT in the amputation stump. This prospective study evaluated the incidence of DVT during the first 35 postoperative days in patients who had undergone amputation of the lower extremity due to PAD and its relation to comorbidities and death. Between September 2004 and March 2006, 56 patients (29 men), with a mean age of 67.25 years, underwent 62 amputations, comprising 36 below knee amputations (BKA) and 26 above knee amputations (AKA). Echo-Doppler scanning was performed preoperatively and on postoperative days 7 and 31 (approximately). All patients received acetylsalicylic acid (100 mg daily) preoperatively and postoperatively, but none received prophylactic anticoagulation. DVT occurred in 25.8% of extremities with amputations (10 AKA and 6 BKA). The cumulative incidence in the 35-day postoperative period was 28% (Kaplan-Meier). There was a significant difference (P = .04) in the incidence of DVT between AKA (37.5%) and BKA (21.2%). Age >or=70 years (48.9% vs 16.8%, P = .021) was also a risk factor for DVT in the univariate analysis. Of the 16 cases, 14 (87.5%) were diagnosed during outpatient care. The time to discharge after amputation was averaged 6.11 days in-hospital stay (range, 1-56 days). One symptomatic nonfatal pulmonary embolism occurred in a patient already diagnosed with DVT. There was no relation between other comorbidities and DVT. The multivariate analysis showed no association between risk factors and the occurrence of DVT in the amputated extremity. DVT ipsilateral to the amputation did not influence the mortality rate (9.7%). The incidence of DVT in the early postoperative period (<or=35 days) was elevated principally in patients aged >or=70 years and for AKA. Patients with PAD who have recently undergone major amputations should be considered at high risk for DVT, even after hospital discharge. Given the high rate of postoperative DVT observed in this study, we now recommend prophylactic anticoagulation for these patients, but further study is needed to determine the optimal duration and efficacy of this treatment. | 18,829,221 |
Prevalence of carotid stenosis and silent myocardial ischemia in asymptomatic subjects with a low ankle-brachial index. | Subjects with symptomatic peripheral artery disease (PAD) have an elevated prevalence of carotid stenosis and of silent myocardial ischaemia. As such, clinical guidelines advocate the detection of sub-clinical vascular disease in this population. However, the prevalence of occult vascular disease in asymptomatic patients with a low ankle-brachial index (ABI) has not been previously evaluated. Cross-sectional study in five primary care centres for patients' selection and two University Hospitals for further assessment. Subjects were 1070 asymptomatic individuals between 60 and 80 years of age with at least two cardiovascular risk factors, selected for ankle-brachial index measurement. Eighty five subjects with an ABI <0.9 and an equal number of controls, matched for age, gender, diabetes, and smoking habit, and with a normal ABI, were referred to the Hospital for carotid ultrasound and exercise stress tests (EST). Main outcome measures were prevalence of a carotid stenosis >50% and an abnormal EST. The prevalence of a low ABI in the overall population was 9.1%. A carotid stenosis >50% was detected in 14.3% of the subjects with a low ABI and in 4.7% of the control subjects (Odds Ratio [OR]: 3.37; 95% Confidence Interval [CI]: 1.04-10.93, P = .033). The prevalence of a positive EST test was 16.2% in those with a low ABI and 10.5% in control subjects (OR: 1.65; 95% CI: 0.63-4.29, P = .309). These prevalences were higher in older subjects, in those with hypertension or diabetes, or in those with dyslipidemia. Our results indicate that in high-risk asymptomatic subjects >60 years of age, the presence of an ABI <0.9 identifies a subgroup of the population with an increased prevalence of carotid stenosis and of silent myocardial ischemia and, as such, are candidates for closer follow-up. | 18,829,225 |
Validation of a method for determination of the ankle-brachial index in the seated position. | To validate a method for determination of the ankle-brachial index (ABI) in the seated position. Peripheral arterial disease (PAD) is a prevalent disorder that is associated with quality of life impairment and increased risk of a major cardiovascular event. The ABI is the initial test for screening and diagnosis of PAD. To prevent error due hydrostatic pressure, accurate measurement of the ABI requires supine patient positioning. Access to ABI measurement is limited for patients who are immobilized or unable to lie flat. Patients presenting to a vascular laboratory for suspected arterial disease were enrolled. Arm and ankle blood pressures were measured in the supine and seated positions. Seated ankle pressures were corrected by the following physiology-based formula: Corrected ankle pressure = Measured ankle pressure - D*(.078), where D = the vertical distance between the arm and ankle cuffs (mm). This formula equates to a correction factor of 78 mm Hg per meter distance between the arm and ankle cuffs. Corrected ankle pressure measurements were used for seated ABI calculation. Complete data were available for 100 patients. Mean ABI was 0.97, and 31% of patients had an ABI < or =0.9. There was excellent correlation between supine and corrected seated ankle pressure measurements (r = 0.884-0.936, P < .001). The difference between measurements was negligible (<5 mm Hg). Similarly, there was excellent correlation between supine and seated ABI measures (r = 0.936, P < .001). There was no significant difference between the supine and seated ABI measures. We have developed and validated a method for determination of the ABI in the seated position which can be used to broaden availability of PAD testing. This method could also be incorporated into new technologies for ABI determination in the seated position. | 18,829,231 |
Duplex ultrasound in aneurysm surveillance following endovascular aneurysm repair: a comparison with computed tomography aortography. | Cumulative radiation dose, cost, and increased demand for computed tomography aortography (CTA) suggest that duplex ultrasonography (DU) may be an alternative to CTA-based surveillance. We compared CTA with DU during endovascular aneurysm repair (EVAR) follow-up. Patients undergoing EVAR had clinical and radiological follow-up data entered in a prospectively maintained database. For the purpose of this study, the gold standard test for endoleak detection was CTA, and an endoleak detected on DU alone was assumed to be a false positive result. DU interpretation was performed independently of CTA and vice versa. One hundred thirty-two patients underwent EVAR, of whom 117 attended for follow-up ranging from six months to nine years (mean, 32 months). Adequate aneurysm sac visualisation on DU was not possible in 1.7% of patients, predominantly due to obesity. Twenty-eight endoleaks were detected in 28 patients during follow-up. Of these, 24 were initially identified on DU (four false negative DU examinations), and eight had at least one negative CTA with a positive DU prior to diagnosis. Twenty-three endoleaks were type II in nature and three of these patients had increased sac size. There was one type I and four type III endoleaks. Two of these (both type III) had an increased sac size. Of 12 patients with increased aneurysm size of 5 mm or more at follow-up, five had an endoleak visible on DU, yet negative CTA and a further five had endoleak visualisation on both DU and CTA. Of six endoleaks which underwent re-intervention, all were initially picked up on DU. One of these endoleaks was never demonstrated on CTA and a further two had at least one negative CTA prior to endoleak confirmation. Positive predictive value for DU was 45% and negative predictive value 94%. Specificity of DU for endoleak detection was 67% when compared with CTA, because of the large number of false positive DU results. Sensitivity for DU was 86%, with all clinically significant endoleaks demonstrated on CTA also detected on DU. Despite its low positive predictive value, we found DU to be a sensitive test for the detection of clinically significant endoleaks. Given concerns about cumulative radiation exposure and cost, and the surprisingly low sensitivity of CTA for endoleak detection in this series, selective CTA based on DU surveillance may be a more appropriate long-term strategy. | 18,829,237 |
Outcomes of endovascular abdominal aortic aneurysm repair compared with open surgical repair in high-risk patients: results from the Swedish Vascular Registry. | The management of infrarenal aortic aneurysms in high-risk patients remains a challenge. Endovascular aneurysm repair (EVAR) is associated with superior short-term mortality rates but unclear long-term results and has not been shown to improve survival in patients unfit for open repair (OR). The aim of this population-based study was to evaluate the outcome after elective EVAR compared with OR in a high-risk patient cohort. Prospectively collected data from January 2000 to December 2006 were retrieved from the Swedish Vascular Registry. The high-risk cohort was defined as age >or=60 years, American Anesthesiologists Association (ASA) class 3 or 4, and at least one cardiac, pulmonary, or renal comorbidity. These criteria were met by 217 of 1000 EVAR patients and 483 of 2831 OR patients. Primary end points were 30-day and 1-year all-cause mortality. Kaplan-Meier curves for survival and multivariate Cox regression analyses were performed. The crude 30-day and 1-year all-cause mortality rates for EVAR vs OR for the whole treatment group (n = 3831) were 1.8% vs 2.8% and 8.0% vs 7.2%, respectively. In the high-risk cohort (n = 700), EVAR patients were approximately 2 years older and renal insufficiency and diabetes mellitus were more common, and smoking was more prevalent in the OR group. About two-thirds of EVAR procedures were performed at university hospitals and one-half of OR procedures were performed at county hospitals. In the high-risk cohort, there was no difference in mortality at 30-days (EVAR, 4.6% vs OR, 3.3%), but OR had lower 1-year mortality (8.5% vs 15.9%; P = .003). More bleeding complications occurred in the EVAR group, but more pulmonary complications occurred in the OR group; however, there was no difference in cardiac, cerebrovascular, or renal complications. The mean follow-up was 3.4 years. EVAR was associated with increased mortality risk after adjusting for age, ASA class, and comorbidities (hazard ratio, 1.50; 95% confidence interval, 1.07-2.12; P = .02). Kaplan-Meier survival analysis showed a lower mortality rate for patients undergoing OR, which remained during follow-up (P = .001). Elective OR of aortic aneurysms seems to have a better outcome compared with EVAR in this specific, population-based, high-risk patient cohort after adjusting for covariates. We cannot confirm the benefit of EVAR from previous registry studies with a similar high-risk definition. In clinical practice, OR may be at least as good as EVAR in high-risk patients fit for surgery. | 18,829,239 |
[Immunosuppressants for auto-immune diseases and pregnancy]. | Therapeutic stability of a systemic disease is a priority during pregnancy. To stop an effective treatment, to reduce dosages or to switch to less effective treatments might induce some loss of chance for pregnant women, and eventually harmful consequences for fetuses. Due to the teratogenic effects of some immunosuppressants, childbearing susceptible women should use effective contraception and be informed of risks in case of pregnancy. A pre-conceptional consultation is of interest, allowing an adaptation of treatment and advices before pregnancy is ongoing. Mycophenolate is highly suspected to be teratogenic in humans. Mycophenolate should not be prescribed in women of childbearing potential unless some criteria are met. Maternal (even fetal) infectious conditions can occur during immunosuppressive treatments. Therefore, obstetricians and pediatricians should be aware of the maternal treatment in order to allow adequate monitoring of the mother and the neonate. | 18,829,249 |
A factor analytic comparison of five models of PTSD symptoms. | This study examined the factor structure of PTSD symptoms in a sample of college students (n=344) reporting exposure to a range of traumatic events. The sample was randomly split and an exploratory factor analysis was conducted with half of the sample. The factor structure obtained in the exploratory analysis was evaluated against three other models using confirmatory factor analysis utilizing the second half of the sample. This series of factor analyses identified and confirmed a three-factor symptom structure consisting of intrusion/avoidance, dysphoria, and hyperarousal clusters. These results add to the body of literature which has found that PTSD includes a cluster of symptoms shared with other diagnoses (dysphoria) and a more specific factor related directly to the effects of encountering traumatic experiences. | 18,829,253 |
Vulnerability of the frontal-temporal connections in temporal lobe epilepsy. | In temporal lobe epilepsy (TLE), frontal-temporal connections are integral parts of the epileptogenic network. Although frontal-temporal gray matter abnormalities have been consistently demonstrated in TLE, white matter connections between these two lobes require further study in this disease setting. We therefore investigated the integrity of two major frontal-temporal white matter association tracts, uncinate fasciculus (UF) and arcuate fasciculus (AF), and their clinical correlates. Using diffusion tensor imaging (DTI) tractography, integrity of the UF and AF was examined in 22 individuals (12 subjects with TLE and 10 age-matched healthy controls). DTI indices of these tracts were compared between the two subject groups and correlates examined with clinical variables that included age of seizure onset, duration of epilepsy, history of febrile seizure and antiepileptic medication exposure. In subjects with TLE, the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of UF and AF ipsilateral to the side of seizure onset were abnormal when compared to healthy controls. Furthermore, lower UF FA correlated with earlier age of seizure onset. TLE is associated with abnormal integrity of frontal-temporal white matter tracts, but only on the side of seizure onset. This suggests that frontal-temporal white matter tracts are vulnerable to recurrent seizures and/or the factors precipitating the epilepsy. | 18,829,258 |
3-Hydrogenkwadaphnine, a novel diterpene ester from Dendrostellera lessertii, its role in differentiation and apoptosis of KG1 cells. | 3-Hydrogenkwadaphnin (3-HK) (Fig. 1) is a daphnane-type diterpene ester isolated from the leaves of Dendrostellera lessertii (Thymelaeaceae) with differentiation and apoptotic potency among several leukemic cells without any measurable adverse effects on normal cells [Moosavi, M.A., Yazdanparast, R., Sanati, M.H., Nejad, A.S., 2005a. 3-Hydrogenkwadaphnin targets inosine 5'-monophosphate dehydrogenase and triggers post-G1 arrest apoptosis in human leukemia cell lines. Int. J. Biochem. Cell Biol. 37, 2366-2379]. In this study, we evaluated differentiating and apoptotic efficiency of a second new anti-proliferating agent from the same plant relative to 3-HK using acute myeloid leukemia (AML) KG1 cell line. 3-HK at 5-30 nM inhibited proliferation of KG1 cells after 24-96 h of treatment. NBT reducing assay and expression of cell surface markers (CD11b and CD14) confirmed that the inhibition of proliferation is associated with differentiation toward macrophage-like morphology. Regarding the relatively weaker potency of 3-HK in the induction of differentiation compared to that of the crude extract, we looked for additional compound(s) with similar properties in the crude extract. This effort led to isolation of the second compound from the leaves' extract with higher differentiating potency. The new compound inhibited proliferation of KG1 cells by almost 48+/-3.1% after 72 h of treatment with a single dose of 1.5 microg/ml. The treated cells differentiated along the monocyte/macrophage lineage based on the morphological features apparent after Wright-Giemsa staining, phagocytic activity and expression of cell surface markers as analyzed by flow cytometry. On the other hand, the results indicated that exposure of KG1 cells to either 3-HK or the new compound for 3-4 days induced apoptosis as assayed qualitatively by acridine orange/ethidium bromide (Ao/EtBr) double staining, agarose gel electrophoresis and quantitatively by Annexin-V technique and sub-G1 DNA staining using flow cytometry. Based on the present data, these two active constituents of D. lessertii have the novelty of being further evaluated for pharmaceutical applications. | 18,829,278 |
The effect of long-term lactobacilli (lactic acid bacteria) enteral treatment on the central nervous system of growing rats. | The aim of this study was to explore the relationship between consumption of large doses of lactic acid bacteria (LAB) and the behaviour and brain morphobiochemistry of normal growing rats. Four groups of rats were treated with LAB cultures twice daily for 6 months. The control group received 1 ml of saline per treatment, while two experimental groups received 1 ml of living bacteria (Lactobacillus plantarum and Lactobacillus fermentum, respectively) and the remaining group received a heat-treated (inactivated) L. fermentum culture. After 2 and 6 months of treatment, respectively, eight animals from each group were sacrificed, and specimens were taken for further analyses. The behaviour of the rats was evaluated five times in an open-field test at monthly intervals throughout the study. Lactobacilli treatment for 2 months induced changes in the motoric behaviour of the rats. The concentration of the astrocytesoluble and filament glial fibrillary acidic protein (GFAP) decreased in the posterior part of the hemispheres, including the thalamus, hippocampus and cortex of the rats treated with L. fermentum. A greater decrease in filament GFAP (up to 50%) was shown in the group receiving the live form of L. fermentum. In contrast, the GFAP in the live L. plantarum-treated group increased, showing elevated levels of the soluble and filament forms of GFAP in the posterior part of the hemispheres. A 60-66% decrease in the amount of the astrocyte-specific Ca-binding protein S-100b was shown in the posterior parts of the hemispheres and in the hindbrain of rats given LAB for 2 months. Prolonged feeding with LAB for 4 months up to full adulthood led to a further decrease in astrocyte reaction, reflected as an additional decrease in the amount of soluble GFAP and locomotor activity in all experimental groups. The changes in filament GFAP and S-100b appeared to disappear after prolonged feeding (total of 6 months) with LAB. In summary, LAB dietary treatment affected the ontogenetic development of the astrocytes, with the highest intensity observed in the early stages of rat development. It can be postulated that LAB treatment may play a preventive role in neurological diseases by decreasing astrocyte reaction and, consequently, lowering locomotor activity. | 18,829,284 |
Recent advances in the treatment of renal cell carcinoma and the role of targeted therapies. | Immunotherapy confers a small but significant overall survival advantage in metastatic renal cell carcinoma (RCC) but only for the minority of patients, i.e. the 20% with good prognostic features. Recent developments in the molecular biology of renal cell carcinoma have identified multiple pathways associated with the development of this cancer. Several strategies have been investigated targeting these pathways, with significant clinical benefits shown in early studies. New agents including the small molecule targeted inhibitors sunitinib, sorafenib and temsirolimus, and the monoclonal antibody bevacizumab have shown anti-tumour activity in randomised clinical trials and have become the standard of care for most patients. Sunitinib and temsirolimus have shown significant improvements in progression-free survival (sunitinib) and overall survival (temsirolimus) in separate phase III studies in the first-line setting when compared with interferon-alpha. Sorafenib has demonstrated prolonged progression-free survival in a phase III study in comparison with placebo in the second-line setting. More recently two phase III studies have compared bevacizumab and interferon-alpha with interferon-alpha alone. Both studies showed a statistically significant improvement in progression-free survival for the combination arm. Additional studies are needed to optimise the use of these agents by identifying those patients who most benefit and elucidating the best way of delivering them, either in combination or as sequential single agents. | 18,829,302 |
Vacuum-assisted excision of breast lesions of uncertain malignant potential (B3) - an alternative to surgery in selected cases. | To assess whether vacuum-assisted excision (VAE) is a safe alternative to surgery in the treatment of breast lesions of uncertain malignant potential (B3) in which no atypia is present on needle core biopsy (NCB). Forty two VAE procedures were performed for B3 lesions. Twenty four (57%) were papillary lesions. Eighteen (43%) were radial scars. Two patients (4.7%) were upgraded to carcinoma at VAE. Two patients with papillary lesions went on to develop cancer in the same breast (at 24 and 41 months post VAE). No cancer developed in the radial scar group. Eight patients (19%) had surgery - four for carcinoma, two for radial scars missed at VAE excision and two for symptomatic papillomatosis. Follow-up mammography after VAE of radial scars often showed residual distortion. VAE can be a safe alternative to surgery in the treatment of B3 lesions without atypia, providing thorough multidisciplinary discussion has taken place. | 18,829,318 |
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