title stringlengths 0 1.13k | abstract stringlengths 1 15.7k | PMID int64 22 36.5M |
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Genotype-correlated expression of lysyl oxidase-like 1 in ocular tissues of patients with pseudoexfoliation syndrome/glaucoma and normal patients. | Pseudoexfoliation (PEX) syndrome is a generalized disease of the extracellular matrix and the most common identifiable cause of open-angle glaucoma. Two single nucleotide polymorphisms in the lysyl oxidase-like 1 (LOXL1) gene (rs1048661 and rs3825942) have been recently identified as strong genetic risk factors for both PEX syndrome and PEX glaucoma. Here we investigated the expression and localization of LOXL1, LOXL2, and lysyl oxidase (LOX) in tissues of PEX syndrome/glaucoma patients and controls in correlation with their individual single nucleotide polymorphism genotypes and stages of disease. LOXL1 ocular expression was reduced by approximately 20% per risk allele of rs1048661, whereas risk alleles of rs3825942, which were highly overrepresented in PEX cases, did not affect LOXL1 expression levels. Irrespective of the individual genotype, LOXL1 expression was significantly increased in early PEX stages but was decreased in advanced stages both with and without glaucoma compared with controls, whereas LOX and LOXL2 showed no differences between groups. LOXL1 was also found to be a major component of fibrillar PEX aggregates in both intra- and extraocular locations and to co-localize with various elastic fiber components. These findings provide evidence for LOXL1 involvement in the initial stages of abnormal fibrogenesis in PEX tissues. Alterations of LOXL1 activation, processing, and/or substrate specificity may contribute to the abnormal aggregation of elastic fiber components into characteristic PEX fibrils. | 18,974,306 |
Bat white-nose syndrome: an emerging fungal pathogen? | White-nose syndrome (WNS) is a condition associated with an unprecedented bat mortality event in the northeastern United States. Since the winter of 2006*2007, bat declines exceeding 75% have been observed at surveyed hibernacula. Affected bats often present with visually striking white fungal growth on their muzzles, ears, and/or wing membranes. Direct microscopy and culture analyses demonstrated that the skin of WNS-affected bats is colonized by a psychrophilic fungus that is phylogenetically related to Geomyces spp. but with a conidial morphology distinct from characterized members of this genus. This report characterizes the cutaneous fungal infection associated with WNS. | 18,974,316 |
Structural insights into a circadian oscillator. | An endogenous circadian system in cyanobacteria exerts pervasive control over cellular processes, including global gene expression. Indeed, the entire chromosome undergoes daily cycles of topological changes and compaction. The biochemical machinery underlying a circadian oscillator can be reconstituted in vitro with just three cyanobacterial proteins, KaiA, KaiB, and KaiC. These proteins interact to promote conformational changes and phosphorylation events that determine the phase of the in vitro oscillation. The high-resolution structures of these proteins suggest a ratcheting mechanism by which the KaiABC oscillator ticks unidirectionally. This posttranslational oscillator may interact with transcriptional and translational feedback loops to generate the emergent circadian behavior in vivo. The conjunction of structural, biophysical, and biochemical approaches to this system reveals molecular mechanisms of biological timekeeping. | 18,974,343 |
Presence of donor-derived DNA and cells in the urine of sex-mismatched hematopoietic stem cell transplant recipients: implication for the transrenal hypothesis. | The term "transrenal DNA" was coined in 2000 to signify that DNA in urine may come from the passage of plasma DNA through the kidney barrier. Although DNA in the urine has the potential to provide a completely noninvasive source of nucleic acids for molecular diagnosis, its existence remains controversial. We obtained blood and urine samples from 22 hematopoietic stem cell transplant (HSCT) recipients and used fluorescence in situ hybridization, PCR for short tandem repeats, mass spectrometry, quantitative PCR, and immunofluorescence detection to study donor-derived DNA in the urine. All HSCT recipients exhibited high amounts of donor-derived DNA in buffy coat and plasma samples. Male donor-derived DNA was detected in supernatants of urine samples from all 5 female sex-mismatched HSCT recipients. Surprisingly, the amount of DNA in urine supernatants was not correlated with the plasma value. Moreover, cell-free urine supernatants contained DNA fragments >350 bp that were absent in plasma. Donor-derived polymorphs were detected in urine by fluorescence in situ hybridization. Coincidentally, donor-derived cytokeratin-producing epithelial cells were discovered in urine samples from 3 of 10 sex-mismatched HSCT recipients as long as 14.2 years after transplantation. This report is the first to demonstrate the presence of donor-derived DNA in the urine of HSCT recipients; however, we show that much of this DNA originates from donor-derived cells, rather than from the transrenal passage of cell-free plasma DNA. Our discovery of donor-derived cytokeratin-producing epithelial cells raises interesting biological and therapeutic implications, e.g., the capacity of marrow stem cells to serve as an extrarenal source for renal tubule regeneration. | 18,974,360 |
The physiology and pathophysiology of human breath-hold diving. | This is a brief overview of physiological reactions, limitations, and pathophysiological mechanisms associated with human breath-hold diving. Breath-hold duration and ability to withstand compression at depth are the two main challenges that have been overcome to an amazing degree as evidenced by the current world records in breath-hold duration at 10:12 min and depth of 214 m. The quest for even further performance enhancements continues among competitive breath-hold divers, even if absolute physiological limits are being approached as indicated by findings of pulmonary edema and alveolar hemorrhage postdive. However, a remarkable, and so far poorly understood, variation in individual disposition for such problems exists. Mortality connected with breath-hold diving is primarily concentrated to less well-trained recreational divers and competitive spearfishermen who fall victim to hypoxia. Particularly vulnerable are probably also individuals with preexisting cardiac problems and possibly, essentially healthy divers who may have suffered severe alternobaric vertigo as a complication to inadequate pressure equilibration of the middle ears. The specific topics discussed include the diving response and its expression by the cardiovascular system, which exhibits hypertension, bradycardia, oxygen conservation, arrhythmias, and contraction of the spleen. The respiratory system is challenged by compression of the lungs with barotrauma of descent, intrapulmonary hemorrhage, edema, and the effects of glossopharyngeal insufflation and exsufflation. Various mechanisms associated with hypoxia and loss of consciousness are discussed, including hyperventilation, ascent blackout, fasting, and excessive postexercise O(2) consumption. The potential for high nitrogen pressure in the lungs to cause decompression sickness and N(2) narcosis is also illuminated. | 18,974,367 |
Lithium upregulates vascular endothelial growth factor in brain endothelial cells and astrocytes. | We recently reported that delayed lithium therapy can improve stroke recovery in rats by augmenting neurovascular remodeling. We tested the hypothesis that lithium can promote the expression of growth factors in brain endothelial cells and astrocytes. Human brain microvascular endothelial cells and primary rat cortical astrocytes were exposed to lithium chloride in serum-free medium. We examined 2 representative growth factors: brain-derived neurotrophic factor and vascular endothelial growth factor (VEGF). Cell lysates were collected for Western blot analysis. Conditioned media was analyzed with enzyme-linked immunosorbent assay. SB-216763 and LY294002 were used to assess the roles of the glycogen synthase kinase-3beta (GSK-3beta) and PI3-K signaling in the lithium-induced responses. No consistent responses were observed for brain-derived neurotrophic factor. However, lithium (0.2 to 20 mmol/L) increased the phosphorylation of GSK-3beta and promoted VEGF secretion in a concentration-dependent manner in both endothelial and astrocyte cells. For endothelial cells, the potent GSK-3beta inhibitor SB-216763 upregulated VEGF, whereas inhibition of PI3-K with LY294002 suppressed lithium-induced responses in both phospho-GSK-3beta and VEGF. In contrast, neither inhibition of GSK-3beta nor inhibition of PI3-K had any detectable effects on VEGF levels in astrocytes. Lithium promotes VEGF expression through PI3-K/GSK-3beta-dependent and -independent pathways in brain endothelium and astrocytes, respectively. This growth factor signaling mechanism may contribute to lithium's reported ability to promote neurovascular remodeling after stroke. | 18,974,377 |
Implantation of adipose-derived regenerative cells enhances ischemia-induced angiogenesis. | Therapeutic angiogenesis using autologous stem/progenitor cells represents a novel strategy for severe ischemic diseases. Recent reports indicated that adipose tissues could supply adipose-derived regenerative cells (ADRCs). Accordingly, we examined whether implantation of ADRCs would augment ischemia-induced angiogenesis. Adipose tissue was obtained from C57BL/6J mice, and ADRCs were isolated using standard methods. ADRCs expressed stromal cell-derived factor 1 (SDF-1) mRNA and proteins. Hind limb ischemia was induced and culture-expanded ADRCs, PBS, or mature adipocytes (MAs) as control cells were injected into the ischemic muscles. At 3 weeks, the ADRC group had a greater laser Doppler blood perfusion index and a higher capillary density compared to the controls. Implantation of ADRCs increased circulating endothelial progenitor cells (EPCs). SDF-1 mRNA abundance at ischemic tissues and serum SDF-1 levels were greater in the ADRC group than in the control group. Finally, intraperitoneal injection of an anti-SDF-1 neutralizing antibody reduced the number of circulating EPCs and therapeutic efficacies of ADRCs. Adipose tissue would be a valuable source for cell-based therapeutic angiogenesis. Moreover, chemokine SDF-1 may play a pivotal role in the ADRCs-mediated angiogenesis at least in part by facilitating mobilization of EPCs. | 18,974,384 |
Determination of aortic valve opening time and left ventricular peak filling rate from the peripheral pulse amplitude in patients with ectopic beats. | Ectopic beats are common in patients who have heart disease and are associated with reduced peripheral pulse amplitude. This study determined the start of the peripheral pulse increase and from it the opening of the aortic valve. The left ventricular peak filling rate was also estimated from the peripheral pulse. Results were compared with published invasive and cardiac imaging data. Twenty-five subjects with ectopic beat electrocardiograms (ECGs) were studied. The ECGs and the peripheral pulses, detected optically at the right index finger by a simple photoplethysmography (PPG) technique, were recorded for subsequent analysis. Peripheral pulse amplitudes for ectopic beats, post-ectopic sinus beats and normal sinus beats were determined. Ectopic beats induced a mean 68% decrease in pulse amplitude in comparison with sinus beats (p < 0.001). In contrast, the mean pulse amplitude for post-ectopic sinus beats increased by 20% (p < 0.01). Pulse amplitude changes were comparable with the published stroke volume differences for ectopic beats and post-ectopic sinus beats. The range of shortest coupling interval (CI) for ectopic beats with observable pulses was from 373 to 531 ms, with the mean value equivalent to 55% of the mean sinus RR interval, comparable with the opening of the aortic valve. Finally, as the CI increased, the pulse amplitude increased quickly from zero. The average rate of increase was equivalent to 4.8 times the normal sinus amplitude in 1 s, equal to 50% filling in 208 ms, showing diastolic rapid filling, comparable with published left ventricular peak filling rate data. In conclusion, the effect of ectopic beat CI on peripheral pulse amplitude has been determined, providing useful information for developing a technique to determine the opening of the aortic valve and the peak filling rate non-invasively and peripherally in patients with frequent ectopic beats. | 18,974,441 |
[Osteoarthritis of the knee joint as a cause of musculoskeletal ambulation disability symptom complex (MADS)]. | Osteoarthritis is considered as a chronic disease of the whole joint, including articular cartilage, meniscus, ligament, and peri-articular muscle that may result from multiple pathophysiological mechanisms. Osteoarthritis is a painful and disabling disease that affects millions of patients. Its aetiology is largely unknown, but is most likely multi-factorial. No proven disease-modifying therapy exists for osteoarthritis and current treatment options for chronic osteoarthritic pain are insufficient, but new pharmacotherapeutic options are emerging. Surgical treatment, such as high tibial osteotomy and total knee arthroplasty are chosen for the patient who have severe pain and disabled patient. In recent 10 years, operation cases are increasing in number, but these procedure still have many issues to resolve. Osteoarthritis of the knee joint is one of a major cause of Musculoskeletal Ambulation Disability Symptom Complex (MADS) , and it is important to improve conservative and surgical treatment. | 18,974,445 |
[Dynamic flamingo therapy]. | A long follow up study of one minute unipedal standing therapy 3 times in a day to prevent femoral neck osteoporosis that have started from 1993 was reported. The registration from July 1993 to March 2004 were 86 cases which measured the femoral neck bone mineral density (BMD) according to dual energy x-ray absorptiometry (DXA) (Hologic QDR 1000 and 2000) in a follow-up period. Average age at starting exercise was 67.9 years old. All cases were female who were registered in our university hospital. The result of unipedal exercise evaluated by the femoral neck BMD was described as follows : The increased cases of BMD were 15/24 (62.5%) post exercise 3 months, 15/37 (40.5%) post 6 months, and 12/21 (57.1%) post one year, 8/25 (32%) post 3 years, 7/13 (53.8%) post 5 years and 1/3 (33.3%) post 10 years. We have no fracture cases in which continued exercise in follow-up period. According to a randomized controlled study of unipedal standing balance therapy to clinically defined high-risk elderly individuals a therapy group reduced fall times by a significant difference than non-therapy group. We conclude that unipedal standing therapy is efficacious against femoral neck osteoporosis and fractures. | 18,974,448 |
Risk of venous thrombosis in patients with hepatic malignancies undergoing surgical resection. | The risk of venous thrombosis is well documented in patients with malignancies, those undergoing abdominal surgery, and those undergoing hepatic resection for malignancy. This study was undertaken to determine whether there was a difference in the risk of thrombosis between those undergoing resection for hepatic metastases and primary hepatic malignancies. We performed a retrospective chart review of patients undergoing initial surgical resection for hepatic malignancies, primarily to determine whether there was a difference in the incidence of venous thrombosis between those with primary and secondary malignancies. Ninety-nine patients underwent surgical resection for either primary or secondary hepatic malignancies from 2001 to 2006. Seven of these patients, all with secondary hepatic malignancy, developed venous thrombosis within 3 months of resection. This retrospective review reveals that a clinical presentation of venous thrombosis is significantly more common among patients undergoing hepatic resection for secondary malignancy than those undergoing resection for primary cancer of the liver. Special attention with regard to prophylaxis for thrombosis may be required in these patients. | 18,974,467 |
Bio-aerosols in indoor environment: composition, health effects and analysis. | Bio-aerosols are airborne particles that are living (bacteria, viruses and fungi) or originate from living organisms. Their presence in air is the result of dispersal from a site of colonization or growth. The health effects of bio-aerosols including infectious diseases, acute toxic effects, allergies and cancer coupled with the threat of bioterrorism and SARS have led to increased awareness on the importance of bio-aerosols. The evaluation of bio-aerosols includes use of variety of methods for sampling depending on the concentration of microorganisms expected. There have been problems in developing standard sampling methods, in proving a causal relationship and in establishing threshold limit values for exposures due to the complexity of composition of bio-aerosols, variations in human response to their exposure and difficulties in recovering microorganisms. Currently bio-aerosol monitoring in hospitals is carried out for epidemiological investigation of nosocomial infectious diseases, research into airborne microorganism spread and control, monitoring biohazardous procedures and use as a quality control measure. In India there is little awareness regarding the quality of indoor air, mould contamination in indoor environments, potential source for transmission of nosocomial infections in health care facilities. There is an urgent need to undertake study of indoor air, to generate baseline data and explore the link to nosocomial infections. This article is a review on composition, sources, modes of transmission, health effects and sampling methods used for evaluation of bio-aerosols, and also suggests control measures to reduce the loads of bio-aerosols. | 18,974,481 |
High rate of mutation K103N causing resistance to nevirapine in Indian children with acquired immunodeficiency syndrome. | In north India the number of paediatric cases with acquired immunodeficiency syndrome (AIDS) is on the rise. Most drug combinations used for treatment of AIDS incorporate nevirapine, resistance to which develops very fast if given singly or because of unplanned interruptions. This paper investigates presence of mutations at codon 103 and codon 215 of the HIV pol gene causing resistance to nevirapine and zidovudine (AZT) respectively in 25 children with AIDS. Mutations T215Y and K103N were detected by a nested cum amplification refractory mutation system polymerase chain reaction (ARMS PCR) and the results were confirmed by direct sequencing in five randomly selected cases. Nineteen patients had received nevirapine containing regimen and six were drug naive. Mutation K103N was observed in 56% (14/25) of the children while mutation T215Y was found in none. Two of the six drug naïve children also showed K103N mutation. Thus, Indian children drug naïve or treated with nevirapine containing regimens show a high rate of mutation conferring resistance to nevirapine which calls for a judicious use of nevirapine both in antenatal and postnatal setting. | 18,974,494 |
Fatal rhino-orbito-cerebral infection caused by Saksenaea vasiformis in an immunocompetent individual: first case report from India. | A 56-year-old female patient presented with history of nasal blockage, nasal bleeding, headache, since one month. On admission the patient developed severe headache, decreased vision of eyes and blindness. Clinical diagnosis of rhino-orbital involvement was confirmed by computerized tomography of the paranasal sinuses. The diagnosis of fungal infection was confirmed by KOH examination, haematoxylin and eosin examination and Gomori's methanamine silver stain of the biopsy material. Diagnosis was confirmed by culture on Sabouraud Dextrose agar, slide culture on Czapek Dox medium and the isolate was identified as Saksenaea vasiformis. The patient was started on intravenous amphotericin B (received only one dose before succumbing), but she did not respond to the treatment, developed hemiparesis, slurred speech, diminished reflexes and ultimately died. The involvement of the brain was confirmed by computerised tomographic scan. We believe this case to be the first case of rhino-orbito-cerebral infection due to Saksenaea vasiformis and that of second case in an immunocompetent patient in the world. | 18,974,499 |
Clinical and histopathological features of posttraumatic iris cyst. | Iris cyst excision involves complex surgical maneuvers and may have a variable visual outcome depending upon preexisting and postoperative complications. Hereby, we report a case series of 10 eyes from which posttraumatic iris cysts were excised and proven histopathologically. Histopathology records were reviewed. Data regarding patient profile, clinical profile, surgical details, treatment outcomes and follow-up were reviewed. Outcome measures were defined as recurrences, visual acuity and number of other surgeries required. Non-parametric Wilcoxon test was used to compare changes in the visual acuity and Fisher test was used to find out the significance of several risk factors. Mean age was 24.7 years (3-58 years). Mean follow-up was 2.36 years. Mean preoperative logMAR visual acuity was 0.56 in comparison to final logMAR visual acuity of 1.62. Factors related to adverse functional outcome were related to post-surgical complications. | 18,974,530 |
Lesch-Nyhan syndrome: a case report. | Lesch-Nyhan syndrome, a rare inborn error of metabolism, is characterized by mental retardation and self-destructive behavior resulting in self-mutilation through biting and scratching. It is a rare anomaly consisting of deficiency in the production of hypoxanthine phosphoribosyltransferase that leads to the overproduction of purine and accumulation of uric acid. No medical treatment exists to alleviate the symptoms of self-mutilation where direct dental intervention is the only way these behavior can be affected. A unique case of this type affecting a 6-year-old male child is reported. | 18,974,538 |
Interpretation of electroneuromyographic studies in diseases of neuromuscular junction and myopathies. | Electroneuromyography (ENMG) also called electrodiagnosis or at times simply (and erroneously) electromyography (EMG), has been used for the diagnosis of neuromuscular and muscle diseases. It consists of tests done serially and assessed collectively, to arrive at a diagnosis of neuromuscular weakness. The test should be treated as an extension of the clinical examination and not a replacement. When done adequately ENMG is the only test which gives information about the function of the peripheral nervous system and hence co-relates well with the clinical signs. This article reviews the role of ENMG in the evaluation of neuromuscular and muscle disease. We hope this will meet the requirements of both practicing neurologists and dedicated electromyographers. | 18,974,561 |
Deletion analysis of spinal muscular atrophy in southern Indian population. | Proximal spinal muscular atrophy (SMA) is a genetically heterogeneous disease with paresis and muscle atrophy due to loss of anterior horn cell function. The survival of motor neuron gene (SMN) and neuronal apoptosis inhibitory protein (NAIP) play a primary role. Both the gene homologues exist as inverted duplications on Chromosome 5q. The telomeric/functional (SMN1) and the centromeric (SMN2) copies differ from each other in eight nucleotides. The C-->T transition (at Codon 280) within Exon 7 of SMN2 causes disruption of an exonic splicing enhancer (ESE) and/or creates an exonic splicing silencer (ESS) leading to abnormal splicing and a truncated protein. To determine the molecular genetics of SMN1 and NAIP genes in SMA from southern India. In the present study, 37 patients from the neuromuscular disorders clinic of National Institute of Mental Health and Neurosciences were assayed for the deletions in the SMN1 and NAIP genes using PCR-RFLP methods. Among the SMA Type I patients, 43% showed deletions of SMN1 and NAIP. In patients Type II SMA, 57% showed deletions of the SMN1 exons. Thus, deletions were found to occur in 47.8% of the Type I and II patients. Lower sensitivity of gene deletion study in clinically suspected SMA needs further study as clinical diagnosis of SMA is not gold standard. However, the results do correlate with other studies conducted in India. | 18,974,562 |
Lipid storage myopathies with unusual clinical manifestations. | We describe the clinical presentation, course and pathologic findings found in three adult patients with lipid storage myopathy. Excessive lipid storage was found in Type 1 fibers of muscle. Clinical improvement on oral levo-carnitine therapy suggests the possibility of carnitine deficiency as the most likely etiology in two of the patients and one had mitochondrial myopathy confirmed on genetic analysis. | 18,974,571 |
Twenty-two year follow-up of an Indian family with dysferlinopathy-clinical, immunocytochemical, western blotting and genetic features. | Long-term observations over a period of 22 years in an Indian family with primary dysferlinopathy are recorded, defining phenotypic variability. In the propositus, the dystrophy began distally in the tibialis anterior muscles, before involving the gastrocnemius. Transient painful calf hypertrophy, followed by calf wasting was observed. The proximal lower and upper limbs weakened after three to four years. The younger sibling presented with the proximo-distal phenotype. Both patients showed very high creatine kinase values early into the illness. Disease progression was slow. The younger sibling lost ambulation 14 years after onset, while the elder one remains ambulatory 22 years into the illness. Muscle biopsy showed dystrophic features and absence of dysferlin. Monocyte western blotting confirmed absence of dysferlin. Genetic analysis detected a heterozygous mutation in Exon 54 [c.6124C>T] in the DYSF gene. This is the first family with a diagnosis of dysferlinopathy supported by genetic data, reported from India. | 18,974,570 |
Wasp sting: an unusual fatal outcome. | Wasp stings are not uncommon especially in populations living in proximity of forested areas all over the world. Local manifestations following stings are common and un-usually life threatening anaphylaxis may occur, requiring prompt treatment. Multi organ failure and acute renal failure following wasp stings are rare and histological evaluation suggest acute tubular necrosis secondary to hemolysis, rhabdomyolysis and direct venom toxicity. A rare com-plication of a patient following multiple wasp stings with disseminated intravascular coagulation, acute renal failure and thrombotic microangiopathy is presented. | 18,974,586 |
Hypertension care at primary health care centers: a report from Abha, Saudi Arabia. | It is well known that effective management of hypertension reduces the incidence of myo-cardial infarction, stroke and vascular complications. The Ministry of Health, Kingdom of Saudi Arabia, introduced the Quality Assurance Guidelines with the hope to improve the management of hypertension in its centers. We conducted an audit of two Primary Health Care Centers namely, Al-Manhal (MPHCC) and Al-Numais (NPHCC), to evaluate how well hypertension was managened at these centers. A check list was derived from the Quality Assurance Manual to audit the process and to assess the health outcome. A retrospective study on a chosen sample of 120 files of hypertensive patients, out of 256 from both the Primary Health Care Centers was performed, during the last three months of the year 2000. Results showed that 61% of the patients were between 45-64 years of age, 56% were females, 85% were married, 54% were illiterate and 7.5% were smokers. A total of 92% of the patients had primary hypertension and 25% had a positive family history of hypertension. Beta-blockers were the most commonly used drugs in both the centers. Although the recording of the information was not perfect, there was no statistical difference in the socio-demongraphic data and also the means of the total score in both the centres. On the other hand, carrying out the important procedures for hypertensive patients was found to be better at MPHCC in comparison to NPHCC (p < 0.05). The commonly missed procedures were chest x-rays, electrolytes and ECG. Hypertension was well controlled in 63% of the patients, 58% were found to have obesity, 9% suffered from hypertension-related complications while almost 50% had good compliance to appointment in both the centers. Our study reveals that the process of hypertension care at the two Primary Health Care Centres in Aseer region was not in accordance with the recommended national standards. The reasons include lack of updating systems, recall system and provision of laboratory services and all these factors need to be addressed to improve care. | 18,974,594 |
Clinical and immunological manifestations of systemic lupus erythematosus: study on 146 south Tunisian patients. | The objective of this study was to determine the main clinical and laboratory features as well as the morbidity and mortality of systemic lupus erythematosus (SLE) in a population of patients predominantly from the south of Tunisia. A retrospective review of a well documented population of 146 patients with SLE was undertaken. All patients fulfilled four or more criteria defined by the American College of Rheumatology. The mean age at presentation was 29.2 years (range 6-55) and the mean duration of follow-up was 62 months (range 0.25-374). Musculoskeletal (84.2%) and mucocutaneous (75.3%) were the most frequent clinical manifestations. Antinuclear antibodies were detected in 97.3%, anti-DNA antibodies in 69.2% and anti-Sm in 39.2% of the patients. Anti-cardiolipin antibodies and lupus anticoagulant were ob-served respectively in 71.6% and 37.8% of the patients. The five-year survival rate in our series was 92%. Renal involvement and thrombocytopenia were associated with poor prognosis (p< 0.05). The clinical and immunological characteristics of our SLE patients are largely comparable to most major studies. Main differences included prominent major organ damage and high pre-valence of anti-Sm and anti-cardiolipin antibodies. | 18,974,596 |
Chelatable Fe (II) is generated in the rat kidneys exposed to ischemia and reperfusion, and a divalent metal chelator, 2, 2'-dipyridyl, attenuates the acute ischemia/reperfusion-injury of the kidneys: a histochemical study by the perfusion-Perls and -Turnbull methods. | The perfusion-Perls and -Turnbull methods supplemented by diaminobenzidine intensification demonstrated the generation and localization of chelatable Fe (II) which can catalyze the generation of cytotoxic hydroxyl radicals (OH.) during the Fenton reaction in rat kidneys exposed to 40 min ischemia or 40 min-ischemia followed by 60 min-reperfusion. The kidneys exposed to 40 min-ischemia showed Fe (II)-deposits largely localized in the deeper half of the cortex, where the deposits densely filled the tubular cell nuclei, with a small amount of them in the cytoplasm of the proximal convoluted tubules (PCT). Intraluminally protruded or exfoliated tubular cell nuclei were also filled with the deposits. The kidneys subjected to 40 min-ischemia/ 60 min-reperfusion showed a more extensive distribution of Fe (II)-deposits, including most depths of the cortex. Furthermore, there were numerous exfoliated, Fe (II)-positive nuclei surrounded by a small amount of cytoplasm in the lumen of the PCT. These cells appeared to undergo apoptotic cell death since the lumen of strongly dilated, down-stream, proximal straight tubules were obstructed with numerous apoptotic cells in the kidneys exposed to 40 min-ischemia and 24 h-reperfusion. Pretreatment with a divalent metal chelator, 2, 2'-dipyridyl, effectively inhibited Fe (II)-staining, decreased the number of exfoliated cells in the kidneys with 40 min-ischemia/ 60 m-reperfusion, and decreased the number of apoptotic cells in the kidneys with 40 min-ischemia/24 h-reperfusion. The generation of highly reactive OH. during the Fe2+-catalyzed Fenton reaction was suggested to play a crucial role in ischemia/reperfusion-induced kidney injury. | 18,974,602 |
Assessment of ileal epithelial P-glycoprotein dysfunction induced by ischemia/reperfusion using in vivo animal model. | We presented the ischemia/reperfusion (I/R) model which can evaluate changes in P-glycoprotein (P-gp) function induced by lipid peroxidation using surgical-sutures connected with the spring balance. The superior mesenteric artery and vein was occluded by hanging itself using surgical-sutures connected with the spring balance for 60 min (ischemia), followed by reperfusion by cutting of sutures. To determine the hanging force of blood vessel during ischemia, treatment at the hanging force of 50g load, 100g load and 150g load for 60 min was carried out and survival rate was evaluated. Although our 150g load group had some effect on survival, the survival was 100% in the case of 50g and 100g load groups. Thiobarbituric acid-reactive substance (TBA-RS) as an indicator of lipid peroxidation and P-gp expression level after I/R was increased and decreased in a load-dependent manner during ischemia, respectively. Also, the decrease in the level of mdr1a mRNA and function of P-gp by I/R depended on load during ischemia. The changes in TBA-RS, P-gp expression level and P-gp function observed in this study corresponded with our in vitro I/R model reported previously. In conclusion, it was shown that this in vivo I/R model can evaluate the function of P-gp through lipid peroxidation. | 18,974,613 |
[MucoRice: development of rice-based oral vaccine]. | Parenteral vaccines are used commonly against most of infectious diseases. It is noted that these injection type vaccines are meant to induce protective immunity in the systemic compartment but not aimed at use of the benefits of mucosal immunity as a first line of defense against mucosal infectious diseases such as AIDS, SARS and Influenza. In addition, one of major practical obstacles to current vaccination is storage of the vaccine under refrigeration (or cold-chain) in the developing countries. To overcome these concerns, a plant-based vaccine is considered to be an attractive strategy. Currently, we have developed a rice-based oral vaccine that offers significant advantages over available vaccines. In the rice-based vaccine MucoRice, cholera toxin B subunit (CTB) as the vaccine antigen was accumulated in protein bodies as rice seed storage organella. When orally fed, rice seeds expressing CTB were taken up by the M cells covering the Peyer's patches (PPs), and inducing toxin-specific serum IgG and mucosal IgA antibodies with neutralizing activity. Further, MuocRice CTB remained stable state and maintained immunogenicity at room temperature for 1.5 years and was protected from pepsin digestion in vitro. Taken together, these findings suggest that MucoRice does not require needle/syringe and cold-chain but induces two layers of immunity in both mucosal and systemic compartments, which is the most effective and highly practical global vaccine to combat emerging and re-emerging infectious diseases. | 18,974,620 |
[Immunotherapy using IL-6 receptor as the target]. | Monoclonal antibody-based therapy targeting interleukine-6 (IL-6) has been established as a treatment for autoimmune diseases, chronic inflammatory diseases, and lymphoproliferative disease. IL-6 is a multifunctional cytokine which plays pathological roles in Castleman's disease, rheumatoid arthritis, juvenile idiopathic arthritis, and Crohn's disease. Many groups have been exploring the therapeutic approach to block the IL-6 signal, and tocilizumab, a humanized monoclonal antibody against human IL-6 receptor, has been the most intensively studied agent for clinical use. A series of clinical trials of tocilizumab have demonstrated the robustness of safety and efficacy of tocilizumab in the treatment of patients with above diseases. In this review, targeting IL-6 actions as an immunotherapy is discussed. | 18,974,624 |
Somatostatin receptor subtypes 2 and 5 are associated with better survival in well-differentiated endocrine carcinomas. | The majority of gastroenteropancreatic well-differentiated endocrine carcinomas (WDEC) express somatostatin receptors (SSTR). To correlate the expression of SSTR subtypes by reverse transcriptase-polymerase chain reaction (RT-PCR) with clinicopathological features and survival in a group of WDEC patients, 42 WDEC tissue specimens from 33 patients were analysed. All patients were treated with somatostatin analogues and had a median follow-up period of 45 months (range 6-196). Neither SSTR2 and SSTR5 expression nor Ki-67 level alone correlated with survival. A significantly better survival rate was observed in patients with tumours expressing SSTR2, SSTR5 and Ki-67 <2%, compared to those with SSTR2- and SSTR5-negative tumours and Ki-67 >or=2% (p < 0.038), with 5-year survival rates of 91 vs. 43%, respectively. Expression of SSTR2 and SSTR5 appears to play a positive prognostic role, possibly correlated with the high affinity that the available somatostatin analogues display for these 2 specific SSTR subtypes. | 18,974,627 |
Vibration response imaging in the detection of pleural effusions: a feasibility study. | Computerized analysis of the regional distribution of breath sound intensity during respiration has generated interest as a possible diagnostic modality. We hypothesized that pleural effusions would create a dependent region of absent breath sounds and thus vibration response imaging (VRI) could be used in the detection of such pleural effusions. A prospective, single-blinded and open-labeled trial was carried out, and VRI recordings were compared to upright chest X-rays, bedside ultrasound examinations and volume of fluid drained via thoracentesis. VRI images were interpreted by a physician who was blinded to the patients' clinical history, physical examination and diagnostic tests. Quantitative assessment of pleural effusion size in the VRI images was performed by ImageJ software and an automatic pixel count analysis. VRI recordings were performed on 57 consecutive patients and correctly predicted the diagnosis in 45 cases (45/56, 80%) as compared to chest X-rays. The calculated sensitivity, specificity, positive predictive value and negative predictive value for diagnosis of pleural effusion were 86% (62/72), 93% (37/40), 95% (62/65) and 79% (37/47), respectively, in a per-hemithorax analysis. In the quantification of effusion size, there were high correlations between VRI images and chest X-ray area as assessed by ImageJ (r = 0.67) and pixel count (r = -0.77). The level of agreement between VRI readings and ultrasonography was 75% (41/55), and correlation with the volume of fluid drained in therapeutic thoracentesis was moderate (r = -0.49). No side effects from the VRI recordings were documented. VRI can be used to detect and quantify pleural effusions. | 18,974,633 |
How to best define patients with moderate chronic kidney disease. | The objective of this study was to identify which formula may best identify moderate chronic kidney disease (CKD) (glomerular filtration rate (GFR) cut-off of 60 ml/min/1.73 m(2)). We compared the performances of 14 serum creatinine (S(cr)) and 11 cystatin C (Cys C) estimated GFR equations using inulin clearance (Cl(in)) as the reference test in a stable CKD population of 101 patients. Scatter, coefficient of variation, bias, precision, accuracy within 30% ranges from the reference method, agreements and receiving operating characteristics (ROC) of each test were compared. ROC analysis identified Davis, Salzar, Virga and Cockcroft-Gault as the most sensitive (>or=85%) and the isotope dilution mass spectrometry (IDMS), Edwards, MacIsaac as the most specific (95%) to define the GFR cut-off level of 60 ml/min/1.73 m(2). Area under the ROC curve (AUC) was generally >0.8 (p <or= 0.0001). 2 x 2 contingency tables to define CKD demonstrated sensitivity of 90% for Davis, while the IDMS was the most specific (95%). Among the Cys-C-based equations, Filler was the most sensitive (83%) and MacIsaac was the most specific (95%). The current equations lack consistent good performance to define CKD. The MDRD-IDMS equation missed 30% but demonstrated a high specificity to confirm those with moderate CKD. A combination of two equations, one sensitive and another specific, may be required for epidemiological studies. | 18,974,650 |
The impact of prior multidisciplinary predialysis care on mineral metabolic control among chronic hemodialysis patients. | Disordered mineral metabolism is independently associated with mortality among chronic dialysis patients. We hypothesized that, upon dialysis start, biochemical markers of mineral metabolism would be better controlled among patients who had received multidisciplinary predialysis care (MDC). We conducted a retrospective cohort study of incident hemodialysis patients between 2002 and 2005. Corrected calcium (Ca), phosphate (P), calcium-phosphate product (CaxP), and intact parathyroid hormone (iPTH) at the time of dialysis initiation and over the first year thereafter were compared based on prior MDC receipt. Furthermore, we examined the relationship between the duration of MDC and mineral metabolic parameters. 67 patients received MDC and 84 patients received conventional or no nephrologist-based care. Patients who received MDC had a higher iPTH (p = 0.03) both at dialysis initiation and over the subsequent year while Ca, P, and CaxP were not significantly impacted. Among patients who received MDC, mineral metabolic values at dialysis initiation did not differ by duration of predialysis care. The receipt of MDC had a limited effect on mineral metabolic profiles at the time of and over the first year following chronic hemodialysis initiation. The survival benefits associated with the receipt of MDC may be mediated by mechanisms other than improved mineral metabolic control. | 18,974,654 |
Building public support for anti-obesity policy initiatives. | Solving the obesity crisis has less to do with post-partisanship and more to do with increasing public support for strong public policy initiatives that will make the healthy choice the easy choice. The government has an important role in mitigating the toxic food environment created by food manufacturers and restaurant chains. Progress to date has occurred on the state level. With greater public support in a new political environment, national progress may be possible in the foreseeable future. | 18,974,667 |
Psychiatric distress among Asian and European American survivors of the 1994 Northridge earthquake. | Relatively few studies focus on the psychological effects of trauma exposure on Asian Americans. This article presents secondary analyses of a random survey of 118 Asian American and 762 European American survivors of the 1994 Northridge, California earthquake. Asian American participants reported more psychiatric distress and were more than twice as likely to meet caseness criteria on the Brief Symptom Inventory. Ethnic differences remained after accounting for group differences in age, immigrant status, and exposure to the earthquake. Moreover, moderator analyses showed that Asian Americans were not more sensitive to these risk factors but that ethnic differences were explained by the interaction of ethnicity and having a foreign born parent. Though more work needs to be done to understand the basis of these differences, these findings challenge model minority myths about Asian American people and draw attention to their potential need for greater mental health resources following a natural disaster. | 18,974,671 |
Mixed-sex wards and patient dignity: nurses and patients perspectives. | With the exception of specialized units, adults have historically been cared for in single-sex hospital wards in the UK. However, over the past two decades, concerns about mixed-sex wards have been reported. Respect and dignity are essential to provide high-quality health care. The issue of whether patients' privacy and dignity are compromised by mixed-sex wards is addressed in this article. Qualitative data were obtained from both nurses and patients on a mixed-sex surgical ward specializing in urology, to obtain individual perspectives relating to factors affecting dignity on the ward. Nurses tried hard to keep bays single-sex but, due to bed shortages, they were under continual pressure to mix the bays. Some patients of both sexes and varied ages perceived that a mixed-sex care environment threatened their dignity. They experienced a lack of privacy, worried about bodily exposure and felt uncomfortable. Nurses used various strategies to reduce patients' discomfort. Mixed sex accommodation is an unacceptable solution to bed shortages. | 18,974,690 |
The problems of alcohol and cigarette abuse: BJN 100 years ago. | The causation of inebriety or drunkenness was thought to be caused by two factors, according to Dr Harry Campbell (a former president of the Society for the Study of Inebriety): low resistance power to the allurement of alcohol and abundant access to alcoholic liquors. | 18,974,692 |
Molecular profiling of heparinase-I resistant glycosaminoglycans in contaminated heparins. Comparative studies with uncontaminated heparin and porcine oversulfated chondroitin sulfate. | Heparin is a widely used anticoagulant which is usually obtained from porcine mucosal tissue. The structure of heparin is comparable to other naturally occurring glycosaminoglycans such as chondroitin sulfate and dermatan sulfate. The commercially available heparin preparations may contain small amounts of dermatan sulfate as a carry-over impurity. More recently (November 2007 to April 2008), an increased incidence of adverse events and deaths associated with the use of heparin alerted regulatory agencies to investigate the composition of heparin. As a result, oversulfated chondroitin sulfate was found to be the main determinant of the observed adverse reactions. This glycosaminoglycan is not usually found in the mammalian tissues. This investigation reports on the comparison of contaminant free and contaminated heparins and their digestion by heparinase-I. It also describes the molecular profile of the contaminant isolated from the recalled heparin preparations in comparison to oversulfated chondroitin sulfate. The anticoagulant and anti-Xa activities are also reported. The contaminant is found to be comparable to the synthesized OSCS as both were resistant to heparinase-I digestion. The contaminant and OSCS exhibited weaker anticoagulant activities than heparin and did not have any anti-Xa effects. This data strongly suggests that such glycosaminoglycans as chondroitin sulfate can be structurally modified to exhibit anticoagulant activities and their molecular weight can be adjusted to mimic heparin. | 18,974,698 |
Specific inspiratory muscle training does not improve performance or VO2max levels in well trained rowers. | The purpose of this study was to examine the effects of specific inspiratory muscle training (IMT) on inspiratory muscle strength, maximal oxygen uptake (VO2max), maximal lactate accumulation (Lmax), dyspnea sensation and rowing performance in rowers. Ninteen well-trained rowers were divided into two groups: IMT (T) and control (C). The T group, in addition to their daily rowing practice, performed IMT by means of a threshold inspiratory muscle trainer for approximately 0.5h.d(-1), 5 times a week for 6 weeks. The C group participated only in their regular daily rowing training. Prior to the initiation and at the completion of the 6-week IMT program, both groups underwent an incremental treadmill run test to determine VO2max. Maximum inspiratory mouth pressure (PImax) was measured at rest and following the VO2max test. On a separate occasion, rowing performance was evaluated by a 2000 m all-out effort on a rowing ergometer. Dyspnea sensation was assessed by a modified Borg scale and Lmax was measured by an enzymatic method. Six weeks of IMT significantly (P < 0.05) increased resting PImax. Moreover, inspiratory muscle training increased PImax following the VO2max test in the T group. In contrast, no changes in PImax were observed in the C group during the 6-week period. No significant differences were observed between pre- and post-test values in VO2max, dyspnea sensation, Lmax, and 2000 m race time in both groups. In conclusion, six weeks of IMT increases inspiratory muscle strength by approximately 28% in highly trained rowers. However, this increase in inspiratory muscle strength does not appear to improve VO2max, dyspnea sensation during exercise, or rowing performance in well-trained rowers. | 18,974,712 |
Tracking of adult adiposity in early, average and late maturing children: a thirty year longitudinal growth study. | To investigate if predictability of adult adiposity is related to maturation status in youth. Data of the longitudinal ''LEGS''-study (N = 550) from 6 to 18 years were used. At 35 years, 59 men and 60 women participated again. Early (EM), average (AM) and late (LM) maturity groups were established, using tertiles of age at peak height velocity (JPA-method). Pearson correlations between the childhood and the adult measurements were calculated. Female sum of 4 skinfolds (Sigma4SF) correlations increase from very low/moderate (6-9 years) to high at 11 years (EM), 15 years (AM) and 17 years (LM). The highest predictability was 65.6% for the Sigma4SF at 14 years in EM. At this age, predictability is 30.3% in AM and 0.8% in LM (P < 0.05). In EM, BMI correlations are moderate/high until 14 yrs (r2 = 0.64 at 13 years), but low until 15 years in LM. Male Sigma4SF correlations are very low/moderate in the three maturity groups. Significant correlation was found in the LM at 16 yrs. Moderate Body Mass index (BMI) correlations are reached at 9 years (LM) and 11 years (EM). At 16 years predictability = 4.9% for BMI in LM males. Predictability of adiposity at 35 years is generally better in girls than in boys. A dose-response effect of maturity on adult adiposity is found in girls but not in boys. Interventions to prevent adult obesity might be more effective in females than in males, particularly in EM females. | 18,974,718 |
The effect of regular long term training on antioxidant enzymatic activities. | It has been reported that exercise induces oxidative stress and causes adaptations in antioxidant defenses. The purpose of the present study was to investigate the effects of regular long term training on antioxidant enzymatic activities consisting of superoxide dismutase (SOD), glutathion peroxidase (GPX) and glutathione S-transferase (GST) in a group of basketball players engaged in a physical training program. SOD, GPX and GST activities were measured as an indicator of antioxidant defenses in long term trained basketball players and compared with non-sporting age matched controls. Independent samples t test was used to compare the data between the two groups. SOD, GPX and GST levels were significantly higher in basketball players than sedentary controls (P < 0.05, P < 0.05 and P < 0.01, respectively). Data suggest that regular long term training can induce antioxidant response to the oxidative stress. These results support the possibility that the beneficial effect of physical exercise on oxidative stress might be associated with increased antioxidant defenses. | 18,974,727 |
Calcimimetics, parathyroid hormone, and vascular calcification in chronic kidney disease. | Vascular calcification (VC) occurs frequently in chronic kidney disease, contributing to cardiovascular mortality. Numerous risk factors have been identified, including renal osteodystrophy and bone turnover, with low turnover as a main determinant. Other reports support high turnover as a factor in VC. Calcimimetics, which lower serum parathyroid hormone, and parathyroidectomy each prevented VC induced by five-sixths nephrectomy in rats. These results favor increased bone turnover due to hyperparathyroidism, instead of low turnover, as a factor in VC in uremia. | 18,974,757 |
Interactions between HIV-1 reverse transcriptase and the downstream template strand in stable complexes with primer-template. | Human immunodeficiency virus type 1 reverse transcriptase (HIV-1 RT) forms stable ternary complexes in which RT is bound tightly at fixed positions on the primer-template (P/T). We have probed downstream interactions between RT and the template strand in the complex containing the incoming dNTP (+1 dNTP*RT*P/T complex) and in the complex containing the pyrophosphate analog, foscarnet (foscarnet*RT*P/T complex). UV-induced cross-linking between RT and the DNA template strand was most efficient when a bromodeoxyuridine residue was placed in the +2 position (the first template position downstream from the incoming dNTP). Furthermore, formation of the +1 dNTP*RT*P/T complex on a biotin-containing template inhibited binding of streptavidin when biotin was in the +2 position on the template but not when the biotin was in the +3 position. Streptavidin pre-bound to a biotin residue in the template caused RT to stall two to three nucleotides upstream from the biotin residue. The downstream border of the complex formed by the stalled RT was mapped by digestion with exonuclease RecJ(F). UV-induced cross-linking of the complex formed by the pyrophosphate analog, foscarnet, with RT and P/T occurred preferentially with bromodeoxyuridine in the +1 position on the template in keeping with the location of RT one base upstream in the foscarnet*RT*P/T complex (i.e., in the pre-translocation position). For +1 dNTP*RT*P/T and foscarnet*RT*P/T stable complexes, tight interactions were observed between RT and the first unpaired template nucleotide following the bound dNTP or the primer terminus, respectively. | 18,974,785 |
A new method for forensic DNA analysis of the blood meal in chagas disease vectors demonstrated using Triatoma infestans from Chuquisaca, Bolivia. | Feeding patterns of the vector are important in the epidemiology of Chagas disease, the leading cause of heart disease in Latin America. Chagas disease is caused by the parasite, Trypanasoma cruzi, which is transmitted by blood feeding insects. Historically, feeding behaviours of haematophagous insects have been investigated using serological reactions, which have detection limits in terms of both taxonomic resolution, and quantity and quality of the blood meal. They are labor intensive, require technical expertise, need fresh or frozen samples and antibodies often are either not available commercially or the resources for synthesis and purification are not available. We describe an assay to identify vertebrate blood meal sources, and the parasite T. cruzi using species-specific PCR assays from insect vectors and use the method to provide information regarding three questions: (1) Do domestic and peri-domestic (chicken coop and animal corral) habitats vary in the blood meals detected in the vectors? (2) What is the pattern of multiple blood meals? (3) Does the rate of T. cruzi infection vary among habitats and is it associated with specific blood meal types? Assays based on the polymerase chain reaction were evaluated for identification of the blood meal source in the heamatophagous Chagas disease vector Triatoma infestans. We evaluate a technique to identify 11 potential vertebrate food sources from the complex mixture extracted from the vector's abdomen. We tested the assay on 81 T. infestans specimens collected from the Andean highlands in the department of Chuquisaca, located in central Bolivia, one of the regions in South America where sylvatic T. infestans have been reported. This area is suggested to be the geographic origin of T. infestans and has very high human infection rates that may be related to sylvatic vector populations. The results of the assays revealed that a high percentage of insects collected in human dwellings had fed on peri-domestic animals. In contrast, one insect from a chicken coop but no bugs from corrals tested positive for human blood. Forty-eight percent of insects tested positive for more than one vertebrate species. T. cruzi infection was detected in 42% of the specimens. From the epidemiological point of view, the results reveal an overall pattern of movement from peri-domestic structures to human habitations for T. infestans in this region of Bolivia as well as the important role of pigs, dogs, chickens and guinea pigs in the dynamics of T. cruzi infection. | 18,974,787 |
A formal ontology of subcellular neuroanatomy. | The complexity of the nervous system requires high-resolution microscopy to resolve the detailed 3D structure of nerve cells and supracellular domains. The analysis of such imaging data to extract cellular surfaces and cell components often requires the combination of expert human knowledge with carefully engineered software tools. In an effort to make better tools to assist humans in this endeavor, create a more accessible and permanent record of their data, and to aid the process of constructing complex and detailed computational models, we have created a core of formalized knowledge about the structure of the nervous system and have integrated that core into several software applications. In this paper, we describe the structure and content of a formal ontology whose scope is the subcellular anatomy of the nervous system (SAO), covering nerve cells, their parts, and interactions between these parts. Many applications of this ontology to image annotation, content-based retrieval of structural data, and integration of shared data across scales and researchers are also described. | 18,974,798 |
Library roles in disaster response: an oral history project by the National Library of Medicine. | To develop a knowledgebase of stories illustrating the variety of roles that librarians can assume in emergency and disaster planning, preparedness, response, and recovery, the National Library of Medicine conducted an oral history project during the summer of 2007. The history aimed to describe clearly and compellingly the activities--both expected and unusual--that librarians performed during and in the aftermath of the disasters. While various types of libraries were included in interviews, the overall focus of the project was on elucidating roles for medical libraries. Using four broad questions as the basis for telephone and email interviews, the investigators recorded the stories of twenty-three North American librarians who responded to bombings and other acts of terrorism, earthquakes, epidemics, fires, floods, hurricanes, and tornados. Through the process of conducting the oral history, an understanding of multiple roles for libraries in disaster response emerged. The roles fit into eight categories: institutional supporters, collection managers, information disseminators, internal planners, community supporters, government partners, educators and trainers, and information community builders. Librarians--particularly health sciences librarians--made significant contributions to preparedness and recovery activities surrounding recent disasters. Lessons learned from the oral history project increased understanding of and underscored the value of collaborative relationships between libraries and local, state, and federal disaster management agencies and organizations. | 18,974,811 |
Cell groups reveal structure of stimulus space. | An important task of the brain is to represent the outside world. It is unclear how the brain may do this, however, as it can only rely on neural responses and has no independent access to external stimuli in order to "decode" what those responses mean. We investigate what can be learned about a space of stimuli using only the action potentials (spikes) of cells with stereotyped -- but unknown -- receptive fields. Using hippocampal place cells as a model system, we show that one can (1) extract global features of the environment and (2) construct an accurate representation of space, up to an overall scale factor, that can be used to track the animal's position. Unlike previous approaches to reconstructing position from place cell activity, this information is derived without knowing place fields or any other functions relating neural responses to position. We find that simply knowing which groups of cells fire together reveals a surprising amount of structure in the underlying stimulus space; this may enable the brain to construct its own internal representations. | 18,974,826 |
Mosaic convergence of rodent dentitions. | Understanding mechanisms responsible for changes in tooth morphology in the course of evolution is an area of investigation common to both paleontology and developmental biology. Detailed analyses of molar tooth crown shape have shown frequent homoplasia in mammalian evolution, which requires accurate investigation of the evolutionary pathways provided by the fossil record. The necessity of preservation of an effective occlusion has been hypothesized to functionally constrain crown morphological changes and to also facilitate convergent evolution. The Muroidea superfamily constitutes a relevant model for the study of molar crown diversification because it encompasses one third of the extant mammalian biodiversity. Combined microwear and 3D-topographic analyses performed on fossil and extant muroid molars allow for a first quantification of the relationships between changes in crown morphology and functionality of occlusion. Based on an abundant fossil record and on a well resolved phylogeny, our results show that the most derived functional condition associates longitudinal chewing and non interlocking of cusps. This condition has been reached at least 7 times within muroids via two main types of evolutionary pathways each respecting functional continuity. In the first type, the flattening of tooth crown which induces the removal of cusp interlocking occurs before the rotation of the chewing movement. In the second type however, flattening is subsequent to rotation of the chewing movement which can be associated with certain changes in cusp morphology. The reverse orders of the changes involved in these different pathways reveal a mosaic evolution of mammalian dentition in which direction of chewing and crown shape seem to be partly decoupled. Either can change in respect to strong functional constraints affecting occlusion which thereby limit the number of the possible pathways. Because convergent pathways imply distinct ontogenetic trajectories, new Evo/Devo comparative studies on cusp morphogenesis are necessary. | 18,974,837 |
Identification of novel single nucleotide polymorphisms in inflammatory genes as risk factors associated with trachomatous trichiasis. | Trachoma is the leading preventable cause of global blindness. A balanced Th1/Th2/Th3 immune response is critical for resolving Chlamydia trachomatis infection, the primary cause of trachoma. Despite control programs that include mass antibiotic treatment, reinfection and recurrence of trachoma are common after treatment cessation. Furthermore, a subset of infected individuals develop inflammation and are at greater risk for developing the severe sequela of trachoma known as trachomatous trichiasis (TT). While there are a number of environmental and behavioral risk factors for trachoma, genetic factors that influence inflammation and TT risk remain ill defined. We identified single nucleotide polymorphisms (SNP) in 36 candidate inflammatory genes and interactions among these SNPs that likely play a role in the overall risk for TT. We conducted a case control study of 538 individuals of Tharu ethnicity residing in an endemic region of Nepal. Trachoma was graded according to World Health Organization guidelines. A linear array was used to genotype 51 biallelic SNPs in the 36 genes. Analyses were performed using logic regression modeling, which controls for multiple comparisons. We present, to our knowledge, the first significant association of TNFA (-308GA), LTA (252A), VCAM1 (-1594TC), and IL9 (T113M) polymorphisms, synergistic SNPs and risk of TT. TT risk decreased 5 times [odds ratio = 0.2 (95% confidence interval 0.11.-0.33), p = 0.001] with the combination of TNFA (-308A), LTA (252A), VCAM1 (-1594C), SCYA 11 (23T) minor allele, and the combination of TNFA (-308A), IL9 (113M), IL1B (5'UTR-T), and VCAM1 (-1594C). However, TT risk increased 13.5 times [odds ratio = 13.5 (95% confidence interval 3.3-22), p = 0.001] with the combination of TNFA (-308G), VDR (intron G), IL4R (50V), and ICAM1 (56M) minor allele. Evaluating genetic risk factors for trachoma will advance our understanding of disease pathogenesis, and should be considered in the context of designing global control programs. | 18,974,840 |
All-optical anatomical co-registration for molecular imaging of small animals using dynamic contrast. | Optical molecular imaging in small animals harnesses the power of highly specific and biocompatible contrast agents for drug development and disease research1-7. However, the widespread adoption of in vivo optical imaging has been inhibited by its inability to clearly resolve and identify targeted internal organs. Optical tomography8-11 and combined X-ray and micro-computed tomography (micro-CT)12 approaches developed to address this problem are generally expensive, complex or incapable of true anatomical co-registration. Here, we present a remarkably simple all-optical method that can generate co-registered anatomical maps of a mouse's internal organs, while also acquiring in vivo molecular imaging data. The technique uses a time series of images acquired after injection of an inert dye. Differences in the dye's in vivo biodistribution dynamics allow precise delineation and identification of major organs. Such co-registered anatomical maps permit longitudinal organ identification irrespective of repositioning or weight gain, thereby promising greatly improved accuracy and versatility for studies of orthotopic disease, diagnostics and therapies. | 18,974,848 |
The treatment of condylar fractures: to open or not to open? A critical review of this controversy. | The treatment of condylar process fractures has generated a great deal of discussion and controversy in oral and maxillofacial trauma and there are many different methods to treat this injury. For each type of condylar fracture, the techniques must be chosen taking into consideration the presence of teeth, fracture height, patient's adaptation, patient's masticatory system, disturbance of occlusal function, deviation of the mandible, internal derangements of the temporomandibular Joint (TMJ) and ankylosis of the joint with resultant inability to move the jaw, all of which are sequelae of this injury. Many surgeons seem to favor closed treatment with maxillomandibular fixation (MMF), but in recent years, open treatment of condylar fractures with rigid internal fixation (RIF) has become more common. The objective of this review was to evaluate the main variables that determine the choice of method for treatment of condylar fractures: open or closed, pointing out their indications, contra-indications, advantages and disadvantages. | 18,974,859 |
10th Anniversary Focus: an overview of trends related to tropical rainforest depletion and climate change. | Public awareness about the problems related to rainforest depletion increased considerably in the 1990s, but the level of emphasis to the problems faced by the world's tropical rainforests has become conspicuously low in recent years. Yet, there is a heightened sense of urgency in respect of the need to handle the challenges posed by climate change and the role that rainforest depletion may play in this process. This paper reviews the relationships between rainforest depletion and climate change, and outlines some areas where action is needed. | 18,974,894 |
Assaying baseline status of particulate laden polyaromatic hydrocarbon for a grass root level industrial project. | A study of particulate laden polyaromatic hydrocarbon was conducted at 13 selected locations in a 10 km radial distance of a proposed site for a grass root level industry. Suspended particulate matter samples were continuously monitored for 24 h over a period of 3 months. The Polyaromatic Hydrocarbons (PAHs) were extracted from the particulate samples and analysed using Gas Chromatograph-Mass Spectrometer. Limit of Quantification was also established for individual PAHs. Coal combustion and traffic emission were the major contributors for PAHs in the region. The relative contribution of 2, 3, 4, 5, and 6 ring PAHs in particulates of different sampling sites was also investigated and it is observed that 4 ring (29.76%) and 5 ring (29.06%) compounds are prominent in the particulates measured in the region. | 18,974,916 |
Remaining lifetime and absolute 10-year probabilities of osteoporotic fracture in Swiss men and women. | Remaining lifetime and absolute 10-year probabilities for osteoporotic fractures were determined by gender, age, and BMD values. Remaining lifetime probability at age 50 years was 20.2% in men and 51.3% in women and increased with advancing age and decreasing BMD. The study validates the elements required to populate a Swiss-specific FRAX model. Switzerland belongs to high-risk countries for osteoporosis. Based on demographic projections, burden will still increase. We assessed remaining lifetime and absolute 10-year probabilities for osteoporotic fractures by gender, age and BMD in order to populate FRAX algorithm for Switzerland. Osteoporotic fracture incidence was determined from national epidemiological data for hospitalised fractured patients from the Swiss Federal Office of Statistics in 2000 and results of a prospective Swiss cohort with almost 5,000 fractured patients in 2006. Validated BMD-associated fracture risk was used together with national death incidence and risk tables to determine remaining lifetime and absolute 10-year fracture probabilities for hip and major osteoporotic (hip, spine, distal radius, proximal humerus) fractures. Major osteoporotic fractures incidence was 773 and 2,078 per 100,000 men and women aged 50 and older. Corresponding remaining lifetime probabilities at age 50 were 20.2% and 51.3%. Hospitalisation for clinical spine, distal radius, and proximal humerus fractures reached 25%, 30% and 50%, respectively. Absolute 10-year probability of osteoporotic fracture increased with advancing age and decreasing BMD and was higher in women than in men. This study validates the elements required to populate a Swiss-specific FRAX model, a country at highest risk for osteoporotic fractures. | 18,974,918 |
Emergence of SCCmec type IV as the most common type of methicillin-resistant Staphylococcus aureus in a university hospital. | The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) has dramatically changed over the last decade by the emergence of community-associated MRSA (CA-MRSA). Recent studies indicate that these strains have already spread to hospitals. To evaluate if SCCmec type IV and Panton-Valentine leukocidin (PVL) are unambiguous markers of CA-MRSA, we analyzed 77 sporadic MRSA strains isolated, in our low MRSA incidence university hospital, from inpatients between 2000 and 2004. MRSA strains were analyzed by staphylococcal cassette chromosome mmecec (SCCmec) typing, PCR for PVL genes and pulsed-field gel electrophoresis (PFGE). MRSA was classified in HA-MRSA or CA-MRSA according to Centers for Disease Control and Prevention (CDC) criteria. Antimicrobial susceptibility testing was performed using microbroth dilution method following CLSI recommendations. Among 77 sporadic single-patient strains, SCCmec types I-IV and four subtypes were identified. Type IV/IVA was most common (42.9%).The distribution of SCCmec types changed over the years. Type IV/IVA strains increased from 33.3% in 2000 to 57.9% in 2004. Type IV strains were resistant to ciprofloxacin in 81.8%, and in 9.1% to tobramycin while type IVA strains were 100% resistant to both antimicrobials. In contrast, non-type IV/IVA strains were resistant to ciprofloxacin in 86.4%, and in 75.0% to tobramycin. Only one strain was PVL positive and harbored SCCmec type III variant. By PFGE analysis, the 33 SCCmec type IV/IVA strains comprised 12 distinct genotypes. 36.4% of 11 CA-MRSA and 43.9% of 66 HA-MRSA harbored SCCmec type IV/IVA. Type IV/IVA has become the most common SCCmec type in inpatients of our university hospital. The SCCmec type IV/IVA is present in both CA-MRSA and HA-MRSA limiting its use as a marker for CA-MRSA. | 18,974,930 |
Molecular cloning and characterization of a single-chain variable fragment antibody specific for benzoylecgonine expressed in Escherichia coli. | Benzoylecgonine is a major metabolite of cocaine. We generated hybridoma cells (C1303) producing anti-benzoylecgonine monoclonal antibody (mAb) with a single-chain variable fragment (scFv) and an antigen-binding domain from the C1303 cells. Genes encoding an scFv antibody and constant region (Fc) were amplified from a cDNA library of C1303 cells using PCR. The two frameworks built for scFv and scFv-Fc consisted of HL [(heavy chain variable region, V(H)) - linker - (light chain variable region, V(L))] and HL-Fc, respectively. A 45 base-pair-long sequence encoding (Gly(4)-Ser)(3) was used as the linker, and the mouse IgG1 constant region sequence (225 amino acids) was used as the Fc domain. These two types of recombinant Abs were determined to be 750 bp in length (which corresponds to a 30 kDa protein) in the HL and 1,432 bp in length (which corresponds to a 65 kDa protein) in the HL-Fc, respectively. The parental Ab and HL-Fc affinities against benzoylecgonine were measured by ELISA and found to be nearly equal to the Ab concentration. We were also able to measure HL affinity using an agarose diffusion assay (Ouchterlony test). The affinity of the recombinant single-chain antibody against benzoylecgonine was sufficiently comparable to that of the parent antibodies to be used for the immunodetection of specific drug compounds or the detoxification of drug abusers by immunotherapy. | 18,974,960 |
Does stress shielding occur with the use of long-stem prosthesis in total knee arthroplasty? | A retrospective study conducted to evaluate the possible occurrence of stress shielding with the use of long-stem tibial prosthesis in total knee arthroplasty. Forty-one patients were reviewed (twenty-three standard prosthesis, eighteen long-stem prosthesis) and forty-one unoperated knee of the contralateral limb). Patients underwent bone mineral density assessment with a dual-energy X-ray absorptiometry (DEXA) bone densitometer for the hip and bilateral knees. The mean time interval between surgery and the DEXA assessment was 87.7 months. There was no significant statistical difference (P > 0.05) in the bone mineral density patterns of the tibia with the use of either standard or long-stem prosthesis. The utilization of the long-stem prosthesis to off-load the tibia is not associated with any significant bone mineral density changes or stress shielding. | 18,974,974 |
Suitability of muscarinic acetylcholine receptor antibodies for immunohistochemistry evaluated on tissue sections of receptor gene-deficient mice. | Acetylcholine (ACh) is a major regulator of visceral function exerting pharmacologically relevant effects upon smooth muscle tone and epithelial function via five types of muscarinic receptors (M1R-M5R). In this paper, we assessed the specificity of muscarinic receptor (MR) antibodies in immunohistochemical labelling on tissue sections by analysing specimens from wild-type and respective gene-deficient mice. Of 24 antibodies evaluated in this study, 16 were tested at 18 different conditions each, and eight of them in 21 different protocols, resulting in a total number of 456 antibody/protocol combinations. Each of them was tested at four antibody dilutions at minimum, so that finally, at least 1,824 conditions were evaluated. For each of them, dorsal root ganglia, urinary bladder and cross-sections through all thoracic viscera were investigated. In all cases where the antigen was available, at least one incubation condition was identified in which only select cell types were immunolabelled in the positive control but remained unlabelled in the pre-absorption control. With two exceptions (M2R antibodies), however, all antibodies produced identical immunohistochemical labelling patterns in tissues taken from corresponding gene-deficient mice even when the pre-absorption control in wild-type mice suggested specificity. Hence, the present data demonstrate the unpleasant fact that reliable immunohistochemical localisation of MR subtypes with antibodies is the exception rather than the rule. Immunohistochemical detection of MR subtype localisation in tissue sections of peripheral organs is limited to the M2R subtype utilising the most commonly used methodological approaches. | 18,974,978 |
Constitutive expression of bergaptol O-methyltransferase in Glehnia littoralis cell cultures. | We investigated whether exogenously supplied precursors of bergapten, namely umbelliferone, psoralen and bergaptol, could be utilized to produce bergapten without elicitation in Glehnia littoralis cell suspension cultures. The levels of added psoralen and bergaptol in the medium soon decreased, and this was followed by the detection of bergapten in both culture fluid and cells. Umbelliferone was also incorporated but in this case no bergapten was produced; instead, skimmin, umbelliferone monoglucoside, was detected. To determine whether conversion of psoralen to bergapten was due to enzyme induction by precursor feeding, the transcript accumulations and enzyme activities of bergaptol O-methyltransferase (BMT, EC 2.1.1.69), which catalyzes the last step of bergapten synthesis, and of phenylalanine ammonia-lyase (PAL, EC 4.3.1.5), which catalyzes the initial step of the phenylpropanoid biosynthetic pathway and is known as a marker enzyme of elicitation, were examined. The results showed that both the expression and the activity of BMT were always detected in all cells, including control cells. Since PAL was slightly induced in the cells supplied with/without precursors, phenylethyl alcohol (PEA, a competitive inhibitor of PAL) was applied to suspension cells prior to the addition of psoralen. PAL activity was effectively inhibited by PEA at 1-5 mM concentrations. Under these conditions, PEA did not affect bergapten production by cell cultures fed with psoralen at all. These results demonstrate that BMT is constitutively expressed in G. littoralis cell cultures. | 18,974,989 |
Is there a need of custom-made prostheses for total hip arthroplasty? Gait analysis, clinical and radiographic analysis of customized femoral components. | Custom-made prosthesis in primary hip arthroplasty based on the concept of a better press-fitting to reach superior clinical results in comparison to conventional implants. Mid-term results provide a more complete picture with respect to gait and electromyographic analyses. The custom-made femoral component (Adaptiva) was implanted in 24 hips and compared to 23 hips with a conventional implant (Alloclassic-SL). The mean retrospective follow-up times were 3.9 (3-4.9) years and 4.8 (3.1-5.1) years. Clinically, the Harris Hip Score (HHS) and the SF 36 were recorded. Motion analysis data (body kinematics, kinetics and muscle activities) were recorded with 3D gait analysis. Neither the HHS nor the SF-36 revealed any statistical differences between the two groups (P > 0.05). The radiographic parameters did not show the intended physiologic load transfer. Periprosthetic changes indicated a more distal load transfer of the customized stem. Gait analysis revealed in comparison to the controls (45.03 degrees ), a reduced mean hip range of motion in the sagittal plane by 11.4% (39.9 degrees ) in the customized stem group versus 17.4% (37.2 degrees ) in the conventional stem group. In keeping with the limited range of hip motion kinematic impairments of the ipsilateral knee and ankle joints were detected. The electromyographic amplitudes of the tensor fasciae latae and gluteus medius muscles both for stabilizing the hip joint in the stance phase were significantly higher in both groups. Compared to a conventional cementless hip prosthesis the custom-made device did not improve the mid-term clinical and radiographic outcome. Despite the individualized reconstruction of the biomechanical hip geometry objective gait analysis failed to show a benefit. | 18,974,995 |
Lincomycin, rational selection of high producing strain and improved fermentation by amino acids supplementation. | Based on the report that the introduction of the biosynthetic precursor of lincomycin, propylproline, could increase the production of lincomycin (Bruce et al. in US Patent 3,753,859, 1973), a mutant strain pro10-20, with resistance of feedback suppression of proline (an analog of propylproline) was thus selected and lincomycin production increased by 10%. The addition of three amino acids (L-proline, L-tyrosine, L-alanine) which are the precursors of propylproline to the fermentation medium was found to enhance the accumulation of L-dopa through different pathways and was favorable to lincomycin biosynthesis. The production of lincomycin was increased by 23, 10, 13%, respectively, with the addition of 0.05 g L(-1) L-proline at 60 h, 0.005 g L(-1) L-tyrosine and 0.1 g L(-1) L-alanine directly in the medium. | 18,975,015 |
Injury to the ulnar collateral ligament of the thumb. | Injury to the ulnar collateral ligament of the thumb is very common and can be disabling when missed or left untreated. We present a review of literature and our preferred way of management. | 18,975,032 |
Blood glucose monitoring is associated with better glycemic control in type 2 diabetes: a database study. | The value of self-monitoring blood glucose (SMBG) in type 2 diabetes is controversial. To determine SMBG testing rates are positively associated with glycemic control in veterans on oral hypoglycemic agents (OHA). Observational database study. Southwestern Healthcare Network veterans taking OHA in 2002 and followed through the end of 2004. OHA and glucose test strip (GTS) prescriptions were derived from pharmacy files. Subjects were categorized into five groups according to their end-of-study treatment status: group 1 (no medication changes), group 2 (increased doses of initial OHA), group 3 (started new OHA), group 4 (both OHA interventions), and group 5 (initiated insulin). We then used multiple linear regression analyses to examine the relationship between the SMBG testing rate and hemoglobin A1c (HbA1c) within each group. We evaluated 5,862 patients with a mean follow-up duration of 798 +/- 94 days. Overall, 44.2% received GTS. Ultimately, 47% of subjects ended up in group 1, 21% in group 2, 9% in group 3, 8% in group 4, and 16% in group 5. A univariate analysis showed no association between the SMBG testing rate and HbA1c. However, after stratifying by group and adjusting for initial OHA dose, we found that more frequent testing was associated with a significantly lower HbA1c in groups 1, 4, and 5. The effect ranged from -0.22% to -0.94% for every ten GTS/week. Higher SMBG testing rates were associated with lower HbA1c, but only when stratifying the analyses to control for treatment intensification. | 18,975,035 |
Is targeted reconstruction necessary for evaluating contrast-enhanced chest computed tomography using a liquid crystal display monitor? | The aim of this study was to examine whether 20-cm field-of-view (FOV) targeted reconstruction (TR) on contrast-enhanced (CE) chest computed tomography (CT) might improve the diagnostic value compared with simple zooming (SZ) from whole-thorax FOV images using a 2 million (2M)-pixel liquid crystal display (LCD) monitor. We prospectively evaluated 44 patients. SZ images were magnified from a FOV of 26-34 cm (mean 29.7 cm). Parameters were 512 x 512 matrix and 3 mm thickness and interval. Images were reconstructed using a soft-tissue kernel. Three radiologists evaluated contour, spiculation, notch, pleural tag, invasion, and internal characteristics of the lesions using 5-scale scores. We also performed a phantom study to evaluate the spatial resolution of images. The diagnostic value of the TR images was similar to that of the SZ images, with the findings identified in 88%-100% of the cases. Artifacts from high-density structures deteriorated the image quality in six (14%), and the SZ images were judged to be preferable in five of them. In the phantom study, there was little difference in spatial resolution between the two images. The SZ images from whole-thorax FOV on CE chest CT were similar in quality to TR images using a 2M-pixel LCD monitor. | 18,975,048 |
HIV-positive persons' awareness and understanding of their state's criminal HIV disclosure law. | Commentary on the potential impact of HIV-specific disclosure laws on persons living with HIV has been critical, plentiful, and enduring. Yet empirical information with which to answer even the most basic questions about these laws, such as whether HIV-positive persons living in a state with a disclosure law are aware of the law, is absent. This study reports on data gathered from a statewide sample of 384 HIV-positive persons living in a state with an HIV disclosure law. Participant awareness and understanding of the law were assessed. Data on the sources from which participants received information on the law and the perceived helpfulness of these sources were also collected. Analyses were conducted to identify associations between participant awareness or understanding of the law and demographic characteristics of participants or information sources encountered. The majority of participants were aware that their state had enacted an HIV-specific disclosure law. Understanding of the law was good, although there was substantial confusion over several provisions. The most prevalent and most helpful sources of information on the law were AIDS-related resources as opposed to mass media. Forty-two percent of the participants learned about the law when first diagnosed with HIV. Sixty-two percent of the participants reported that their case manager had told them about the law. | 18,975,069 |
Durability of antiviral response in HBeAg-positive chronic hepatitis B patients who maintained virologic response for one year after lamivudine discontinuation. | The purpose of this study is to determine the long-term relapse rate and associated risk factors in HBeAg-positive chronic hepatitis B (CHB) patients who had maintained virologic response (VR) for 1 year after lamivudine (LMV) discontinuation. We enrolled 55 treatment-naive HBeAg-positive CHB patients who achieved and maintained VR until 1 year after LMV discontinuation. Delayed relapse was defined as an elevation of HBV DNA after sustained VR for 1 year. During follow-up, 16 of 55 patients (29%) showed delayed relapse. Beginning 1 year after LMV discontinuation, the cumulative rates of relapse after 2 and 4 years were 29 and 44%, respectively. In multivariate analysis, age (P = 0.029) and >2,000 copies/ml HBV DNA 3 months after LMV discontinuation (P = 0.047) were significant predictors of delayed relapse. Delayed relapse is not infrequent, even in patients who maintain VR for 1 year after LMV discontinuation. Therefore, LMV maintenance therapy might be considered in HBeAg-positive CHB patients who achieve VR. | 18,975,080 |
Regulatory T-cell function is impaired in celiac disease. | Celiac disease (CD) is characterized by intolerance to gluten and high risk of developing autoimmune phenomena. Possible defects in immune tolerance could have a role in the pathogenesis of the disease. As regulatory T-cells (Tregs) are the main population involved in maintaining peripheral tolerance, we investigated the number of these cells in celiac patients as compared with healthy donors. Moreover, we analyzed the suppressive function of CD4+CD25+ T-cells from celiac disease patients and controls on autologous responder T-cells (CD4+CD25-). The percentage of CD4+CD25+FOXP3+ cells was not different in celiacs and in healthy controls, and among positive cells the level of expression of the two regulatory markers was comparable. However, the suppressor activity of Tregs was significantly impaired in CD patients. These results suggest that a defect in Tregs function could play a role in the pathogenesis of CD and in CD-associated autoimmunity. | 18,975,083 |
Role exchange in medical interpretation. | Prior research has documented that medical interpreters engage in non-conduit roles during medical visits. However, agreement on the appropriateness of these roles and their impact on the medical encounter have not yet been achieved. The purpose of this study was to identify non-conduit behavior (role exchange), elucidate the various forms it takes among different types of interpreters, and assess its potential to affect clinical encounters. Using audiotapes from 13 pediatric outpatient visits, we found that "chance" and uncertified hospital interpreters engaged in role exchange by assuming the provider's role; the patient's role; and taking other non-interpretive roles such as socializing with mothers or acting in one's alternate professional role. These behaviors occurred frequently among both types of interpreters while the provider was actively engaged in conducting the medical visit. In most instances, the interpreter did not make his or her behavior transparent to either the provider or the mother. Implications for interpreter and provider training are discussed. | 18,975,091 |
Immunohistochemical analysis of lens cells on formation of different types of age-related cataract in humans. | The aim of the present work was to perform a comparative immunohistochemical study of the ocular lens in normal conditions and after formation of various type of age-related cataract in humans. The control group consisted of lenses from young men dying from accidents and serving as corneal donors (n = 10, not more than one hour after death). Lenses from patients (aged 60-70 years) undergoing surgery for cortical (n = 20) and nuclear (n = 20) cataracts were studied. The investigations demonstrated plasticity in the phenotype of lens cells in age-related cataract. Changes in the phenotype of lens cells were found to depend on the type of age-related cataract. Development of the cortical variant of age-related cataract was associated with positive reactions with monoclonal antibodies to neuron-specific enolase, S-100 protein, and vimentin only within the lens cortex. Formation of age-related nuclear cataract was associated with positive reactions with antibodies to alpha-smooth muscle actin and pancytokeratin, which were detected only in the lens nucleus. This provides evidence of the need to develop a differential approach to the treatment of different types of age-related cataract. | 18,975,114 |
Effect of plant trichomes on the vertical migration of Haemonchus contortus infective larvae on five tropical forages. | The influence of trichomes on vertical migration and survival of Haemonchus contortus infective larvae (L3) on different forages was investigated. Four different forages showing different distributions of trichomes (Brachiaria brizantha cv. Marandu, Brachiaria brizantha cv. Xaraes, Andropogon gayanus, and Stylosanthes spp.), and one forage species without trichomes (Panicum maximum cv. Tanzania), were used. Forages cut at the post-grazing height were contaminated with faeces containing L3. Samples of different grass strata (0-10, 10-20, >20 cm) and faeces were collected for L3 quantification once per week over four weeks. In all forages studied, the highest L3 recovery occurred seven days after contamination, with the lowest recovery on A. gayanus. In general, larvae were found on all forages' strata. However, most of the larvae were at the lower stratum. There was no influence of trichomes on migration and survival of H. contortus L3 on the forages. | 18,975,119 |
Effect of hepatic cirrhosis on the pharmacokinetics of theophylline in rats. | The experimental hepatic cirrhosis was induced either by bile duct ligation (BDL) or by pretreatment with dimethylnitrosamine (DMNA). The pharmacokinetics of theophylline were studied after a single intravenous or a single oral administration. Using the ultrafiltration method, protein-drug binding experiments were also carried out. The bilirubin level was several-fold increased by BDL, but not by DMNA treatment. The albumin content was decreased in both cirrhotic groups. The total clearance (Clt, ml/kg/hr) of theophylline in both hepatic cirrhosis groups significantly decreased and the terminal half-life (t(1/2)) in the cirrhotic rats was increased about two-fold after intravenous and oral administration. The volume of distribution at steady state (Vdss, ml/kg) was increased slightly in the cirrhotic groups. Protein binding in BDL (8.67+/-4.85%) decreased about four-folds, but in DMNA (73.00+/-9.85%) similar result, was observed as compared with the control. Increased free fraction of theophylline did not increase the volume of distribution in BDL. Therefore decreased total body clearance of theophylline was mainly due to decreased intrinsic clearance of theophylline in the liver. The absolute bioavailability of theophylline in these experiments was between 63.8 and 72.8%(66.1% in BDL, 63.8% in Sham operated and Control, 72.8% in DMNA). These results suggest that in the experimental hepatic cirrhosis model, administration route does not affect the disposition of theophylline. | 18,975,172 |
Chongmyungtang attenuates kainic acid-induced seizure and mortal effect in the mouse. | TheChongmyungtang (CMT; the combination ofAcorus gramineus, polygala tenuifolia andPoria cocos) has been recognized to possess the preventive effect against several neurologic disorders in human. In this study, we examined the effect of CMT on the three parameters associated with kainic acid (KA)-induced neurotoxicities; seizure/mortality, increased fos-related antigen (FRA) and glial fibrillary acidic protein (GFAP) expression. KA induced vigorous convulsions lasting 4-6 hr. Pretreatments with CMT before KA injection significantly reduced the seizure intensity as well as the mortality. CMT pretreatments also attenuated the KA-induced increase in FRA/GFAP expression in the hippocampus. These results suggest that CMT has a neuroprotective effect against KA-induced neurotoxicities. | 18,975,183 |
Optimal immobilization of penicillinase for lon-selective electrode. | Penicillin sensor was prepared by immobilizing penicillinase (Pcase) on H(+)-selective carboxylated poly (vinyl chloride) (PVC-COOH) membrane or cellulose filter membrane. The immobilization techniques are as follows. Pcase was immobilized with GTH on H(+)-selective PVC-COOH membrane or some amount of BSA was dropped on that membrane. Another method to make immobilization is to mix type I Pcase with GTH and drop on a cellulose filter membrane. According to immobilization techniques, there were some differences in response properties of enzyme electrodes, however, all electrodes responded to Pcase-resistant penicillin derivatives. Pcase immobilized on cellulose filter membrane with H(+)-selective PVC membrane eletrode was more stable and more sensitive to penicillinase-resistant penicillin derivatives than any other immobilization techniques. | 18,975,214 |
Synthesis and anti-inflammatory and analgesic activities of phenoxyalkanoic acid derivatives. | The synthesis of phenoxyalkanoic acid derivatives and their anti-inflammatory and analgesic activities are described. Analysis of structure-activity relationships shows that in trichlorophenoxy derivatives anti-edematous potency is associated with the presence of 1-thiopropyl moiety and 2 or 4-aminopyridyl moiety at R' position contributes to the analgesic activity. | 18,975,215 |
Isolation of 4,4'-dihydroxybenzyl sulfoxide fromGastrodia elata. | In the course of continous work on tubers ofGastrodia elata, a new constituent, 4,4'-dihydroxybenzyl sulfoxide was isolated from the ethyl acetate soluble fraction prepared from the methanol extract. The structure of the compound was identified from the elemental analytical and spectroscopic data in comparison with those of non-substituted benzyl sulfoxide. | 18,975,220 |
The relationship between hours worked and partner's disability in opposite- and same-sex couples. | When a partner is disabled and not in the labour force, the need for earnings provided by the non-disabled partner increases. However, the disabled partner's need for care raises the value of time spent at home by the non-disabled partner. The direction of the relation between partner disability and hours worked varies with couple type because connecting links are affected by couple type. Relevant issues include foregone earnings, amount of income lost by the disabled partner, accumulated savings and healthcare coverage. In order to determine whether there is a significant relation between hours worked and having a disabled partner, controlling for other characteristics, Tobit regression equations were estimated using the US 2000 Decennial Census 5% sample. Among same-sex partners, unmarried opposite-sex partners and married men, individuals with disabled partners worked fewer hours in the labour force than did those without disabled partners. Only among married women did those with a disabled partner work more hours. | 18,975,226 |
Avoiding shame: young LGBT people, homophobia and self-destructive behaviours. | This paper reports on findings from qualitative research conducted in the UK that sought to explore the connections between sexual identities and self-destructive behaviours in young people. International evidence demonstrates that there are elevated rates of suicide and alcohol abuse amongst lesbian, gay, bisexual and transgender (LGBT) youth. Rarely included in this body of research are investigations into young LGBT people's views and experiences of self-destructive behaviours. Data from interviews and focus groups with young LGBT participants suggest a strong link between homophobia and self-destructive behaviours. Utilising a discourse analytic approach, we argue that homophobia works to punish at a deep individual level and requires young LGBT people to manage being positioned, because of their sexual desire or gendered ways of being, as abnormal, dirty and disgusting. At the centre of the complex and multiple ways in which young LGBT people negotiate homophobia are 'modalities of shame-avoidance' such as: the routinization and minimizing of homophobia; maintaining individual 'adult' responsibility; and constructing 'proud' identities. The paper argues that these strategies of shame-avoidance suggest young LGBT people manage homophobia individually, without expectation of support and, as such, may make them vulnerable to self-destructive behaviours. | 18,975,229 |
Plasmalemmal and vesicular gamma-aminobutyric acid transporter expression in the developing mouse retina. | Plasmalemmal and vesicular gamma-aminobutyric acid (GABA) transporters influence neurotransmission by regulating high-affinity GABA uptake and GABA release into the synaptic cleft and extracellular space. Postnatal expression of the plasmalemmal GABA transporter-1 (GAT-1), GAT-3, and the vesicular GABA/glycine transporter (VGAT) were evaluated in the developing mouse retina by using immunohistochemistry with affinity-purified antibodies. Weak transporter immunoreactivity was observed in the inner retina at postnatal day 0 (P0). GAT-1 immunostaining at P0 and at older ages was in amacrine and displaced amacrine cells in the inner nuclear layer (INL) and ganglion cell layer (GCL), respectively, and in their processes in the inner plexiform layer (IPL). At P10, weak GAT-1 immunostaining was in Müller cell processes. GAT-3 immunostaining at P0 and older ages was in amacrine cells and their processes, as well as in Müller cells and their processes that extended radially across the retina. At P10, Müller cell somata were observed in the middle of the INL. VGAT immunostaining was present at P0 and older ages in amacrine cells in the INL as well as processes in the IPL. At P5, weak VGAT immunostaining was also observed in horizontal cell somata and processes. By P15, the GAT and VGAT immunostaining patterns appear similar to the adult immunostaining patterns; they reached adult levels by about P20. These findings demonstrate that GABA uptake and release are initially established in the inner retina during the first postnatal week and that these systems subsequently mature in the outer retina during the second postnatal week. | 18,975,268 |
Failure to fully disclose during pretransplant psychological evaluation in alcoholic liver disease: a driving under the influence corroboration study. | The prevention of recidivism in alcoholic liver disease is one of the aims of pretransplant psychological evaluation (PE). Failure to fully disclose the extent of alcohol use is evidence of ongoing alcoholism. Driving under the influence (DUI) represents objective evidence of alcohol abuse, but verifying DUIs through official records is not standard during PE. The aim of this study was to determine whether there was failure to fully disclose alcohol abuse on the part of patients on the basis of the Wisconsin Department of Transportation (DOT) DUI rate. Demographics, alcohol abuse/abstinence history, and DUIs admitted by the patient on PE were collected for 82 alcoholic patients with cirrhosis. The DOT was queried for DUIs before PE for all patients. Discrepancies between PE and DOT DUI numbers were evaluated and re-presented to the psychologist without identifiers. Psychosocial recommendation was then evaluated in light of DOT/PE DUI discrepancies. Six patients did not drive. The remaining 76 had 29 +/- 8 years of alcohol abuse and reported sobriety for 55 +/- 64 months before PE. Eighteen DUIs that were not originally admitted were discovered; 63% of DUIs occurred in the period during which patients claimed to be sober. Two patients had been rejected for transplant for other causes. Re-presenting the case to the psychologist with the new knowledge of DUIs would have prevented transplant clearance for the remaining 16 (21%, P = 0.000005 versus prior PE). In conclusion, official DUI records in prospective transplant candidates may identify patients who do not fully disclose the extent of their alcohol abuse and may be at risk for adverse outcomes. | 18,975,271 |
Graft histology characteristics in long-term survivors of pediatric liver transplantation. | The factors that influence the long-term histological outcome of transplanted liver allografts in children are not yet fully understood, and the role of surveillance biopsies in patients with normal graft function remains controversial. The aims of this study were to describe the long-term graft histology of pediatric liver transplant recipients surviving at least 3 years and to analyze factors correlating with long-term histological outcome. Histological slides of 63 long-term liver transplant recipients were assessed for inflammation and fibrosis. The histological findings were correlated with clinical, biochemical, serological, and radiological findings. A significant proportion of biopsies from these patients showed some type of histological abnormalities, with fibrosis being observed in 61 (97%) patients. Duration of transplantation of >6 years and > or =grade 2 inflammation were significantly associated with advanced fibrosis. We could not identify any correlation between > or =stage 3 fibrosis and donor age, cold and warm ischemia time, history of de novo autoimmune hepatitis, hepatic artery thrombosis, chronic rejection, or alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase values. In conclusion, liver fibrosis appears to be a common finding in long-term pediatric liver transplant survivors. The cause of this fibrosis is uncertain, and normal alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels do not exclude the presence of significant fibrosis. | 18,975,292 |
Detecting lifetime alcohol problems in individuals referred for liver transplantation for nonalcoholic liver failure. | Transplantation for alcoholic liver disease is becoming increasingly common, and with adequate screening, short- to medium-term outcomes are very good. However, while conducting a prospective study of the outcome of liver transplantation in Birmingham, United Kingdom, we observed that a research diagnosis of alcohol abuse or dependence was made in a number of cases in which no reference to alcohol problems had been made by the referring agency. This article explores the characteristics of these "missed" cases and highlights key patient characteristics that might prompt a more detailed assessment of alcohol consumption. Two hundred eight individuals completed the research interview, and 80 (39%) met Diagnostic and Statistical Manual of Mental Disorders IV criteria for a lifetime diagnosis of either alcohol abuse (n = 29) or dependence (n = 51). When the initial referral details were reviewed, the possibility of alcohol problems had not been raised in 10 (12.5%) of these cases. Hepatitis C was the most common primary diagnosis in the missed cases, but there was no difference between diagnosed and missed cases in terms of demographic factors, severity of liver disease, or the number or degree of lifetime problems associated with alcohol. However, members of the missed group were more likely to have drunk alcohol in the past 6 months and in a greater volume and were more likely to have used illicit drugs such as opiates, amphetamines, hallucinogens, and cannabis. These findings point to the need to take an adequate history of lifetime alcohol problems in all patients being considered for liver transplantation. | 18,975,295 |
Liver transplantation for hepatoblastoma. | From October 1993 to February 2007, 25 liver transplantations were performed for hepatoblastoma. Of these 25, 18 children received cadaveric grafts, and 7 received left lateral segments from living donors. Fifteen patients were at level IV in the pretreatment extent of disease staging system for hepatoblastoma (PRETEXT IV; 11 received cadaveric grafts and 4 underwent living related liver transplantation [LRLT]) and 10 were level III (PRETEXT III; 7 received cadaveric grafts and 3 underwent LRLT). Preoperative chemotherapy was given according to the risk stratification system for children with hepatoblastoma protocols of the International Childhood Liver Tumour Strategy Group of the International Society of Paediatric Oncology (SIOPEL): SIOPEL I in the first 3 patients, SIOPEL II in 6, SIOPEL III in 10, and SIOPEL IV in 3 patients. Patient and graft survival after cadaveric transplantation was 91%, 77.6%, and 77.6%, at 1, 5, and 10 years, respectively, with no retransplantations. Patient and graft survival for children undergoing LRLT was 100%, 83.3%, and 83.3%, at 1, 5, and 10 years, respectively. All surviving children but 1 remain disease-free, with a median follow up of 6.8 years (range, 0.9-14.9). There were 5 deaths at a median of 13 months post-transplantation, secondary to tumor recurrence (4) and respiratory failure (1). Liver transplantation is an established treatment for unresectable hepatoblastoma confined to the liver following chemotherapy. LRLT is a therapeutic option given that the outcome is similar to that of resection and cadaveric transplantation. | 18,975,296 |
Severity of baseline magnetic resonance imaging-evident sacroiliitis and HLA-B27 status in early inflammatory back pain predict radiographically evident ankylosing spondylitis at eight years. | Magnetic resonance imaging (MRI) is increasingly used to detect sacroiliitis earlier. This study was undertaken to investigate what proportion of patients with MRI-evident sacroiliitis develop ankylosing spondylitis (AS) in the long term and whether there are predictors of outcome. Consecutive undiagnosed patients with early inflammatory back pain (IBP) (of <2 years' duration) were assessed clinically and radiologically. Baseline imaging assessments included fat-suppressed MRI sequences of the sacroiliac joints and lumbar spine that were scored for active bone marrow edema representative of acute inflammation, and anteroposterior radiographs of the pelvis and lateral radiographs of the lumbar spine, which were scored using the Stoke Ankylosing Spondylitis Spine Score. Patients were reassessed clinically and radiographically after 8 years. The primary outcome was the modified New York criteria for AS at followup. Fifty patients were assessed at the beginning of the study, and 40 patients were followed up after a mean of 7.7 years. Of these 40 patients, 58% were HLA-B27 positive, and 98% met the European Spondylarthropathy Study Group criteria. At baseline, 33 (83%) of the 40 patients followed up had MRI-evident sacroiliitis, and 6 (12%) had unequivocal AS according to the modified New York criteria. At followup, despite significant improvements in clinical outcomes, 13 of 39 patients (33.3%) had AS according to the modified New York criteria. The combination of severe sacroiliitis seen on MRI with HLA-B27 positivity was an excellent predictor of future AS (likelihood ratio [LR] 8.0, specificity 92%), while mild or no sacroiliitis, regardless of HLA-B27 status, was a predictor of not having AS (LR 0.4, specificity 38%). Our findings indicate that in patients with early IBP, a combination of severe sacroiliitis and HLA-B27 positivity has a high specificity for development of AS, compared with mild or no sacroiliitis, regardless of HLA-B27 status, which confers a low likelihood of developing AS. This has implications for the diagnosis of "early" AS and possibly for selection of more aggressive therapies. | 18,975,311 |
Toll-like receptor 2 variants are associated with acute reactive arthritis. | We previously reported a recent outbreak of salmonellosis in which some individuals developed complications of the enteric infection. The objective of this study was to identify genetic variants that might predispose infected individuals to develop articular and/or extraarticular sequelae after Salmonella enteritidis infection. The entire exposed cohort was invited to participate in the study by sending a saliva sample for DNA analysis. Seventy-five Salmonella-infected subjects for whom there was clinical information agreed to participate and were stratified into 4 groups. Group 1 patients had arthritis and extraarticular features, group 2 patients had arthritis alone, group 3 patients had extraarticular features alone, and group 4 patients had neither. DNA samples from an uninfected cohort of 91 normal subjects were also genotyped. Genotyping was performed using 2 Toll-like receptor 2 (TLR-2) (rs5743708 and rs5743704) and 2 TLR-4 (rs4986790 and rs4986791) single-nucleotide polymorphisms (SNPs). Statistical analyses were carried out using chi-square tests. There was no association of TLR-4 exonic variants with any clinical events that were reported as accompanying the Salmonella infection. In contrast, compared with normal controls, one of the rare TLR-2 SNPs (rs5743708, R753Q) was associated with the development of arthritis and extraarticular features (P = 0.015 by chi-square test). The TLR-2 variant 753Q was not detected in any of the infected individuals with an uncomplicated course. Another TLR-2 variant, 631H, was associated with articular symptoms in infected males (P = 0.03 by chi-square test). In this outbreak, genetic variants of TLR-2, but not TLR-4, were associated with acute reactive arthritis following infection with S enteritidis. | 18,975,326 |
Borrelia burgdorferi NapA-driven Th17 cell inflammation in lyme arthritis. | Human Lyme arthritis caused by Borrelia burgdorferi is characterized by an inflammatory infiltrate that consists mainly of neutrophils and T cells. This study was undertaken to evaluate the role of the innate and acquired immune responses elicited by the neutrophil-activating protein A (NapA) of B burgdorferi in patients with Lyme arthritis. Serum anti-NapA antibodies were measured in 27 patients with Lyme arthritis and 30 healthy control subjects. The cytokine profile of synovial fluid T cells specific for NapA was investigated in 5 patients with Lyme arthritis. The cytokine profile induced by NapA in neutrophils and monocytes was also investigated. Serum anti-NapA antibodies were found in 48% of the patients with Lyme arthritis but were undetectable in the healthy controls. T cells from the synovial fluid of patients with Lyme arthritis produced interleukin-17 (IL-17) in response to NapA. Moreover, NapA was able to induce the expression of IL-23 in neutrophils and monocytes, as well as the expression of IL-6, IL-1beta, and transforming growth factor beta (TGFbeta) in monocytes, via Toll-like receptor 2. These findings indicate that NapA of B burgdorferi is able to drive the expression of IL-6, IL-1beta, IL-23, and TGFbeta by cells of the innate immune system and to elicit a synovial fluid Th17 cell response that might play a crucial role in the pathogenesis of Lyme arthritis. | 18,975,343 |
No dead certainties? | In July the NHS published mortality rates on four operations. Health professionals are still divided on the benefits of publishing these. How the public will understand and use such outcome rates remains uncertain. | 18,975,435 |
Intracranial epidermoid--a 10-year study. | Twenty-eight cases of intracranial epidermoids were operated over a period of 10 years at the Bangur Institute of Neurology, Kolkata; 17 of them were male and 11 were female with an age range of 11 to 55 (mean 28.21) years. Their locations include--cerebellopontine angle region (n = 15), fourth ventricle (n = 6), lateral ventricle (n = 3), corpus callosum (n = 2), pineal region (n = 1) and basal cistern near temporal lobe (n = l). Hearing loss and vertigo were commonest features of cerebellopontine angle epidermoids. Fourth ventricular tumours presented with gait disturbances and cerebellar signs. Symptomatology of other lesions were varied. CT scan was diagnostic in 23 cases. Sixteen patients had ventriculomegaly and 10 of them required ventriculoperitoneal shunt. Total removal was achieved in 6, near total in 14 and partial in 8 cases. Five patients died. Postoperative complications included chemical meningitis in 7, worsening of cerebellar functions in 3 and aggravation of cranial nerve deficits in 2 patients. All of them except one case of cranial nerve deficit resolved with time. Nineteen patients were followed up over a mean duration of 5 years and 10 months. Reoperation was required in one. Rest had satisfactory outcome. | 18,975,500 |
Acute intermittent porphyria presenting as acute pancreatitis and posterior reversible encephalopathy syndrome. | Acute intermittent porphyria (AIP) is an inherited metabolic disease that can affect the autonomic, peripheral and central nervous systems. Pancreatic diseases assocated with AIP is rarely reported. We report here a 60-year-old non-alcoholic male who had typical manifestations of AIP, including abdominal pain, constipation, tachycardia, hypertension, mental disturbances, psychiatric manifestations, seizures, peripheral neuropathy, and excessive excretion of porphyrin precursors in urine. Increases of serum amylase and lipase, as well as mild pancreatic edema on ultrasonography, were noted during the acute attack of AIP, suggesting concomitant acute pancreatitis. In this patient, brain magnetic resonance imaging revealed reversible multifocal cerebral lesions resembling a posterior reversible encephalopathy syndrome (PRES) during the acute attack of AIP. Because the clinical manifestations of acute pancreatitis could be present with an acute attack of AIP, early confirmation of diagnosis is mandatory to effectively manage the attack and avoid inappropriate treatment. | 18,975,524 |
Hypereosinophilic syndrome with recurrent strokes: a case report. | Hypereosinophilic syndrome is a rare disorder which can cause ischemic stroke. Although cardioembolism is acknowledged as the most common etiology for stroke, the underlying pathogenesis of hypereosinophilic syndrome could be heterogeneous. Herein we describe a patient with persistent hypereosnophillia with recurrent strokes focusing on the pathogenetic mechanism of stroke. A 43-year-old male patient with persistent primary eosinophilia presented with ischemic stroke which persisted for three weeks. Magnetic resonance imaging showed bilateral multiple cerebral infarctions over both anterior and posterior vascular territories. Segmental stenosis of the right posterior cerebral artery was revealed with magnetic resonance angiography and computed tomography angiography. Extensive laboratory workup ruled out other etiologies for the strokes except eosinophilia, which responded well to corticosteroid therapy. Cerebrovascular wall damage inflicted by eosinophilia may be the pathogenesis of the thromboembolic strokes in this case. | 18,975,525 |
[Sudden vocal cord closure during general anesthesia using remifentanil]. | We experienced three cases of ventilatory difficulty through a Proseal laryngeal mask airway was encountered during general anesthesia using remifentanil and sevoflurane. General anesthesia was induced with propofol and maintained with remifentanil (0.2-0.25 microg x kg(-1) x min(-1)) and sevoflurane (1-1.5%). Increased airway pressure was noticed suddenly. Initially in cases 1 and 2, we suspected insufficient depth of anesthesia as a cause of this event. However, in case 3, we observed vocal cord closure by fiberoptic bronchoscopy, suggesting that airway obstruction occurred at the level of the glottis. The patient could be easily ventilated after administration of muscle relaxant (suxamethonium). The inability to ventilate patients with opioids has been ascribed to increased thoracic wall rigidity or vocal cord closure or combination of both factors. In our three cases, the closure of vocal cord after remifentanil administration seems to be the major cause of difficult ventilation during general anesthesia. Therefore, supraglottic airway devices should be applied with caution during general anesthesia with remifentanil and sevoflurane without muscle relaxant. | 18,975,534 |
[Comparative study of sublingual midazolam with oral midazolam for premedication in pediatric anesthesia]. | We studied the efficacy of sublingual midazolam compared with oral midazolam for predmedication in children. Forty-two children (9 months-11 years of age) for minor elective surgery were divided into 2 groups; one group treated with sublingual midazolam at 30 minutes before the entrance into operating room, and the other group receiving oral midazolam at 30 minutes before entering operating room. The group treated with sublingual midazolam at 30 minutes received sublingual midazolam 0.2 mg x kg(-1), while the other group received oral midazolam 0.5 mg x kg(-1) with syrup. We evaluated the taste acceptability, the effect of sedation, the anxiolysis and the cooperation for mask acceptance by using scales. Twenty children accepted sublingual midazolam, and twenty-one accepted oral midazolam. It was effective and satisfactory in taste acceptability, sedation, anxiolysis and cooperation in both groups. There was no difference between the two groups. Any respiratory depression and delayed recovery were not observed. Sublingual midazolam 0.2 mg x kg(-1) is useful for premedication in pediatric anesthesia, and it equals with oral midazolam 0.5 mg x kg(-1) in efficacy. | 18,975,537 |
[To distinguish true glottic opening using laryngoscope is very difficult for probationers]. | The video intubating laryngoscope (VIL) can share information with co-workers, that otherwise only one probationer could obtain. Tracheal intubation was reviewed using recorded videotapes via VIL. It was supposed that the esophageal changes by laryngoscope might cause esophageal intubation. In this study, we investigated the impressions about the changed esophagus caused by laryngoscope, and our purpose is to find better educational method for tracheal intubation. We randomly selected 21 first year junior residents for inexperienced group and 12 expert anesthesiologists for expert group, respectively. They were asked one questionnaire; "What do you think of it?" about three snapshots (A, B, C) recorded by VIL. Each answer was compared in both groups. The percentage of correct answers to snapshot A were 19% and 50% (P = 0.065) in inexperienced group and expert group; snapshot B, 14% and 50% (P = 0.026); and snapshot C, 14% and 92% (P < 0.0001), respectively. It was clarified that probationers significantly more often recognized the changed esophagus as the glottis opening. It is very important for us to teach and emphasize those points when we instruct the inexperienced in tracheal intubation. | 18,975,551 |
[Relationship between glycated albumin (GA) and glycated hemoglobin (A1c) in 255 patients with liver diseases using cross-sectional laboratory data]. | To investigate how liver disease alter the serum glycated proteins as markers of diabetic control, we studied serum GA, A1c and especially GA/A1c ratio in 255 patients having over 35IU/L in ALT(transaminase) compared with those of 829 type 2 diabetes mellitus (DM) in cross sectional manner. 255 patients with liver diseases were divided into 69 patients with biopsy proven liver cirrhosis (LC), 66 patients with chronic hepatitis(CH) and 120 patients with fatty liver(FL) diagnosed by abdominal echography. The mean GA/A1c ratio (+/-SD) was significantly higher (p<0.0001) in LC group(3.71+/-1.03) than the other groups (3.03+/-0.45 for CH, 3.05+/-0.42 for DM), while the mean GA/A1c ratio in FL group was significantly lower(2.74+/-0.31) (p<0.0001)) than that of DM groups. In LC group the GA/A1c ratio increased significantly depending upon serum albumin and/or platelet reductions. The GA/A1c ratio was significantly correlated with the other laboratory data such as serum albumin, cholinesterase, total cholesterol levels and weakly correlated with serum hemoglobin level. We also followed the serum levels of GA and A1c and the GA/A1c ratio during about 13 months (5 times blood collections) in 18 patients enrolled in this study. Resultantly the coefficient of variation of GA/A1c ratio was the smaller than the others(GA, A1c). The ROC curve of GA/A1c ratio for LC versus FL group was the most reliable between four groups and the cut-off value for LC versus FL was 2.94. Theses results suggest that GA/A1c ratio could be an useful marker for different diagnosis when facing patients with abnormal serum ALT level in a clinical setting. | 18,975,554 |
[Neutrophil function tests and oxidative stress detection as clinical examinations]. | We herein introduce several clinically available methods to detect neutrophil function and oxidative stress. The flowcytometric detection of adhesive protein expression, such as CD11b(Mac-1), assessment of phagocytosis activity, and measurement of reactive oxygen species (ROS) production are relatively easy to apply as tools for laboratory medicine. A new device to simultaneously detect superoxide and calcium ion influx is also introduced. Oxidative stress induced by ROS produced not only from phagocytic cells but also from the mitochondria or endoplamic reticulum of all kinds of living cells is etiologically related to many disorders and also aging. A simple method using the FRAS4 instrument is demonstrated. These methods are expected to be clinically beneficial, especially in hematology, transfusion medicine, and the public health field. | 18,975,558 |
[Role of coil embolization and arterial injection in elderly subarachnoid hemorrhage patients: preliminary report]. | With the recent advanced aging seen in society, the number of elderly patients with aneurismal subarachnoid hemorrhage (SAH) is increasing. We focused on current management of SAH in patients who were over 75 years old. From January 1st, 2004 to the end of June, 2007, we had treated 170 SAH patients including 39 who were over 75 years old. We divided the patients into three groups : Coiling Group, Clipping Group, and conservative treatment group (Conservative Group). We analyzed the Hunt-Kosnik grade (H-K), the rate of symptomatic vasospasm, the rate of shunting operation, the Glasgow Outcome Scale (GOS) at 30 days after the onset of SAH, bed rest periods and rate of shunt operation retrospectively. The Conservative Group included many H-K poor grade cases. Symptomatic vasospasm occurred significantly less in the Coiling Group. Rates of shunting operation did not have any significant change. GOS of the Coiling Group and Clipping Group had no significant change, due to the effectiveness of arterial injection for vasospasm. Patients in the Coiling Group started walking significantly earlier than members of other groups. Twenty-five percent of the Clipping Group needed a shunt operation but no patients of the Coiling Group needed a shunt. For elderly SAH patients, we recommend doing coil embolization or clipping and maintaining the patients' activity in daily life. Interventional treatment is necessary to improve results for elderly SAH patients. | 18,975,562 |
[Case of large sphenoid ridge meningioma treated by 2-stage surgery]. | Large skull base meningiomas frequently encase the major cerebral vessels and cranial nerves, and receive blood supply from the branches of the internal carotid artery. One-stage resection of these tumors is difficult due to the long time needed for surgery and profuse bleeding from the tumor. We report herein a case of large sphenoid ridge atypical meningioma that was successfully resected using a combination of two-stage surgery and irradiation. A 56-year-old man was referred to us with mild left hemiparesis and visual deterioration. Computed tomography and magnetic resonance imaging showed a large sphenoid ridge meningioma. Angiography showed blood supply from the branches of both external and internal carotid arteries, and pial blood supply from the middle cerebral artery. In the first surgery after embolization of feeder vessels from the external carotid artery, the tumor was still hemorrhagic and was partially resected with 2,374 ml of blood loss. Symptoms were improved after the first surgery. Pathological diagnosis was atypical meningioma. In the second surgery after 40 Gy of irradiation, the remnant tumor was no longer hemorrhagic and was totally resected. Staged surgery with irradiation is one treatment option for large vascular skull base meningiomas, particularly for atypical meningiomas. | 18,975,564 |
[Combination therapy consisting of gemcitabine, docetaxel and carboplatin as a second-line chemotherapy for patients with MVAC-treated metastatic urothelial carcinoma]. | From 2001 to 2006, 11 patients with MVAC-treated metastatic urothelial carcinoma received as a second-line therapy GDC therapy consisting of gemcitabine (1,000 mg/m2) on day land 8, docetaxel (80 mg/m2) on day 1 and carboplatin (AUC 5) on day 1 in each 21-day cycle. The 11 patients received a total of 42 cycles. The median progression-free survival and the median overall survival were 3 months (range 0-51) and 10 months (range 2-51), respectively. The median overall survival from diagnosis of the metastasis was 13.0 months (range 7-55). Complete response and partial response rates were 1/11 (9%) and 5/11 (45%), respectively. One- and two-year survival rates were 36 and 9%, respectively. Grade 3 or 4 hematologic toxicity included neutropenia (69.0%), thrombocytopenia (47.6%) and anemia (45.2%). Non-hematologic toxicity of grade 3 or 4 consisted mainly of diarrhea (23.8%) and anorexia (21.4%). GDC regimen as a second-line chemotherapy was effective in 54% of patients with MVAC-treated metastatic urothelial carcinoma, although the high incidence of hematologic toxicities and short period of progression-free survival remain to be major problems. | 18,975,570 |
[Case of bilateral renal cell carcinoma with the tumor thrombus in the inferior vena cava]. | We describe a case of bilateral renal cell carcinoma with the tumor thrombus in the inferior vena cava. A 71-year-old male was admitted to our department for, careful examination of bilateral renal tumors. Abdominal computed tomography (CT) revealed bilateral solid enhanced renal masses with the tumor thrombus in the inferior vena cava (IVC) and the left renal vein. The renal tumor did not reveal distant metastatic lesions. We enforced two-term operation for bilateral renal tumor. First, right nephrectomy and tumor thrombectomy in the IVC were performed. On the 32th day after the first operation, we performed left nephrectomy. On the second day after the last operation, the patient received hemodialysis. The histopathological diagnosis revealed bilateral renal cell carcinomas. At 9 months after the last operation, the patient had multiple bone metastases, multiple liver metastases and multiple lung metastases. | 18,975,575 |
[Sensorineural deafness in Guillain-Barré syndrome]. | The patient was a 31-year-old woman in whom facial paralysis occurred 1 week after the onset of pyelonephritis. Peripheral facial paralysis, sensorineural deafness, dysarthria, weakness of the four limbs, loss of tendon reflex, and peripheral sensory disturbance of the four limbs were noted during the initial examination. These symptoms were dominant in left side. The number of cells and protein level were increased in the cerebrospinal fluid, and reduced motor nerve action potential was detected with peripheral nerve conduction test. Based on these findings, axonal Guillain-Barré syndrome (GBS) was diagnosed. Left side-dominant bilateral hypoacusia was noted with audiogram, and left side-dominant bilateral prolongation of I wave latency was noted with auditory brainstem response (ABR). The ABR findings indicated that the auditory nerve was impaired on the peripheral side, which may have been associated with GBS. Interestingly, the laterality of the auditory nerve impairment was marked as with other neurological signs, such as paralysis. Since fewer cases of hearing impairment associated with GBS have been reported, further neurotological approaches to GBS are necessary. | 18,975,606 |
Changes in the properties of secretory granules in the palatine gland acinar cells of the postnatally developing rat. | This study was designed to examine whether or not phospholipid is contained in the secretory granules of the rat palatine gland acinar cells, and if present, to examine the movements of phospholipid in the secretory granules during postnatal development. The palatine glands of male Wistar rats aged 0 to 56 days were used. Acid-hematin staining showed a few positive acinar cells with a faint reaction in the acini on day 0, numerous positive cells with an intense reaction on day 7, a weakening reaction in the cells on day 14, and almost no reactivity on day 35 and after. In contrast, alcian blue staining showed acinar cells with a weak reaction on day 7, a gradual increase in the reaction from day 14, and the presence of many cells with an intense reaction on day 28 and after. Electron probe microanalysis (EPMA) revealed a higher density of phosphorus in samples on day 7 than on day 56. These findings suggest that developing rat palatine gland acinar cells contain phospholipid in the secretory granules, being particularly more conspicuous around postnatal day 7, but that the amount of phospholipid decreases as the cells change to mature mucous cells. | 18,975,612 |
Sensory processing patterns and daily activity preferences of Israeli children. | One determinant of participation is activity preferences, which may be influenced by sensory processing patterns. To compare daily activity preferences of Israeli children who have typical versus atypical sensory processing patterns, according to age and gender. Twenty-five children with atypical sensory processing patterns and 109 typical peers aged 6 - 10.75 years completed the Preference for Activities of Children (PAC) questionnaire. Sensory processing patterns were determined according to the Short Sensory Profile (SSP). Children with atypical sensory processing patterns showed greater preference for active physical activities. Lower energy level was correlated with greater preference for self-improvement activities. Activity preferences may be affected by children's sensory processing patterns. These effects are minimal among children with atypical sensory processing but no other co-morbidities. Evaluating these effects may assist in establishing occupational therapy interventions, facilitate children's engagement in the intervention, and enhance their participation in daily living. | 18,975,668 |
[Retrospective study of a method of automobile driving evaluation in adult mental health]. | In adult mental health, there are few practice guidelines for occupational therapists with regards to the assessment of driving capacities. This article describes a clinical approach, with regards to driving assessments, in adult mental health. A retrospective study was completed from a chart review of clients seen in occupational therapy, between 1999 and 2004, in the psychiatric out-patient clinic of a university-affiliated hospital. The occupational therapists are not offering road tests but results on the following tests discriminate those individuals considered safe or unsafe drivers: "Trail A" (p=0,0004), "Trail B" (p=0,0005), "Cognitive Behavioural Driver's Inventory" (p=0.006), "Continuous Performance Test" (p=0,001). Results on some psychometric measures have an impact on recommendations made by occupational therapists assessing driving capacities. Future studies should include road test performance of clients in adult mental health. | 18,975,669 |
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