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Pulsatile luteinizing hormone secretion in hypothalamic amenorrhea, anorexia nervosa, and polycystic ovarian disease during naltrexone treatment. To determine if chronic treatment with the long-acting oral opioid antagonist naltrexone can increase luteinizing hormone (LH) and follicle-stimulating hormone (FSH) secretion in women with secondary amenorrhea. Prospective. Large reproductive endocrinology unit of an academic hospital. Three groups of women with oligomenorrhea or amenorrhea: (1) hypothalamic amenorrhea; (2) anorexia nervosa; and (3) polycystic ovarian disease (PCOD). Naltrexone 50 mg every day for 4 days. Luteinizing hormone pulse pattern, frequency and amplitude, mean LH and FSH levels, measured by serial blood sampling over a 6-hour period before and after naltrexone. Naltrexone caused a significant increase (P less than 0.05) of the LH pulse frequency in patients with hypothalamic amenorrhea and in PCOD but not in anorexia nervosa. The mean levels of LH and FSH and LH pulse amplitudes were not significantly changed by naltrexone. The naltrexone nonresponders were underweight either because of simple weight loss or anorexia nervosa and had low levels of estradiol and an LH pulse pattern similar to the luteal one. The luteal LH pulse pattern in weight loss-related amenorrhea is caused by a nonopioid, undernutrition-linked factor.

Inhibition of retroviral pathogenesis by RNA interference. RNA interference (RNAi) is a newly discovered cellular defense system that is known to suppress replication of genomic parasites in model organisms. It has been widely conjectured that RNAi may also serve as an antiviral system in vertebrates. Retroviral infection could be initiated by electroporation of cloned Rous sarcoma virus (RSV) proviral DNA into the developing chick neural tube. Coelectroporation of proviral DNA and short double-stranded RNAs matching sequences of avain retroviruses, which were designed to induce RNAi against RSV, inhibited viral replication. Replication of RSV after electroporation resulted in disruption of embryonic development and early death, but this, too, could be suppressed by RNAi against the RSV genome. RNAi could also inhibit the growth of RSV and HIV in cell culture. Analysis of the step of the retroviral life cycle that is inhibited by RNAi revealed that it primarily prevented accumulation of the viral RNAs synthesized late during infection. RNA genomes introduced in viral particles early during infection were less sensitive. RNAi can block retroviral infection in vertebrates. The tissue electroporation method described here should allow RNAi to be used widely to study gene function and control of infection in vertebrate animals.

Rationalization of the selection of tracheal tubes. The problems of selection of tracheal tubes, and the need for a rationale, are outlined. Tracheal tubes of 7.5 mm and 8.5 mm i.d. are recommended for female and male patients, respectively. Tracheal size was determined using high pressure-low volume cuffs as measuring devices. The average diameter of the cuff at seal point was 16.2 mm (SD 1.2 mm) for female, and 20.8 mm (SD 2.3 mm) for male patients. To provide a seal with low pressure-high volume cuffed tubes, cuff sizes of 20.5 mm and 27.5 mm are recommended for female and male patients, respectively. The mechanism of sealing with low pressure-high volume cuffs is reviewed.

Rh-Catalyzed Cyclization of 3-Aryloxycarbonyldiazonaphthoquinones for the Synthesis of β-Phenylnaphthalene Lactones and Formal Synthesis of Pradimicinone. In this study, we developed a novel method for the synthesis of β-phenylnaphthalene lactones. The diazo-transfer reactions of 2-azido-1,3-dimethylimidazolinium chlorides to 3-aryloxycarbonyl-1-naphthols proceeded smoothly to give corresponding 3-aryloxycarbonyldiazonaphthoquinones in high yields. These intermediates were further transformed to β-phenylnaphthalene lactones through a Rh-catalyzed intramolecular formal C-H insertion reaction. This method of lactone formation was efficiently applied to the formal total synthesis of pradimicinone.

Use of the radial maze in studies of phencyclidine and other drugs of abuse. Effects of drugs known to disrupt performance in an 8-arm radial maze are reported in terms of changes caused in the pattern of arm entry. Phencyclidine (PCP) and N-allyl-N-normetazocine (SKF-10,047) alter the pattern of arm entry in a way which distinguishes their actions from those of scopolamine and certain serotonergic agonists. The apparent rank order of potencies for causing this effect is (+)SKF-10,047 greater than PCP greater than (-)SKF-10,047. Results of previous radial maze studies evaluating the interactions of clonidine and verapamil with PCP are summarized. Data are reported which indicate that the ability of verapamil to potentiate PCP's behavioral effects stems from an alteration of the pharmacokinetics of PCP; when verapamil (20 mg/kg, IP) was administered 15 minutes before [3H]PCP (40 microCi/kg, IP), brain levels of tritium were increased by 154 to 225 percent. Finally, possible advantages of using a 4-arm radial maze in studies of PCP and related drugs are discussed.

Initiating the T Cell Response to Liver-Stage Malaria. Kurup et al. (Cell Host Microbe 2019;25:565-577.e6) define the liver-based antigen-presenting cell driving CD8 T cell responses to mosquito transmission of Plasmodium spp., and show direct interaction of CD11c+ cells with infected hepatocytes. We discuss this work in context, highlighting gaps and new approaches suggested by the work to target liver-stage vaccine antigens.

Assisted and unassisted suicide in men and women: longitudinal study of the Swiss population. In Switzerland assisted suicide is legal if no self-interest is involved. To compare the strength and direction of associations with sociodemographic factors between assisted and unassisted suicides. We calculated rates and used Cox and logistic regression models in a longitudinal study of the Swiss population. Analyses were based on 5 004 403 people, 1301 assisted and 5708 unassisted suicides from 2003 to 2008. The rate of unassisted suicides was higher in men than in women, rates of assisted suicides were similar in men and women. Higher education was positively associated with assisted suicide, but negatively with unassisted. Living alone, having no children and no religious affiliation were associated with higher rates of both. Some situations that indicate greater vulnerability such as living alone were associated with both assisted and unassisted suicide. Among the terminally ill, women were more likely to choose assisted suicide, whereas men died more often by unassisted suicide.

Serum alpha-tocopherol, lipids, potassium, and creatine phosphokinase in normal and malabsorption patients. Serum alpha-tocopherol, lipids, potassium, and creatine phosphokinase levels were measured in 20 adult male control patients and eight malabsorption patients. The malabsorption group had significantly lower serum alpha-tocopherol levels than the control group. This change was independent of serum total lipid levels that were not significantly different among the two groups. Serum potassium and creatine phosphokinase levels that are normally used to assess muscle pathology in man did not correlate with serum alpha-tocopherol levels in either the control of the malabsorption groups. Body mass indices that are directly related to adiposity of the individuals were calculated. Among the control patients, there was a significant increase in serum alpha-tocopherol and serum total lipids with increase in body mass index. Similar correlations did not exist in the malabsorption group. In the latter group serum alpha-tocopherol levels may have reached low enough levels to be independent of factors such as adiposity and serum total lipids.

Unihemispheric slow-wave sleep in the Amazonian dolphin, Inia geoffrensis. An electroencephalographic study of sleep in Amazonian dolphins, Inia geoffrensis, revealed that unihemispheric slow-wave sleep is the dominant sleep type in this species, as in the other two dolphin species that were studied earlier.

Comparative recovery of 50-Hz and 100-Hz posttetanic twitch following profound neuromuscular block. To determine if posttetanic twitch following 100-Hz tetanic stimulation enables titration of a nondepolarizing relaxant infusion to a greater depth of block than that achieved with posttetanic twitch following 50 Hz. Prospective, observational study. Operating rooms of a university tertiary care center. 10 ASA physical status II and III patients free of known neuromuscular disease and undergoing general endotracheal anesthesia for routine elective surgery. Following induction of general anesthesia, neuromuscular block was maintained with a continuous intravenous vecuronium infusion. Depth of neuromuscular block was assessed by tactile evaluation of the evoked responses of the adductor pollicis muscle following supramaximal stimulation of the ulnar nerve via surface electrodes. The vecuronium infusion was titrated to loss of posttetanic twitch following 100-Hz tetanic stimulation, at which point the infusion was discontinued. 100-Hz tetanic stimulation was repeated every two minutes until recovery of the first posttetanic twitch, at which point 50-Hz tetanic stimulation was repeated every two minutes until recovery of the first posttetanic twitch. The median time (interquartile range) from discontinuation of the vecuronium infusion to recovery of the first posttetanic twitch following 100-Hz tetanic stimulation was 27% faster than the corresponding time to recovery of the first posttetanic twitch following 50-Hz tetanic stimulation [19 (10 to 24) min and 26 (20 to 30) min respectively, p < 0.002]. Posttetanic twitch following 100-Hz tetanic stimulation enables titration of a vecuronium infusion to a greater depth of block than posttetanic twitch following 50-Hz tetanic stimulation. The present findings should enable more effective titration of this relaxant, thereby reducing the likelihood of unwanted patient movement or unduly prolonged recovery due to relaxant overdosing.

Ocular melanoma. Intraocular melanoma of the ciliary body and choroid is the most common primary ocular malignant tumor in adults and the most common noncutaneous melanoma. To describe the most salient clinical features, histopathologic findings, and treatment modalities of intraocular melanoma, as well as the novel therapies currently being tested. Clinically, it is important to determine which lesions carry a worse prognosis so as to offer patients the best treatment modalities available. Tumor location, size, histopathology, cytogenetic abnormalities, and tumor profiling are all used in determining the risk of death from metastatic disease of uveal melanocytic lesions. Despite successful local tumor control, up to 50% of patients have metastatic disease within 15 years of diagnosis; there is no effective treatment for metastatic disease. Pathologists should be aware of the importance of tumor gross description, cellular histopathology classification, the use of fine-needle aspiration biopsy coupled with cytogenetics, and the new classification of uveal malignant melanomas that is based on chromosome 3 status.

Achilles tendinitis as a rare extraintestinal manifestation of ulcerative colitis. Patients with inflammatory bowel disease often have extraintestinal manifestations (EIMs) involving almost all organ systems, but little has been reported on Achilles tendinitis. Herein, we present a unique case of Achilles tendinitis, which manifested shortly after initiation of mesalazine therapy for ulcerative colitis. A 26-year-old Japanese woman with bloody diarrhea and abdominal cramps lasting for 7 days was referred to our hospital. The Lichtiger clinical activity index (CAI) score was 9 at the first visit. Based on the clinical symptoms and examination results, she was diagnosed with ulcerative pancolitis in the active phase, and treatment with mesalazine (2.4 g/day) and probiotics was initiated. Her symptoms resolved within 7 days of treatment (CAI 3). However, she then developed bilateral Achilles tendinitis without any apparent cause. The Achilles tendinitis subsided with conservative management within 2 weeks, despite continuation of mesalazine therapy. This case instructively suggests that Achilles tendinitis should be noted as an EIM of ulcerative colitis.

Investigation on the heavy metal content of zinc-carbon and alkaline manganese dry cells. The objective of this work was to test the compliance of commercially available batteries with the German Battery Ordinance, a project of the German government that was initiated by the Federal Environment Agency. Different types of commercially available dry cells were analysed for their cadmium, lead and mercury contents. The dry cells underwent mechanical pre-treatment, separation of the different components and microwave-assisted digestion before determination of the heavy metals. Mercury is sometimes added to prevent the generation of gaseous hydrogen from the electrochemical process. Lead could be present since it is sometimes used as an alloying element of zinc. Cadmium has no technical importance and is an undesirable impurity. None of the batteries contained higher heavy metal mass fractions than the permissible limits.

[The assessment of 99mTc-HMPAO tumor scintigraphy using VX-2 tumors in rabbits]. Tumor scintigraphy using 99mTc-hexamethyl-propyleneamine oxime (99mTc-HMPAO) was performed in VX-2 tumors implanted in the muscles of the lower limbs of rabbits to evaluate the possibility that this agent could be used to estimate the blood perfusion of the tumor. The distribution of 99mTc-HMPAO in the tumor immediately after the intravenous injection of this radiopharmaceutical exhibited almost the same distribution on the static image 1 hour after administration. Tumor time-activity curve for 99mTc-HMPAO revealed initial peak after the injection followed by fading of 99mTc-HMPAO activity and subsequent gradual decrease in activity over the next 1 hour. The ratio of 99mTc-HMPAO activity in the tumor to that in normal muscle tissue during this next 1 hour was high and independent of time. These findings indicate that static 99mTc-HMPAO scintigraphy can provide qualitative but not quantitative data useful in the estimation of tumor blood perfusion. Moreover, comparison of distribution of 99mTc-HMPAO on the static images and angiographic, histological findings also suggest that static 99mTc-HMPAO images accurately reflect tumor blood perfusion.

Revision gastric bypass after laparoscopic adjustable gastric band: a 10-year experience at a public teaching hospital. In Australia, there is limited access to public revisional bariatric procedures. However, the need for such procedures is rising. We investigated the safety and efficacy of band-to-bypass procedures in our experience at a public teaching hospital over a period of 10 years. Using a prospectively maintained bariatric surgical database, we analysed 91 consecutive planned band-to-bypass procedures from 2007 to November 2016. All patients had prior laparoscopic adjustable gastric bands removed and formation of Roux-en-Y gastric bypass, in one or two stages. Primary outcomes were 30-day complication rate and excess weight loss from 12 months. The impact of fellows as primary operators on these outcomes was assessed. Eighty-two patients met the inclusion criteria. Seventy-one (84.5%) were females. Mean age was 48.8 years (SD: 8.85). Immediate post-operative complications included six (7.3%) patients with gastrojejunostomy leak, three of whom required conversion to laparotomy, with one mortality (1.22%). Fifty-two patients had follow-up of 1 year or more (median: 2.36, range: 1-9.24). Mean excess weight loss at the end of follow-up was 52.79% (SD: 46.46). Twenty-eight (34.14%) cases were performed primarily by a fellow under the guidance of an experienced bariatric surgeon, with equivalent results. Revisional band-to-bypass in the public setting is an effective but complex procedure associated with morbidity. Some risk may be ameliorated by development of selection criteria to exclude certain high-risk groups. We hope discussion amongst other bariatric groups will further refine this approach.

Correlation of clinical and pathologic evaluation of scarring alopecia. Differentiating scarring and nonscarring alopecia poses a diagnostic dilemma for clinicians, with histopathology used to distinguish. The extent to which dermatologists are able to clinically classify alopecia has not been evaluated. A retrospective study of pathology reports on 458 patients was used to calculate a kappa coefficient to correlate clinical presence of scarring or nonscarring alopecia to histopathologic presence of scarring or nonscarring. A multivariate analysis was performed to assess for associations with scarring. The kappa correlation coefficient was 0.59 (P < 0.0001), indicating moderate agreement and varied by race and sex. There were 15 times higher odds of making the clinical diagnosis of scarring alopecia (OR 14.64 95% CI [8.64-24.18]; P < 0.001), and this increased with age. These results suggest that clinical exam is moderately reliable in distinguishing between scarring and nonscarring alopecia. Our results highlight the need for education and diagnostic schemata for evaluation of alopecia based on gender and in skin of color.

Radiation Dosimetry for Ureteroscopy Patients: A Phantom Study Comparing the Standard and Obese Patient Models. To determine the effect of obesity on radiation exposure during simulated ureteroscopy. A validated anthropomorphic adult male phantom with a body mass index (BMI) of approximately 24 kg/m(2), was positioned to simulate ureteroscopy. Padding with radiographic characteristics of human fat was placed around the phantom to create an obese model with BMI of 30 kg/m(2). Metal oxide semiconductor field effect transistor (MOSFET) dosimeters were placed at 20 organ locations in both models to measure organ dosages. A portable C-arm was used to provide fluoroscopic x-ray radiation to simulate ureteroscopy. Organ dose rates were calculated by dividing organ dose by fluoroscopy time. Effective dose rate (EDR, mSv/sec) was calculated as the sum of organ dose rates multiplied by corresponding ICRP 103 tissue weighting factors. The mean EDR was significantly increased during left ureteroscopy in the obese model at 0.0092 ± 0.0004 mSv/sec compared with 0.0041 ± 0.0003 mSv/sec in the nonobese model (P < 0.01), as well as during right ureteroscopy at 0.0061 ± 0.0002 and 0.0036 ± 0.0007 mSv/sec in the obese and nonobese model, respectively (P < 0.01). EDR during left ureteroscopy was significantly greater than right ureteroscopy in the obese model (P = 0.02). Fluoroscopy during ureteroscopy contributes to the overall radiation dose for patients being treated for nephrolithiasis. Obese patients are at even higher risk because of increased exposure rates during fluoroscopy. Every effort should be made to minimize the amount of fluoroscopy used during ureteroscopy, especially with obese patients.

Half-Quantum Vortices in an Antiferromagnetic Spinor Bose-Einstein Condensate. We report on the observation of half-quantum vortices (HQVs) in the easy-plane polar phase of an antiferromagnetic spinor Bose-Einstein condensate. Using in situ magnetization-sensitive imaging, we observe that pairs of HQVs with opposite core magnetization are generated when singly charged quantum vortices are injected into the condensate. The dynamics of HQV pair formation is characterized by measuring the temporal evolutions of the pair separation distance and the core magnetization, which reveals the short-range nature of the repulsive interactions between the HQVs. We find that spin fluctuations arising from thermal population of transverse magnon excitations do not significantly affect the HQV pair formation dynamics. Our results demonstrate the instability of a singly charged vortex in the antiferromagnetic spinor condensate.

Changes in axonal physiology and morphology after chronic compressive injury of the rat thoracic spinal cord. The spinal cord is rarely transected after spinal cord injury. Dysfunction of surviving axons, which traverse the site of spinal cord injury, appears to contribute to post-traumatic neurological deficits, although the underlying mechanisms remain unclear. The subpial rim frequently contains thinly myelinated axons which appear to conduct signals abnormally, although it is uncertain whether this truly reflects maladaptive alterations in conduction properties of injured axons during the chronic phase of spinal cord injury or whether this is merely the result of the selective survival of a subpopulation of axons. In the present study, we examined the changes in axonal conduction properties after chronic clip compression injury of the rat thoracic spinal cord, using the sucrose gap technique and quantitatively examined changes in the morphological and ultrastructural features of injured axonal fibers in order to clarify these issues. Chronically injured dorsal columns had a markedly reduced compound action potential amplitude (8.3% of control) and exhibited significantly reduced excitability. Other dysfunctional conduction properties of injured axons included a slower population conduction velocity, a longer refractory period and a greater degree of high-frequency conduction block at 200 Hz. Light microscopic and ultrastructural analysis showed numerous axons with abnormally thin myelin sheaths as well as unmyelinated axons in the injured spinal cord. The ventral column showed a reduced median axonal diameter and the lateral and dorsal columns showed increased median diameters, with evidence of abnormally large swollen axons. Plots of axonal diameter versus myelination ratio showed that post-injury, dorsal column axons of all diameters had thinner myelin sheaths. Noninjured dorsal column axons had a median myelination ratio (1.56) which was within the optimal range (1.43-1.67) for axonal conduction, whereas injured dorsal column axons had a median myelination ratio (1.33) below the optimal value. These data suggest that maladaptive alterations occur postinjury to myelin sheath thickness which reduce the efficiency of axonal signal transmission.In conclusion, chronically injured dorsal column axons show physiological evidence of dysfunction and morphological changes in axonal diameter and reduced myelination ratio. These maladaptive alterations to injured axons, including decrease in myelin thickness and the appearance of axonal swellings, contribute to the decreased excitability of chronically injured axons. These results further clarify the mechanisms underlying neurological dysfunction after chronic neurotrauma and have significant implications regarding approaches to augment neural repair and regeneration.

Monte Carlo studies of three-dimensional O1 and O4 phi4 theory related to Bose-Einstein condensation phase transition temperatures. The phase transition temperature for the Bose-Einstein condensation (BEC) of weakly interacting Bose gases in three dimensions is known to be related to certain nonuniversal properties of the phase transition of three-dimensional O(2) symmetric phi(4) theory. These properties have been measured previously in Monte Carlo lattice simulations. They have also been approximated analytically, with moderate success, by large N approximations to O(N) symmetric phi(4) theory. To begin investigating the region of validity of the large N approximation in this application, the same Monte Carlo technique developed for the O(2) model [P. Arnold and G. Moore, Phys. Rev. E 64, 066113 (2001)] to O(1) and O(4) theories has been applied. The results indicate that there might exist some theoretically unanticipated systematic errors in the extrapolation of the continuum value from lattice Monte Carlo results. The final results show that the difference between simulations and next-to-leading order large N calculations does not improve significantly from N=2 to N=4. This suggests that one would need to simulate yet larger N's to see true large N scaling of the difference. Quite unexpectedly (and presumably accidentally), the Monte Carlo result for N=1 seems to give the best agreement with the large N approximation among the three cases.

Tissue reparative effects of macrolide antibiotics in chronic inflammatory sinopulmonary diseases. It is well established that macrolide antibiotics are efficacious in treating sinopulmonary infections in humans. However, a growing body of experimental and clinical evidence indicates that they also express distinct salutary effects that promote and sustain the reparative process in the chronically inflamed upper and lower respiratory tract. Unlike the anti-infective properties, these distinct effects are manifested at lower doses, usually after a relatively prolonged period (weeks) of treatment, and in the absence of an identifiable, viable pathogen. Long-term, low-dose administration of macrolide antibiotics has been used most commonly for sinusitis, diffuse panbronchiolitis, asthma, bronchiectasis, and cystic fibrosis. It is associated with down-regulation of nonspecific host inflammatory response to injury and promotion of tissue repair. Although large-scale trials are lacking, the prolonged use of these drugs has not been associated with emergence of clinically significant bacterial resistance or immunosuppression. Long-term, low-dose administration of 14- and 15-membered ring macrolide antibiotics may represent an important adjunct in the treatment of chronic inflammatory sinopulmonary diseases in humans.

Dopaminergic inhibition of gonadotropic release in hibernating frogs, Rana temporaria. The influence of a dopaminergic antagonist, metoclopramide (MET), and an agonist, bromocriptine (BROMO), on reproductive status was examined in female frogs, Rana temporaria. MET induced advanced ovulation during hibernation, suggesting dopaminergic inhibition of gonadotropin (LH) release during this period. BROMO did not decrease plasma LH in intact females in comparison with vehicle (VEH)-treated controls (VEH: 11 +/- 6 vs BROMO: 5 +/- 4 ng/ml) or in sham-lesioned (SL) females (SL; 12 +/- 5 vs SL + BROMO: 9 +/- 8 ng/ml). However, BROMO significantly depressed the rise in plasma LH following lesioning (L) which disconnected the hypothalamus from the medium eminence-pituitary complex (L + BROMO: 29 +/- 10 vs L: 74 +/- 30 ng/ml; P < 0.002). Taken together with previous results of lesion studies, these data point to an important role of dopaminergic inhibition in the regulation of seasonal reproduction in this frog.

Subtraction method for the high-performance liquid chromatographic measurement of plasma adenosine. The measurement of plasma adenosine with traditional high-performance liquid chromatographic techniques is difficult because of its nanomolar concentration, its short half-life in blood, and because of the difficulty in isolating adenosine from interfering peaks in the chromatogram. To prevent loss of adenosine in the blood sample, a "stop solution" is used to prevent enzymatic degradation and cellular uptake. Peak-shifting techniques on fractionated samples to measure adenosine derivatives have been used in the past to avoid interfering peaks in the chromatogram. A new method has been developed by which nanomolar levels of plasma adenosine can be accurately measured despite co-eluting peaks in the chromatogram. In this method, plasma samples are collected with a stop solution, processed, and divided. Adenosine deaminase is added to part of the sample to form a blank. A computer program subtracts the blank chromatogram from the paired unknown, and the result is compared to adenosine standards prepared from the blank and subtracted in a similar fashion. With this subtraction method, the overall recovery of physiological concentrations of adenosine was 89% from dog blood, and the average coefficient of variation was 12%. In summary, the subtraction method of plasma adenosine measurement offers good recovery, reproducibility, and the ability to quantify low levels of adenosine despite interfering peaks in the chromatogram.

DNA aptamers as analyte-responsive cation transporters in fluorogenic vesicles: signal amplification by supramolecular polymerization. We report that single-stranded (ss) DNA aptamers can be activated by counterions such as dodecylguanidinium (DG) to act as transporters in fluorogenic vesicles. However, their activity is independent of the presence or absence of the analyte. Dimerization into ds-DNA helices increases activity in an overadditive manner. Duplex disassembly in response to analyte binding is thus detectable as inactivation. Shortened and mismatched antiaptamers destabilize the active duplex, reduce activity, and increase the sensitivity for the analyte. Supramolecular polymerization of aptamer/antiaptamer duplexes with "sticky ends" is shown to further increase activity without losses in sensitivity for the analyte. The results demonstrate that the principles of DNA nanotechnology are directly applicable to membrane based sensing systems with high precision and fidelity.

Prognostic differences of the Mini Nutritional Assessment short form and long form in relation to 1-year functional decline and mortality in community-dwelling older adults receiving home care. To compare the prognostic value of the revised Mini Nutritional Assessment short form (MNA-SF) classification with that of the long form (MNA-LF) in relation to mortality and functional change in community-dwelling older adults receiving home care in Germany. Multicenter, 1-year prospective observational study. Community. Older adults (≥ 65) receiving home care (n = 309). Nutritional status (well nourished, at risk of malnutrition, malnourished) was classified using the MNA-SF and MNA-LF at baseline. Functional status was determined according to the Barthel Index of activities of daily living (ADLs) at baseline and after 1 year. Hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality were calculated for MNA-SF and MNA-LF categories using stepwise Cox regression analyses. Repeated-measurements analysis of covariance was used to examine changes in ADL scores over time for MNA-SF and MNA-LF categories. MNA-SF classified 15% of the sample as malnourished and 41% as being at risk of malnutrition, whereas the MNA-LF classified 14% and 58%, respectively. During the follow-up year, 15% of participants died. The estimated hazard ratios (HR) for 1-year mortality were lower for MNA-SF than for MNA-LF categories (at risk of malnutrition: HR = 2.21, 95% confidence interval (CI) = 1.02-4.75 vs HR = 5.05, 95% CI = 1.53-16.58; malnourished: HR = 3.27, 95% CI = 1.34-8.02 vs HR = 8.75, 95% CI = 2.45-31.18). For MNA-SF categories, no differences in functional change were found. According to the MNA-LF, ADL decline tended to be greater in those at risk of malnutrition (7.1 ± 10.1 points) than in those who were well nourished (3.7 ± 10.1 points) and malnourished (4.9 ± 10.1 points). In this sample of older adults receiving home care, the MNA-LF was superior to the MNA-SF in predicting mortality and differentiating functional decline during 1 year of follow-up.

Inhibition by ammonium ion of germination of unactivated spores of Bacillus cereus T induced by l-alanine and inosine. Studies were carried out on the inhibitory effect of NH4+ on germination of spores of Bacillus cereus T induced by L-alanine and inosine. Kinetic analysis showed that NH4+ inhibited the germination competitively. Its inhibitory effect was greater when the unactivated spores had been preincubated with L-alanine. NH4+ did not inhibit the response of unactivated spores to L-alanine during preincubation. These results suggest that L-alanine sensitizes the spores to the inhibitory effect of NH4+.

An evaluation of 222Rn concentrations in Idaho groundwater. Factors potentially correlated with 222Rn concentrations in groundwater were evaluated using a database compiled by the U.S. Geological Survey. These included chemical and radiological factors, and both well depth and discharge rate. The 222Rn concentrations contained within this database were examined as a function of latitude and longitude. It was observed that the U.S. Geological Survey sample locations for 222Rn were not uniformly distributed throughout the state. Hence, additional samples were collected in southeastern Idaho, a region where few 222Rn in water analyses had been performed. 222Rn concentrations in groundwater, in Idaho, were found using ANOVA (alpha = 0.05) to be independent of the chemical, radiological, and well parameters thus far examined. This lack of correlation with other water quality and well parameters is consistent with findings in other geographical locations. It was observed that an inverse relationship between radon concentration and water hardness may exist.

Presenting features and diagnosis of rabies. The early clinical features important in the establishment of a diagnosis of rabies are described from experience of 23 fatal cases in Sri Lanka. The importance of the "fan test" as a diagnostic sign is stressed. The earliest features of the disease may suggest hysteria if a history of a bite from a rabid animal is not obtained. In a district in which there is an outbreak of rabies cases of rabies hysteria may also develop.

Effects of alcohol on prolonged cognitive performance measured with Stroop's Color Word Test. 24 men and 24 women were randomly assigned in equal numbers to an Alcohol group, a Placebo group, or a Control group. The alcohol dose was 1.0 ml of 100% alcohol/kg of body weight. Subjects were tested three consecutive times using Stroop's Color Word Test. The dependent measures were total time needed to complete the test, number of errors made and number of hesitations. Data were grouped into three blocks of 100 words. Results indicated that number of hesitations was too insensitive a measure to yield any significant effects. On the two first measures alcohol had a detrimental effect in that the Alcohol group needed more time to complete the test and made more errors than the Placebo group. There was also a significant interaction of alcohol dose by sex by blocks on both these measures, indicating that the detrimental effect of alcohol over time was restricted to women. Different implications of the results were discussed.

Perceptual-motor skill learning in Gilles de la Tourette syndrome. Evidence for multiple procedural learning and memory systems. Procedural learning and memory systems likely comprise several skills that are differentially affected by various illnesses of the central nervous system, suggesting their relative functional independence and reliance on differing neural circuits. Gilles de la Tourette syndrome (GTS) is a movement disorder that involves disturbances in the structure and function of the striatum and related circuitry. Recent studies suggest that patients with GTS are impaired in performance of a probabilistic classification task that putatively involves the acquisition of stimulus-response (S-R)-based habits. Assessing the learning of perceptual-motor skills and probabilistic classification in the same samples of GTS and healthy control subjects may help to determine whether these various forms of procedural (habit) learning rely on the same or differing neuroanatomical substrates and whether those substrates are differentially affected in persons with GTS. Therefore, we assessed perceptual-motor skill learning using the pursuit-rotor and mirror tracing tasks in 50 patients with GTS and 55 control subjects who had previously been compared at learning a task of probabilistic classifications. The GTS subjects did not differ from the control subjects in performance of either the pursuit rotor or mirror-tracing tasks, although they were significantly impaired in the acquisition of a probabilistic classification task. In addition, learning on the perceptual-motor tasks was not correlated with habit learning on the classification task in either the GTS or healthy control subjects. These findings suggest that the differing forms of procedural learning are dissociable both functionally and neuroanatomically. The specific deficits in the probabilistic classification form of habit learning in persons with GTS are likely to be a consequence of disturbances in specific corticostriatal circuits, but not the same circuits that subserve the perceptual-motor form of habit learning.

Comparison of Rappaport-Vassiliadis Enrichment Medium and Tetrathionate Brilliant Green Broth for Isolation of Salmonellae from Meat Products. The effectiveness of Rappaport-Vassiliadis enrichment medium (RV medium) and Difco's tetrathionate brilliant green broth (TBG) for detection of Salmonella in 553 samples of meat products was compared. All samples were preenriched for 20 h in buffered peptone water. Then 0.1 ml of the preenrichment was inoculated into 10 ml of RV medium, 1 ml was added to 9 ml of TBG broth, and 1 ml was inoculated into 10 ml of Muller-Kauffman (MK) tetrathionate broth. All enrichments were incubated at 43°C for 24 h, except for MK broth which was incubated for 48 h, and all were subcultured onto brilliant green deoxycholate agar and bismuth sulfite agar. The Rappaport-Vassiliadis medium was superior to Difco's tetrathionate brilliant green broth, being considerably more sensitive and more specific. The superiority of RV medium concerned the number of positive samples (36% and 28%, respectively), and also the number of Salmonella serotypes and strains. The RV medium inhibited the lactose- and sucrose-negative competing organisms much more than the Difco's tetrathionate broth. The performance of Difco and Muller-Kauffman tetrathionate brilliant green broths was similar. Addition of the brilliant green solution after boiling the tetrathionate broth slightly increased its efficacy. The effectiveness of brilliant green deoxycholate agar and bismuth sulfite agar was similar, whether after enrichment in RV medium or in any of the studied tetrathionate brilliant green broths.

Conservation and reiteration of a kinase cascade. A cascade of three protein kinases has emerged as a conserved functional module in a wide variety of signal transduction pathways in diverse organisms. In addition to this evolutionary conservation, studies in yeast demonstrate that versions of this module are used in different signalling pathways. Thus, homologous kinase cascades function in response to different stimuli in the same cell.

Significance of early tubular extraction in the first minute of Tc-99m MAG3 renal transplant scintigraphy. Renal transplant perfusion curves obtained using Tc-99m MAG3 differ from those with Tc-99m DTPA. The perfusion curve can be divided into a first phase (up to the first-pass peak) and a second phase (the curve after the initial peak). The second phase of the MAG3 perfusion curve is usually ascending in contrast to the descending Tc-99m DTPA curve. This ascending MAG3 curve reflects early tubular extraction of MAG3. However, the second phase of the MAG3 curve is sometimes flat or descending. We hypothesized that a flat or descending curve reflects poor early tubular extraction and therefore graft dysfunction. Ninety-two studies of 59' renal transplant patients were retrospectively reviewed. The second phase of the perfusion curve was visually classified as ascending, flat, or descending. 77.2% of studies had ascending curves, 16.3% flat curves, and 6.5% descending curves. A descending curve had a positive predictive value (PPV) of 100% for medical graft dysfunction, while a flat curve had a PPV of 93.3%. A nonascending second phase curve was specific (96.4%) but not sensitive (33.9%) for graft dysfunction. Patients with acute tubular necrosis were not significantly more likely to have a nonascending curve than those with acute rejection. There was no significant difference in creatinine level between patients with medical graft dysfunction and ascending vs. nonascending curves. A nonascending second phase Tc-99m MAG3 perfusion curve is predictive for graft dysfunction. An ascending curve is nonspecific and can be seen in both normally and poorly functioning grafts.

Vasoconstrictive effects of human post-hemorrhagic cerebrospinal fluid on cat pial arterioles in situ. Cat cortical arterioles were exposed in vivo to cerebrospinal fluid (CSF) from four patients with subarachnoid hemorrhage (SAH) due to a ruptured intracranial aneurysm. Pial arteriolar caliber was measured by the television image-splitting technique. There was a consistent vasoconstrictive response to CSF. This effect could be ascribed neither to the pH of the CSF nor to the potassium concentration. The vasoconstriction, which was more pronounced with decreasing arteriolar caliber, could be resolved by the perivascular application of nifedipine.

Frequency of feeding, weight reduction and energy metabolism. A study was conducted to investigate the effect of feeding frequency on the rate and composition of weight loss and 24 h energy metabolism in moderately obese women on a 1000 kcal/day diet. During four consecutive weeks fourteen female adults (age 20-58 years, BMI 25.4-34.9 kg/m2) restricted their food intake to 1000 kcal/day. Seven subjects consumed the diet in two meals daily (gorging pattern), the others consumed the diet in three to five meals (nibbling pattern). Body mass and body composition, obtained by deuterium dilution, were measured at the start of the experiment and after two and four weeks of dieting. Sleeping metabolic rate (SMR) was measured at the same time intervals using a respiration chamber. At the end of the experiment 24 h energy expenditure (24 h EE) and diet-induced thermogenesis (DIT) were assessed by a 36 h stay in the respiration chamber. There was no significant effect of the feeding frequency on the rate of weight loss, fat mass loss or fat-free mass loss. Furthermore, fat mass and fat-free mass contributed equally to weight loss in subjects on both gorging and nibbling diet. Feeding frequency had no significant effect on SMR after two or four weeks of dieting. The decrease in SMR after four weeks was significantly greater in subjects on the nibbling diet. 24 h EE and DIT were not significantly different between the two feeding regimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Non-equilibrium x-ray spectroscopy using direct quantum dynamics. Advances in experimental methodology aligned with technological developments, such as 3rd generation light sources, X-ray Free Electron Lasers, and High Harmonic Generation, have led to a paradigm shift in the capability of X-ray spectroscopy to deliver high temporal and spectral resolution on an extremely broad range of samples in a wide array of different environments. Importantly, the complex nature and high information content of this class of techniques mean that detailed theoretical studies are often essential to provide a firm link between the spectroscopic observables and the underlying molecular structure and dynamics. In this paper, we present approaches for simulating dynamical processes in X-ray spectroscopy based upon on-the-fly quantum dynamics with a Gaussian basis set. We show that it is possible to provide a fully quantum description of X-ray spectra without the need of precomputing highly multidimensional potential energy surfaces. It is applied to study two different dynamical situations, namely, the core-hole lifetime dynamics of the water monomer and the dissociation of C F 4 + recently studied using pump-probe X-ray spectroscopy. Our results compare favourably to previous experiments, while reducing the computational effort, providing the scope to apply them to larger systems.

Successful treatment of radiation induced breast ulcer with hyperbaric oxygen. The purpose of this report was to investigate the efficacy of hyperbaric oxygen treatment in the management of a persisting radiation induced ulcer following standard breast irradiation. A 57-year-old Caucasian patient was referred following partial mastectomy and axillary node clearance for a T2N0 grade 3 infiltrating ductal carcinoma of the left breast. She received 45 Gy in 25 fractions at 1.8 Gy per fraction to the isocentre to the whole breast using tangential fields and 4 MV photons, in conjunction with intravenous chemotherapy (cyclophosphamide, methotrexate and 5 fluorouracil). Treatment was interrupted for 3.5 weeks because of a grade 4 skin and subcutaneous reaction. Treatment resumed to the tumour bed alone. Chemotherapy was abandoned. The tumour bed received 14 Gy in 7 fractions at 2 Gy per fraction prescribed to the 100% using 10 MeV electrons and a direct field, completing treatment on 7 July 1998. The radiation induced a painful 8x4 cm ulcer which persisted in spite of rigorous treatment including Gentian Violet, Silvazine Cream, Duoderm and antibiotics. The patient received 30 hyperbaric treatments, six times a week, completing treatment on 15 December 1998. The patient required insertion of bilateral ear grommets under local anaesthetic. The breast ulcer showed a response to treatment with early healing after 7-8 days and clinical evidence of re-epithelization. At completion of 30 treatments the patient was left with a small shallow faintly discharging multilocular 3-4 cm ulcer. The ulcer had completely healed by 14 January 1999. The patient has been symptom free since completion of treatment. This report highlights the efficacy of hyperbaric oxygen therapy in the management of persisting radiation-induced ulcers.

Blunted increase in plasma adenosine levels following dipyridamole stress in dilated cardiomyopathy patients. Heart failure is characterized by chronically increased adenosine levels, which are thought to express a protective anti-heart failure activation of the adenosinergic system. The aim of the study was to assess whether the activation of adenosinergic system in idiopathic dilated cardiomyopathy (IDC) can be mirrored by a blunted increase in plasma adenosine concentration following dipyridamole stress, which accumulates endogenous adenosine. Two groups were studied: IDC patients (n = 19, seven women, mean age 60 +/- 12 years) with angiographically confirmed normal coronary arteries and left ventricular ejection fraction <35%; and normal controls (n = 15, six women, mean age 68 +/- 5 years). Plasma adenosine was assessed by high-performance liquid chromatography methods in blood samples from peripheral vein at baseline and 12 min after dipyridamole infusion (0.84 mg kg-1 in 10 min). At baseline, IDC patients showed higher plasma adenosine levels than controls (276 +/- 27 nM L-1 vs. 208 +/- 48 nM L-1, P < 0.001). Following dipyridamole, IDC patients showed lower plasma adenosine levels than controls (322 +/- 56 nM L-1 vs. 732 +/- 250 nM L-1, P < 0.001). The dipyridamole-induced percentage increase in plasma adenosine over baseline was 17% in IDC and 251% in controls (P < 0.001). By individual patient analysis, 18 IDC patients exceeded (over the upper limit) the 95% confidence limits for normal plasma adenosine levels at baseline, and all 19 exceeded (below the lower limit) the 95% confidence limits for postdipyridamole plasma adenosine levels found in normal subjects. Patients with IDC have abnormally high baseline adenosine levels and--even more strikingly--blunted plasma adenosine increase following dipyridamole infusion. This is consistent with a chronic activation of the adenosinergic system present in IDC, which can be measured noninvasively in the clinical theatre.

Regeneration of elastic fibers by three-dimensional culture on a collagen scaffold and the addition of latent TGF-β binding protein 4 to improve elastic matrix deposition. The objective of this study was to investigate the effects of latent TGF-β binding protein 4 (LTBP-4) on elastic fiber regeneration in three-dimensional cultures of human dermal fibroblasts (HDFs). Appropriate collagen scaffold for elastic fiber regeneration was also examined. Collagen sponges cross-linked at 120 °C and composed of small pores (25 μm on average) was favorable for elastic fiber regeneration by HDFs. Addition of LTBP-4, followed by culture for 21 days, accelerated elastic fiber accumulation within the scaffolds. Conditioned scaffolds containing either HDFs or LTBP-4-built mature elastic fibers were implanted between the dermis and the cutaneous muscle of mice. The combined use of HDFs and LTBP-4 resulted in thicker tissues containing elastic fibers. These results indicate that weakly cross-linked collagen sponges can be used as scaffolds for regenerating elastic fibers both in vitro and in vivo, and that the addition of LTBP-4 accelerates the deposition of both elastin and fibrillin-1, and increases cell proliferation. These techniques may be useful for generating cutaneous or cardiovascular tissue equivalents; furthermore, they may serve as a useful method for the three-dimensional analyses of drugs used to treat skin diseases or to examine the microstructure of elastin networks.

Insulin-induced release of plasminogen activator from human blood platelets. Incubation of washed platelets in Tyrode buffer, pH 7.5, with insulin (200 microU/ml) and CaCl2 (1.2 mM) at 37 degrees C for 3 h resulted in a threefold increase of plasminogen activator activity in the supernatant over the basal level as determined by both the amidolytic assay and the proteolysis of alpha-casein through the formation of plasmin from plasminogen. This plasminogen activator showed no plasmin-like activity and was inhibited by anti-tissue plasminogen activator antibody as well as by type 1 plasminogen activator inhibitor. The substrate specificity and the inhibition of the enzymic activity by various inhibitors indicated that the platelet plasminogen activator (pPA) was related to tissue-type plasminogen activator of relative molecular weight 56,000. Fibrinolytic activity of pPA and its insulin-dependent release were demonstrated by the shortening of euglobulin lysis time and by the clot lysis time of platelet-rich plasma from normal and type I diabetes mellitus patients. Treatment of platelet membranes with insulin also increased the release of pPA. Increased levels of adenosine 3',5'-cyclic monophosphate (cAMP) in platelets by incubation with various agents completely inhibited the insulin-induced release of the activator. On the other hand, inhibition of platelet aggregation by aspirin had no effect on the release of pPA, indicating that the effect of cAMP was not due to the inhibition of platelet aggregation by the nucleotide.

[Rhinoviruses]. Human rhinoviruses (RV) belong to the Picornaviridae and are divided into three species: rhinovirus A, B and C. As causative viruses of upper airway infections (common cold), they possess enormous epidemiological and clinical importance. Furthermore, rhinoviruses are significant pathogens of acute exacerbations of chronic airway diseases such as asthma and chronic obstructive pulmonary disease. Their role as a cofactor in the development of pneumonia and their relevance in critically ill patients is still unclear and the focus of current research. Due to the unspecific clinical symptoms, diagnosis is difficult. Laboratory detection is sophisticated and a distinction between clinically relevant infection and contamination not always possible. Specific therapeutic antiviral strategies against rhinovirus infection do not exist as yet and, due to the large variety of subtypes, the development of vaccines remains a considerable challenge.

Characterization of the novel HLA-DRB3*03:37 allele by sequencing-based typing. HLA-DRB3*03:37 differs from HLA-DRB3*03:01:01:01 by one nucleotide substitution in codon 205 in exon 4.

[The rescue station--a multidisciplinary treatment unit in the hospital]. The creation of integrative organizational structures are seen as an objective requirement of medicine characterized by progress of knowledge and specialisation. For emergency cases the rescue station has stood the test as a multidisciplinary unit of the hospital. This thesis is confirmed by experiences obtained from practical work in the Frankfurt/Oder District Hospital and by discussions in the "Working Group Rescue Station" of the "Society of Emergency Medicine of the GDR." In order to realize the function of the rescue chain as well as the multidisciplinary motivation, intensive quantitative and qualitative promotion of rescue stations is required.

A Lipid Transfer Protein Variant with a Mutant Eight-cysteine Motif Causes Photoperiod-thermo-sensitive Dwarfism in Rice. Plant height is an important trait for plant architecture patterning and crop yield improvement. Although the pathways involving in gibberellins and brassinosteroid have been well studied, there are still many gaps in the picture of the networks controlling plant height. Here, we revealed that a dominant photoperiod- and thermo-sensitive dwarf mutant is caused by the active role of a mutated gene Ptd1, of which the wild-type gene encodes a non-specific lipid transfer protein (nsLTP). The Ptd1 plants showed severe dwarfism under long-day and low-temperature conditions, but grew nearly normal under short-day and high-temperature conditions; these phenotypic variations were associated with the Ptd1 mRNA level and its protein accumulation. Furthermore, we found that the growth inhibition in Ptd1 might result from the special protein conformation of Ptd1 due to loss of two disulfide bonds in the Eight-cysteine motif (8-CM) that is conserved among nsLTPs. Our findings give new insights into the understanding of the novel function of disulfide bonds in 8-CM, and provide a new strategy for regulation of cell development and plant height, by modifying the amino acid residues involved in protein conformation patterning.

Comparing alignment methods for inferring the history of the new world lizard genus Mabuya (Squamata: Scincidae). The rapid increase in the ability to generate molecular data, and the focus on model-based methods for tree reconstruction have greatly advanced the use of phylogenetics in many fields. The recent flurry of new analytical techniques has focused almost solely on tree reconstruction, whereas alignment issues have received far less attention. In this paper, we use a diverse sampling of gene regions from lizards of the genus Mabuya to compare the impact, on phylogeny estimation, of new maximum likelihood alignment algorithms with more widely used methods. Sequences aligned under different optimality criteria are analyzed using partitioned Bayesian analysis with independent models and parameter settings for each gene region, and the most strongly supported phylogenetic hypothesis is then used to test the hypothesis of two colonizations of the New World by African scincid lizards. Our results show that the consistent use of model-based methods in both alignment and tree reconstruction leads to trees with more optimal likelihood scores than the use of independent criteria in alignment and tree reconstruction. We corroborate and extend earlier evidence for two independent colonizations of South America by scincid lizards. Relationships within South American Mabuya are found to be in need of taxonomic revision, specifically complexes under the names M. heathi, M. agilis, and M. bistriata (sensu, M.T. Rodrigues, Papeis Avulsos de Zoologia 41 (2000) 313).

[Treatment of bladder neoplasm: vesical instillation of BCG vaccine in microdoses]. We administered BCG at microdoses (1 mg) to 34 patients after surgical operation for bladder cancer, from 1981 to 1989. A 9% recurrency rate was observed during a 42 month follow up period. This is not significantly different from that observed with 120 mg doses, which are associated to known complications.

A nonsurgical approach to low back pain. Low back pain, a leading cause of disability in the United States, has a significant economic impact not only on lost productivity but also on healthcare expenditures. Approximately a fifth of patients will see multiple physicians in their quest for relief of low back pain. Primary care physicians therefore play a crucial role in the initial approach to these patients. A thorough history and physical examination directed toward the neurologic, orthopedic, and osteopathic evaluation are essential. This article reviews the diagnosis and assessment of pain levels and a triad system of therapy involving cortical, spinal, and peripheral levels. Options include antidepressants, neuroleptics, neurostimulants, and osteopathic manipulative treatment (OMT) (cortical level); opiates, tramadol hydrochloride, and transcutaneous electrical nerve stimulators (spinal level); and nonsteroidal anti-inflammatory drugs, epidural injections, spinal blocks, antispasmodics, physical therapy, muscle relaxants, exercise, and OMT (peripheral level), By choosing a modality directed at each level, the clinician may provide the patient with a pain management program that will maximize the chosen mode of therapy and restore function and mobility.

Association between pediatric asthma care quality and morbidity and English language proficiency in Ohio. Limited English proficiency can be a barrier to asthma care and is associated with poor outcomes. This study examines whether pediatric patients in Ohio with limited English proficiency experience lower asthma care quality or higher morbidity. We used electronic health records for asthma patients aged 2-17 years from a regional, urban, children's hospital in Ohio during 2011-2015. Community-level demographics were included from U.S. Census data. By using chi-square and t-tests, patients with limited English proficiency and bilingual English-speaking patients were compared with English-only patients. Five asthma outcomes-two quality and three morbidity measures-were modeled using generalized estimating equations. The study included 15 352 (84%) English-only patients, 1744 (10%) patients with limited English proficiency, and 1147 (6%) bilingual patients. Pulmonary function testing (quality measure) and multiple exacerbation visits (morbidity measure) did not differ by language group. Compared with English-only patients, bilingual patients had higher odds of ever having an exacerbation visit (morbidity measure) (adjusted odds ratio [aOR], 1.4; 95% confidence interval [CI], 1.2-1.6) but lower odds of admission to intensive care (morbidity measure) (aOR, 0.3; 95% CI, 0.2-0.7), while patients with limited English proficiency did not differ on either factor. Recommended follow-up after exacerbation (quality measure) was higher for limited English proficiency (aOR, 1.8; 95% CI, 1.4-2.3) and bilingual (aOR, 1.6; 95% CI, 1.3-2.1), compared with English-only patients. In this urban, pediatric population with reliable interpreter services, limited English proficiency was not associated with worse asthma care quality or morbidity.

Cadmium phytoremediation potential of turnip compared with three common high Cd-accumulating plants. Phytoextraction is a phytoremediation technique used for remediating polluted soils and it greatly relies on the plants' capacities to accumulate contaminants. Turnip is a high cadmium (Cd)-accumulating plant. We compared the Cd tolerance, growth, and Cd accumulation characteristics of two turnip landraces with three additional commonly known high Cd-accumulating species to systematically estimate its Cd phytoremediation potential. Results showed that the turnips could tolerate relatively lower Cd concentrations than other plants. Growth characteristics analyses indicated that the turnips initially grew rapidly and then gradually slowed down, and their photosynthetic parameters indicated that biomass accumulation was easily affected by light. However, the Cd uptake and translocation capacities of the two turnip landraces were higher than those of Phytolacca americana Linn. and Bidens pilosa Linn. but close to that of Brassica napus Linn.. Ultimately, large amounts of Cd accumulated in turnips during early growth and slightly increased as the fleshy roots increased in size. Based on these findings, the present turnip landraces have potential for soil remediation, but additional research is needed before these landraces can be practically used. Moreover, turnips are good candidates for studying the molecular mechanism of high Cd accumulation in plants.

The relationship of impulsivity, sensation seeking, coping, and substance use in youth gamblers. This study examines the relationship of impulsivity, sensation seeking, coping, and substance use to disordered gambling in a sample of 1,339 youth (637 males and 702 females), 17-21 years old. Results indicate that males with serious gambling problems were more likely than their peers to abuse substances and to use avoidant stress-coping strategies, such as seeking emotional outlets, distracting themselves with other activities, and using humor. In contrast, female disordered gamblers were less likely to engage in active coping and planning strategies. Overall, substance use, coping through distraction, and impulsivity proved the most predictive of disordered gambling for males, and intensity seeking and impulsivity proved most predictive for females. Implications for prevention, intervention, and education are discussed.

Biotechnological production of human milk oligosaccharides. Human milk contains a large variety of oligosaccharides (HMOs) that have the potential to modulate the gut flora, affect different gastrointestinal functions, and influence inflammatory processes. This review introduces the recent advances in the microbial and coupled enzymatic methods to produce HMOs with grouping them into trisaccharides (sialyllactose and fucosyllactose) and complex oligosaccharides (lacto-N-biose derivatives). The high purity and low cost of HMOs should make their use possible in new fields such as the food or pharmaceutical industries.

Detection and ecology of leptospirosis in Iowa wildlife. To gain additional information on the extent of leptospirosis in wildlife following a human outbreak in Iowa, wild mammals and lower forms of life were collected. Isolation, darkfield microscopic, serologic and pathologic procedures were used to identify past or present evidence of leptospiral infection. Leptospires were isolated from 7 of 75 (9%) mammals. Serotype grippotyphosa was isolated from three raccoons (procyon lotor) and one Western Harvest Mouse (Reithrodontomys megalotis). Serotype ballum was isolated from three opossums (Didelphis marsupialis). Leptospires, unidentified to date, were isolated from frog (Rana pipiens) kidneys. Other positive serologic and pathologic tests gave evidence of infection or previous infection. Utilization of Darkfield microscopic and silver staining techniques did not detect all cases of leptospiral infection. Macroscopic and microscopic serologic methods failed to identify evidence of leptospirosis in all mammals from which leptospires were isolated. Pathologic lesions could only be considered presumptive evidence for leptospirosis. These findings indicate that detection of leptospirosis in wildlife cannot be limited to a single diagnostic test. A combination of diagnostic procedures and clinical evaluation is necessary. Although serotype pomona was implicated as the predominant infecting leptospire in the human cases and domestic animals and was isolated from water at a swimming site, only serotypes grippotyphosa, ballum and ICF (frog isolate) were isolated from wild mammals and lower forms of life in the same vicinity.

Ca2+- and voltage-dependent K+ conductance in dispersed parathyroid cells. The membrane ionic conductances of dispersed parathyroid cells kept in primary culture were studied using the "whole-cell" and "inside-out excised patch" variants of the patch-clamp technique. The major component of the total current was a voltage-dependent outward K+ current without an appreciable inward current. The amplitude of the K+ current was markedly reduced when free internal Ca2+ was buffered by addition of 10 mM EGTA. Recordings of single-channel current in excised membrane patches revealed the presence of K+ channels with large unitary conductance (200 pS in symmetrical 130 mM K+ solutions) which were also activated by depolarization when internal Ca2+ concentration was about 10(-5)-10(-6) M. At any membrane voltage these channels were closed most of the time at internal Ca2+ concentrations lower than 10(-10) M. These results demonstrate the existence of a Ca2+- and voltage-dependent K+ permeability in parathyroid cells which may participate in the unusual membrane potential changes induced by alterations of external Ca2+ and, possibly, in the regulation of parathormone secretion.

Phospholipid spherules (liposomes) as a model for biological membranes. This review describes the properties of artificial spherules composed of phospholipids and various long-chain anions or cations. The lipids, which are in the liquid-crystal state, trap aqueous solutes such as cations, anions, glucose, or glycine in aqueous compartments between a series of lipid bilayers. The diffusion of these solutes from the spherules can be studied in the same way that diffusion across biological membranes is studied. The spherules exhibit many of the properties of natural membrane-bounded structures: they are capable of ion-discrimination, osmotic swelling, and response to a variety of physiologic and pharmacologic agents. These agents (steroids, drugs, toxins, antibiotics) accelerate or retard diffusion of ions or molecules from the spherules in a way that qualitatively mimics their action on erythrocytes, lysosomes, or mitochondria. Thus the spherules constitute a valuable model system with which to study the properties of biological membranes that may be dependent on their lipid components.

Low-maintenance management: using a simple classification to rate employees' productivity and support requirements. Employees vary in their productivity and their need for guidance, support, and other inputs that may be called "maintenance." This article provides a guide to classifying your team members by a gross ratio of perceived managerial inputs to productivity outputs. It also gives some approaches to understanding your own reactions and dealing with the needs of each group.

Portasystemic shunt fraction quantification using transrectal administration of iodine-123 iodoamphetamine in dogs with chronic bile duct ligation and after propranolol administration. Following transrectal administration, 123I iodoamphetamine (IMP) has been shown in both animal and patient studies to be capable of detecting the presence of portasystemic shunting (PSS). However, the ability of this method to actually quantitate PSS in the presence of cirrhosis and propranolol has not been demonstrated. We studied nine dogs with hitologically proven cirrhosis induced by chronic bile duct ligation. After intravenous injection of propranolol, PSS were measured with both the IMP method and the standard of portal vein infusion of 99mTc macroaggregated albumin (MAA) given through a mesenteric vein catheter. Based on linear regression, a close relationship was seen, given by the equation: MAA = IMP 0.9 + 0.035, with correlation coefficient of 0.99. Thus, in dogs with cirrhosis secondary to chronic bile duct ligation and after propranolol administration, PSS can be quantitated with the transrectal IMP method.

Effects of intestinal bacteria on the development of colonic neoplasm II. Changes in the immunological environment. To study the effects of intestinal bacteria on the development of colonic neoplasm, we have established gnotobiotic mice with a single species of intestinal bacteria. In the previous study, the incidence of colonic adenoma induced with 1,2-dimethylhydrazine (DMH) in the gnotobiotic mice with Lactobacillus acidophilus, gnotobiotic mice with Escherichia coli and germ-free mice were 30, 50 and 74%, respectively. In this study, 7-week-old mice in each group were sacrificed without the administration of DMH to examine the constituents of immuno-competent cells in various mouse organs using flow cytometry. In the gnotobiotic mice, CD3 intermediate interleukin (IL)-2Rbeta positive cells were observed predominantly in the liver. In the gnotobiotic mice with L. acidophilus, Mac-1 positive Gr-1 positive cells were observed predominantly in the colonic lamina propria. The activation of extrathymic T cells in the liver and granulocytes in the colonic mucosa may be related to anti-neoplastic effects of L. acidophilus in this experimental model.

Divergent ontogeny of sigma and phencyclidine binding sites in the rat brain. The postnatal developmental patterns of sigma (sigma) and phencyclidine (PCP) binding sites were compared in the rat brain. The results show diametrically different ontogenic patterns for the sites. While both the affinity and the density of sigma sites remain constant throughout the developmental period tested (postnatal day 1 to 1 year), the density of PCP binding sites increases from the time of birth, reaching the adult level by postnatal day 14. The differences in developmental patterns provide evidence for distinctive properties of cerebral sigma and PCP binding sites.

Pharmacological activation of PPAR gamma ameliorates vascular endothelial insulin resistance via a non-canonical PPAR gamma-dependent nuclear factor-kappa B trans-repression pathway. Vascular endothelial insulin resistance (IR) is a critically initial factor in cardiocerebrovascular events resulted from diabetes and is becoming a worldwide public health issue. Thiazolidinediones (TZDs) are clinical insulin-sensitizers acting through a canonical peroxisome proliferator-activated receptor gamma (PPARγ)-dependent insulin trans-activation pathway. However, it remains elusive whether there are other mechanisms. In current study, we investigated whether TZDs improve endothelial IR induced by high glucose concentration or hyperglycemia via a non-canonical PPARγ-dependent nuclear factor-kappa B (NF-κB) trans-repression pathway. Our results showed that pre-treatment with TZDs dramatically decrease the susceptibility of endothelial cell to IR, while post-treatment notably improve the endothelial IR both in vitro and in vivo. Moreover, TZDs substantially increase the levels of endothelial nitric oxide synthase (eNOS) and inhibitory κB alpha (IκBα), whereas decrease those of the phosphorylated inhibitory κB kinase alpha/beta (phosphor-IKKα/β) and the cytokines including tumor necrosis factor alpha (TNFα), interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cellular adhesion molecule-1 (sVCAM-1), suggesting that TZDs act indeed through a PPARγ-dependent NF-κB trans-repression pathway. These findings highlighted a non-canonical mechanism for TZDs to ameliorate endothelial IR which might provide a potential strategy to prevent and treat the diabetic vascular complications clinically.

Phytoplasma: phytopathogenic mollicutes. During the past decade, research has yielded new knowledge about the plant and insect host ranges, geographical distribution, and phylogenetic relationships of phytoplasmas, and a taxonomic system has emerged in which distinct phytoplasmas are named as separate "Candidatus phytoplasma species." In large part, this progress has resulted from the development and use of molecular methods to detect, identify, and classify phytoplasmas. While these advances continue, research has recently begun on the phytoplasma genome, how phytoplasmas cause disease, the role of mixed phytoplasmal infections in plant diseases, and molecular/genetic phenomena that underlie symptom development in plants. These and other recent advances are laying the foundation for future progress in understanding the mechanisms of phytoplasma pathogenicity, organization of the phytoplasma genome, evolution of new phytoplasma strains and emergence of new diseases, bases of insect transmissibility and specificity of transmission, and plant gene expression in response to phytoplasmal infection, as well as the design of novel approaches to achieve effective control of phytoplasmal diseases.

Severe demodexfolliculorum-associated oculocutaneous rosacea in a girl successfully treated with ivermectin. There is a limited therapeutic armamentarium for recalcitrant cases of childhood rosacea. We report the case of a 12-year-old girl who presented with severe ocular and cutaneous rosacea unresponsive to oral doxycycline, oral isotretinoin, and topical tacrolimus. A biopsy specimen showed numerous mites within the folliculosebaceous unit. Treatment with a single dose of oral ivermectin achieved resolution of her symptoms. The causative role of Demodex folliculorum should be considered in immunocompetent children with rosacea or rosacea-like refractory eruptions. In such cases, treatment with ivermectin can be beneficial.

[Can the urine dipstick be used in the diagnosis of urinary bacterial colonizations in a preoperative urological assessment?]. The use of the dipstick urinalysis has been validated for the diagnosis of symptomatic urinary infections, cystitis and pyelonephritis thanks to an excellent negative predictive value. For prostatitis, it is rather its positive predictive value that is interesting. The aim of this study is to validate its use in the screening of urinary colonizations in the preoperative assessment in urology. A monocentric prospective study was carried out for one year in 2011 comparing the data from the urine dipstick test with a fresh-voided midstream urinary examination and culture performed on the day of admission with the same urine sample in 598 asymptomatic patients programmed for a urological procedure. The gold standard to diagnose a microbiological-confirmed urinary tract infection or colonization was uropathogen growth of ≥10(3) colony-forming units per ml (cfu/mL) with or without leucocyturia. The study disclosed 5% of colonized patients. The urine dipstick test had a 65% sensitivity and a 97% negative predictive value. However, the low sensitivity of the urine dipstick test entailed 34% of false negatives. In spite of a good negative predictive value linked to a low prevalence of colonized patients (5%), the low sensitivity of the urine dipstick test entails a non-negligible number of false negatives. Its use as a single test of preoperative screening would expose colonized patients to the prospect of an operation, which seems to be unacceptable for some of them, notably endoscopic ones. 4.

The relationship between yogurt consumption, body weight, and metabolic profiles in youth with a familial predisposition to obesity. This study examined the relationship between yogurt consumption, family history of obesity (FHO), and health determinants. Youth (n = 198; mean age: 20 ± 0.5 years) from the Québec Family Study were first classified based on their FHO, defined as the presence or absence of at least one obese (BMI ≥30 kg/m2) parent [with FHO (FHO+; n = 112) or without FHO (FHO-; n = 86)] and then on their yogurt consumption [yogurt consumers (YC+) n = 61 or non-consumers (YC-) n = 137]. A two-factor mixed ANOVA was performed to evaluate the association between FHO, YC, and their interaction with health determinant such as weight and body composition, metabolic and behavioral profiles. There was a main effect of FHO, but not YC, for weight and body composition, but no interaction between YC and FHO for these measures. However, a significant interaction between YC and FHO was observed for fasting insulin (P = 0.02), insulin area under the curve (AUC) (P = 0.02), and homeostatic model assessment of insulin resistance (HOMA-IR; P = 0.03) after adjustment for studied covariates. Specifically, lower fasting plasma insulin, insulin AUC, and HOMA-IR were observed in FHO+ and YC+ youth compared to YC- youth of the same group while no differences were found between the FHO- sub-groups. Consuming yogurt may protect against insulin resistance more specifically among youth at risk of obesity, and this relationship appears to be independent of body composition and lifestyle factors measured in this study.

TCR down-regulation controls T cell homeostasis. TCR and cytokine receptor signaling play key roles in the complex homeostatic mechanisms that maintain a relative stable number of T cells throughout life. Despite the homeostatic mechanisms, a slow decline in naive T cells is typically observed with age. The CD3gamma di-leucine-based motif controls TCR down-regulation and plays a central role in fine-tuning TCR expression and signaling in T cells. In this study, we show that the age-associated decline of naive T cells is strongly accelerated in CD3gammaLLAA knock-in mice homozygous for a double leucine to alanine mutation in the CD3gamma di-leucine-based motif, whereas the number of memory T cells is unaffected by the mutation. This results in premature T cell population senescence with a severe dominance of memory T cells and very few naive T cells in middle-aged to old CD3gamma mutant mice. The reduced number of naive T cells in CD3gamma mutant mice was caused by the combination of reduced thymic output, decreased T cell apoptosis, and increased transition of naive T cells to memory T cells. Experiments with bone marrow chimeric mice confirmed that the CD3gammaLLAA mutation exerted a T cell intrinsic effect on T cell homeostasis that resulted in an increased transition of CD3gammaLLAA naive T cells to memory T cells and a survival advantage of CD3gammaLLAA T cells compared with wild-type T cells. The experimental observations were further supported by mathematical modeling of T cell homeostasis. Our study thus identifies an important role of CD3gamma-mediated TCR down-regulation in T cell homeostasis.

Interregional correlation of cerebral glucose metabolism in unmedicated schizophrenia. To investigate metabolic relationships between different brain regions in schizophrenia, we measured regional brain metabolism using positron emission tomography (PET) and [18F]fluorodeoxyglucose (FDG) in 15 unmedicated schizophrenic patients and 15 healthy subjects. We analyzed correlations between glucose metabolism data of multiple brain regions using factorial analysis and correlation coefficient comparisons. Absolute regional intercorrelations in schizophrenic brains were found to be significantly stronger than in controls, in relationship to the greater variability of metabolic rates in schizophrenic patients. Variability of normalized metabolic rates and regional intercorrelations were not significantly different between schizophrenic patients and control subjects. We conclude that a global metabolic factor accounts for the variability of metabolic data in untreated schizophrenia.

Purification and characterization of sialyl-Le(a)-carrying mucins of human bile; evidence for the presence of MUC1 and MUC3 apoproteins. Purification of sialyl-Le(a)-carrying mucins from primary human bile by trichloroacetic acid precipitation, delipidation, and gel filtration in guanidinium chloride gave three separable fractions, one of which was further purified by affinity chromatography. These fractions, named SBG1 (for soluble bile glycoprotein), SBG2, and SBG3 had molecular masses of > 1100, 800-950, and 100-250 kDa, respectively, as estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Their mucin characteristics were indicated by a high carbohydrate content, ranging from 74 to 95%. The carbohydrate compositions indicated the presence of very long fucosylated polylactosamine chains. Amino acid analyses showed high abundance of serine and threonine in all three fractions (19-36%), confirming their mucin-like nature. Immunochemical analyses of deglycosylated samples detected the MUC1 mucin apoprotein in SBG2 and the MUC3 protein in SBG1. To our knowledge, this is the first report of a MUC3 mucin being purified. This mucin showed no significant reduction in size upon trypsin treatment or disulfide bond reduction and alkylation. Gel filtration of three samples of secondary bile showed that the size distribution of sialyl-Le(a)-carrying glycoproteins was similar to that found in primary bile, and immunochemical analysis showed that the MUC1 protein was present in all three samples. In one sample an additional fraction was isolated, which was insoluble in 6 M guanidinium chloride, but was solubilized upon reduction and alkylation. mRNAs from gallbladder epithelia were analyzed in Northern blot hybridizations showing that the MUC1 and MUC3 but not the MUC2 mucin apoprotein genes were expressed.

Life at the epicentre: my first year at North York General Hospital. My inaugural year at NYGH neatly bisects, with the two halves marked by decidedly different challenges. The first six months brought its share of difficulties, and with it some tests of will on my part. But it all paled in comparison with what followed, as we coped with the outbreak of SARS.

Paying for your BSN degree: five steps to success. Registered nurses confronted with the necessity of financing their BSN degree need to develop a careful plan to get the needed monetary support. The use of a logical five step model will facilitate the process involved in earning financial assistance from the government or private sources. Nurses can be creative in designing their own financial sources and support packages.

Light regulation of plant gene expression by an upstream enhancer-like element. Light regulates many varied physiological and developmental phenomena during plant growth and differentiation, including the formation of a photosynthetically competent chloroplast from a proplastid. The expression of ribulose 1,5-bisphosphate carboxylase small subunit (rbcS) genes is regulated by light in a development- and tissue-specific manner2,3. In some plant species, phytochrome has been demonstrated to mediate this response, and photoregulation of rbcS expression occurs at least in part at the level of transcription. We have shown previously that a 5'-noncoding fragment (4-973 base pairs (bp) upstream of the messenger RNA cap site) of the pea rbcS ss3.6 gene contains all of the nucleotide sequence information necessary to direct the photoregulated expression of a bacterial chloramphenicol acetyltransferase (cat) gene in tobacco. Consistent with these findings, Morelli et al.11 have shown by deletion analysis of a second rbcS gene promoter, that the sequences required for photoregulated expression of rbcS E9 reside within the 5'-noncoding region. They identified an upstream region of approximately 700 bp needed for maximum transcription but not light-dark regulation, and a region from -35 to -2 bp which included the TATA box and contained the necessary information for light responsiveness. We now demonstrate that regulatory sequences 5' distal to the rbcS ss3.6 TATA box and transcriptional start site not only contain the information necessary for maximum expression, but also confer photoregulation. These upstream regulatory sequences function independently of orientation when fused to their homologous promoter or a heterologous promoter.

4D Lorentz electron microscopy imaging: magnetic domain wall nucleation, reversal, and wave velocity. Magnetization reversal is an important topic of research in the fields of both basic and applied ferromagnetism. For the study of magnetization reversal dynamics and magnetic domain wall (DW) motion in ferromagnetic thin films, imaging techniques are indispensable. Here, we report 4D imaging of DWs by the out-of-focus Fresnel method in Lorentz ultrafast electron microscopy (UEM), with in situ spatial and temporal resolutions. The temporal change in magnetization, as revealed by changes in image contrast, is clocked using an impulsive optical field to produce structural deformation of the specimen, thus modulating magnetic field components in the specimen plane. Directly visualized are DW nucleation and subsequent annihilation and oscillatory reappearance (periods of 32 and 45 ns) in nickel films on two different substrates. For the case of Ni films on a Ti/Si(3)N(4) substrate, under conditions of minimum residual external magnetic field, the oscillation is associated with a unique traveling wave train of periodic magnetization reversal. The velocity of DW propagation in this wave train is measured to be 172 m/s with a wavelength of 7.8 microm. The success of this study demonstrates the promise of Lorentz UEM for real-space imaging of spin switching, ferromagnetic resonance, and laser-induced demagnetization in ferromagnetic nanostructures.

Regular Exercise and Depressive Symptoms in Community-Dwelling Elders in Northern Taiwan. According to World Health Organization, depressive disorder will be a Top 2 disease in the world by 2020. In light of Taiwan's rapidly increasing elderly population, elderly psychological health is expected to become an increasingly important issue in healthcare. This study examines the association between regular exercise and depressive symptoms in community-dwelling older adults by gender in northern Taiwan. The participants were selected using a probability-proportional-to-size procedure from community-dwelling adults who were aged 65 years or older and living in northern Taiwan. A cross-sectional study and interviews were used to collect information about their exercise behaviors, depressive symptoms, and the factors influencing the depressive symptoms. Percentage, chi-square, t test, and logistic regression were used to analyze the data. One thousand twenty elderly individuals completed the questionnaires. Among the participants with the average age of 73.5 years, 44.5% were men, and 55.5% were women. Two hundred seventeen of the participants (21.3%) had depressive symptoms. Five hundred eighty-five of the participants (57.4%) exercised regularly. The result of logistic regression showed that regular exercise was a significant predictor of depressive symptoms in elderly individuals (odds ratio = 3.54, 95% confidence interval [1.76, 7.12]). Other factors such as gender, chronicle diseases, and health status were not related to depressive symptoms. Moreover, both for male and female individuals, regular exercise was a significant predictor of depressive symptoms (odds ratio = 4.76, 95% confidence interval [1.65, 13.72] and odds ratio = 3.03, 95% confidence interval [1.18, 7.69], respectively). Other factors were not related to depressive symptoms. This study shows regular exercise to be a significant predictor of depressive symptoms in both men and women. Therefore, senior citizens should be encouragedto exercise regularly as a way to promote good mental health.

Suppression of juvenile social behavior requires antagonism of central opioid systems. Pairs of male and female rats were injected with either tertiary naltrexone (NTX) which readily crosses the blood-brain barrier, or quaternary naltrexone (QNTX) which does not, to determine the importance of central opioid systems in the elaboration of juvenile social behavior. In the first experiment, only intraperitoneal injections of NTX (1.0 mg/kg) suppressed the frequency of wrestling pins. Peripheral injections of QNTX (10.0 mg/kg) were without effect. In a second experiment, QNTX (2.0, 4.0, or 8.0 micrograms/4.0 microliters) was injected directly into the lateral ventricles. Intracerebroventricular injection of the moderate dose reliably reduced frequency of pinning while the higher dose was severely incapacitating and the low dose was without effect. The results of these two experiments confirm an important role for brain opioid systems in the control of juvenile social interaction.

Apoptosis induction by hypercross-linking of the surface antigen CD5 with anti-CD5 monoclonal antibodies in B cell chronic lymphocytic leukemia. We evaluated cells from 24 patients with B cell chronic lymphocytic leukemia (B-CLL) to determine apoptosis induced by CD5 hypercross-linking. Following the CD5 hypercross-linking with anti-CD5 monoclonal antibodies (MoAbs), we identified 10 patients where CD5 hypercross-linking induced apoptosis (group A) and 14 patients whose cells were resistant to the anti-CD5 MoAbs (group B). The programmed cell death pathway of the cells from patient group A was caspase-3 and poly (ADP-ribose) polymerase (PARP)-dependent, involved a reduction of the mitochondrial transmembrane potential DeltaPsi and a down-regulation of the anti-apoptotic Bcl-2, Mcl-1 and iNOS proteins. Early activation-associated molecules such as CD25 and CD69 were expressed at higher levels than in controls after 6 h of culture with anti-CD5 MoAb. The expression of CD5 and of CD72, the ligand for CD5, were significantly lower in group A compared with group B. Anti-CD20 MoAb had similar activity with anti-CD5 MoAb and the combination of the two MoAbs seemed to be additive. In this study, it is suggested that the cells from some B-CLL patients can be induced into programmed cell death by CD5 hypercross-linking with anti-CD5 MoAbs.

Mifepristone sensitizing cisplatin for cervical adenocarcinoma HeLa cell sensitivity to chemotherapy and its mechanism. The study was designed to investigate proliferation inhibition for cervical adenocarcinoma HeLa cell treated with cisplatin combined with mifepristone and access its possible mechanism. HeLa cell was processed by different concentrations of mifepristone, cisplatin, and their combination respectively. Cell's proliferation inhibition rate and induction apoptosis ability were detected by MTT assay, FCM; the expression of P53, survivin and HPV E6 protein were measured by Western Blot. The results showed that cisplatin inhibits proliferation of HeLa cells in different concentrations (p <0.01). Mifepristone had no effect on HeLa cell proliferation inhibition rate during 24 and 48 hours (p > 0.05). Mifepristone at low concentrations (< or = 10 micromol/l) combined with cisplatin can significantly enhance the inhibitory effect of cisplatin on HeLa cell line. Flow cytometry showed that mifepristone at low concentrations (< or = 10 micromol/l) combined with cisplatin can induce apparent apoptosis of HeLa cell line in concentration dependent manner. Western blotting demonstrated that the expression of P53 protein increased and the expression of HPV E6 survivin protein decreased in HeLa cells treated with MIF at low concentrations (< or = 10 micromol/l) combined with cisplatin. Mifepristone at low concentrations (< or = 10 micromol/1) can enhance chemosensitivity and capability of inducing apoptosis of cisplatin to HeLa cells. The strengthening effect of growth inhibition and chemosensitivity to cisplatin of mifepristone are associated with down-regulating HPV E6 survivin protein and upregulating p53 protein.

Beta-endorphin decreases fatigue and increases glucose uptake independently in normal and dystrophic mice. beta-Endorphin and a C-terminal analogue have been shown to decrease muscle fatigue and increase glucose uptake in muscles of normal mice. In order to provide evidence whether these peptides might be useful in muscle-wasting conditions and whether the two actions of the peptides are interdependent, the effect of beta-endorphin on muscle fatigue and glucose uptake was studied using isolated hemidiaphragm preparations of dystrophic mice as well as normal mice. Muscle contractions were elicited by high-frequency stimulation of the phrenic nerve. Glucose uptake was measured using (nonmetabolizable) 2-deoxy-D-[1-(3)H]glucose. beta-Endorphin and the C-terminal analogue reduced fatigue in normal muscles of males but not females. Insulin had no effect in either sex. The peptides increased 2-deoxyglucose uptake in contracting and noncontracting muscles of normal males and females. beta-Endorphin reduced fatigue and increased deoxyglucose uptake in dystrophic muscles. The effect on fatigue was not due to increased glucose uptake, as the energy substrate present was pyruvate. Nerve stimulation released beta-endorphin immunoreactivity from intramuscular nerves of dystrophic mice. It is hypothesized that beta-endorphin released from motor nerves as well as from the pituitary could be responsible for improving muscle function during exercise. beta-Endorphin or analogues could have therapeutic use in muscle-wasting disease.

Antibody responses of mice to intragastric and parenterally administered aeroallergens. Intragastric administration of aeroallergens (pollen extract)-primed mice to produce transient serum IgE antibody responses following subsequent parenteral stimulation while the same initial dose of extract, given parenterally, did not have this effect. In previously immunized animals, intragastric administration of pollen extract was found to enhance systemic antibody production. These observations indicate that exposure of gut-associated lymphoid tissue to aeroallergens can have a profound effect on subsequent reaginic antibody production. This procedure provides a useful model for studying IgE responses to allergens without the complication of an initial injection with adjuvant. A combination of parenteral immunization with oral administration may therefore offer a convenient immunotherapeutic manoeuvre for patients with seasonal rhinitis/asthma.

Cardiac hypertrophy secondary to ACTH treatment in children. The usefulness of ACTH in the treatment of childhood epilepsy is assessed by improvement in the EEG and in the clinical condition. However, pronounced side effects, even serious ones, must be encountered. The most common complications are Cushing syndrome, infections, and arterial hypertension. We report on seven patients with infantile myoclonic seizures, who exhibited myocardial hypertrophy with increased left ventricular function during ACTH treatment. These changes were detected and followed by serial echocardiographic investigations. Within a period of 5 months after the termination of ACTH therapy the abnormal echocardiographic findings disappeared. We believe that the cardiac hypertrophy is ACTH-induced. Based on the various biological effects of ACTH different explanations are proposed: oedema or deposition of glycogen in the myocardial tissue, hyperinsulinism, arterial hypertension and increased inotropic stimulus. Because of our observations, we suggest careful monitoring of children treated with ACTH by performing serial echocardiographic investigations.

Turmeric Extract: Potential Use as a Prebiotic and Anti-Inflammatory Compound? Prebiotics are regarded as the non-digestible food constituents that are selectively consumed by health-promoting bacteria (probiotics). In fact, a number of active metabolites is released due to intensive interaction between prebiotics and probiotics in the gut which exert local and systemic beneficial effects including regulation of intestinal disorders and modulation of host immunity. Turmeric is one of the most important medicinal herbaceous that is derived from Curcuma longa rhizome. Curcumin is a well-recognized component of turmeric which contributes to the prevention of multiple inflammatory diseases. Despite curcumin as a well-known compound, few researches have focused on the turmeric extract (TE) and its potential as prebiotic and anti-inflammatory compound. The aim of this study was to evaluate the prebiotic potential and some functional-structural properties of TE. The Fourier-transform-infrared spectroscopy (FTIR) spectrum of TE showed identical peaks that belonged to β configuration in pyranose and glycosidic bonds. High performance liquid chromatography (HPLC) analysis revealed the presence of potent phenolic and flavonoid anti-oxidants and curcuminoids, and some functional monosaccharides. TE demonstrated excellent resistance to artificial human gastric and intestine juice compared to the standard prebiotic (inulin) (p ≤ 0.05). Interestingly, our time course experiment showed that TE not only is digested by probiotics including Lactobacillus rhamnosus GG (LGG) and Bifidobacterium animalis BB12, but also supports the growth of these bacteria even after 72 h (p ≤ 0.05). To our knowledge, this is the first report evaluating prebiotic potential of TE and exploring its suppressive effects on LPS induced IL-8 production in HT29-19A cell line.

Food insecurity affects school children's academic performance, weight gain, and social skills. Food insecurity has been associated with diverse developmental consequences for U.S. children primarily from cross-sectional studies. We used longitudinal data to investigate how food insecurity over time related to changes in reading and mathematics test performance, weight and BMI, and social skills in children. Data were from the Early Childhood Longitudinal Study-Kindergarten Cohort, a prospective sample of approximately 21,000 nationally representative children entering kindergarten in 1998 and followed through 3rd grade. Food insecurity was measured by parent interview using a modification of the USDA module in which households were classified as food insecure if they reported > or =1 affirmative response in the past year. Households were grouped into 4 categories based on the temporal occurrence of food insecurity in kindergarten and 3rd grade. Children's academic performance, height, and weight were assessed directly. Children's social skills were reported by teachers. Analyses examined the effects of modified food insecurity on changes in child outcomes using lagged, dynamic, and difference (i.e., fixed-effects) models and controlling for child and household contextual variables. In lagged models, food insecurity was predictive of poor developmental trajectories in children before controlling for other variables. Food insecurity thus serves as an important marker for identifying children who fare worse in terms of subsequent development. In all models with controls, food insecurity was associated with outcomes, and associations differed by gender. This study provides the strongest empirical evidence to date that food insecurity is linked to specific developmental consequences for children, and that these consequences may be both nutritional and nonnutritional.

Effect of time and sex on tissue selenium concentrations in chicks fed practical diets supplemented with sodium selenite or calcium selenite. An experiment was conducted with 384 1-d-old male and female broiler-chicks. The basal corn-soybean meal diet (.07 ppm Se DM basis) was supplemented with 0, .1, .2, or .3 ppm added Se as either sodium selenite (Na2SeO3) or calcium selenite (CaSeO3), and fed for 1, 3, or 5 wk. There was no effect of Se source or level on feed intake or gain, but males consumed more (P less than .01) feed than females. There was no effect (P greater than .10) of sex or Se source on plasma, liver, or kidney Se concentration. The Se concentration of all tissues increased (P less than .01) with time and increasing dietary Se concentration. Based on multiple regression slope ratios of liver, kidney, and plasma Se concentrations, Se from CaSeO3 was as available (103%) as Se from Na2SeO3.

Influence of Danazol on gonadotropin secretion and synthesis by rat pituitary cells in cultures. Comparison with gonadal steroids. Increasing concentrations of estradiol, testosterone, progesterone (1.10(-10) to 1.10(-7] and Danazol (1.10(-9) to 1.10(-6) M) have been added to male rat pituitary cells maintained in monolayer cultures for a preincubation period of three days followed by a six hour incubation with or without GnRH (1.10(-8) M). Concentrations of LH and FSH have been assessed in the culture media and in the cells at the end of the experiments allowing an estimation of the influence of these steroids on gonadotropin release and synthesis. In these experimental conditions, estradiol does not modify basal and GnRH induced FSH release and synthesis but reduces the GnRH-induced response of LH. Testosterone and progesterone stimulate synthesis of FSH but inhibit synthesis and secretion of LH in the presence of GnRH. These results have been compared with those of literature. Danazol, in the same experimental conditions, stimulates synthesis of gonadotropins and simultaneously inhibits their release induced by the presence of GnRH. We conclude that Danazol is able to act at the pituitary level as testosterone which is in good agreement with its androgenic properties.

Vancomycin-resistant Enterococcus faecium sensitivity to isopropyl alcohol before and after implementing alcohol hand rubbing in a hospital. A recent study reported enterococci that developed alcohol tolerance. We measured minimum inhibitory concentrations (MICs) of isopropyl alcohol against 55 vancomycin-resistant Enterococcus faecium. We did not find an increase in MICs when comparing the periods before and after the use of alcohol for hand hygiene in a hospital, and we did not find a single isolate with a MIC higher than 11.5%. We consider alcohol to still be an effective measure for hand antisepsis.

[Biotherapy of malignant peritoneal effusions in ovarian carcinoma]. Malignant peritoneal effusions often arise in patients with ovarian carcinoma. They are a hazardous complication of cancer. Systematic intraperitoneal chemotherapy is not necessarily followed by long-term remission and may even induce untoward side effects. Intraperitoneal interleukin-2 (IL-2) and IL-2/lymphokine-activated killers (LAK) biotherapy showed high efficacy in treatment of ovarian carcinoma patients suffering from peritoneal effusions. The objective effect was 80.1% and 82.6%, respectively. Our results suggest that intraperitoneal biotherapy may be extended to dealing with malignant peritoneal effusions in ovarian carcinoma.

Influence of Cross-Linkers on the in Vitro Chondrogenesis of Mesenchymal Stem Cells in Hyaluronic Acid Hydrogels. This study aims to investigate the effect of the structures of cross-linkers on the in vitro chondrogenic differentiation of bone mesenchymal stem cells (BMSCs) in hyaluronic acid (HA)-based hydrogels. The hydrogels were prepared by the covalent cross-linking of methacrylated HA with different types of thiol-tailored molecules, including dithiothreitol (DTT), 4-arm poly(ethylene glycol) (PEG), and multiarm polyamidoamine (PAMAM) dendrimer using thiol-ene "click" chemistry. The microstructure, mechanical properties, diffusivity, and degradation rates of the resultant hydrogels were controlled by the structural feature of different cross-linkers. BMSCs were then encapsulated in the resulting hydrogels and cultured in chondrogenic conditions. Overall, chondrogenic differentiation was highly enhanced in the PEG-cross-linked HA hydrogels, as measured by glycosaminoglycan (GAG) and collagen accumulation. The physical properties of hydrogels, especially the mechanical property and microarchitecture, were resulted from the structures of different cross-linkers, which subsequently modulated the fate of BMSC differentiation.

Male cytogenetic evaluation prior to assisted reproduction procedures performed in Mar del Plata, Argentina. This paper aimed to estimate the frequency of occurrence and the types of chromosomal abnormalities found in 141 infertile men with abnormal semen parameters. the frequency and type of chromosomal abnormalities were determined with male mitotic karyotype analysis from peripheral blood through chromosome banding techniques before assisted reproduction procedures. In this series of 141 infertile men, 19 (13%) had chromosomal anomalies and 35 (25%) had polymorphic variants. The main chromosome abnormalities were reciprocal translocations and marker chromosomes in mosaic. These results stress the relevance of cytogenetic studies for infertile males as a diagnostic tool and a valuable input in genetic counseling.

Guidelines Insights: Acute Lymphoblastic Leukemia, Version 1.2019. Survival outcomes for older adults with acute lymphoblastic leukemia (ALL) are poor and optimal management is challenging due to higher-risk leukemia genetics, comorbidities, and lower tolerance to intensive therapy. A critical understanding of these factors guides the selection of frontline therapies and subsequent treatment strategies. In addition, there have been recent developments in minimal/measurable residual disease (MRD) testing and blinatumomab use in the context of MRD-positive disease after therapy. These NCCN Guidelines Insights discuss recent updates to the NCCN Guidelines for ALL regarding upfront therapy in older adults and MRD monitoring/testing in response to ALL treatment.

NMR methods for studying protein-protein interactions involved in translation initiation. Translation in the cell is carried out by complex molecular machinery involving a dynamic network of protein-protein and protein-RNA interactions. Along the multiple steps of the translation pathway, individual interactions are constantly formed, remodeled, and broken, which presents special challenges when studying this sophisticated system. NMR is a still actively developing technology that has recently been used to solve the structures of several translation factors. However, NMR also has a number of other unique capabilities, of which the broader scientific community may not always be aware. In particular, when studying macromolecular interactions, NMR can be used for a wide range of tasks from testing unambiguously whether two molecules interact to solving the structure of the complex. NMR can also provide insights into the dynamics of the molecules, their folding/unfolding, as well as the effects of interactions with binding partners on these processes. In this chapter, we have tried to summarize, in a popular format, the various types of information about macromolecular interactions that can be obtained with NMR. Special attention is given to areas where the use of NMR provides unique information that is difficult to obtain with other approaches. Our intent was to help the general scientific audience become more familiar with the power of NMR, the current status of the technological limitations of individual NMR methods, as well as the numerous applications, in particular for studying protein-protein interactions in translation.

FTIR spectroscopy of metalloproteins. Absorption of infrared radiation by proteins gives important information about their structure and function. The most intense infrared bands correspond to the overlap of all the peptide bond absorption. Additionally, in many metalloproteins their prosthetic groups have intrinsic ligands or bind substrates/inhibitors that absorb intensively in the infrared. Here, we describe thoroughly several Fourier transform infrared methods for studying structure-function relationships in metalloproteins, using hydrogenases as an example.

Catechins are bioavailable in men and women drinking black tea throughout the day. Tea consumption has been associated with reduced risk of both cancer and cardiovascular disease in population studies, but clinical data demonstrating bioavailability of the individual catechins and other polyphenolic components of tea are limited. This study assessed the apparent bioavailability of the prominent catechins from black tea in humans drinking tea throughout the day. After 5 d of consuming a low flavonoid diet, subjects drank a black tea preparation containing 15.48, 36.54, 16.74, and 31.14 mg of (-)-epigallocatechin (EGC), (-)-epicatechin (EC), (-)-epigallocatechin gallate (EGCG) and (-)-epicatechin gallate (ECG), respectively, at four time points (0, 2, 4 and 6 h). Blood, urine and fecal specimens were collected over a 24- to 72-h period and catechins were quantified by HPLC with coularray detection. Plasma concentrations of EGC, EC and EGCG increased significantly relative to baseline (P < 0.05). Plasma EGC, EC and EGCG peaked after 5 h, whereas ECG peaked at 24 h. Urinary excretion of EGC and EC, which peaked at 5 h, was increased relative to baseline amounts (P < 0.05) and fecal excretion of all four catechins was increased relative to baseline (P < 0.05). Approximately 1.68% of ingested catechins were present in the plasma, urine and feces, and the apparent bioavailability of the gallated catechins was lower than the nongallated forms. Thus, catechins were bioavailable. However, unless they are rapidly metabolized or sequestered, the catechins appeared to be absorbed in amounts that were small relative to intake.

Development of crohn's disease following treatment for juvenile idiopathic arthritis in a nigerian child: Case report and review of literature. Juvenile idiopathic arthritis (JIA) and Crohn's disease (CD) are diseases that are rarely seen in the black African child. CD has been reported to occur following therapy with etanercept in JIA patients. We report the case of a Nigerian child with JIA who developed CD following treatment for JIA. A 9-year-old male with JIA was referred to the pediatric gastroenterology unit of the Lagos University Teaching Hospital on the account of chronic diarrhea with occasional passage of bloody stools. He had been on prednisolone and methotrexate which had controlled the joint flares. Colonoscopy revealed extensive colitis, ulcers, abscesses, and ileocecal disease. Histology confirmed the CD. In view of the unavailability of the recommended treatment, namely biologics in the country and financial constraints; steroids; and sulfasalazine were added to his treatment regimen, and subsequently, he has made significant clinical improvement.

Prevalence, incidence and distribution of erosion. There is evidence that the presence of erosion is growing steadily. Due to different scoring systems, samples and examiners, it is difficult to compare the different studies. Preschool children from 2 to 5 years showed erosion on deciduous teeth in 1 to 79% of the subjects. Schoolchildren (aged from 5 to 9 years) already had erosive lesions on permanent teeth in 14% of the cases. In the adolescent group (aged between 9 and 20 years), 7 to 100% of the persons examined showed signs of erosion. Incidence data (the increase in the number of subjects presenting signs of dental erosion) was evaluated in four of these studies and presented average annual values between 3.5 and 18%, depending on the initial age of the examined sample. In adults (aged from 18 to 88 years) prevalence data ranged between 4 and 100%. Incidence data are scarce in this age group, and only one study was found analysing the increase of affected surfaces, showing an incidence of 5% for the younger and 18% for older age groups. In general, males present more erosive tooth wear than females. The distribution showed a predominance of affected occlusal surfaces (mandibular first molars) followed by facial surfaces (anterior maxillary teeth). Oral erosion was frequently found on maxillary incisors and canines. Overall, prevalence data are not homogeneous. Nevertheless, there is a trend towards a more pronounced rate of erosion in younger age groups. Furthermore, a tendency was found for more erosive lesions with increasing age and these erosions progressed with age.

Assessment of hygiene habits and attitudes among removable partial denture wearers in a university hospital. The aim of this study was conducting a survey of hygiene habits and use of removable partial dentures (RPDs) and correlate them with the social conditions of the interviewees. A total of 145 RPD wearers were interviewed by experienced clinical staff using a structured questionnaire. A Chi-squared test was performed to evaluate statistical significance between the variables, and the level of significance was P<0.05. A total of 72 (49%) patients reported that they had not been well informed by the dentists. Brushing was the most frequent cleaning method (57.6%). 77 (53.1%) patients did not take off their dentures at night. The frequency of cleaning dentures and using cleansing tablet was significantly higher in females than in males (P<0.05). The frequency of denture cleaning, cleaned parts of denture, use of cleansing tablet, removal of dentures at night, frequency of tooth brushing, does not show any significant difference according to age, educational status or duration of denture usage (P>0.05). RPD wearers did not clean their dentures and natural teeth satisfactorily and had limited knowledge of denture cleansing and oral hygiene maintenance. Hygiene habits and attitudes may be affected by gender, but education level and hygiene attitudes may not always present positive correlation. Dentists should thoroughly inform patients about the harmful effects of overnight wearing and motivate to clean metal parts of RPD's and cleansing tablet use in order to minimize the abrasive effect of widely preferred cleaning method of brushing with toothpaste.

Treatment Protocol for Compromised Nasal Skin. As the number of patients seeking surgical and nonsurgical rhinoplasty continues to increase, the risk of nasal skin compromise after surgery also has risen. Vascular insult to the nasal skin envelope can lead to permanent disfigurement that is nearly impossible to correct. Tissue loss often requires major reconstruction that yields suboptimal cosmetic results. This article discusses prevention, early recognition, and effective treatment that aim to mitigate skin necrosis and the resulting soft tissue destruction.

[Reduced loading of one lower limb as a cause of local osteopenia]. An impact of diminished mechanical loading of lower extremity on bone densitometry has been quantitatively assessed with ultrasound. Seventy-three females with lower limb fracture history, coxarthrosis or scoliosis were evaluated. Both heels were submitted to measurements with Achilles densitometer (Lunar, USA). The following parameters were analyzed: Speed of Sound, Broadband Ultrasound Attenuation and Stiffness Index. Decreased values of all parameters were found in unloaded extremities. Speed of Sound was reduced most and in the group with fracture history. To avoid local bone loss short immobilization, early rehabilitation and pharmacotherapy is suggested.

Effects of transthoracic impedance and peak current flow on defibrillation success in a prehospital setting. To assess whether transthoracic impedance and peak current are determinants of defibrillation success in patients with out-of-hospital ventricular fibrillation (VF). A retrospective cohort study was carried out in a suburban Canadian EMS system. Participants were patients who experienced out-of-hospital cardiac arrest in the regional municipality of Ottawa-Carleton, had VF rhythm at presentation, and received countershocks from the Laerdal Heartstart 2000 automated external defibrillator. A total of 310 patients met the inclusion criteria. Collectively they received 717 countershocks. The first shocks were successful in converting VF rhythm 25.5% of the time. The most important determinant of shock success was the interval from when the call was received until delivery of the first shock (P<.01). Length of time at scene, current, impedance, and patient age were not significant determinants of success of first shock. The time interval until first shock was also a determinant of survival (P<.01). EMS response time, whether the arrest was witnessed, initial impedance, and current were not determinants of survival. OHCA shock success and survival are associated with EMS system factors such as the interval from when the call was received until delivery of the first shock. The importance of impedance and peak current remain theoretic for out-of-hospital defibrillation success and did not influence defibrillation success in this study.

Clinical comparison of high-resolution with high-sensitivity collimators in low-count cardiac gated blood pool studies. We compared high-sensitivity (HS) and high-resolution (HR) collimators for 2.5-minute low-count acquisitions in 13 patients undergoing cardiac gated blood pool studies. High-count acquisitions served as standards. Ejection fractions calculated from low-count acquisitions were plotted against high-count acquisitions for each collimator; the variance of the HS plot was lower, and HS images were superior.

Comparison of hypothetical LNG and fuel oil fires on water. Large spills of refined petroleum products have been an occasional occurrence over the past few decades. This has not been true for large spills of liquefied natural gas (LNG). This paper compares the likely similarities and differences between accidental releases from a ship of sizable quantities of these different hydrocarbon fuels, their subsequent spreading, and possible pool-fire behavior. Quantitative estimates are made of the spread rate and maximum slick size, burn rate, and duration; effective thermal radiation; and subsequent soot generation.

Suboptimal use of pharmacological venous thromboembolism prophylaxis in cirrhotic patients. Cirrhosis was previously perceived as a haemorrhagic disease state due to frequent associations with coagulopathy and bleeding. However, the coagulopathy of cirrhosis is complex with defects in both procoagulant and anticoagulant factors. Derangements in common laboratory indices of coagulation do not accurately reflect bleeding risk or protection from thrombotic events. To assess the rate of pharmacological prophylaxis for venous thromboembolism (VTE) among hospital inpatients with cirrhosis and analyse factors associated with prophylaxis being inappropriately withheld. A retrospective cohort study was performed in a tertiary teaching hospital. Patients included were admitted for greater than 48 h with discharge diagnosis codes corresponding to chronic liver disease and/or cirrhosis. The use of VTE chemoprophylaxis with enoxaparin was assessed in cirrhotic patients and non-cirrhotic controls. Patient data collected included contraindications to prophylaxis, known high-risk varices, international normalised ratio (INR), creatinine, bilirubin, haemoglobin and platelet count. Of 108 patients with cirrhosis eligible for VTE prophylaxis, 61 (56.5%) received prophylaxis compared to 104 (96.3%) non-cirrhotic patients. Platelets and INR were significantly different between those who did and did not receive VTE prophylaxis. On multivariate analysis, platelet count and INR were independent predictors for VTE not being administered. The administration of chemoprophylaxis in accordance with the hospital guidelines was suboptimal in patients with cirrhosis. Platelet count and INR were independent predictors of prophylaxis use. Our results suggest persistent misperceptions that prolonged INR and thrombocytopenia predict bleeding risk in cirrhosis.

Stroke risk of blood pressure indices determined by home blood pressure measurement: the Ohasama study. The purpose of this prospective cohort study was to investigate associations between stroke and blood pressure (BP) indices (systolic BP [SBP], diastolic BP [DBP], mean BP, and pulse pressure [PP]) determined by home BP measurement. Associations between stroke and BP indices were examined in a rural Japanese population. Home BP data of 2369 subjects (40% men) > or =35 years of age (mean, 59 years) without a history of stroke were obtained. Associations between stroke and each index were determined using Cox proportional hazards regression and the likelihood ratio (LR) test. During follow-up (mean, 11.7 years), 238 strokes occurred. The LR test showed that SBP and mean BP were significantly more strongly associated with total and ischemic stroke than DBP and PP (LR chi2 > or =9.3, P<0.01 for SBP/mean BP, LR chi2 < or =3.8, P> or =0.05 for DBP/PP). SBP tended to be more strongly associated with total/ischemic stroke than mean BP (LR chi2=3.8, P=0.05 for SBP, LR chi2 < or =0.2, P>0.6 for mean BP). PP tended to be slightly more strongly associated with ischemic stroke than DBP (LR chi2=7.5, P<0.01 for DBP, LR chi(2)=9.3, P<0.01 for PP), whereas DBP was significantly more strongly associated with hemorrhagic stroke than PP (LR chi2=9.2, P<0.01 for DBP, LR chi2=2.5, P=0.01 for PP). PP obtained from home BP measurements was weakly associated with stroke, whereas SBP showed the strongest association. Additionally, DBP and PP may be associated with different stroke types.

Synthesis of 3-substituted 4-aroylisoquinolines via Pd-catalyzed carbonylative cyclization of 2-(1-alkynyl)benzaldimines. A number of 3-substituted 4-aroylisoquinolines have been prepared in good yields by treating N-tert-butyl-2-(1-alkynyl)benzaldimines with aryl halides in the presence of CO and a palladium catalyst. Synthetically the methodology provides a simple and convenient route to isoquinolines containing an aryl, alkyl, or vinylic group at C-3 and an aroyl group at C-4 of the isoquinoline ring. The reaction is believed to proceed via cyclization of the alkyne containing a proximate nucleophilic center promoted by an acylpalladium complex.