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One-stage repair of severe hypospadias using modified tubularized transverse preputial island flap with V-incision suture.
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Although hypospadias repair for preserving the urethral plate is popular among pediatric urologists, applying this procedure to severe hypospadias is controversial. We report the outcome of applying additional modifications to the modified tubularized transverse preputial island flap (TPIF) procedure reported previously [Patel RP, Shukla AR, Austin JC and Canning DA. Modified tubularized transverse preputial island flap repair for severe proximal hypospadias. BJU Int 2005;95:901-4] for repairing severe hypospadias. We retrospectively evaluated our series of 22 patients (mean age 17.5 months) who underwent the modified TPIF with an additional simple modification of meatoplasty with V-incision suture. Patients were followed for a mean period of 18 months. After releasing the chordee, the hypospadiac orifice was retracted to become penile in five patients (22.7%), penoscrotal in six (27.3%), scrotal in nine (40.9%), and perineal in two (9.1%). The median length of the neourethra was 46 mm. One-stage repair was successful in 19 patients (86.4%) without any complications. Our modified TPIF procedure yielded favorable outcomes functionally and cosmetically with a low postoperative morbidity rate. Such a procedure can be considered useful for repairing severe hypospadias when the urethral plate cannot be preserved.
| 19,013,413
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Hypoxia-inducible factor 1alpha is deregulated by the serum of rats with adjuvant-induced arthritis.
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Rheumatoid arthritis (RA) is known to be associated with increased risks of hypoxia-related diseases, whose progresses are critically determined by HIF-1alpha. The authors hypothesized that the hypoxia-related complications of RA are associated with HIF-1alpha deregulation by some factor(s) in RA serum. Arthritis was induced in female Lewis rats by injecting complete Freund's adjuvant. The effects of arthritic rat serum (ARS) on hypoxic responses were investigated by incubating Hep3B cells in ARS. In the presence of ARS, HIF-1alpha was down-regulated and inactivated under hypoxic conditions. ARS inactivated AKT and mTOR, which led to impaired HIF-1alpha protein synthesis. Furthermore, insulin was found to be deficient in ARS and insulin supplementation fully recovered HIF-1alpha synthesis with AKT and mTOR activation. These results suggest that HIF-1alpha deregulation by components in serum is responsible for the RA-associated aggravation of hypoxic diseases in extra-articular tissues.
| 19,013,431
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Novel progesterone receptor modulators with gene selective and context-dependent partial agonism.
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Progesterone receptor (PR) modulators are used in contraception and post-menopausal hormone therapy, and are under clinical development for reproductive disorders such as uterine fibroids and endometriosis. Development of tissue selective PR modulators (SPRMs) with reduced side effects and improved pharmacology represents a large unmet medical need in the area of women's health. One approach to addressing this need is to focus on the two PR isoforms PR-A and PR-B. In vitro and in vivo studies have revealed both distinct as well as overlapping gene regulation and functional responses of the two PR isoforms that suggests that PR-A selective modulators may retain a desired biological profile. We have identified a chemical series of 4-(4-chlorophenyl)-substituted piperazine carbimidothioic acid esters (PCEs) that have partial PR agonist activity and selectively activate some PR-A isoform regulated genes in T47D cells. However, full microarray analysis in these cells does not predict a global isoform selective profile for these compounds, but rather a unique gene-selective profile is observed relative to steroidal progestins. Using multiplexed peptide interaction profiling and co-activator recruitment assays we find that the mechanism of partial agonism is only partly defined by the ability to recruit known co-activators or peptides but also depends on the cell and promoter context of the gene under investigation. The data demonstrate global consequences of mechanistic and functional differences that can lead to selective biological responses of novel steroid receptor modulators.
| 19,013,437
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Maternal Interferon Regulatory Factor 6 is required for the differentiation of primary superficial epithelia in Danio and Xenopus embryos.
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Early in the development of animal embryos, superficial cells of the blastula form a distinct lineage and adopt an epithelial morphology. In different animals, the fate of these primary superficial epithelial (PSE) cells varies, and it is unclear whether pathways governing segregation of blastomeres into the PSE lineage are conserved. Mutations in the gene encoding Interferon Regulatory Factor 6 (IRF6) are associated with syndromic and non-syndromic forms of cleft lip and palate, consistent with a role for Irf6 in development of oral epithelia, and mouse Irf6 targeted null mutant embryos display abnormal differentiation of oral epithelia and skin. In Danio rerio (zebrafish) and Xenopus laevis (African clawed frog) embryos, zygotic irf6 transcripts are present in many epithelial tissues including the presumptive PSE cells and maternal irf6 transcripts are present throughout all cells at the blastula stage. Injection of antisense oligonucleotides with ability to disrupt translation of irf6 transcripts caused little or no effect on development. By contrast, injection of RNA encoding a putative dominant negative Irf6 caused epiboly arrest, loss of gene expression characteristic of the EVL, and rupture of the embryo at late gastrula stage. The dominant negative Irf6 disrupted EVL gene expression in a cell autonomous fashion. These results suggest that Irf6 translated in the oocyte or unfertilized egg suffices for early development. Supporting the importance of maternal Irf6, we show that depletion of maternal irf6 transcripts in X. laevis embryos leads to gastrulation defects and rupture of the superficial epithelium. These experiments reveal a conserved role for maternally-encoded Irf6 in differentiation of a simple epithelium in X. laevis and D. rerio. This epithelium constitutes a novel model tissue in which to explore the Irf6 regulatory pathway.
| 19,013,452
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Isolation of human proteasomes and putative proteasome-interacting proteins using a novel affinity chromatography method.
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The proteasome is the primary subcellular organelle responsible for protein degradation. It is a dynamic assemblage of 34 core subunits and many differentially expressed, transiently interacting, modulatory proteins. This paper describes a novel affinity chromatography method for the purification of functional human holoproteasome complexes using mild conditions. Human proteasomes purified by this simple procedure maintained the ability to proteolytically process synthetic peptide substrates and degrade ubiquitinated parkin. Furthermore, the entire purification fraction was analyzed by mass spectrometry in order to identify proteasomal proteins and putative proteasome-interacting proteins. The mild purification conditions maintained transient physical interactions between holoproteasomes and a number of known modulatory proteins. In addition, several classes of putative interacting proteins co-purified with the proteasomes, including proteins with a role in the ubiquitin proteasome system for protein degradation or DNA repair. These results demonstrate the efficacy of using this affinity purification strategy for isolating functional human proteasomes and identifying proteins that may physically interact with human proteasomes.
| 19,013,454
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Posterior capsule opacification.
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Posterior Capsule Opacification (PCO) is the most common complication of cataract surgery. At present the only means of treating cataract is by surgical intervention, and this initially restores high visual quality. Unfortunately, PCO develops in a significant proportion of patients to such an extent that a secondary loss of vision occurs. A modern cataract operation generates a capsular bag, which comprises a proportion of the anterior and the entire posterior capsule. The bag remains in situ, partitions the aqueous and vitreous humours, and in the majority of cases, houses an intraocular lens. The production of a capsular bag following surgery permits a free passage of light along the visual axis through the transparent intraocular lens and thin acellular posterior capsule. However, on the remaining anterior capsule, lens epithelial cells stubbornly reside despite enduring the rigours of surgical trauma. This resilient group of cells then begin to re-colonise the denuded regions of the anterior capsule, encroach onto the intraocular lens surface, occupy regions of the outer anterior capsule and most importantly of all begin to colonise the previously cell-free posterior capsule. Cells continue to divide, begin to cover the posterior capsule and can ultimately encroach on the visual axis resulting in changes to the matrix and cell organization that can give rise to light scatter. This review will describe the biological mechanisms driving PCO progression and discuss the influence of IOL design, surgical techniques and putative drug therapies in regulating the rate and severity of PCO.
| 19,013,456
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Clinical correlates of histopathology in pediatric nonalcoholic steatohepatitis.
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Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in American children. Noninvasive means to discriminate between NAFLD and nonalcoholic steatohepatitis (NASH) might diminish the requirement for liver biopsy or predict those at increased risk for progression. Data obtained prospectively from children (age, 6-17 y) enrolled in the NASH Clinical Research Network were analyzed to identify clinical-pathologic correlates of pediatric NAFLD. All participants underwent liver biopsy within 6 months of clinical data that were reviewed by a central pathology committee. A total of 176 children (mean age, 12.4 y; 77% male) were eligible for inclusion. By using ordinal logistic regression analysis, increasing aspartate aminotransferase (AST) level (odds ratio [OR], 1.017 per U/L; 95% confidence interval [CI], 1.004-1.031) and gamma-glutamyltransferase level (OR, 1.016 per U/L; 95% CI, 1.000-1.033) were associated independently with increasing severity of NASH. Increasing AST level (OR, 1.015 per U/L; 95% CI, 1.006-1.024), increasing white blood cell count (OR, 1.22 per 1000/mm(3); 95% CI, 1.07-1.38), and decreasing hematocrit (OR, 0.87 per %; 95% CI, 0.79-0.96) were associated independently with increasing severity of fibrosis. Area under the receiver operator characteristic curve for a model with AST and alanine aminotransferase was 0.75 (95% CI, 0.66-0.84) and 0.74 (95% CI, 0.63-0.85) for distinguishing steatosis from more advanced forms of NASH and bridging fibrosis from lesser degrees of fibrosis, respectively. Certain components of routine laboratory tests are predictive of NAFLD pattern and fibrosis severity, but do not have adequate discriminate power to replace liver biopsy in evaluating pediatric NAFLD.
| 19,013,463
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Coordinated responses to developmental hormones in the Kenyon cells of the adult worker honey bee brain (Apis mellifera L.).
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The brains of experienced forager honey bees exhibit predictable changes in structure, including significant growth of the neuropil of the mushroom bodies. In vertebrates, members of the superfamily of nuclear receptors function as key regulators of neuronal structure. The adult insect brain expresses many members of the nuclear receptor superfamily, suggesting that insect neurons are also likely important targets of developmental hormones. The actions of developmental hormones (the ecdysteroids and the juvenile hormones) in insects have been primarily explored in the contexts of metamorphosis and vitellogenesis. The cascade of gene expression activated by 20-hydroxyecdysone and modulated by juvenile hormone is strikingly conserved in these different physiological contexts. We used quantitative RT-PCR to measure, in the mushroom bodies of the adult worker honey bee brain, relative mRNA abundances of key members of the nuclear receptor superfamily (EcR, USP, E75, Ftz-f1, and Hr3) that participate in the metamorphosis/vitellogenesis cascade. We measured responses to endogenous peaks of hormones experienced early in adult life and to exogenous hormones. Our studies demonstrate that a population of adult insect neurons is responsive to endocrine signals through the use of conserved portions of the canonical ecdysteroid transcriptional cascade previously defined for metamorphosis and vitellogenesis.
| 19,013,465
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Human health risk assessment from the presence of human pharmaceuticals in the aquatic environment.
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Assessments for potential impact to human health from environmental exposures were carried out for 44 active pharmaceutical ingredients (APIs) marketed by GlaxoSmithKline (GSK), representing approximately 22 general pharmacological classes exhibiting a broad spectrum of therapeutic activities. These assessments use the considerable amount of information available on the human pharmacology and toxicology of the APIs to develop acceptable daily intakes (ADIs) which are believed to be without pharmacological or toxicological effect. With the exception of the anti-cancer drugs and some antibiotics, the minimum dose producing the intended therapeutic effect was typically used as the point of departure for calculation of ADIs. The ADI values were used to generate predicted no effect concentrations from environmental exposure for human health (PNEC(HH)s) from drinking water or fish consumption. These PNECs were compared to predicted environmental concentrations (PECs) calculated using the regional assessment models PhATE for North America and GREAT-ER for Europe. Risk was characterized by calculating the ratio of the 90th percentile PECs to the PNEC(HH)s. For the APIs reported here, these ratios are less than one for all of the compounds, varying from 7x10(-2) to 6x10(-11), indicating that based upon currently available data, these compounds do not appear to pose an appreciable risk to human health from potential environmental exposure from drinking water and fish consumption.
| 19,013,494
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2-Deoxy-d-glucose protects neural progenitor cells against oxidative stress through the activation of AMP-activated protein kinase.
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2-Deoxy-d-glucose (2DG) is an analog of glucose that is effectively taken up by cells competing with normal glucose but cannot be further utilized to produce energy. It was previously reported that 2DG can mimic the beneficial effects of dietary restriction in experimental models of neurodegenerative disorders and cancer. In the present study, we report that pretreatment with 2DG increases the resistance of neural progenitor cells (NPC) to oxidative insults. 2DG significantly suppressed the proliferation of NPC, and high concentrations of 2DG were toxic to NPC. However, a treatment with a moderate concentration of 2DG protected the NPC against tBHP-induced oxidative stress suggesting that this chemical had hormetic action mimicking dietary restriction. Furthermore, we showed that the protective mechanism of 2DG involved the activation of AMP-activated protein kinase. Our findings demonstrate that 2DG can modulate the cellular responses to oxidative stress and confer cellular resistance in NPC by activating the metabolic regulator.
| 19,013,500
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The complete mitochondrial genome of Macaca thibetana and a novel nuclear mitochondrial pseudogene.
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The complete mitochondrial genome of Macaca thibetana was determined by the long and accurate polymerase chain reaction (LA-PCR) and primer walking sequencing methods. It is 16,540 bp and contains 13 protein-coding genes, 22 transfer RNA genes, two ribosomal RNA genes and one control region. Most codon usage followed the typical pattern of vertebrates. Two rare start codons were found, in which GTG initiated the NADH dehydrogenase subunit 1 (ND1) gene and the ATP8 gene, and ATT initiated the ND2 gene. A new mitochondrial DNA-like sequence (2003 bp) in the nuclear genome of M. thibetana was found. It matched with the 3' end of the ND1 gene, the tRNA(Ile)-tRNA(Gln)-tRNA(Met) genes, the ND2 gene, and the 5' end of the tRNA(Trp) gene. Sequence divergence between the nuclear pseudogene and the mitochondrial homologue suggested that the translocation of this mtDNA fragment into the nuclear genome occurred 3.16 approximately 3.48 million years ago (MYA). Molecular phylogenetic analysis of 16 Cercopithecidae species was performed using sequences from 12 concatenated heavy-strand encoded protein coding genes. The results provided more evidence to support previous morphological and chromosomal studies on Cercopithecidae.
| 19,013,508
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Sildenafil augments early protective transcriptional changes after ischemia in mouse myocardium.
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Recently, targeting cyclic-GMP specific phosphodiesterase-5 (PDE5) has attracted much interest in several cardiopulmonary diseases, in particular myocardial ischemia (MI). Although multiple mechanisms were postulated for these beneficial effects at cellular level, early transcriptional changes were unknown. The aim of present study was to examine gene expression profiles in response to MI after 24 h of ischemia in murine model and compare transcriptional modulation by sildenafil, a popular phosphodiesterase 5 (PDE5) inhibitor. Mice were divided into four groups: Control sham (C), Sildenafil sham (S), Control MI (CMI) and Sildenafil MI (SMI). Sildenafil was given at a dose of 0.7 mg/kg intraperitoneally 30 min before LAD occlusion. cDNA microarray analysis of peri-infarct tissue was done using a custom cloneset and employing a looped dye swap design. Replicate signals were median averaged and normalized using LOWESS algorithm. R/MAANOVA analysis was used and false discovery rate corrected permutation p-values <0.005 were employed as significance thresholds. 156 genes were identified as significantly regulated demonstrating fold difference >1.5 in at least one of the four groups. 52 genes were significantly upregulated in SMI compared to CMI. For a randomly chosen subset of genes (9), microarray data were confirmed through real time RT-PCR. The differentially expressed genes could be classified into following groups based on their function: phosphorylation/dephosphorylation, apoptosis, differentiation, ATP binding. Our results suggest that sildenafil treatment might regulate early genetic reprogramming strategy for preservation of the ischemic myocardium.
| 19,013,509
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Ophthalmic timolol in a hydrogel vehicle leads to minor inter-individual variation in timolol concentration in aqueous humor.
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Ophthalmic timolol has been used for decades in the treatment of glaucoma and ocular hypertension, traditionally in aqueous 0.5% eye drops. Recently a timolol 0.1% hydrogel has been developed to improve systemic safety. The aim of the present study was to compare aqueous humor timolol concentrations after administration of 0.1% hydrogel and aqueous 0.5% timolol in patients scheduled for a cataract operation. The concentration in the aqueous humor was 210+/-175 ng/ml (mean+/-S.D.) 2h after administration of timolol 0.1% hydrogel and 538+/-304 ng/ml after aqueous 0.5% timolol. In the aqueous 0.5% timolol group more patients had unnecessarily high concentrations of timolol in the aqueous humor. beta(1)-receptors and beta(2)-receptors were practically 100% occupied after administration of both products. The hydrogel proved to be an excellent formulation in giving smaller inter-individual variation in penetration of timolol into the aqueous humor. Only a weak correlation was seen between corneal thickness and the aqueous humor concentration of timolol in the aqeuous 0.5% timolol group. In conclusion, in contrast to the conventional aqueous 0.5% timolol, 0.1% timolol hydrogel caused only slight inter-individual variation in timolol concentration in the aqueous humor.
| 19,013,521
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Control of Dead end localization and activity--implications for the function of the protein in antagonizing miRNA function.
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Dead end (dnd) is a vertebrate-specific component of the germ plasm and germ-cell granules that is crucial for germ-cell development in zebrafish and mouse. Dnd counteracts the inhibitory function of miRNAs, thereby facilitating the expression of proteins such as Nanos and Tdrd7 in the germ cells. Here, we show that cis-acting elements within dnd mRNA and the RNA recognition motive (RRM) of the protein are essential for targeting protein expression to the germ cells and to the perinuclear granules, respectively. We demonstrate that as it executes its function, Dnd translocates between the germ-cell nucleus and germ-cell granules. This phenomenon is not observed in proteins mutated in the RRM motif, correlating with loss of function of Dnd. Based on molecular modeling, we identify the putative RNA binding domain of Dnd as a canonical RRM and propose that this domain is important for protein subcellular localization and function.
| 19,013,519
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Time-dependent adaptation in the hemodynamic response to hypoxia.
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In rats, acute exposure to hypoxia causes a decrease in mean arterial pressure (MAP) caused by a predominance of hypoxic vasodilation over chemoreflex-induced vasoconstriction. We previously demonstrated that exposure to chronic intermittent hypoxia (CIH) impairs hypoxic vasodilation in isolated resistance arteries; therefore, we hypothesized that the acute systemic hemodynamic responses to hypoxia would be altered by exposure to CIH. To test this hypothesis, rats were exposed to CIH for 14 days. Heart rate (HR) and MAP were monitored by telemetry. On the first day of CIH exposure, acute episodes of hypoxia caused a decrease in MAP (-9+/-5 mmHg) and an increase in HR (+45+/-4 beats/min). On the 14th day of CIH exposure the depressor response was attenuated (-4+/-1mmHg; 44% of the day 1 response) and the tachycardia was enhanced (+68+/-2 beats/min; 151% of the day 1 response). The observed time-dependent modulation of the acute hemodynamic responses to hypoxia may reflect important changes in neurocirculatory regulation that contribute to CIH-induced hypertension.
| 19,013,546
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Memory for an imagined pathway and strategy effects in sighted and in totally congenitally blind individuals.
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The literature reports mixed results on the imagery abilities of the blind, at times showing a difference between sighted and blind individuals and at other times similarities. However, the possibility that the results are due to different strategies spontaneously used in performing the imagery tasks has never been systematically studied. A large group of 30 totally congenitally blind (TCB) individuals and a group of 30 sighted individuals matched for gender age and schooling were presented with a mental pathway task on a complex two-dimensional (5 x 5) matrix. After administering the task, participants were interviewed in order to establish the strategy they used. Results showed that both sighted and TCB may use a spatial mental imagery, a verbal or a mixed strategy in carrying out the task. Differences between the groups emerged only when last location and then entire pathway had to be remembered rather than just the last position, and were clearly affected by the type of strategy. Specifically, TCB performed more poorly than the sighted individuals when they used a spatial mental imagery strategy, whereas the two groups had a similar performance with a verbal strategy.
| 19,013,547
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A comparison of primary and passaged chondrocytes for use in engineering the temporomandibular joint.
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This study examines the tissue engineering potential of passaged (P3) and primary (P0) articular chondrocytes (ACs) and costal chondrocytes (CCs) from skeletally mature goats for use in the temporomandibular joint (TMJ). These four cell types were assembled into scaffoldless tissue engineered constructs and cultured for 4 wks. The constructs were then tested for cell, collagen, and glycosaminoglycan (GAG) content with biochemical assays, and collagen types I and II with enzyme-linked immunosorbent assays. Constructs were also tested under tension and compression to determine biomechanical properties. Both primary and passaged CC constructs had greater GAG/wet weight than AC constructs. Primary AC constructs had significantly less total collagen and contained no collagen type I. AC P3 constructs had the largest collagen I/collagen II ratio, which was also greater in passaged CC constructs relative to primary groups. Primary AC constructs were not mechanically testable, whereas passaged AC and CC constructs had significantly greater tensile properties than primary CC constructs. Primary CCs are considerably better than primary ACs and have potential use in tissue engineering when larger quantities of collagen type II are desired. The poor performance of the ACs, in this study, which contradicts the results seen with previous studies using immature bovine ACs, may thus be attributed to the animals' maturity. However, CC P3 cells appear particularly well suited for tissue engineering fibrocartilage of the TMJ due to the high quantity of collagen and GAG, and tensile and compressive mechanical properties.
| 19,013,549
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Preclinical atherosclerosis covaries with individual differences in reactivity and functional connectivity of the amygdala.
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Cardiovascular disease (CVD) is a major source of medical comorbidity for patients with mood and anxiety disorders, and it remains the leading public health burden for the general population in industrialized nations. Indirect neurobiological evidence suggests that preclinical risk for atherosclerosis, the main contributor to CVD, may be conferred by interindividual variation in the functionality of the amygdala, a brain system jointly involved in processing behaviorally salient stimuli and regulating the cardiovascular system. In a neuroimaging study of 36 middle-aged adults (18 women) who were screened for confounding clinical cardiovascular and psychiatric disorders, we examined the direct covariation between a marker of preclinical atherosclerosis, carotid artery intima-media thickness (IMT), and interindividual variation in amygdala reactivity and functional connectivity assessed during the processing of behaviorally salient stimuli (angry and fearful facial expressions). After accounting for traditional CVD risk factors, a thickening of carotid IMT across individuals covaried with greater amygdala reactivity and a more positive functional connectivity between the amygdala and perigenual anterior cingulate cortex, a corticolimbic area also implicated in behavioral salience processing and cardiovascular regulation. Individual differences in amygdala reactivity and functional connectivity may reflect facets of a novel, systems-level neural phenotype conferring risk for atherosclerosis and CVD.
| 19,013,557
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Dietary intervention with Okinawan vegetables increased circulating endothelial progenitor cells in healthy young women.
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Circulating endothelial progenitor cells (EPCs) play a critical role in maintaining the integrity of vascular vessels. The number of EPCs inversely correlates with the number of atherosclerotic risk factors. Although nonpharmacological treatment represents the first approach to the primary prevention of atherosclerotic diseases, little is known about the effects of diet on EPCs. We investigated the effect of a dietary intervention with vegetables that are commonly eaten in Okinawa on the number of EPCs. Forty-five healthy young women were employed and randomized to a dietary intervention group (n=24) or a control group (n=21). Subjects in the intervention group received typical Okinawan vegetables through home-parcel delivery for 2 weeks. After the dietary intervention, urinary potassium and magnesium excretion increased only in the intervention group and changes were greater than in the control group (p=0.007, 0.010, respectively). The consumption of total vegetables correlated with changes in both urinary potassium and magnesium excretion. Serum folic acid increased and plasma homocysteine decreased in both groups but the change was significant only in the intervention group. The EPCs number significantly increased in the intervention group but did not in the control group. An inverse correlation was observed between EPC number and plasma homocysteine level (r=-0.272, p=0.016). Changes in the EPC number inversely correlated with changes in both serum total cholesterol and low-density lipoprotein cholesterol level (r=-0.555, p=0.0002; r=-0.626, p<0.0001, respectively). The consumption of vegetables increased the number of circulating EPCs; this change might be associated with a homocysteine-lowering effect.
| 19,013,573
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The relationship between nocturnal polyuria and the distribution of body fluid: assessment by bioelectric impedance analysis.
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Increased nocturnal urinary volume is closely associated with nocturia. We investigated the relationship between nocturnal polyuria and the variation of body fluid distribution during the daytime using bioelectric impedance analysis. A total of 34 men older than 60 years were enrolled in this study. A frequency volume chart was recorded. Nocturnal polyuria was defined as a nocturnal urine volume per 24-hour production of greater than 0.35 (the nocturnal polyuria index). Bioelectric impedance analysis was performed 4 times daily at 8 and 11 a.m., and 5 and 9 p.m. using an InBody S20 body composition analyzer (BioSpace, Seoul, Korea). A significant difference was found in mean +/- SEM 24-hour urine production per fat-free mass between the groups with and without nocturnal polyuria (17.8 +/- 1.4 vs 7.7 +/- 0.9 ml/kg). The increase in fluid in the legs compared with the volume at 8 a.m. was significantly larger at 5 p.m., while there was no difference in the arms or trunk. Nocturnal urine volume significantly correlated with the difference in fluid volume in the legs (r = 0.527, p = 0.0019) and extracellular fluid volume (r = 0.3844, p = 0.0248) between the volumes at 8 a.m. and 9 p.m. Overproduction of urine per fat-free mass leads to nocturnal polyuria. Extracellular fluid accumulates as edema in the legs during the day in patients with nocturnal polyuria. The volume of accumulated extracellular fluid correlates with nocturnal urine volume. We suggest that leg edema is the source of nocturnal urine volume and decreasing edema may cure nocturnal polyuria.
| 19,013,595
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Single institution 2-year patient reported validated sexual function outcomes after nerve sparing robot assisted radical prostatectomy.
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To identify surgeon specific factors for preserving sexual function (and minimize patient related factors) we report 2-year potency outcomes in men 65 years or younger with normal preoperative sexual function undergoing nerve sparing robot assisted laparoscopic radical prostatectomy. Between July 2004 and February 2006, 200 consecutive patients underwent robot assisted laparoscopic radical prostatectomy by 1 surgeon. Inclusion criteria were age 65 years or younger with normal baseline 5-item International Index of Erectile Function score of 22 to 25 and complete 2-year followup. Postoperatively potency was defined by a yes to "erections adequate for vaginal penetration" and "satisfactory erections" on prospective self-administered validated questionnaires with or without phosphodiesterase type 5 medications. Men also reported 5-item International Index of Erectile Function scores and erectile fullness of 0% to 10%, 25%, 50%, 75% or 100% compared to before surgery. A total of 62 patients met the inclusion criteria, and of these 3 were lost to followup and 1 was excluded from study due to receiving hormonal therapy. At 3 months 32.1% reported potency. At 24 months potency was 89.7% (52 of 58) overall, 93.0% (40 of 43) for bilateral and 80.0% (12 of 15) for unilateral nerve sparing. For potent men the mean 5-item International Index of Erectile Function score was 20.4 at 3 months vs 21.3 at 24 months. Mean erectile firmness at 24 months was 91% compared to preoperative baseline, with 34 of 52 (65%) reporting 100% of preoperative fullness. The 5-item International Index of Erectile Function score and fullness at 24 months were equivalent for unilateral nerve sparing and bilateral nerve sparing. Overall 90% of men reported return of potency at 24 months, and 46% returned to baseline with normal 5-item International Index of Erectile Function scores and 100% firmness. Remarkably there was no difference in 5-item International Index of Erectile Function scores or fullness between unilateral nerve sparing and bilateral nerve sparing.
| 19,013,596
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Serum biomarker measurements of endothelial function and oxidative stress after daily dosing of sildenafil in type 2 diabetic men with erectile dysfunction.
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We investigated changes in serum biomarkers of vascular function after short-term, continuous sildenafil dosing in men with type 2 diabetes with erectile dysfunction. Men with erectile dysfunction associated with type 2 diabetes mellitus were randomized to receive continuous, daily sildenafil (50 mg for 1 week run-in and 100 mg for 3 weeks) (148), or placebo (144) for 4 weeks (phase I) and then sildenafil (25, 50 or 100 mg) on demand for 12 weeks (phase II). Blood draws at baseline and after phases I and II were analyzed for cyclic guanosine monophosphate (endothelial function marker), 8-isoprostane (oxidative stress marker), and interleukin-6 and interleukin-8 (inflammatory cytokines). Primary and secondary erectile function outcome variables were affirmative responses on Sexual Encounter Profile question 3 (ability to maintain erection sufficient for sexual intercourse) and Erection Hardness Score, respectively. Serum cyclic guanosine monophosphate levels were increased in the sildenafil group relative to the placebo group at 4 (p <0.01) and 16 (p <0.05) weeks, correlating with affirmative responses to Sexual Encounter Profile question 3 at the 4-week interval only (p <0.05). Serum 8-isoprostane levels were decreased to a nonsignificant degree in the sildenafil group at 4 weeks with no further change at 16 weeks, whereas interleukin-6 and interleukin-8 levels were unchanged at either interval, and these levels were unassociated with erectile function outcomes. These data suggest that short-term, continuous sildenafil treatment causes systemic endothelial function to be enhanced and remain so for a duration after its discontinuation. However, they do not indicate any influence of this treatment on systemic oxidative stress or inflammation, or an effect on long-term erectile function improvement.
| 19,013,603
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Bladder neck transection for intractable pediatric urinary incontinence.
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We report the indications, technique and outcome of a large series of children who underwent bladder neck transection for intractable urinary incontinence. We retrospectively reviewed demographics, operative details, complications and outcomes of 76 patients (47 males, 29 females) who underwent bladder neck closure at our institution between 1996 and 2006. Mean patient age at the time of the procedure was 12 years, 10 months. The most common diagnosis was bladder exstrophy. Of the patients 31 had undergone prior bladder neck reconstruction (30) or sling repair (1). All patients underwent concomitant augmentation and creation of a catheterizable stoma. A total of 50 patients had more than 12 months of followup (mean 44, range 12 to 128). Continence was achieved initially in 86% of the patients (43 of 50). Of the 7 primary failures 2 leaked via the urethra and 5 via the stoma. Six of these patients achieved dryness with revision, for a final continence rate of 98%. A single renal unit suffered significant loss of function during this period. New, nonobstructive hydronephrosis developed in 8 additional renal units. Stones developed in 30% of the patients. There were no spontaneous bladder ruptures. Bladder neck transection in combination with enterocystoplasty and creation of a continent catheterizable stoma is an effective approach to incontinent cases with severely damaged bladder outlets and poor quality bladders in which other reconstructive approaches either have failed or are deemed likely to fail. Specific concerns regarding the risk of poor renal outcomes and perforation seem unwarranted at present.
| 19,013,617
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Gene delivery in vitro and in vivo from bioreducible multilayered polyelectrolyte films of plasmid DNA.
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Layer-by-layer (LbL) films were assembled on flexible stainless steel substrate using plasmid DNA and reducible hyperbranched poly(amido amine) (RHB) polycation. The films were characterized by XPS and their disassembly in reducing conditions confirmed by ellipsometry. Fibroblast and smooth muscle cell attachment and proliferation on DNA/RHB films were indistinguishable from those on control DNA/poly(ethylenimine) (PEI) films. In vitro transfection activity was evaluated using reporter plasmids encoding for secreted alkaline phosphatase (SEAP) and green fluorescent protein (GFP). DNA/RHB films showed higher and longer lasting transfection activity than control DNA/PEI films using SEAP plasmid. It was revealed through the use of GFP plasmid that DNA/RHB films transfected almost the entire cell population growing on the films. In vivo transfection activity was evaluated by subcutaneously implanting a stainless steel substrate coated with the DNA/RHB films containing SEAP plasmid DNA and measuring the levels of SEAP secreted into the blood circulation of rats. It was found that the plasma levels of SEAP peaked at approximately 160 ng SEAP/mL five days post-implantation.
| 19,013,638
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IGF-I, EGF, and sex steroids regulate autophagy in bovine mammary epithelial cells via the mTOR pathway.
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Mammary gland growth and involution are based on a dynamic equilibrium between proliferation and apoptosis of mammary epithelial cells (MEC). The main type of cell death responsible for bovine mammary gland involution is apoptosis, but MEC also exhibit morphological features of autophagy. The present study has been undertaken in order to examine factors, which are responsible for the regulation of autophagy in bovine MEC. We used a model of in vitro mammary gland involution known to be dependent on fetal bovine serum (FBS) deficiency in the culture of bovine BME-UV1 cells. We investigated the effects of insulin-like growth factor-1 (IGF-I) and epidermal growth factor (EGF) signaling, as well as sex steroids and rapamycin (a specific inhibitor of mammalian target of rapamycin, mTOR, kinase) on autophagy in the MEC line BME-UV1. Our main focus was on the role of mTOR in the regulation of autophagy by growth factors and hormones. Laser scanning cytometry, electron microscopy, Western-blot analysis, GFP-LC3 reporter-based expression analysis, and LysoTracker Green-related fluorescence were used to determine the activity of autophagy in BME-UV1 cells. We found that FBS deficiency induced both autophagy and apoptosis with the highest intensity of both processes after 48h of MEC exposure to the deficient medium (0.5% FBS). Addition of IGF-I or/and EGF to the FBS-deficient medium clearly diminished autophagy. We also show that IGF-I and EGF are involved in the activation of mTOR in bovine MEC, whereas inhibition of mTOR by rapamycin abrogated the suppressive effects of IGF-I and EGF on autophagy. This suggests that mTOR links IGF-I and EGF signaling in inhibiting the autophagy pathways. Contrary to IGF-I and EGF, 17beta-estradiol and progesterone exerted stimulatory effects on autophagy in bovine MEC. At the same time we observed a suppressive effect of both steroids on mTOR activation/phosphorylation. In conclusion, autophagy in bovine MEC undergoes complex regulation, where its activity is controlled by survival pathways dependent on IGF-I and EGF, which are involved in suppression of autophagy, and by pregnancy steroids, which act as inducers of the process.
| 19,013,662
|
Utility of spa typing for investigating the local epidemiology of MRSA on a UK intensive care ward.
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In the UK, meticillin-resistant Staphylococcus aureus (MRSA) is frequently endemic on intensive care units (ICUs), yet our understanding of the local epidemiology of MRSA within the ICU is poor and the best methods for preventing MRSA acquisition remain controversial. Newer molecular typing methods may aid epidemiological investigation of local MRSA strains. We applied Staphylococcal Protein A (spa) typing to MRSA strains collected from patients in a UK ICU. spa typing allowed better discrimination than multilocus sequence typing (MLST) but 73% of strains were either spa type t032 or t018 (associated with the prevalent UK MRSA strains, EMRSA-15 and EMRSA-16). MRSA infections were preceded by MRSA colonisation in 72% of patients, and in 88% of these, both commensal and disease-causing strains had identical MLST and spa types. spa typing helped elucidate the transmission of MRSA between patients for 19 strains with unusual spa types, although the high incidence of EMRSA-15 and -16 types t032 and t018 prevented its use for the majority of strains. Surprisingly, only four (9%) of 45 new MRSA isolates occurring within 28 days of isolation of an unusual spa type could have been due to cross-contamination. These results suggest that prompt transmission of MRSA between patients is rare in our ICU, at least for those strains with unusual spa types.
| 19,013,682
|
Impacts of the physiochemical properties of chlorinated solvents on the sorption of trichloroethylene to the roots of Typha latifolia.
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Sorption to plant roots is the first step for organic contaminants to enter plant tissues. Mounting evidence is showing that sorption to plant roots is nonlinear and competitive. The objective of this study was to investigate the effects of physiochemical properties of homologous chlorinated ethenes and ethanes on the competitive sorption of trichloroethylene (TCE) to the roots of Typha latifolia (cattail). The results showed that chlorinated ethenes exerted significantly stronger competition on the sorption of TCE than chlorinated ethanes. Individual physiochemical properties of organic compounds could be related to the competitive capacity of chlorinated ethenes, but the roles appeared secondary, with molecular structures showing primary effects. Based on these observations, a two-step sorption mechanism was proposed, consisting of the interactions between organic compounds and functional groups on the root surface and subsequent pore filling and absorption to the hydrophobic domains in the composition of roots.
| 19,013,701
|
Immunosurveillance of pancreatic adenocarcinoma: insights from genetically engineered mouse models of cancer.
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The resurgent theory of cancer immunosurveillance holds that the immune system plays an important role in the suppression of tumors, particularly in the elimination of early neoplastic lesions. Tumors with reduced immunogenicity or those that have acquired mechanisms to suppress immune effector functions, however, can emerge from this selection pressure and grow progressively. This is an especially important issue in pancreatic cancer, which although inflammatory in vivo is nevertheless highly aggressive and nearly always lethal. Here, we review emerging data obtained from novel genetically defined mouse models of pancreatic adenocarcinoma that suggest that the immune system may be complicit in the inception and progression of pancreatic cancer. Host immune cells with suppressive properties infiltrate the pancreas early during tumorigenesis, even at the earliest stages of neoplasia, preceding and effectively undermining any lymphocytes with potential antitumor function. Thus, in pancreatic adenocarcinoma, the failure of immunosurveillance is likely an early event during tumorigenesis, a concept that carries important implications for the design of novel immunotherapeutics in this disease.
| 19,013,709
|
Anti-Trichomonas vaginalis activity of synthetic lipophilic diamine and amino alcohol derivatives.
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Taking in account the increased prevalence of metronidazole-resistant infections, alternative drugs are necessary for the treatment of trichomonosis. We report in this work the preparation and the in vitro anti-trichomonads activity of two diamines 1 and 2, and three different lipophilic amino alcohol derivatives 3, 4 and 5. These compounds were tested for in vitro activity against two isolates of Trichomonas vaginalis and displayed inhibition of the parasite growth. Five concentrations of each compound were tested. The butanediamine derivative 1, at a final concentration of 5.85 microM, presented a cytotoxic effect against 47% of T. vaginalis trophozoites. Furthermore, the cytotoxicity of 1 did not present statistically significant difference when compared to metronidazole in the same range of concentration (0.1-1.5 microg/mL).
| 19,013,752
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Effect of carvedilol on pulse pressure and left ventricular hypertrophy in spontaneously hypertensive rats with adriamycin nephropathy.
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Recent studies indicated pulse pressure as a risk factor for left ventricular hypertrophy, myocardial infarction, congestive heart failure and stroke as well as chronic renal failure progression. The present study examined the effects of carvedilol and its combination with captopril on blood pressure, left ventricular hypertrophy, kidney vascular changes and kidney function in spontaneously hypertensive rats with adriamycin nephropathy. Four groups of 20 SHR each were involved: (1) control group: SHR; (2) ADR group: SHR treated with ADR (2mg/kg i.v. twice in 20 days); (3) ADR-C group: SHR treated with ADR and carvedilol (30 mg/kg/day) and (4) ADR-CC group: SHR treated with ADR and carvedilol (30 mg/kg/day) and captopril (60 mg/kg/day). Systolic-, diastolic- and mean-pressures and pulse pressure were determined at weeks 6 and 12 after the second ADR injection; and body weight, creatinine clearance and proteinuria at weeks -3, 6 and 12. The rats were sacrificed at week 6 or 12, the weights of the left and right ventricles and kidneys measured and the kidney vascular index was calculated as described by Bader and Mayer. Both carvedilol alone and combined with captopril significantly reduced systemic blood pressure but the effect of the latter was more pronounced and registered from week 4 till the end of the study. Carvedilol and its combination with captopril significantly decreased SBP, DBP and MAP. They also decreased PP, prevented the development of LVH, and renal vascular changes and slowed the progression of chronic renal failure and these effects were stronger in the ADR-CC group than in the ADR-C group. The antihypertensive drugs failed to prevent proteinuria in ADR SHR. Significant positive correlations were found between PP (but not SBP, DBP and MAP) and both proteinuria and Ccr in all groups of rats. In conclusion, carvedilol alone, but more strongly in combination with captopril, significantly reduced blood pressure, PP, LVH, renal blood vessel changes and chronic renal failure progression.
| 19,013,753
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Poor reporting of search strategy and conflict of interest in over 250 narrative and systematic reviews of two biologic agents in arthritis: a systematic review.
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To evaluate the quality of reviews about etanercept (ETN) and infliximab (IFX), two biologic treatments for rheumatoid arthritis (RA). A comprehensive, systematic review, including searches of MEDLINE, EMBASE, and other electronic databases and hand-searches for published and unpublished literature. Two raters independently examined each article and identified systematic reviews as those including either a description of: (1) sources for identification and data retrieval; or (2) search strategy. They applied the quality of reporting of meta-analyses (QUOROM) instrument to systematic reviews. Of 3,620 total citations, 281 were identified as reviews. Of these, 26 (9%) qualified as systematic rather than narrative. Overall, few reviews described selection of sources, critical appraisal, or quantitative summary or synthesis. Systematic reviews most often failed to explain validity assessment. Several articles did not disclose authors' participation in industry-funded clinical trials. Most reviews published in high impact factor and rheumatology journals did not meet many quality standards. Significant associations existed between review type (narrative vs. systematic) and reported funding (P=0.05), conflicts of interest (P=0.005), and country of publication (P<0.0001). More than 90% of the published reviews were narrative and did not report methods and conflicts of interest in sufficient detail, raising concerns about selection and reporting bias.
| 19,013,763
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Prediction of risk of COPD exacerbations by the BODE index.
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This study assesses the power of the BODE index, a multidimensional grading system that predicts mortality, to predict subsequent exacerbations in patients with COPD. Prospective cohort study. A total of 275 COPD patients were followed every 6 months up to 8 years (median of 5.1 years). Baseline clinical variables were recorded and the BODE index was calculated. We investigated the prognostic value of BODE quartiles (scores 0-2, 3-4, 5-6 and 7-10) for both the number and severity of exacerbations requiring ambulatory treatment, emergency room visit, or hospitalization. The annual rate of COPD exacerbations was 1.95 (95% CI, 0.90-2.1). The mean time to a first exacerbation was inversely proportional to the worsening of the BODE quartiles (7.9 yrs, 5.7 yrs, 3.4 yrs and 1.3 yrs for BODE scores of 0-2, 3-4, 5-6 and 7-10, respectively). Similarly, the mean time to a first COPD emergency room visit was 6.7 yrs, 3.6 yrs, 2.0 yrs and 0.8 yrs for BODE quartiles (all p<0.05). Using ROC curves, the BODE index was a better predictor of exacerbation than the FEV(1) alone (p<0.01). The BODE index is a better predictor of the number and severity of exacerbations in COPD than FEV(1) alone.
| 19,013,781
|
Patient-reported outcomes: assessment and current perspectives of the guidelines of the Food and Drug Administration and the reflection paper of the European Medicines Agency.
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Patient-reported outcomes (PROs) have recently gained greater credibility with regulatory bodies aiming to standardise their use and interpretation in RCTs, thereby supporting medicinal product submissions. For this reason, the United States (US) Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) have released guidelines. This review paper provides an overview of the current perspectives and views on these guidelines. To evaluate the FDA and EMEA PRO guidelines, 47 expert responses to the FDA guidance were qualitatively reviewed. Two reviewers independently extracted data from these letters and checked these responses to warrant consistency and agreement in the evaluation process. A PubMed literature review was systematically examined to obtain supporting evidence or related articles for both the guidance documents. Generally, there is agreement between regulatory authorities and the research community on the contents of the FDA and EMEA PRO draft guidance. However, disagreements exist on significant philosophical topics (e.g. the FDA focuses more on conceptual models and symptoms than the EMEA) and design topics (e.g. the FDA is more restrictive on issues of recall bias, blinding of oncology trials and degrees of psychometric validation than researchers and the EMEA). This could influence the approval of PRO claims. PRO guidance from the EMEA and FDA has been valuable, and has raised the profile and active debate of PROs in oncology. However, our review of the current opinion shows that there are controversial aspects of the guidance. Consequently, greater latitude should be given to how the guidance is interpreted and applied.
| 19,013,787
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Acute subdural hematoma after transsphenoidal surgery.
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We report the case of a 48-year-old male who developed an acute subdural hematoma after transsphenoidal decompression of a pituitary adenoma followed by a lumbar drain to conservatively manage postoperative cerebrospinal fluid rhinorrhoea. An attempt is made to discuss the risk factors. The need for constant monitoring, early imaging and prompt treatment is stressed.
| 19,013,804
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Three adolescents with Lhermitte-Duclos disease.
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Lhermitte-Duclos disease (LDD) is a rare, benign cerebellar disorder, characterized by replacement of granular cells and Purkinje cells by an overgrowth of cerebellar ganglion cells. LDD can be associated with Cowden's syndrome (CS). We studied three adolescent LDD patients, including two with CS. MRI revealed the typical tiger-stripe pattern in all patients. CS was diagnosed on the basis of secondary mucocutaneous lesions and a PTEN/MMAC1 gene mutation. Adolescent-onset LDD appears to have the same phenotype and genotype as adult-onset LDD. Total resection of the lesion is recommended as an initial management strategy. We strongly recommend that patients with LDD undergo genetic screening to find out as early as possible whether CS has developed.
| 19,013,808
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Comorbidities and their impact on mortality in HCV and HCV-HIV-coinfected persons on dialysis.
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To determine the rates of non-human immuno deficiency virus (HIV)-related comorbidities and their impact on survival in hepatitis C virus (HCV) and HCV-HIV coinfected persons on dialysis. We identified HCV-infected subjects and diagnoses of medical and psychiatric comorbidities in the United States Renal Data System using ICD-9 codes. Logistic regression was used to determine the odds of comorbidities and predictors of mortality. We identified 5310 HCV-infected and 427 HCVHIV-coinfected subjects. The latter were younger, more likely to be male, black race, and had a lower body mass index. After adjusting for age, race, and sex we found that coronary artery disease (CAD), diabetes mellitus (DM) as primary cause of renal failure and cirrhosis were less frequently diagnosed in the HCVHIV-coinfected subjects, whereas hepatitis B, wasting, drug and alcohol abuse, and dependence were more frequently diagnosed.Increasing age, CAD, stroke, DM, cirrhosis, wasting, cancer,and drug abuse and dependence were associated with higher odds of death in the HCV monoinfected subjects, whereas cirrhosis, wasting, and smoking were the only such factors in the HCV-HIV-coinfected subjects. The frequency and patterns of comorbidities and predictors of death differ in HCV-monoinfected and HCVHIV-coinfected persons on dialysis. These differences should be taken into account when designing future interventions.
| 19,013,829
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The human brain endothelial cell line hCMEC/D3 as a human blood-brain barrier model for drug transport studies.
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The human brain endothelial capillary cell line hCMEC/D3 has been developed recently as a model for the human blood-brain barrier. In this study a further characterization of this model was performed with special emphasis on permeability properties and active drug transport. Para- or transcellular permeabilities (P(e)) of inulin (0.74 x 10(-3) cm/min), sucrose (1.60 x 10(-3) cm/min), lucifer yellow (1.33 x 10(-3) cm/min), morphine (5.36 x 10(-3) cm/min), propranolol (4.49 x 10(-3) cm/min) and midazolam (5.13 x 10(-3) cm/min) were measured. By addition of human serum the passive permeability of sucrose could be reduced significantly by up to 39%. Furthermore, the expression of a variety of drug transporters (ABCB1, ABCG2, ABCC1-5) as well as the human transferrin receptor was demonstrated on the mRNA level. ABCB1, ABCG2 and transferrin receptor proteins were detected and functional activity of ABCB1, ABCG2 and the ABCC family was quantified in efflux experiments. Furthermore, ABCB1-mediated bidirectional transport of rhodamine 123 was studied. The transport rate from the apical to the basolateral compartment was significantly lower than that in the inverse direction, indicating directed p-glycoprotein transport. The results of this study demonstrate the usefulness of the hCMEC/D3 cell line as an in vitro model to study drug transport at the level of the human blood-brain barrier.
| 19,013,850
|
Advanced imaging technologies for mapping cadaveric lymphatic anatomy: magnetic resonance and computed tomography lymphangiography.
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Lymphatic anatomy has become increasingly clinically important as surgical techniques evolve for investigating and treating cancer metastases. However, due to limited anatomical techniques available, research in this field has been insufficient. The techniques of computed tomography (CT) and magnetic resonance (MR) lymphangiography have not been described previously in the imaging of cadaveric lymphatic anatomy. This preliminary work describes the feasibility of these advanced imaging technologies for imaging lymphatic anatomy. A single, fresh cadaveric lower limb underwent lymphatic dissection and cannulation utilizing microsurgical techniques. Contrast materials for both CT and MR studies were chosen based on their suitability for subsequent clinical use, and imaging was undertaken with a view to mapping lymphatic anatomy. Microdissection studies were compared with imaging findings in each case. Both MR-based and CT-based contrast media in current clinical use were found to be suitable for demonstrating cadaveric lymphatic anatomy upon direct intralymphatic injection. MR lymphangiography and CT lymphangiography are feasible modalities for cadaveric anatomical research for lymphatic anatomy. Future studies including refinements in scanning techniques may offer these technologies to the clinical setting.
| 19,013,880
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Trabeculectomy with mitomycin-C in neovascular galucoma patients.
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We sought to determine the effectiveness of trabeculectomy with mitomycin-C (MMC) in neovascular glaucoma (NVG) patients. Trabeculectomy with MMC in NVG patients is a method that has high rate of short-term success.
| 19,013,913
|
Clinical and coronary angiographic characteristics of patients with coronary slow flow.
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The coronary slow flow phenomenon is an angiographic finding characterized by delayed distal vessel opacification in the absence of significant epicardial coronary disease, and is an important clinical entity because it may be the cause of angina at rest or during exercise, acute myocardial infarction, and hypertension. The pathophysiological mechanisms of the coronary slow flow phenomenon remain undetermined. Endothelial dysfunction and microvascular dysfunction have been suggested as underlying mechanisms. The slow coronary flow (SCF) phenomenon is considered to be a form of early phase atherosclerosis in some studies.A study of patients with SCF was conducted to determine the associated clinical and angiographic properties. Eighty-five patients with SCF and 85 control subjects without SCF were included in the study. All subjects had angiographically proven normal coronary arteries. Coronary flow patterns of the latter were determined by the thrombolysis in myocardial infarction frame count method. Clinical and angiographic characteristics of the patients were obtained from case records. Patients with SCF had higher total cholesterol, and LDL-C levels. Body mass index (BMI) was higher and metabolic syndrome was more frequent in SCF compared to control subjects. Patients with SCF were more symptomatic than the control group, and hospital admissions were also more frequent. BMI correlated statistically significantly, but weakly, with mean TIMI frame count for the 3 coronary arteries. In this study we demonstrated that patients with SCF had a significant metabolic disarrangement compared to the control group. Patients with SCF have a high incidence of metabolic syndrome which leads to development of coronary microvascular dysfunction via several mechanisms.
| 19,014,000
|
High prevalence of the metabolic syndrome in hypertensive rural Chinese women.
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The metabolic syndrome has become a major public health issue worldwide.This study was designed to evaluate and compare the epidemiological features of the metabolic syndrome in hypertensive rural Chinese women. A cross-sectional survey was conducted during 2004-2006, which undertook cluster multistage sampling to a representation sample of hypertensive women living in 50 rural villages of Liaoning, China. A total of 3607 women aged > or =35 years were selected.At baseline, lifestyle and other factors were obtained. The metabolic syndrome was proposed by the International Diabetes Federation definition. Of the study population 49.6% (age-adjusted: 49.3%) had metabolic syndrome. Overall, 64.7%, 39.2%, 33.8%, and 33.9% of the hypertensive women had central obesity, hypertriglyceridaemia, low HDL cholesterol, and high fasting plasma glucose, respectively. 87.7% of the sample had at least one component of the metabolic syndrome. Multivariate logistic regression revealed that Mongolian nationality and obesity were risk factors for metabolic syndrome. Moderate levels of physical activity and current drinking status were shown as protective factors. There was a positive association between metabolic syndrome and age in the age group between 55 and 64 years. The current study demonstrated that the prevalence of metabolic syndrome was dramatically high in hypertensive women, even in the rural areas of China. Further, our study indicated that remarkable ethnic differences exist in the prevalence of metabolic syndrome. Obese and moderate levels of physical activity were a modifiable risk factor.
| 19,014,002
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Lack of association between endothelial nitric oxide synthase gene polymorphisms and risk of premature coronary artery disease in the Greek population.
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Genetic polymorphisms in the gene for endothelial nitric oxide synthase have been considered as potential risk factors for the development of coronary artery disease in some populations. We studied two polymorphisms of the NOS3 gene, the VNTR in intron 4 (4VNTR) and the Glu298Asp polymorphism in exon 7, in relation to the existence of premature coronary artery disease and the occurrence of myocardial infarction.A total number of 370 individuals of the Greek population was examined by PCR-RFLP method.The patient group consisted of 209 subjects, aged less than 58 years presenting symptomatic coronary artery disease, documented by coronary angiography. The frequencies for bb, ab and aa genotypes of 4VNTR polymorphism were 0.67, 0.29, 0.04, respectively, for the patient group and 0.73, 0.24, 0.03 for the control group.The frequencies for GG (Glu/Glu), GT (Glu/Asp),TT (Asp/Asp) of the Glu298Asp polymorphism were 0.52, 0.41, 0.07, respectively, in patients compared to 0.47, 0.46, 0.07, in control subjects. Statistical analysis indicated that there are no significant differences in the frequencies of the genotypes between patients and control subjects for both polymorphisms. The combined analysis of the two polymorphisms indicated no synergistic effect of the a and T alleles on coronary artery disease. We have found no evidence for association between the a allele of the 4VNTR polymorphism, or the T allele of Glu298Asp polymorphism and the risk for premature coronary artery disease or occurrence of myocardial infarction. Furthermore, no synergistic contribution of these polymorphisms to the development of premature coronary artery disease has been observed.
| 19,014,005
|
Lasers in cosmetic dentistry.
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Lasers have become a necessary instrument in the esthetic restorative armamentarium. This article presents smile design guidelines for soft tissue lasers, as well as an overview of hard tissue procedures that may be performed using all-tissue lasers. The goal is to help dentists determine the appropriate laser for a given clinical situations.
| 19,014,026
|
A comprehensive treatment approach focusing on the restoration of the anterior maxilla.
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Proper diagnosis, thorough evaluation, and a comprehensive treatment plan are fundamental to restoring each patient's oral health and esthetic concerns. This case report presents the strategy of a comprehensive evaluation, diagnosis, and treatment focusing on the patient's compromised anterior maxillary dentition. Oral rehabilitation was accomplished through selective dental extractions, immediate placement of dental implants, elective endodontic treatment, and fixed restorations. Adequate surgical, restorative, and preventive protocols were utilized to achieve optimal function and esthetic results.
| 19,014,031
|
Neuroendocrine carcinoma of the oral cavity: a case report and review of the literature.
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Neuroendocrine (NE) carcinoma is a rare disease originating from the NE cell system, which is considered to be the third division of the nervous system. Based on their biological characteristics, NE carcinomas are classified into three subtypes: well-differentiated NE carcinoma (typical carcinoid tumor), moderately differentiated NE carcinoma (atypical carcinoid tumor), and poorly differentiated carcinoma (small cell carcinoma). Among the primary tumors, the propensity for disease to spread to the oral region varies. Although metastatic oral disease is rare, dentists should be aware of such a possibility, particularly when examining patients with a known history of malignancy. This case report describes a patient with an unknown primary NE malignancy that led to metastatic lesions in both the liver and mandibular soft tissues.
| 19,014,033
|
Diabetes mellitus in a nanday conure (Nandayus nenday).
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A 3-year-old male nanday conure (Nandayus nenday) was presented with acute lethargy, polyuria, and polydipsia. Marked persistent hyperglycemia, glycosuria, and ketonuria were also noted. The serum insulin concentration (< 3 microU/ml) was lower than reference ranges described for other psittacine birds. Initial treatment included insulin, antibiotics, and supportive care. Insulin therapy was adjusted based on results of serial blood glucose curves. Histopathologic examination of pancreatic biopsy samples revealed normal exocrine pancreatic tissue with rare lymphoplasmocytic infiltrates and absence of pancreatic islets, suggesting atrophy of endocrine pancreatic tissue. Resolution of clinical signs and a normalized blood glucose curve were obtained after administration of long-acting insulin (0.3 IU/kg IM AM and 0.25 IU/kg IM PM). One month after initial presentation, the conure was admitted for severe dyspnea and lethargy and died despite supportive care. Histopathologic examination of the pancreas revealed nearly total depletion of the endocrine pancreas with moderate lymphoplasmocytic pancreatitis. Immunohistochemical evaluation of the remaining pancreatic islets was negative for the presence of insulin and positive for glucagon. Results of polymerase chain reaction tests for Chlamydophila psittaci performed on tissues from the liver, spleen, and lung were negative. Transmission electron microscopy did not demonstrate viruses. Clinical and pathological findings observed in this case are consistent with insulin-dependant type 1 diabetes.
| 19,014,099
|
[Educational campaign targeting high school smokers].
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The problem of smoking among young people continues to be a major health problem. In this study, high school students from the provinces of Rimini and Ravenna were invited to take the carbon monoxide test, in order to investigate the main reasons behind their smoking behaviour and to analyse attitudes towards changing the habit. The initiative involved 288 students: 56% males and 44% females aged between 14 and 20. The average daily consumption of cigarettes was 7.9 for the 14-17 age range, and 8.5 for the older group; the average age of starting smoking was 14.6 years. The consumption was seen to rise in both sexes at the weekend among those who smoked more than 10 cigarettes a day. The main reasons for smoking were relaxation and pleasure; the females were more addicted to cigarettes and to the rituals surrounding the habit. Although the students were aware of the risks involved in smoking, only 15% intended to quit. This confirms that awareness of the dangers alone is not sufficient to break the habit. Once again the school environment appears to be the most suitable place to meet young people in order to establish and assess their needs, and to set up programs of health promotion and education.
| 19,014,106
|
Providing patients with information on caring for skin.
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This article examines why healthcare professionals may find it difficult to advise patients about care of chronic skin conditions such as psoriasis, eczema and acne. Strategies that might be helpful in improving advice for patients are discussed.
| 19,014,143
|
Management and prevention of diabetic foot ulcers and infections: a health economic review.
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Diabetic foot ulcers and infections are common and incur substantial economic burden for society, patients and families. We performed a comprehensive review, on a number of databases, of health economic evaluations of a variety of different prevention, diagnostic and treatment strategies in the area of diabetic foot ulcers and infections. We included English-language, peer-reviewed, cost-effectiveness, cost-minimization, cost-utility and cost-benefit studies that evaluated a treatment modality against placebo or comparator (i.e. drug, standard of care), regardless of year. Differences were settled through consensus. The search resulted in 1885 potential citations, of which 20 studies were retained for analysis (3 cost minimization, 13 cost effectiveness and 4 cost utility). Quality scores of studies ranged from 70.8% (fair) to 87.5% (good); mean = 78.4% +/- 5.33%.In diagnosing osteomyelitis in patients with diabetic foot infection, magnetic resonance imaging (MRI) showed 82% sensitivity and 80% specificity. MRI cost less than 3-phase bone scanning + Indium (In)-111/Gallium (Ga)-67; however, when compared with prolonged antibacterials, MRI cost $US120 (year 1993 value) more without additional quality-adjusted life-expectancy. Prevention strategies improved life expectancy and QALYs and reduced foot ulcer rates and amputations.Ampicillin/sulbactam and imipenem/cilastatin were both 80% successful in treating diabetic foot infections but the latter cost $US2924 more (year 1994 value). Linezolid cure rates were higher (97.7%) than vancomycin (86.0%) and cost $US873 less (year 2004 value). Ertapenem costs were significantly lower than piperacillin/tazobactam ($US356 vs $US503, respectively; year 2005 values). Becaplermin plus good wound care may be cost effective in specific populations. Bioengineered living-skin equivalents increased ulcer-free months and ulcers healed, but costs varied between countries. Promogran produced more ulcer-free months than wound care alone (3.75 vs 3.41 months, respectively). Treatment with cadexomer iodine resulted in higher rates of healed ulcer (29% vs 11%) and lower weekly treatment costs (Swedish krona [SEK]903 vs SEK1421; year 1993 values) than standard care. Filgrastim decreased hospital stays, time to resolution and costs (36% lower) compared with usual care. Adjunctive hyperbaric oxygen produced an incremental cost per QALY at year 1 of $US27 310 and $US2255 at year 12 (year 2001 values).Overall, preventive strategies were shown to be cost effective and potentially cost saving. Various antibacterial regimens are cost effective but empiric choices should be based on local resistance patterns. MRI was cost effective compared with three-phase bone scanning + In-111/Ga-67 but not against prolonged antibacterial therapy. Other innovations (becaplermin, bioengineered living-skin equivalents, filgrastim, cadexomer iodine ointment, hyperbaric oxygen, Promogran may be cost effective in this population but more studies are needed to confirm these findings.
| 19,014,203
|
Within-subjects experiments on blocking and facilitation in honeybees (Apis mellifera).
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It has long been suspected in the vertebrate literature, but demonstrated only recently in work with honeybees (Apis mellifera), that the different treatments of nontarget stimuli in conventional between-groups blocking experiments may give the appearance of blocking independently of experience with the target stimulus. The same difficulty does not arise in within-subjects experiments, and in a series of such experiments with odors and colors free-flying honeybees gave no evidence of blocking; separate reinforced presentations of one element of a reinforced compound failed to reduce responding to the second. There was, however, clear evidence of facilitation; separate nonreinforced presentations of one element of a reinforced compound increased responding to the second. The implications of the results for further work on compound conditioning in honeybees and other animals are considered.
| 19,014,261
|
Personality in free-ranging Hanuman langur (Semnopithecus entellus) males: subjective ratings and recorded behavior.
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The authors obtained behavioral observations and personality ratings for 27 free-ranging Hanuman langur males. Subjects were rated using a questionnaire based on the human Five-Factor Model (FFM). Behavioral observations were taken over 5 months using an ethogram that included 50 behaviors. Principal Component Analysis (PCA) of ratings revealed Agreeableness_(R), Confidence_(R), and Extraversion_(R) components. Each personality dimension was associated with a unique set of observed behaviors. PCA of 36 behavioral indices revealed Dominance_(B), Involvement_(B), and Activity_(B) components. Bivariate correlations showed that Agreeableness_(R) was negatively correlated with Dominance_(B); Confidence_(R) was positively correlated with Dominance_(B) and Involvement_(B) but negatively correlated with Activity_(B); and Extraversion_(R) was positively correlated with Activity_(B). Dominance rank was positively correlated with Confidence_(R) and Dominance_(B) but negatively correlated with Agreeableness_(R) and Activity_(B). These results highlight the comparability of behavioral coding and personality ratings and suggest that some aspects of personality structure were present in the common ancestor of Old World monkeys.
| 19,014,262
|
Aping humans: age and sex effects in chimpanzee (Pan troglodytes) and human (Homo sapiens) personality.
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Ratings of 202 chimpanzees on 43 personality descriptor adjectives were used to calculate scores on five domains analogous to the human Five-Factor Model and a chimpanzee-specific Dominance domain. Male and female chimpanzees were divided into five age groups ranging from juvenile to old adult. Internal consistencies and interrater reliabilities of factors were stable across age groups and approximately 6.8 year retest reliabilities were high. Age-related declines in Extraversion and Openness and increases in Agreeableness and Conscientiousness paralleled human age differences. The mean change in absolute standardized units for all five factors was virtually identical in humans and chimpanzees after adjustment for different developmental rates. Consistent with their aggressive behavior in the wild, male chimpanzees were rated as more aggressive, emotional, and impulsive than females. Chimpanzee sex differences in personality were greater than comparable human gender differences. These findings suggest that chimpanzee and human personality develop via an unfolding maturational process.
| 19,014,265
|
Veterinarian-client-patient communication during wellness appointments versus appointments related to a health problem in companion animal practice.
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To compare the clinical interview process, content of the medical dialog, and emotional tone of the veterinarian-client-patient interaction during wellness appointments and appointments related to a health problem in companion animal practice. Cross-sectional descriptive study. A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. For each practitioner, 6 clinical appointments (3 wellness appointments and 3 problem appointments) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes. Wellness appointments were characterized by a broad discussion of topics, with 50% of data-gathering statements and 27% of client education statements related to the pet's lifestyle activities and social interactions. Wellness appointments included twice as much verbal interaction with the pet as did problem appointments, and the emotional atmosphere of wellness appointments was generally relaxed. There were more social talk, laughter, statements of reassurance, and compliments directed toward the client and pet. In contrast, during problem appointments, 90% of the data gathering and client education focused on biomedical topics. Coders rated veterinarians as hurried during 30 of the 150 (20%) problem appointments; they rated clients as anxious during 39 (26%) problem appointments and as emotionally distressed during 21 (14%). Results suggested that veterinarian-client-patient communication differed between wellness and problem appointments. Owing to the emphasis on biomedical content during problem appointments, veterinarians may neglect lifestyle and social concerns that could impact patient management and outcomes, such as client satisfaction and adherence to veterinarian recommendations.
| 19,014,290
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Successful treatment of head shaking by use of infrared diode laser deflation and coagulation of corpora nigra cysts and behavioral modification in a horse.
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A 15-year-old Saddlebred gelding used for competitive pleasure driving had a 1-year history of head shaking while pulling a cart. The horse had cystic corpora nigra in both eyes and concomitant classic and operant conditioned responses to wearing a bridle with bilateral eye covers (blinkers). Deflation and coagulation of the cysts with an infrared diode laser and behavior modification consisting of desensitization and counter-conditioning were used to successfully restore performance. Behavioral changes in horses can result from a combination of physical and psychologic causes. A combination of appropriate medical treatment of physical abnormalities and a behavioral modification plan is necessary to successfully treat behavioral problems in these patients.
| 19,014,298
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Single-case experimental designs for the evaluation of treatments for self-injurious and suicidal behaviors.
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Single-case experimental designs (SCEDs) provide a time- and cost-effective alternative to randomized clinical trials and offer significant advantages in terms of internal and external validity. A brief history and primer on SCEDs is provided, specifically for use in suicide intervention research. Various SCED methodologies, such as AB, ABAB, multiple baseline, and changing criterion designs, are described. Advantages and disadvantages of their use specifically for intervention research for suicidal and self-injurious behaviors are detailed.
| 19,014,302
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University students' perceived self-efficacy in identifying suicidal warning signs and helping suicidal friends find campus intervention resources.
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Currently, suicide is the third leading cause of death among youth 18 to 24 years of age and the second leading cause of death on college campuses. A sample of students (N = 1,019) from three midwestern universities were surveyed regarding their perceived self-efficacy in identifying suicide warning signs and campus suicide intervention resources. The results indicated that 11% strongly believed they could recognize a friend at suicidal risk, while 17% strongly believed they could ask a friend if he or she was suicidal. Students who had received high school suicide prevention education and who had ever had a family member or friend express suicidal thoughts to them were those most confident in recognizing a friend at risk, asking a friend if he/she is suicidal, and helping a friend to see a counselor. Most (71%) were not aware of on-campus help resources. These findings underscore the importance of suicide prevention education throughout the high school and college years.
| 19,014,311
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Expression of opioid growth factor (OGF)-OGF receptor (OGFr) axis in human nonmedullary thyroid cancer.
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Although thyroid cancers are readily treatable with surgery and radioactive iodine, there are problems in managing recurring, as well as locally advanced, thyroid cancer. The opioid growth factor (OGF) and its receptor, OGF receptor (OGFr), form a tonically active, autocrine-paracrine loop that serves to inhibit cell proliferation in a wide variety of normal and abnormal cells and tissues. In the present study we examined the presence and distribution of OGF and OGFr in nonmedullary thyroid cancer, including papillary, follicular, and anaplastic, as well as thyroid tissue from patients with nonmalignant disease. Patient samples of thyroid cancers and goiter were collected at the time of resection and processed for immunohistochemistry of OGF and OGFr, as well as pharmacological binding assays for OGFr. Both peptide and receptor were detected in the cytoplasm and nucleus of all nonmedullary thyroid cancers, as well as in goiter. Specific and saturable binding of OGFr was found in all thyroid samples. The finding that a potent negative growth regulator and its receptor are present in nonmedullary thyroid cancers and thyroid tissues from patients with nonmalignant disease lead us to suggest that the OGF-OGFr axis serves as a regulator of cell proliferation in these tissues. Moreover, modulation of this biological system may be used to treat progression of nonmedullary thyroid neoplasias.
| 19,014,324
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Purification and characterization of human phosphatidylserine synthases 1 and 2.
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PS (phosphatidylserine) in mammalian cells is synthesized by two distinct base-exchange enzymes, PSS1 (PS synthase 1) and PSS2, which are responsible for the conversion of PC (phosphatidylcholine) and PE (phosphatidylethanolamine) respectively into PS in intact cells. The PS synthesis in cultured mammalian cells is inhibited by exogenous PS, and this feedback control occurs through inhibition of PSSs by PS. In the present study, we purified epitope-tagged forms of human PSS1 and PSS2. The purified PSS2 was shown to catalyse the conversion of PE, but not PC, into PS, this being consistent with the substrate specificity observed in intact cells. On the other hand, the purified PSS1 was shown to catalyse the conversion of both PC and PE into PS, although PSS1 in intact cells had been shown not to contribute to the conversion of PE into PS to a significant extent. Furthermore, we found that the purified PSS2, but not the purified PSS1, was inhibited on the addition of PS to the enzyme assay mixture, raising the possibility that there was some difference between the mechanisms of the inhibitory actions of PS towards PSS1 and PSS2.
| 19,014,349
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Effects of post-translational modifications catalysed by pollen transglutaminase on the functional properties of microtubules and actin filaments.
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TGases (transglutaminases) are a class of calcium-dependent enzymes that catalyse the interactions between acyl acceptor glutamyl residues and amine donors, potentially making cross-links between proteins. To assess the activity of apple (Malus domestica) pollen TGase on the functional properties of actin and tubulin, TGase was prepared from apple pollen by hydrophobic- interaction chromatography and assayed on actin and tubulin purified from the same cell type. The enzyme catalysed the incorporation of putrescine into the cytoskeleton monomers. When tested on actin filaments, pollen TGase induced the formation of high-molecular-mass aggregates of actin. Use of fluorescein-cadaverine showed that the labelled polyamine was incorporated into actin by pollen TGase, similar to with guinea pig liver TGase. The pollen TGase also reduced the enzyme activity and the binding of myosin to TGase-treated actin filaments. Polymerization of tubulin in the presence of pollen TGase also yielded the formation of high-molecular-mass aggregates. Furthermore, the pollen TGase also affected the binding of kinesin to microtubules and reduced the motility of microtubules along kinesin-coated slides. These results indicate that the pollen TGase can control different properties of the pollen tube cytoskeleton (including the ability of actin and tubulin to assemble and their interaction with motor proteins) and consequently regulate the development of pollen tubes.
| 19,014,351
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Expression and distribution of 'high affinity' glutamate transporters GLT1, GLAST, EAAC1 and of GCPII in the rat peripheral nervous system.
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l-Glutamate is one of the major excitatory neurotransmitters in the mammalian central nervous system, but recently it has been shown to have a role also in the transduction of sensory input at the periphery, and in particular in the nociceptive pathway. An excess of glutamate is implicated in cases of peripheral neuropathies as well. Conventional therapeutic approaches for treating these diseases have focused on blocking glutamate receptors with small molecules or on reducing its synthesis of the receptors through the inhibition of glutamate carboxypeptidase II (GCPII), the enzyme that generates glutamate. In vivo studies have demonstrated that the pharmacological inhibition of GCPII can either prevent or treat the peripheral nerve changes in both BB/Wor and chemically induced diabetes in rats. In this study, we characterized the expression and distribution of glutamate transporters GLT1, GLAST, EAAC1 and of the enzyme GCPII in the peripheral nervous system of female Wistar rats. Immunoblotting results demonstrated that all glutamate transporters and GCPII are present in dorsal root ganglia (DRG) and the sciatic nerve. Immunofluorescence localization studies revealed that both DRG and sciatic nerves were immunopositive for all glutamate transporters and for GCPII. In DRG, satellite cells were positive for GLT1 and GCPII, whereas sensory neurons were positive for EAAC1. GLAST was localized in both neurons and satellite cells. In the sciatic nerve, GLT1 and GCPII were expressed in the cytoplasm of Schwann cells, whereas GLAST and EAAC1 stained the myelin layer. Our results give for the first time a complete characterization of the glutamate transporter system in the peripheral nervous system. Therefore, they are important both for understanding glutamatergic signalling in the PNS and for establishing new strategies to treat peripheral neuropathies.
| 19,014,361
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Phosphorylation of tau at Ser214 mediates its interaction with 14-3-3 protein: implications for the mechanism of tau aggregation.
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The microtubule associated protein tau is a major component of neurofibrillary tangles in Alzheimer disease brain, however the neuropathological processes behind the formation of neurofibrillary tangles are still unclear. Previously, 14-3-3 proteins were reported to bind with tau. 14-3-3 Proteins usually bind their targets through specific serine/threonine -phosphorylated motifs. Therefore, the interaction of tau with 14-3-3 mediated by phosphorylation was investigated. In this study, we show that the phosphorylation of tau by either protein kinase A (PKA) or protein kinase B (PKB) enhances the binding of tau with 14-3-3 in vitro. The affinity between tau and 14-3-3 is increased 12- to 14-fold by phosphorylation as determined by real time surface plasmon resonance studies. Mutational analyses revealed that Ser214 is critical for the phosphorylation-mediated interaction of tau with 14-3-3. Finally, in vitro aggregation assays demonstrated that phosphorylation by PKA/PKB inhibits the formation of aggregates/filaments of tau induced by 14-3-3. As the phosphorylation at Ser214 is up-regulated in fetal brain, tau's interaction with 14-3-3 may have a significant role in the organization of the microtubule cytoskeleton in development. Also as the phosphorylation at Ser214 is up-regulated in Alzheimer's disease brain, tau's interaction with 14-3-3 might be involved in the pathology of this disease.
| 19,014,373
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Relationship of CSF neurotransmitter metabolite levels to disease severity and disability in multiple sclerosis.
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Axonal degeneration and brain tissue loss occur during disease progression in multiple sclerosis (MS) and are expected to influence neurotransmitter activities, with consequences on neurologic and psychiatric symptomatology. We searched for relationships of disease duration, disability, and severity of MS patients to CSF levels of the major metabolites of noradrenaline, dopamine, and serotonin, MHPG, methoxyhydroxyphenylglycol (MHPG), homovanillic acid, and 5-hydroxyindoleacetic acid (5-HIAA), respectively, in 39 patients with relapsing-remitting (RR) MS in remission, and 26 patients with progressive (PR) MS. Disability and Disease Severity were assessed by the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Severity Score (MSSS). Compared with the levels of 50 control subjects, MHPG levels were not different in either MS group, correlated negatively to duration of illness and number of relapses in the RRMS group, but not to EDSS score or to MSSS. Homovanillic acid levels were significantly lower only in the PRMS group, with a negative correlation to duration of illness, and a strong negative correlation to EDSS score, but not to MSSS. 5-HIAA was significantly lower in both RRMS and PRMS groups. In the RRMS group, 5-HIAA levels were negatively related to EDSS and to MSSS. Multiple regression analyses revealed a significant association of MHPG to duration of illness, and a strong negative association of 5-HIAA to MSSS rather than to EDSS. The strong negative correlation of MSSS to CSF 5-HIAA levels in RRMS group of patients indicates that deficits in central serotonergic activity are related to the rate of disability accumulation in RRMS, and could be linked to the reported reduction of disease activity by serotonergic drugs.
| 19,014,375
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Understanding your inhibitions: effects of GABA and GABAA receptor modulation on brain cortical metabolism.
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A targeted neuropharmacological, (1)H/(13)C NMR spectroscopy and multivariate statistical approach was used to examine the effects of exogenous GABA and ligands at the GABA(A) receptor family on brain metabolism in the Guinea pig cortical tissue slice. All ligands at GABA(A) receptors generated metabolic patterns which were distinct from one another with the major variance in the data arising because of metabolic work (shown by net flux into Krebs cycle byproducts and increased metabolic pool sizes). Three major clusters of metabolic signatures were identified which corresponded to: (i) activity at phasic (synaptic) GABA(A) receptors, dominated by alpha1-containing receptors and responsive to GABA at 10 micromol/L; (ii) activity at perisynaptic receptors, dominated by response to high (40 micromol/L) GABA and the superagonist 4,5,6,7-tetrahydroisoxazolo[5,4-c]pyridine-3-ol hydrochloride, and C, activity at extrasynaptic receptors, dominated by response to low (0.1-1.0 micromol/L) GABA, zolpidem (400 nmol/L) and the non-specific allosteric modulator RO19-4603 (1 nmol/L). These results highlight the utility of a different but robust approach to study of the GABAergic system using metabolic systems analysis.
| 19,014,380
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Evaluation of safety and efficacy of topical prostaglandin E2 in treatment of vitiligo.
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Prostaglandin E2 (PGE2) has stimulant and immunomodulatory effects on melanocytes and regulates their proliferation. To study the efficacy and safety of topical PGE2 in treating stable vitiligo patches involving <5% body surface area. Fifty-six consecutive patients with clinically diagnosed stable vitiligo of types vulgaris, focal, segmental, lip and genital applied a translucent PGE2 (0.25 mg g(-1)) gel twice daily for 6 months. Evaluation was fortnightly for 3 months and monthly thereafter up to 6 months. Assessment was based on degree of repigmentation in treated patches ranging from 0% (no change) to 100% (complete repigmentation). Overall response was graded as: poor, 1-25% repigmentation; moderate, 26-50%; good, 51-75%; excellent, >75%. Vitiligo vulgaris was the most common type (n=22; 39%), followed by focal and lip vitiligo, with lesions being mostly on the face (25%) and lips. Repigmentation was seen in 40 of 56 patients (71%), with mean onset at 2 months. Patients with disease duration of 6 months or less repigmented best, with face and scalp responding earliest (1-1.5 months). Complete clearance occurred in eight of 40 patients, six of the eight having face lesions. Excellent response was seen in 22 of 40 patients. All neck, scalp and trunk lesions, 33% genital, 29% lip vitiligo, 100% segmental and 63% focal patches showed moderate to excellent response. Incidence of side-effects was 18%, mainly a transient burning sensation especially on the lips. The efficacy and safety of topical PGE2 make it a promising therapy for localized stable vitiligo.
| 19,014,395
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Women's attitude towards prenatal screening for red blood cell antibodies, other than RhD.
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Since July 1998 all Dutch women (+/- 200,000/y) are screened for red cell antibodies, other than anti-RhesusD (RhD) in the first trimester of pregnancy, to facilitate timely treatment of pregnancies at risk for hemolytic disease of the fetus and newborn (HDFN). Evidence for benefits, consequences and costs of screening for non-RhD antibodies is still under discussion. The screening program was evaluated in a nation-wide study. As a part of this evaluation study we investigated, according to the sixth criterium of Wilson and Jüngner, the acceptance by pregnant women of the screening program for non-RhD antibodies. Controlled longitudinal survey, including a prenatal and a postnatal measurement by structured questionnaires. information satisfaction, anxiety during the screening process (a.o. STAI state inventory and specific questionnaire modules), overall attitude on the screening program. Univariate analysis was followed by standard multivariate analysis to identify significant predictors of the outcome measures. 233 pregnant women, distributed over five groups, according to the screening result. Satisfaction about the provided information was moderate in all groups. All screen- positive groups desired more supportive information. Anxiety increased in screen- positives during the screening process, but decreased to basic levels postnatally. All groups showed a strongly positive balance between perceived utility and burden of the screening program, independent on test results or background characteristics. Women highly accept the non-RhD antibody screening program. However, satisfaction about provided information is moderate. Oral and written information should be provided by obstetric care workers themselves, especially to screen-positive women.
| 19,014,424
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Delayed diagnosis of intermittent mesenteroaxial volvulus of the stomach by computed tomography: a case report.
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Gastric volvulus is a rare condition. Presenting acutely, mesenteroaxial gastric volvulus has characteristic symptoms and may be easily detected with upper gastrointestinal contrast studies. In contrast, subacute, intermittent cases present with intermittent vague symptoms from episodic twisting and untwisting. Imaging in these cases is only useful if performed in the symptomatic interval. We describe a patient with a long history of intermittent chest and epigastric pain. An earlier barium meal was not diagnostic. Diagnosis was finally secured during the current admission by a combination of (1) serum investigations, (2) endoscopy, and finally (3) computed tomography. Non-specific and misleading symptoms and signs may delay the diagnosis of intermittent, subacute volvulus. Imaging studies performed in the well interval may be non-diagnostic. Elevated creatine kinase and aldolase of a non-cardiac cause and endoscopic findings of ischaemic ulceration and difficulty in negotiating the pylorus may raise the suspicion of gastric volvulus. In this case, abdominal computed tomography with spatial reconstruction was crucial in securing the final diagnosis.
| 19,014,426
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Pathways affected by asbestos exposure in normal and tumour tissue of lung cancer patients.
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Studies on asbestos-induced tumourigenesis have indicated the role of, e.g., reactive oxygen/nitrogen species, mitochondria, as well as NF-kappaB and MAPK signalling pathways. The exact molecular mechanisms contributing to asbestos-mediated carcinogenesis are, however, still to be characterized. In this study, gene expression data analyses together with gene annotation data from the Gene Ontology (GO) database were utilized to identify pathways that are differentially regulated in lung and tumour tissues between asbestos-exposed and non-exposed lung cancer patients. Differentially regulated pathways were identified from gene expression data from 14 asbestos-exposed and 14 non-exposed lung cancer patients using custom-made software and Iterative Group Analysis (iGA). Western blotting was used to further characterize the findings, specifically to determine the protein levels of UBA1 and UBA7. Differences between asbestos-related and non-related lung tumours were detected in pathways associated with, e.g., ion transport, NF-kappaB signalling, DNA repair, as well as spliceosome and nucleosome complexes. A notable fraction of the pathways down-regulated in both normal and tumour tissue of the asbestos-exposed patients were related to protein ubiquitination, a versatile process regulating, for instance, DNA repair, cell cycle, and apoptosis, and thus being also a significant contributor of carcinogenesis. Even though UBA1 or UBA7, the early enzymes involved in protein ubiquitination and ubiquitin-like regulation of target proteins, did not underlie the exposure-related deregulation of ubiquitination, a difference was detected in the UBA1 and UBA7 levels between squamous cell carcinomas and respective normal lung tissue (p = 0.02 and p = 0.01) without regard to exposure status. Our results indicate alterations in protein ubiquitination related both to cancer type and asbestos. We present for the first time pathway analysis results on asbestos-associated lung cancer, providing important insight into the most relevant targets for future research.
| 19,014,429
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Surgical strategies for treatment of malignant pancreatic tumors: extended, standard or local surgery?
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Tumor related pancreatic surgery has progressed significantly during recent years. Pancreatoduodenectomy (PD) with lymphadenectomy, including vascular resection, still presents the optimal surgical procedure for carcinomas in the head of pancreas. For patients with small or low-grade malignant neoplasms, as well as small pancreatic metastases located in the mid-portion of pancreas, central pancreatectomy (CP) is emerging as a safe and effective option with a low risk of developing de-novo exocrine and/or endocrine insufficiency. Total pancreatectomy (TP) is not as risky as it was years ago and can nowadays safely be performed, but its indication is limited to locally extended tumors that cannot be removed by PD or distal pancreatectomy (DP) with tumor free surgical margins. Consequently, TP has not been adopted as a routine procedure by most surgeons. On the other hand, an aggressive attitude is required in case of advanced distal pancreatic tumors, provided that safe and experienced surgery is available. Due to the development of modern instruments, laparoscopic operations became more and more successful, even in malignant pancreatic diseases. This review summarizes the recent literature on the above mentioned topics.
| 19,014,474
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Sox genes in the coral Acropora millepora: divergent expression patterns reflect differences in developmental mechanisms within the Anthozoa.
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Sox genes encode transcription factors that function in a wide range of developmental processes across the animal kingdom. To better understand both the evolution of the Sox family and the roles of these genes in cnidarians, we are studying the Sox gene complement of the coral, Acropora millepora (Class Anthozoa). Based on overall domain structures and HMG box sequences, the Acropora Sox genes considered here clearly fall into four of the five major Sox classes. AmSoxC is expressed in the ectoderm during development, in cells whose morphology is consistent with their assignment as sensory neurons. The expression pattern of the Nematostella ortholog of this gene is broadly similar to that of AmSoxC, but there are subtle differences--for example, expression begins significantly earlier in Acropora than in Nematostella. During gastrulation, AmSoxBb and AmSoxB1 transcripts are detected only in the presumptive ectoderm while AmSoxE1 transcription is restricted to the presumptive endoderm, suggesting that these Sox genes might play roles in germ layer specification. A third type B Sox gene, AmSoxBa, and a Sox F gene AmSoxF also have complex and specific expression patterns during early development. Each of these genes has a clear Nematostella ortholog, but in several cases the expression pattern observed in Acropora differs significantly from that reported in Nematostella. These differences in expression patterns between Acropora and Nematostella largely reflect fundamental differences in developmental processes, underscoring the diversity of mechanisms within the anthozoan Sub-Class Hexacorallia (Zoantharia).
| 19,014,479
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XM02 is superior to placebo and equivalent to Neupogen in reducing the duration of severe neutropenia and the incidence of febrile neutropenia in cycle 1 in breast cancer patients receiving docetaxel/doxorubicin chemotherapy.
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Recombinant granulocyte colony-stimulating factors (G-CSFs) such as Filgrastim are used to treat chemotherapy-induced neutropenia. We investigated a new G-CSF, XM02, and compared it to Neupogen after myelotoxic chemotherapy in breast cancer (BC) patients. A total of 348 patients with BC receiving docetaxel/doxorubicin chemotherapy were randomised to treatment with daily injections (subcutaneous 5 microg/kg/day) for at least 5 days and a maximum of 14 days in each cycle of XM02 (n = 140), Neupogen (n = 136) or placebo (n = 72). The primary endpoint was the duration of severe neutropenia (DSN) in cycle 1. The mean DSN in cycle 1 was 1.1, 1.1, and 3.9 days in the XM02, Neupogen, and placebo group, respectively. Superiority of XM02 over placebo and equivalence of XM02 with Neupogen could be demonstrated. Toxicities were similar between XM02 and Neupogen. XM02 was superior to placebo and equivalent to Neupogen in reducing DSN after myelotoxic chemotherapy.
| 19,014,494
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Analysis of the nucleotide sequence of the guinea pig cytomegalovirus (GPCMV) genome.
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In this report we describe the genomic sequence of guinea pig cytomegalovirus (GPCMV) assembled from a tissue culture-derived bacterial artificial chromosome clone, plasmid clones of viral restriction fragments, and direct PCR sequencing of viral DNA. The GPCMV genome is 232,678 bp, excluding the terminal repeats, and has a GC content of 55%. A total of 105 open reading frames (ORFs) of > 100 amino acids with sequence and/or positional homology to other CMV ORFs were annotated. Positional and sequence homologs of human cytomegalovirus open reading frames UL23 through UL122 were identified. Homology with other cytomegaloviruses was most prominent in the central approximately 60% of the genome, with divergence of sequence and lack of conserved homologs at the respective genomic termini. Of interest, the GPCMV genome was found in many cases to bear stronger phylogenetic similarity to primate CMVs than to rodent CMVs. The sequence of GPCMV should facilitate vaccine and pathogenesis studies in this model of congenital CMV infection.
| 19,014,498
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Characterization of housekeeping genes in zebrafish: male-female differences and effects of tissue type, developmental stage and chemical treatment.
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Research using the zebrafish model has experienced a rapid growth in recent years. Although real-time reverse transcription PCR (QPCR), normalized to an internal reference ("housekeeping") gene, is a frequently used method for quantifying gene expression changes in zebrafish, many commonly used housekeeping genes are known to vary with experimental conditions. To identify housekeeping genes that are stably expressed under different experimental conditions, and thus suitable as normalizers for QPCR in zebrafish, the present study evaluated the expression of eight commonly used housekeeping genes as a function of stage and hormone/toxicant exposure during development, and by tissue type and sex in adult fish. QPCR analysis was used to quantify mRNA levels of bactin1, tubulin alpha 1(tuba1), glyceraldehyde-3-phosphate dehydrogenase (gapdh), glucose-6-phosphate dehydrogenase (g6pd), TATA-box binding protein (tbp), beta-2-microglobulin (b2m), elongation factor 1 alpha (elfa), and 18s ribosomal RNA (18s) during development (2 - 120 hr postfertilization, hpf); in different tissue types (brain, eye, liver, heart, muscle, gonads) of adult males and females; and after treatment of embryos/larvae (24 - 96 hpf) with commonly used vehicles for administration and agents that represent known environmental endocrine disruptors. All genes were found to have some degree of variability under the conditions tested here. Rank ordering of expression stability using geNorm analysis identified 18s, b2m, and elfa as most stable during development and across tissue types, while gapdh, tuba1, and tpb were the most variable. Following chemical treatment, tuba1, bactin1, and elfa were the most stably expressed whereas tbp, 18s, and b2m were the least stable. Data also revealed sex differences that are gene- and tissue-specific, and treatment effects that are gene-, vehicle- and ligand-specific. When the accuracy of QPCR analysis was tested using different reference genes to measure suppression of cyp19a1b by an estrogen receptor antagonist and induction of cyp1a by an arylhydrocarbon receptor agonist, the direction and magnitude of effects with stable and unstable genes differed. This study provides data that can be expected to aid zebrafish researchers in their initial choice of housekeeping genes for future studies, but underlines the importance of further validating housekeeping genes for each new experimental paradigm and fish species.
| 19,014,500
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The responsiveness of the uterine fibroid symptom and health-related quality of life questionnaire (UFS-QOL).
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A number of noninvasive alternatives to hysterectomy have become available as treatments for uterine fibroids. These alternative therapies, however, may not relieve all symptoms. Consequently, the need for patient-reported outcomes to assess symptom reduction of uterine fibroids has become increasingly important to evaluate the clinical success of patients who choose these alternative therapies. The purpose of the study was to examine the responsiveness of the Uterine Fibroid Symptom and Health-Related Quality of Life Questionnaire (UFS-QOL) with treatment of uterine fibroids. The responsiveness of the UFS-QOL was assessed as a post-hoc analysis of patients treated with MRI-guided focused ultrasound thermal ablation (MRgFUS) for uterine fibroids. The UFS-QOL and SF-36 were completed at baseline and months 1, 3, and 6. Patient perceived overall treatment effect (OTE) was assessed at month 3, while satisfaction with treatment was collected at month 6. The responsiveness of the UFS-QOL was examined using effect sizes and change scores by patient-reported overall treatment effect and satisfaction. A total of 102 women with complete UFS-QOL data were included in the analysis; the mean age was 45 years and 79% were Caucasian. From baseline to 6 months, significant improvements were observed in UFS-QOL Symptom Severity and all Health-Related Quality of Life (HRQL) subscale scores (p < 0.0001). When examining change in general health status over the 6-month follow-up period, significant improvements were noted in all 8 SF-36 subscales. The UFS-QOL was highly responsive with subscale effect sizes ranging from 0.74 for Sexual Function to -1.9 for Symptom Severity. Improvements in UFS-QOL subscales were associated with patient perceptions of perceived benefit and treatment satisfaction. The UFS-QOL is responsive to treatment for uterine fibroids and is a useful outcome measure for uterine-sparing uterine fibroid treatments.
| 19,014,505
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Determinants of non attendance to mammography program in a region with high voluntary health insurance coverage.
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High participation rates are needed to ensure that breast cancer screening programs effectively reduce mortality. We identified the determinants of non-participation in a public breast cancer screening program. In this case-control study, 274 women aged 50 to 64 years included in a population-based mammography screening program were personally interviewed. Socio-demographic characteristics, health beliefs, health service utilization, insurance coverage, prior mammography and other preventive activities were examined. Of the 192 cases and 194 controls contacted, 101 and 173, respectively, were subsequently interviewed. Factors related to non-participation in the breast cancer screening program included higher education (odds ratio [OR] = 5.28; 95% confidence interval [CI95%] = 1.57-17.68), annual dental checks-ups (OR = 1.81; CI95%1.08-3.03), prior mammography at a private health center (OR = 7.27; CI95% 3.97-13.32), gynecologist recommendation of mammography (OR = 2.2; CI95%1.3-3.8), number of visits to a gynecologist (median visits by cases = 1.2, versus controls = 0.92, P = 0.001), and supplemental private insurance (OR = 5.62; CI95% = 3.28-9.6). Among women who had not received a prior mammogram or who had done so at a public center, perceived barriers were the main factors related to non-participation. Among women who had previously received mammograms at a private center, supplemental private health insurance also influenced non-participation. Benign breast symptoms increased the likelihood of participation. Our data indicate that factors related to the type of insurance coverage (such as prior mammography at a private health center and supplemental private insurance) influenced non-participation in the screening program.
| 19,014,522
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Cytokine activation is predictive of mortality in Zambian patients with AIDS-related diarrhoea.
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Mortality in Zambian AIDS patients is high, especially in patients with diarrhoea, and there is still unacceptably high mortality in Zambian patients just starting anti-retroviral therapy. We set out to determine if high concentrations of serum cytokines correlate with mortality. Serum samples from 30 healthy controls (HIV seropositive and seronegative) and 50 patients with diarrhoea (20 of whom died within 6 weeks) were analysed. Concentrations of tumour necrosis factor receptor p55 (TNFR p55), macrophage migration inhibitory factor (MIF), interleukin (IL)-6, IL-12, interferon (IFN)-gamma and C-reactive protein (CRP) were measured by ELISA, and correlated with mortality after 6 weeks follow-up. Apart from IL-12, concentrations of all cytokines, TNFR p55 and CRP increased with worsening severity of disease, showing highly statistically significant trends. In a multivariable analysis high TNFR p55, IFN-gamma, CRP and low CD4 count (CD4 count <100) were predictive of mortality. Although nutritional status (assessed by body mass index, BMI) was predictive in univariate analysis, it was not an independent predictor in multivariate analysis. High serum concentrations of TNFR p55, IFN-gamma, CRP and low CD4 count correlated with disease severity and short-term mortality in HIV-infected Zambian adults with diarrhoea. These factors were better predictors of survival than BMI. Understanding the cause of TNFR p55, IFN-gamma and CRP elevation may be useful in development of interventions to reduce mortality in AIDS patients with chronic diarrhoea in Africa.
| 19,014,537
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Transcriptional and apoptotic responses of THP-1 cells to challenge with toxigenic, and non-toxigenic Bacillus anthracis.
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Bacillus anthracis secretes several virulence factors targeting different host organs and cell types during inhalational anthrax infection. The bacterial expression of a key virulence factor, lethal toxin (LeTx) is closely tied to another factor, edema toxin (EdTx). Both are transcribed on the same virulence plasmid (pXO1) and both have been the subject of much individual study. Their combined effect during virulent anthrax likely modulates both the global transcriptional and the phenotypic response of macrophages and phagocytes. In fact, responses brought about by the toxins may be different than each of their individual effects. Here we report the transcriptional and apoptotic responses of the macrophage-like phagocytic cell line THP-1 exposed to B. anthracis Sterne (pXO1+) spores, and B. anthracis Delta Sterne (pXO1-) spores. These cells are resistant to LeTx-induced cytolysis, a phenotype seen in macrophages from several mouse strains which are sensitive to toxigenic anthrax infection. Our results indicate that the pXO1-containing strain induces higher pro-inflammatory transcriptional responses during the first 4 hours of interaction with bacterium, evident in the upregulation of several genes relevant to Nf-kappaB, phosphatases, prostaglandins, and TNF-alpha, along with decreases in expression levels of genes for mitochondrial components. Both bacterial strains induce apoptosis, but in the toxigenic strain-challenged cells, apoptosis is delayed. This delay in apoptosis occurs despite the much higher level of TNF-alpha secretion induced by the toxigenic-strain challenge. Interestingly, CFLAR, an important apoptotic inhibitor which blocks apoptosis induced by large amounts of extracellular TNF-alpha, is upregulated significantly during toxigenic-strain infection, but not at all during non-toxigenic-strain infection, indicating that it may play a role in blocking or delaying TNF-alpha-mediated apoptosis. The suppression of apoptosis by the toxigenic anthrax strain is consistent with the notion that apoptosis itself may represent a protective host cell response.
| 19,014,542
|
Alkaptonuria diagnosed in a 4-month-old baby girl: a case report.
|
The mother of a four month old female baby attended in the well baby clinic with the complaint of black staining of the diaper after few minutes of urination. The baby was born of a non consanguineous marriage, healthy and breast fed. Mother noticed that stain first at the age of two and half month. The urine when kept in a test tube for two hours turned black. Laboratory examination of urine revealed increased concentration of homogentisic acid. The patient was diagnosed as alkaptonuria.
| 19,014,543
|
The Kv2.1 K+ channel targets to the axon initial segment of hippocampal and cortical neurons in culture and in situ.
|
The Kv2.1 delayed-rectifier K+ channel regulates membrane excitability in hippocampal neurons where it targets to dynamic cell surface clusters on the soma and proximal dendrites. In the past, Kv2.1 has been assumed to be absent from the axon initial segment. Transfected and endogenous Kv2.1 is now demonstrated to preferentially accumulate within the axon initial segment (AIS) over other neurite processes; 87% of 14 DIV hippocampal neurons show endogenous channel concentrated at the AIS relative to the soma and proximal dendrites. In contrast to the localization observed in pyramidal cells, GAD positive inhibitory neurons within the hippocampal cultures did not show AIS targeting. Photoactivable-GFP-Kv2.1-containing clusters at the AIS were stable, moving <1 microm/hr with no channel turnover. Photobleach studies indicated individual channels within the cluster perimeter were highly mobile (FRAP tau=10.4+/-4.8 sec), supporting our model that Kv2.1 clusters are formed by the retention of mobile channels behind a diffusion-limiting perimeter. Demonstrating that the AIS targeting is not a tissue culture artifact, Kv2.1 was found in axon initial segments within both the adult rat hippocampal CA1, CA2, and CA3 layers and cortex. In summary, Kv2.1 is associated with the axon initial segment both in vitro and in vivo where it may modulate action potential frequency and back propagation. Since transfected Kv2.1 initially localizes to the AIS before appearing on the soma, it is likely multiple mechanisms regulate Kv2.1 trafficking to the cell surface.
| 19,014,551
|
Atypical presentation of "takotsubo cardiomyopathy" without ST segment elevation: a case report.
|
"Takotsubo cardiomyopathy" is characterized by transient LV dysfunction and mimicking acute myocardial infarction. We reported a case with atypical presentation of "takotsubo cardiomyopathy" without ST segment elevation, but with severe transient left ventricular dysfunction. Diagnosis of "takotsubo cardiomyopathy" should be based on typical left ventricular dysfunction without coronary artery disease.
| 19,014,564
|
Malignant mesothelioma of the tunica vaginalis of the testis without exposure to asbestos.
|
Mesotheliomas are rare tumours that usually are seen in the pleura after asbestos exposure. Mesotheliomas have been reported around the testicular region but are even rarer following trauma, herniorrhaphy and long term hydrocoele. An elderly male farmer presented to us with an insidious onset of painless swelling in his left lower limb which gradually progressive. At the time of presentation it had involved his entire limb. A hard palpable mass of size 5 * 4 cms was detected in the left iliac fossa and a testicular enlargement was noted on the left side. The ultrasound of the testes showed that the left testis was enlarged 3.9*3*3.2 cms showing diffusely heterogenous echo-texture and irregular nodular surface with irregular hypoechoic thickening of the scrotal wall with left sided hydrocele. A separate hypoechoic *1.2 cms lesion was visualized in the anterior scrotal wall. FNAC from the scrotal mass showed tumour cells of simialr morphology present singly in monolayered sheets and in three dimensional fragments. The overall immunomorphological features suggested a malignant mesothelioma likely to have arisen from the tunica vaginalis. In conclusion, though a rare tumor, malignant mesothelioma of the tunica vaginalis of the testis should be considered whenever a paratesticular mass lesion is seen even without a history of trauma or asbestos exposure as is highlighted in this case. Ultrasound findings are helpful and fine needle aspiration of the tumor may assist in arrival at a diagnosis. Surgical orchidectomy remains the modality of treatment.
| 19,014,568
|
Spermatogonial stem cell sensitivity to capsaicin: an in vitro study.
|
Conflicting reports have been published on the sensitivity of spermatogenesis to capsaicin (CAP), the pungent ingredient of hot chili peppers. Here, the effect of CAP on germ cell survival was investigated by using two testis germ cell lines as a model. As CAP is a potent agonist of the transient receptor potential vanilloid receptor 1 (TRPV1) and no information was available of its expression in germ cells, we also studied the presence of TRPV1 in the cultured cells and in germ cells in situ. The rat spermatogonial stem cell lines Gc-5spg and Gc-6spg were used to study the effects of different concentrations of CAP during 24 and 48 h. The response to CAP was first monitored by phase-contrast microscopy. As germ cells appear to undergo apoptosis in the presence of CAP, the activation of caspase 3 was studied using an anti activated caspase 3 antibody or by quantifying the amount of cells with DNA fragmentation using flow cytometry. Immunolocalization was done with an anti-TRPV1 antibody either with the use of confocal microscopy to follow live cell labeling (germ cells) or on Bouin fixed paraffin embedded testicular tissues. The expression of TRPV1 by the cell lines and germ cells was confirmed by Western blots. Initial morphological observations indicated that CAP at concentrations ranging from 150 uM to 250 uM and after 24 and 48 h of exposure, had deleterious apoptotic-like effects on both cell lines: A large population of the CAP treated cell cultures showed signs of DNA fragmentation and caspase 3 activation. Quantification of the effect demonstrated a significant effect of CAP with doses of 150 uM in the Gc-5spg cell line and 200 uM in the Gc-6spg cell line, after 24 h of exposure. The effect was dose and time dependent in both cell lines. TRPV1, the receptor for CAP, was found to be expressed by the spermatogonial stem cells in vitro and also by premeiotic germ cells in situ. CAP adversely affects spermatogonial survival in vitro by inducing apoptosis to those cells and TRPV-1, a CAP receptor, may be involved in this effect as this receptor is expressed by mitotic germ cells.
| 19,014,578
|
Age-related differences in dual task walking: a cross sectional study.
|
Variability in stride velocity during walking characterizes gait instability and predicts falling in older individuals. Walking while executing a cognitive task is also associated with increased risk of falling, particularly in older adults. Variability in stride velocity, particularly during dual task walking conditions, may differ between younger and older individuals. The purpose of this study was to examine whether gait velocity and variability in stride velocity differ between older community-dwelling women and younger women during dual task walking. Twenty-three older (80 +/- 9 years) and 19 younger (23 +/- 2 years) women walked under each of two conditions: (1) walking at a self-selected velocity and (2) walking at a self-selected velocity while incrementally counting backwards. Gait velocity and variability in stride velocity were measured with GAITRite instrumentation. Gait velocity decreased and variability in stride variability increased, in both groups, during dual task walking. The relative reduction in gait velocity and the magnitude of variability in stride velocity were greater in the older subjects than younger subjects. The gait changes observed in dual task walking characterize reduced gait stability and indicate that cognitively demanding tasks during walking have a destabilizing effect on gait that may place older persons at greater risk of falls.
| 19,014,583
|
Cone inputs to murine striate cortex.
|
We have recorded responses from single neurons in murine visual cortex to determine the effectiveness of the input from the two murine cone photoreceptor mechanisms and whether there is any unique selectivity for cone inputs at this higher region of the visual system that would support the possibility of colour vision in mice. Each eye was stimulated by diffuse light, either 370 (strong stimulus for the ultra-violet (UV) cone opsin) or 505 nm (exclusively stimulating the middle wavelength sensitive (M) cone opsin), obtained from light emitting diodes (LEDs) in the presence of a strong adapting light that suppressed the responses of rods. Single cells responded to these diffuse stimuli in all areas of striate cortex. Two types of responsive cells were encountered. One type (135/323-42%) had little to no spontaneous activity and responded at either the on and/or the off phase of the light stimulus with a few impulses often of relatively large amplitude. A second type (166/323-51%) had spontaneous activity and responded tonically to light stimuli with impulses often of small amplitude. Most of the cells responded similarly to both spectral stimuli. A few (18/323-6%) responded strongly or exclusively to one or the other spectral stimulus and rarely in a spectrally opponent manner. Most cells in murine striate cortex receive excitatory inputs from both UV- and M-cones. A small fraction shows either strong selectivity for one or the other cone mechanism and occasionally cone opponent responses. Cells that could underlie chromatic contrast detection are present but extremely rare in murine striate cortex.
| 19,014,590
|
The experience of linking Victorian emergency medical service trauma data.
|
The linking of a large Emergency Medical Service (EMS) dataset with the Victorian Department of Human Services (DHS) hospital datasets and Victorian State Trauma Outcome Registry and Monitoring (VSTORM) dataset to determine patient outcomes has not previously been undertaken in Victoria. The objective of this study was to identify the linkage rate of a large EMS trauma dataset with the Department of Human Services hospital datasets and VSTORM dataset. The linking of an EMS trauma dataset to the hospital datasets utilised deterministic and probabilistic matching. The linking of three EMS trauma datasets to the VSTORM dataset utilised deterministic, probabilistic and manual matching. There were 66.7% of patients from the EMS dataset located in the VEMD. There were 96% of patients located in the VAED who were defined in the VEMD as being admitted to hospital. 3.7% of patients located in the VAED could not be found in the VEMD due to hospitals not reporting to the VEMD. For the EMS datasets, there was a 146% increase in successful links with the trauma profile dataset, a 221% increase in successful links with the mechanism of injury only dataset, and a 46% increase with sudden deterioration dataset, to VSTORM when using manual compared to deterministic matching. This study has demonstrated that EMS data can be successfully linked to other health related datasets using deterministic and probabilistic matching with varying levels of success. The quality of EMS data needs to be improved to ensure better linkage success rates with other health related datasets.
| 19,014,622
|
Dermatosis neglecta in a case of multiple fractures, shoulder dislocation and radial nerve palsy in a 35-year-old man: a case report.
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Dermatosis neglecta is an often misdiagnosed and under-diagnosed condition. In dermatosis neglecta, a progressive accumulation of sebum, sweat, keratin and other dirt and debris, occurs due to inadequate local hygiene resulting in a localized hyperpigmented patch or a verrucous plaque. Vigorous rubbing with alcohol-soaked gauze or soap and water results in a complete resolution of the lesion. This is the first case of dermatosis neglecta reported in a patient with multiple traumatic injuries. We report a case of a 35-year-old male Caucasian of Pakistani origin, with multiple fractures, neurological deficit and immobility sustained in a fall, leading to the development of dermatosis neglecta of the left hand. Early and prompt clinical recognition of this condition eliminates the need for aggressive diagnostic and therapeutic procedures.
| 19,014,627
|
Semen quality in Peruvian pesticide applicators: association between urinary organophosphate metabolites and semen parameters.
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Organophosphates are broad class of chemicals widely used as pesticides throughout the world. We performed a cross-sectional study of associations between dialkylphosphate metabolites of organophosphates and semen quality among pesticide applicators in Majes (Arequipa), Peru. Thirty-one men exposed to organophosphate (OP) pesticides and 31 non-exposed were recruited (age, 20-60 years). In exposed subjects, semen and a blood sample were obtained one day after the last pesticide application. Subjects were grouped according to levels of OP metabolites in urine. Semen samples were analyzed for sperm concentration, percentage of sperm motility, percentage of normal morphology, semen leucocytes and concentrations of fructose and zinc. Exposure to OP was assessed by measuring six urinary OP metabolites (dimethyl and diethyl phosphates and thiophosphates) by gas chromatography using a single flame photometric detector. Diethyldithiophosphate (p = 0.04) and diethylthiophosphate (p = 0.02) better reflected occupational pesticide exposure than other OP metabolites. Semen analysis revealed a significant reduction of semen volume and an increase in semen pH in men with OP metabolites. Multiple regression analysis showed that both occupational exposure to pesticides and the time of exposure to pesticides were more closely related to alterations in semen quality parameters than the single measurement of OP metabolites in urine. The study demonstrated that occupational exposure to OP pesticides was more closely related to alterations in semen quality than a single measurement of urine OP metabolites. Current measurement of OP metabolites in urine may not reflect the full risk.
| 19,014,632
|
Connective tissue growth factor promoter activity in normal and wounded skin.
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In skin, connective tissue growth factor (CTGF/CCN2) is induced during tissue repair. However, what the exact cell types are that express CTGF in normal and wounded skin remain controversial. In this report, we use transgenic knock-in mice in which the Pacific jellyfish Aequorea victoria enhanced green fluorescent protein (E-GFP) gene has been inserted between the endogenous CTGF promoter and gene. Unwounded (day 0) and wounded (days 3 and 7) skin was examined for GFP to detect cells in which the CTGF promoter was active, alpha-smooth muscle actin (alpha-SMA) to detect myofibroblasts, and NG2 expression to detect pericytes. In unwounded mice, CTGF expression was absent in epidermis and was present in a few cells in the dermis. Upon wounding, CTGF expression was induced in the dermis. Double immunolabeling revealed that CTGF-expressing cells also expressed alpha-SMA, indicating the CTGF was expressed in myofibroblasts. A subset (approximately 30%) of myofibroblasts were also NG2 positive, indicating that pericytes significantly contributed to the number of myofibroblasts in the wound. Pericytes also expressed CTGF. Collectively, these results indicate that CTGF expression in skin correlates with myofibroblast induction, and that CTGF-expressing pericytes are significant contributors to myofibroblast activity during cutaneous tissue repair.
| 19,014,648
|
High-efficiency Rosa26 knock-in vector construction for Cre-regulated overexpression and RNAi.
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Rosa26 is a genomic mouse locus commonly used to knock-in cDNA constructs for ubiquitous or conditional gene expression in transgenic mice. However, the vectors generally used to generate Rosa26 knock-in constructs show instability problems, which have a severe impact on the efficiency of the system. We have optimized the cloning procedure to generate targeting vectors for Cre-regulated expression of constructs within several days with minimal hands-on time, thereby enabling high-throughput approaches. We demonstrate that transient expression of Cre still results in expression of the construct, as shown by the expression level and via functional assays. In addition to its well-established possibilities in expressing cDNA constructs, we show that the Rosa26 locus can be used to drive expression of functional miRNA constructs from its endogenous promoter. We provide a new high-efficiency cloning system for Rosa26 knock-in constructs to express either cDNA or miRNA fragments. Our system will enable high-throughput approaches for controlled expression of cDNA or miRNA constructs, with the latter providing a potential high-speed alternative for conditional knock-out models.
| 19,014,667
|
Expression profiles of switch-like genes accurately classify tissue and infectious disease phenotypes in model-based classification.
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Large-scale compilation of gene expression microarray datasets across diverse biological phenotypes provided a means of gathering a priori knowledge in the form of identification and annotation of bimodal genes in the human and mouse genomes. These switch-like genes consist of 15% of known human genes, and are enriched with genes coding for extracellular and membrane proteins. It is of interest to determine the prediction potential of bimodal genes for class discovery in large-scale datasets. Use of a model-based clustering algorithm accurately classified more than 400 microarray samples into 19 different tissue types on the basis of bimodal gene expression. Bimodal expression patterns were also highly effective in differentiating between infectious diseases in model-based clustering of microarray data. Supervised classification with feature selection restricted to switch-like genes also recognized tissue specific and infectious disease specific signatures in independent test datasets reserved for validation. Determination of "on" and "off" states of switch-like genes in various tissues and diseases allowed for the identification of activated/deactivated pathways. Activated switch-like genes in neural, skeletal muscle and cardiac muscle tissue tend to have tissue-specific roles. A majority of activated genes in infectious disease are involved in processes related to the immune response. Switch-like bimodal gene sets capture genome-wide signatures from microarray data in health and infectious disease. A subset of bimodal genes coding for extracellular and membrane proteins are associated with tissue specificity, indicating a potential role for them as biomarkers provided that expression is altered in the onset of disease. Furthermore, we provide evidence that bimodal genes are involved in temporally and spatially active mechanisms including tissue-specific functions and response of the immune system to invading pathogens.
| 19,014,681
|
Effect of foot orthoses on lower extremity kinetics during running: a systematic literature review.
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Throughout the period of one year, approximately 50% of recreational runners will sustain an injury that disrupts their training regimen. Foot orthoses have been shown to be clinically effective in the prevention and treatment of several running-related conditions, yet the physical effect of this intervention during running remains poorly understood. The aim of this literature review was therefore to evaluate the effect of foot orthoses on lower extremity forces and pressure (kinetics) during running. A systematic search of electronic databases including Medline (1966-present), CINAHL, SportDiscus, and The Cochrane Library occurred on 7 May 2008. Eligible articles were selected according to pre-determined criteria. Methodological quality was evaluated by use of the Quality Index as described by Downs & Black, followed by critical analysis according to outcome variables. The most widely reported kinetic outcomes were loading rate and impact force, however the effect of foot orthoses on these variables remains unclear. In contrast, current evidence suggests that a reduction in the rearfoot inversion moment is the most consistent kinetic effect of foot orthoses during running. The findings of this review demonstrate systematic effects that may inform the direction of future research, as further evidence is required to define the mechanism of action of foot orthoses during running. Continuation of research in this field will enable targeting of design parameters towards biomechanical variables that are supported by evidence, and may lead to advancements in clinical efficacy.
| 19,014,705
|
Biomimetic poly(amidoamine) hydrogels as synthetic materials for cell culture.
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Poly(amidoamine)s (PAAs) are synthetic polymers endowed with many biologically interesting properties, being highly biocompatible, non toxic and biodegradable. Hydrogels based on PAAs can be easily modified during the synthesis by the introduction of functional co-monomers. Aim of this work is the development and testing of novel amphoteric nanosized poly(amidoamine) hydrogel film incorporating 4-aminobutylguanidine (agmatine) moieties to create RGD-mimicking repeating units for promoting cell adhesion. A systematic comparative study of the response of an epithelial cell line was performed on hydrogels with agmatine and on non-functionalized amphoteric poly(amidoamine) hydrogels and tissue culture plastic substrates. The cell adhesion on the agmatine containing substrates was comparable to that on plastic substrates and significantly enhanced with respect to the non-functionalized controls. Interestingly, spreading and proliferation on the functionalized supports are slower than on plastic exhibiting the possibility of an easier control of the cell growth kinetics. In order to favor the handling of the samples, a procedure for the production of bi-layered constructs was also developed by means the deposition via spin coating of a thin layer of hydrogel on a pre-treated cover slip. The obtained results reveal that PAAs hydrogels can be profitably functionalized and, in general, undergo physical and chemical modifications to meet specific requirements. In particular the incorporation of agmatine warrants good potential in the field of cell culturing and the development of supported functionalized hydrogels on cover glass are very promising substrates for applications in cell screening devices.
| 19,014,710
|
Spontaneous improvement of a haemodynamically significant ventricular septal defect produced by blunt chest trauma in a child.
|
We describe the progress of a girl aged 5 years, who suffered blunt trauma to the chest producing a ventricular septal defect of 1 centimetre in diameter. The shunt generated a mild dilation of the left-sided chambers, and exertional dyspnoea. Three months later, therapeutic catheterisation revealed important diminution in the extent of shunting. We decided, therefore, not to close the defect, and she has since remained asymptomatic.
| 19,014,715
|
[Psychosis in affective disorders].
|
Psychosis in affective disorder is prevalent as 15-20% of depressive patients and approximately 50% of manic patients present with psychotic features. Psychosis in conjunction with affective disorder has a poor prognosis. It is particularly so for depression where psychosis is associated with an increased risk of recurrence, development of bipolar disorder and suicide. It is still being debated whether these conditions reflect independent illness entities and their relationship to schizoaffective disorder and schizophrenia is also unresolved.
| 19,014,720
|
[Psychosis and crime].
|
The number of forensic patients has increased dramatically in Denmark as well as in many other countries during the last three decades. The patients predominantly suffer from schizophrenia. The offences committed by the patients are often violence. The increasing number of forensic patients has been linked to a decreased use of inpatient treatment. In Denmark, most forensic patients are treated by general psychiatrists for whom the growing number of such patients is a major challenge. General psychiatrists require more training and knowledge within this area.
| 19,014,727
|
[Have the 2005 guidelines for resuscitation been implemented?].
|
In 2005, new international evidence-based guidelines for cardiopulmonary resuscitation (CPR) were published by the International Liaison Committee on Resuscitation (ILCOR). The aim of these new guidelines is to improve the quality of care and, thereby, the outcome from cardiac arrest. This necessitates that the guidelines are known and implemented in clinical practice. The purpose of this investigation is to elucidate the extent of implementation of Guidelines 2005 (G2005) among doctors on Cardiac Arrest Teams (CAT) one year after the publication. In addition, the date of implementation is examined among medical emergency services and major providers of basic life support (BLS) courses. A telephone enquiry about CPR among CAT doctors on-duty. Ambulance services and BLS-course providers are contacted by e-mail. Approximately 70% of the doctors were able to answer simple and essential topics on CPR, e.g. compression/ventilation ratio and the number of shocks in a sequence in accordance with G2005. The ambulance service, Falck A/S, implemented G2005 during 2007, while the other ambulance services implemented G2005 within six months after publication. The majority of BLS-course providers implemented the guidelines one year after their publication. One year after the publication of G2005, there is limited knowledge of the guidelines among doctors on duty. The study does not give any explanation for the lack of implementation. The barriers to implementation should be clarified, and future guidelines should be accompanied by an active strategy for implementation.
| 19,014,735
|
[Glucagonoma syndrome without diabetes mellitus].
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A patient developed depression, weight loss, ulcers and a migrating, denuded erythematous skin area. Punch biopsy revealed necrolytic migrating erythema. Computerised tomography and endoscopic ultrasound showed a solid tumour of the pancreas. A blood sample showed an increased level of glucagon without diabetes. Glucagonoma syndrome is characterized by glucagon overproduction, diabetes, depression, deep venous thrombosis and necrolytic migrating erythema. Glucagonoma is frequently diagnosed late which increases the risk of metastases. It is important not to rule out glucagonoma in patients with a relevant clinical picture but without diabetes.
| 19,014,744
|
Sleep and dreaming in Greek and Roman philosophy.
|
Theories as to the function of sleep and dreaming have been with us since the beginning of recorded history. In Ancient Greece and Rome the predominant view of dreams was that they were divine in origin. This view was held not only in theory but also in practice with the establishment of various dream-oracles and dream interpretation manuals (Oneirocritica). However, it is also in the Greek and Roman writings, paralleling advances in philosophy and natural science, that we begin to see the first rationalistic accounts of dreaming. This paper reviews the evolution of such rational accounts focusing on the influence of Democritus, who provides us with the first rationalistic account of dreaming in history, and Aristotle, who provides us with the most explicit account of sleep and dreaming in the ancient world.
| 19,014,776
|
Evaluation of psychiatric symptoms in cocaine users in the Brazilian public health system: need for data and structure.
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Few studies of comorbidity among cocaine users have been undertaken in Brazil, despite the fact that cocaine is one of the most commonly used illegal drugs in the country. The aim of this paper is to review existing data on psychiatric evaluations of cocaine users, and present data from two studies that have addressed this issue as it pertains to the Brazilian public health system. Review and results from two studies (cross-sectional and matched control). The Brazilian literature on PubMed, Lilacs, Psychinfo and DATASUS was searched using the key words: 'psychiatric symptoms', 'diagnosis', 'evaluation', 'assessment', 'cocaine disorders' and others related to this issue. Intake data from two studies of male and female cocaine users were also analysed with regard to psychiatric symptoms as measured by the Symptom Check List - 90 Revised (SCL-90). The literature review found no specific studies regarding psychiatric evaluation of cocaine users in Brazil. Analyses from the two studies presented showed high levels of psychiatric symptoms in this population. In the first study, psychiatric symptoms were measured at treatment entry and their prevalence was high, ranging from 27.4% to 53.4%. In the second study, SCL-90R scores at programme admission were higher in cocaine users than normal controls, with effect sizes ranging from moderate to high. To the authors' knowledge, this is the first article to discuss psychiatric evaluations of comorbidity among cocaine users in Brazil. The results indicate a need to: pay more attention to the evaluation of psychiatric symptoms in cocaine users; emphasize the importance of standardized data collection in this area; and evaluate the course of these symptoms, their impact on outcome, and how they are best addressed in treatment.
| 19,014,831
|
Efficacy of cefditoren pivoxil and amoxicillin/clavulanate in the treatment of pediatric patients with acute bacterial rhinosinusitis in Thailand: a randomized, investigator-blinded, controlled trial.
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The recommended treatment for acute bacterial rhinosinusitis in adults and children is 10 to 14 days of high doses of oral cephalosporins or amoxicillin/clavulanate. This study compared the clinical efficacy and tolerability of cefditoren pivoxil and amoxicillin/clavulanate in children with uncomplicated acute bacterial rhinosinusitis. This was a randomized, investigator-blinded, controlled study in pediatric patients (age 1-15 years) with clinical and radiographic signs and symptoms of acute rhinosinusitis. Patients were allocated to receive either cefditoren (8-12 mg/kg daily) or amoxicillin/clavulanate (80-90 mg/kg amoxicillin daily) for 14 days. Changes in sinus symptoms were assessed daily by patients or their parents using a quantitative symptom score (the S5 score). Rates of improvement, the primary efficacy measure, were also evaluated by the study investigators 7 and 14 days after the initial visit. Secondary outcome measures included time to improvement, adverse effects, and rates of relapse (assessed at days 21 and 28) and recurrence (assessed at day 60) of sinus symptoms. Relapse was defined as a subjective rating of lack of improvement at day 21 or 28 in a patient rated as improved on day 14, and recurrence was defined as sinus symptoms lasting for >or=10 days during the second month of follow-up in a patient rated as improved on day 28. Time to improvement was defined as the number of days between the initial visit and the time at which caregivers noted an improvement in patients' symptoms. Adverse events were monitored by parents/caregivers using a self-administered questionnaire and were also elicited by telephone contact. The study enrolled 142 pediatric patients: 70 in the cefditoren group (42 males, 28 females; median age, 7.15 years) and 72 in the amoxicillin/clavulanate group (37 males, 35 females; median age, 6.60 years). Four patients in the cefditoren group were excluded from the study analyses (2 who were noncompliant [used <80% of the assigned medication] and 2 who developed infection at other sites). There were no significant differences in baseline medical history or signs and symptoms between the 2 groups. Rates of improvement at day 14 in the cefditoren and amoxicillin/clavulanate groups were 78.8% (52/66) and 84.7% (61/72), respectively (P = NS). There was no significant difference in the change in S5 scores between groups at day 14. The median time to improvement was 3.0 days in both groups. There were no significant differences between groups in rates of relapse (9.1% and 11.1%) or recurrence (3.0% and 5.6%) of sinus symptoms. The most common adverse event in both groups was diarrhea, occurring in 4.5% of the cefditoren group and 18.1 % of the amoxicillin/clavulanate group (P = 0.02). In these children with acute bacterial rhinosinusitis, there were no significant differences between cefditoren and amoxicillin/clavulanate, the currently recommended treatment, in terms of rates of response, relapse, or recurrence.
| 19,014,842
|
Water softening by combination of ultrasound and ion exchange.
|
Ion exchange resin used in this work was styrene-divinylbenzene co-polymer with sulfonic acid group as a strong acid cation resin. This resin is particularly well suited for the removal of water hardness. In water treatment, commonly used softening processes are chemical precipitation and ion exchange. In this study, a combination of ultrasound and ion exchange was applied for reducing the hardness of water. The rate of exchange or kinetics of ion exchange is governed by several parameters. Therefore, important variables such as intensity of ultrasound, amount of resin, concentration of ions and contact time were investigated. The experimental data related to the removal of magnesium and calcium ions were fitted properly with Langmuir model. The kinetic of removal for both ions was pseudo-first-order. In point of mechanism, the internal porous and film diffusion were both effective in the process. The capacity of sorption and the velocity of removal were higher in the presence of ultrasound than control method and this is related to the cavitation process.
| 19,014,894
|
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