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Background: The long saphenous vein is routinely used for coronary bypass graft (CABG) surgery, and two primary techniques are commonly utilized: endoscopic vessel harvesting (EVH) and open vessel harvesting (OVH). The aim of this study was to compare the clinical outcomes of the EVH and OVH techniques used for CABG within the confines of a tertiary hospital. Methods: The clinical data of all patients subjected to either EVH or OVH for CABG surgery between 2014 and 2018 were retrospectively analyzed. Statistical analysis was performed to discern variations in the rates of postoperative complications between EVH and OVH. Results: A cohort of 1884 individuals were included in this study, 75.3% of whom underwent EVH. Notably, the incidence of postoperative leg wound complications was significantly different between the patients who underwent OVH and the patients who underwent EVH, with incidence rates of 18.6% and 32%, respectively (p < 0.001). Leg wound complications (p < 0.001; OR 1.946; 95% CI 1.528–2.477) and leg wound infections (p = 0.050, OR 1.517, 95% CI 0.999–2.303) were significantly associated with OVH. Moreover, leg wound hematoma (p = 0.039, OR = 0.402, 95% CI = 0.169–0.957) and EVH were strongly associated. Conclusions: The large sample of patients and the inclusion of a range of Asian ethnic groups provided notable insights into postoperative complications related to different modalities. EVH was associated with a lower incidence of postoperative leg wound complications, which suggests that EVH is a better modality for those undergoing CABG surgery. [ABSTRACT FROM AUTHOR]

Some bacteria can antagonize and competitively exclude pathogens by producing antimicrobial substances in their immediate environment. These antimicrobial agents can be grouped into enzymes, protein such as polypeptides and non-protein compounds. Of the various crop pests and pathogens that devastate harvests, oomycetes and fungi are the most broadly distributed groups causing global issues in food security and environmental damage in natural ecosystems. In this study, three bacterial isolates, Bacillus amyloliquefaciens (UQ154), Bacillus velezensis (UQ156) and Acinetobacter sp. (UQ202), previously shown to promote plant growth and anti-oomycete properties against Phytophthora spp., were selected for further investigation. These isolates were subjected to extractions with dichloromethane. The crude extracts were fractionated by preparative silica gel thin-layer chromatography and tested for their anti-oomycete activities against Phytophthora capsici. The results show that nine out of 16 fractions exhibited high (> 50%) P. capsici growth inhibition, comparable to the application of the live bacterial isolates. Using GCMS analyses, the compounds identified from the bacterial fractions were pyrrolopyrazine and various phenolic compounds, including the previously identified diketopiperazine compounds (DKPs) from the crude bacterial extracts. The ability of these bacterial isolates and their bioactive compounds to inhibit plant pathogen growth deserves further investigations, offering a potential roadmap for the development of bio-pesticides. [ABSTRACT FROM AUTHOR]

Purpose: Conical implant-abutment connections for platform switching have been recently introduced in implant systems. This study investigated the load fatigue performance of three conical abutment systems and their corresponding titanium and zirconia abutments. Materials and Methods: Regular-diameter implants of the Ankylos (AK), PrimaConnex (PC), and Straumann (ST) systems were tested with their corresponding titanium (Ti) and zirconia (Zr) abutments tightened to the recommended torque (n = 5 implant-abutment assemblies per group). A rotational load fatigue machine applied a sinusoidally varying tensile-compressive 21 N load to specimens at a 45-degree angle, producing an effective bending moment of 35 Ncm at a frequency of 10 Hz. The number of cycles to failure was recorded, with the upper limit set at 5 million cycles. Results were evaluated through analyses of variance. Results: Except for the ST Zr group, which showed no failures in four samples and one failure just below the screw head, and the AK Ti group, in which one sample was preserved without fracture, all groups experienced failure of at least one of the components, whether the abutment screw only, the abutment, and/or the implant neck. There were significant differences between systems. There was no difference between systems for the Ti abutments, and the ST group was significantly different from the AK and PC groups for the Zr abutments. Conclusions: Ti conical abutments appear to have poorer load fatigue performance compared with earlier studies of external-hexagon connections. The load fatigue performance of Zr conical abutments varied and seemed to be highly system dependent. Many of the fractures in both the Ti and Zr abutment groups occurred within the implant, and retrieval would pose asignificant clinical challenge. The clinician should weigh the mechanical, biologic, and esthetic considerations before selection of any implant system, connection type, or abutment material. [ABSTRACT FROM AUTHOR]

Aims: To examine the relationship between depression and somatization and pain during muscle and joint palpation as well as limitations related to mandibular functioning (LRMF) in patients with temporomandibular disorders. Methods: The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) data for Axes I and II for 196 consecutive patients (56 men and 140 women) with a history of facial pain were obtained. The mean age of the predominantly Chinese patient population (83.2%) was 33.4 years frange 18 to 55 years). A computerized diagnostic system was used to collect the RDC/TMD history data. The Symptom Check List (SCL-90) depression and somatization scales were generated on-line and archived. The mean muscle pain (MP), joint pain UP), and LRMF scores were computed with depression and somatization as main effects. Data were subjected to analysis of variance (Scheffe test) and Pearson's correlation at a significance level of .05. Results: Depression scores ranged from 4.03 to 8.16 (MP), from 0.67 to 1.03 UP), and from 0.30 to 0.38 (LRMF); somatization scores ranged from 2.64 to 7.75 (MP), from 0.58 to 1.00 (JP), and from 0.30 to 0.41 (LRMF). Interaction effects between depression and somatization were not significant. Patients with severe depression had significantly higher MP scores than normal patients or patients with moderate depression. Patients with moderate and severe somatization had significantly higher MP scores than normal patients. LRMF scores of patients with severe somatization were significantly greater than those who were normal or suffered from moderate somatization. No significant difference in JP scores was observed for depression and somatization scales. Correlations between depression/somatization and MP, JP, and LRMF scores were significant and positive but weak; coefficients ranged from 0.15 to 0.41. Conclusion: The results suggest that depression and somatization are related to the self-report of MP. In addition, severe somatization may be associated with an increase in jaw disability. [ABSTRACT FROM AUTHOR]

Aims: To use the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) to investigate the physical diagnoses, psychologic distress, and psychosocial dysfunction in Asian TMD patients. The RDC/TMD Axis I and II findings were compared to those of Swedish and American TMD patients. Methods: One hundred ninety-one patients (53 male and 138 female) referred to 2 institutionalized TMD clinics in Singapore were enrolled in the study. The mean age of the predominantly Chinese population (83.2%) was 33.6 ± 9.3 years. Data from a RDC/TMD history questionnaire and clinical examination were fed directly by patients and clinicians into a computerized diagnostic system (NUS TMDv1.1). Axis I and II findings were generated on-line, based on RDC/TMD rule engines. Data were automatically exported to SPSS for statistical analysis. Results: Group I (muscle) disorders were found in 31.4% of the patients; Group II (disc displacement) disorders were found in 15.1% and 15.7% of the patients in the left and right temporomandibular joints, respectively; and Group III (arthralgia, arthritis, and arthrosis) disorders were found in 12.6% and 13.0% of the patients in the left and right joints, respectively. Axis II assessment of psychologic status showed that 39.8% of patients experienced moderate to severe depression and 47.6% had moderate to severe nonspecific physical symptom scores. Psychosocial dysfunction was observed in only 4.2% of patients based on graded chronic pain scores. Conclusion: Axis I and II findings of Asian TMD patients were generally similar to their Swedish and American cohorts. In all 3 populations, women of child-bearing age represented the majority of patients. Muscle disorders were the most prevalent type of TMD. A substantial portion of TMD patients were depressed and experienced moderate to severe somatization. [ABSTRACT FROM AUTHOR]

Purpose: This study assessed multiple pain conditions and their association with psychosocial functioning, psychologic distress, and somatization in patients with temporomandibular disorders (TMD) based on RDC/TMD Axis II findings. Nonspecific pain items examined included headaches, heart/chest pain, lower back pain, nausea/abdominal pain, and muscle pain. Materials and Methods: In this study, 202 TMD patients (58 men and 144 women) referred to two TMD clinics participated. The mean age of the predominantly Chinese patient population (82%) was 32.6 years (range 13 to 65). The RDC/TMD history questionnaire was input directly into computers by patients. Graded chronic pain and SCL-90 scales were generated online and automatically archived for statistical analysis. Data were subjected to Spearman's rank-order correlation and Kruskal-Wallis and Mann-Whitney tests at a significance level of .05. Results: Of the patients, 43% were moderately to extremely distressed by headaches. The percentage of patients who were distressed by heart/chest pain (7%), lower back pain (26%), nausea/abdominal pain (17%), and soreness of muscles (22%) was lower. Of the TMD patients, 16% experienced more than three pain items. Significant and positive correlations were observed between number of pain items experienced and graded chronic pain severity, depression, and somatization. Correlation coefficients ranged from .27 to .65 for graded chronic pain scales and somatization (without pain items) scores, respectively. Conclusion: Results suggest that the number of nonspecific pain conditions reported may be a predictor of psychosocial dysfunction, depression, and somatization. [ABSTRACT FROM AUTHOR]

Adrenal crisis is a life-threatening emergency that causes significant excess mortality in patients with adrenal insufficiency. Delayed recognition by medical staff of an impending adrenal crisis and failure to give timely hydrocortisone therapy within the emergency department continue to be commonly encountered, even in metropolitan teaching hospitals. Within the authors' institutions, several cases of poorly handled adrenal crises have occurred over the last 2 years. Anecdotal accounts from members of the Addison's support group suggest that these issues are common in Australia. This manuscript is a timely reminder for clinical staff on the critical importance of the recognition, treatment and prevention of adrenal crisis. The manuscript: (i) outlines a case and the clinical outcome of sub-optimally managed adrenal crisis, (ii) summarises the clinical features and acute management of adrenal crisis, (iii) provides recommendations on the prevention of adrenal crisis and (iv) provides guidance on the management of 'sick days' in patients with adrenal insufficiency. [ABSTRACT FROM AUTHOR]

Preferential conversion of azathioprine or 6-mercaptopurine into methylated metabolites is a major cause of thiopurine resistance. To seek potentially Mendelian causes of thiopurine hypermethylation, we recruited 12 individuals who exhibited extreme therapeutic resistance while taking azathioprine or 6-mercaptopurine and performed whole-exome sequencing (WES) and copy-number variant analysis by array-based comparative genomic hybridisation (aCGH). Exome-wide variant filtering highlighted four genes potentially associated with thiopurine metabolism (ENOSF1 and NFS1), transport (SLC17A4) or therapeutic action (RCC2). However, variants of each gene were found only in two or three patients, and it is unclear whether these genes could influence thiopurine hypermethylation. Analysis by aCGH did not identify any unusual or pathogenic copy-number variants. This suggests that if causative mutations for the hypermethylation phenotype exist they may be heterogeneous, occurring in several different genes, or they may lie within regulatory regions not captured by WES. Alternatively, hypermethylation may arise from the involvement of multiple genes with small effects. To test this hypothesis would require recruitment of large patient samples and application of genome-wide association studies. [ABSTRACT FROM AUTHOR]

Background Ipilimumab ( Yervoy; Bristol- Myers Squibb) is a novel fully humanised monoclonal antibody that blocks cytotoxic T-lymphocyte antigen 4, an immune checkpoint molecule, to augment anti-tumour T-cell responses. It is associated with significant immune-related side-effects including hypophysitis. Aim We reviewed the clinical and biochemical characteristics of 10 patients with ipilimumab-induced hypophysitis ( IH), and developed guidelines for the early detection and management of IH based on our experiences at three major teaching hospitals in Sydney. Methods All patients were evaluated at the Crown Princess Mary Cancer Centre and Department of Endocrinology, Westmead Hospital, Department of Endocrinology, Royal Prince Alfred Hospital, the Melanoma Institute Australia and Macarthur Cancer Therapy Centre, Campbelltown Hospital from 2010 to 2014. Relevant data were extracted by review of medical records. Main outcome measures included clinical features, hormone profile and radiological findings associated with IH, and presence of pituitary recovery. Results Ten patients were identified with IH. In four patients who underwent monitoring of plasma cortisol, there was a fall in levels in the weeks prior to presentation. The pituitary-adrenal and pituitary-thyroid axes were affected in the majority of patients, with the need for physiological hormone replacement. Imaging abnormalities were identified in five of 10 patients, and resolved without high-dose glucocorticoid therapy. To date, all patients remain on levothyroxine and hydrocortisone replacement, where appropriate. Conclusions There is significant morbidity associated with development of IH. We suggest guidelines to assist with early recognition and therapeutic intervention. [ABSTRACT FROM AUTHOR]

Background: Double-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli (indigenous peoples) of Peninsular Malaysia. This study aimed to identify the presence of DBM at the community and household levels in Orang Asli population and its associated demographic and socio-economic factors. Methods: This cross-sectional study was conducted in 11 Orang Asli villages surrounding the Krau Wildlife Reserve, Peninsular of Malaysia from October 2011 to January 2012. Of 438 households, a total of 981 adults and 304 children who met the study criteria agreed to participate. About 160 households were further selected with pairs of children aged 3-59 months and non-pregnant mothers aged 15-55 years. Demographic and socio-economic data were obtained using interviewer-administered questionnaire while weight and height were measured using standard procedures. Double-burden of malnutrition was defined as overweight/obese mother-underweight child (OWOBM/UWC), overweight/obese mother-stunted child (OWOBM/STC) or overweight/obese mother-underweight or/and stunted child (OWOBM/UWSTC). Binary logistic regression identified the demographic and socio-economic factors associated with double-burden households. Results: About 26 % of overweight and obese adults coexisting with high proportions of underweight (49 %) and stunted (64 %) children in these Orang Asli villages. There was a higher prevalence of households with OWOBM/ UWSTC (20 %) and OWOBM/STC (19.4 %) than households with OWOBM/UWC (12.5 %). Boys (P < 0.05), older age mothers (P < 0.05), mothers with higher education (P < 0.05) and households with income per capita less than USD 29.01 (RM 97.00) (P < 0.01) were associated with higher odds of OWOBM/STC. Jah Hut (P < 0.05) and higher number of children (P < 0.05) were significantly associated with lower odds of OWOBM/UWC. Conclusions: The occurrence of double-burden of malnutrition in Orang Asli population deserves attention. Poverty reduction, access to quality diet and improved health and nutrition literacy are among strategies that could address the coexistence of DBM in this population. [ABSTRACT FROM AUTHOR]

Background: Double-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli (indigenous peoples) of Peninsular Malaysia. This study aimed to identify the presence of DBM at the community and household levels in Orang Asli population and its associated demographic and socio-economic factors. Methods: This cross-sectional study was conducted in 11 Orang Asli villages surrounding the Krau Wildlife Reserve, Peninsular of Malaysia from October 2011 to January 2012. Of 438 households, a total of 981 adults and 304 children who met the study criteria agreed to participate. About 160 households were further selected with pairs of children aged 3–59 months and non-pregnant mothers aged 15–55 years. Demographic and socio-economic data were obtained using interviewer-administered questionnaire while weight and height were measured using standard procedures. Double-burden of malnutrition was defined as overweight/obese mother-underweight child (OWOBM/UWC), overweight/obese mother-stunted child (OWOBM/STC) or overweight/obese mother-underweight or/and stunted child (OWOBM/UWSTC). Binary logistic regression identified the demographic and socio-economic factors associated with double-burden households. Results: About 26 % of overweight and obese adults coexisting with high proportions of underweight (49 %) and stunted (64 %) children in these Orang Asli villages. There was a higher prevalence of households with OWOBM/ UWSTC (20 %) and OWOBM/STC (19.4 %) than households with OWOBM/UWC (12.5 %). Boys (P < 0.05), older age mothers (P < 0.05), mothers with higher education (P < 0.05) and households with income per capita less than USD 29.01 (RM 97.00) (P < 0.01) were associated with higher odds of OWOBM/STC. Jah Hut (P < 0.05) and higher number of children (P < 0.05) were significantly associated with lower odds of OWOBM/UWC. Conclusions: The occurrence of double-burden of malnutrition in Orang Asli population deserves attention. Poverty reduction, access to quality diet and improved health and nutrition literacy are among strategies that could address the coexistence of DBM in this population. [ABSTRACT FROM AUTHOR]

Background High on-treatment platelet reactivity has been associated with poor outcomes following acute coronary syndromes ( ACS). Both the loss of function CYP 2 C 19*2 allele and the gain of function CYP 2 C 19*17 allele along with a range of clinical characteristics have been associated with variation in the response to clopidogrel. Aim The study aims to examine the frequency of CYP2 C19 variants and understand the factors associated with on-treatment platelet reactivity in a New Zealand ACS population. Methods We prospectively enrolled 312 ACS patients. We collected clinical characteristics and measured on-treatment platelet reactivity using two validated point-of-care assays, VerifyNow and Multiplate. DNA was extracted and CYP 2 C 19*2 and *17 alleles were identified using real-time polymerase chain reaction. Results CYP 2 C 19*2 or CYP 2 C 19*17 alleles were observed in 101 (32%) and 106 (34%) of patients, respectively, with significant differences in distribution by ethnicity. In Maori and Pacific Island patients, 47% (confidence interval ( CI) 31-63%) had CYP 2 C 19*2 and 11% ( CI 4-19%) CYP 2 C 19*17 compared with 26% ( CI 19-32%) and 41% ( CI 32-49%) in white people. Carriage of CYP 2 C 19*2 alleles was associated with higher levels of platelet reactivity measured by either assay, but we observed no relationship between platelet reactivity and CYP 2 C 19*17. In multivariate analysis diabetes, clopidogrel dose and CYP 2 C 19*2 status were all significant independent predictors of platelet reactivity. Conclusions Both CYP 2 C 19*2 and *17 were common in a New Zealand ACS population, with CYP 2 C 19*2 observed in almost half the Maori and Pacific Island patients. CYP 2 C 19*2, diabetes and clopidogrel dose were independent contributors to on-treatment platelet reactivity. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the influence of irrigation protocols on the bond strength of a glass fiber post bonded to dentin using two resin cements. In 200 root-filled teeth, post space was prepared and divided into five groups (n = 40) based on the irrigation protocol: group 1 (3% sodium hypochlorite), group 2 (3% sodium hypochlorite – 17% Ethylene diamine tetraacetic acid), group 3 (a mixture of sodium hypochlorite and etidronic acid), group 4 (sodium hypochlorite – QMix), and group 5 (distilled water). Samples were subdivided into two subgroups (n =  10) and fiber posts were cemented using subgroup A (Self-adhesive dual-cure resin cement; SEA) or B (dual-cure resin cement following an etch-and-rinse protocol, ER). Push-out bond strength was performed after 24 h and four months (n =  10) and failure modes were categorized. Statistical analysis of data was carried out by appropriate analyses (p < 0.05). The irrigation protocol and the resin cement had a significant impact on push-out bond strength. Subgroup A group showed lower bond strength than B at both time periods when 3% NaOCl–17% EDTA and 1:1 mixture of 6% NaOCl + 18%EA protocols were used. Three percent NaOCl used in combination with 17% EDTA or QMix significantly decreased the push-out bond strength of ER at the end of four months (p < 0.05). In conclusion, dual-cure resin cements bonded with etch-and-rinse protocol showed highest bond strength when a mixture of NaOCl and etidronic acid was used as root canal irrigant. These values were differentially influenced by time. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 40-year-old woman presented to her local emergency department with history of vomiting and history of blurred vision, lightheadedness and menorrhagia. Topics discussed include prescription of metoclopramide on the day of admission, becoming severely hypoxic while receiving three liters of intravenous fluid, and occurrence of multi-organ failure.

The zinc finger transcription factor Osterix/Sp7 is an essential regulator of osteoblastogenesis. In mammals, osterix expression is regulated by Runx2, Msx2 and Dlx5 but recent findings suggest that also retinoic acid plays an important role for osteoblast differentiation and function. Yet, how these and other factors act on the osterix promoter is largely unknown. Expression, knock-down and promoter analyses have indicated that the function of Osterix in osteoblasts is conserved in teleosts and mammals. In the present study, we have used the teleost medaka to identify and characterize a region containing potential retinoic acid response elements in the osterix promoter. We analysed whether this region is important for activity in osteoblasts in vivo, using transgenic medaka lines with modified osterix promoter regions. Promoter activity in vivo and in vitro revealed a short nucleotide sequence in the promoter with crucial positive regulatory function. Mutations of this element lead to a complete inactivation of the osterix promoter in osteoblasts and made it insensitive to retinoic acid treatment. The comparison with the regulatory regions of osterix in other species suggests that the function of this element is highly conserved in vertebrates. [ABSTRACT FROM AUTHOR]

Background Cytomegalovirus ( CMV) infection is one of the most common and important opportunistic infections following kidney transplantation. It causes significant morbidity and mortality. Valganciclovir ( VGCV) is the drug of choice for prophylaxis to prevent CMV infection. Methods We conducted a post-hoc analysis of a randomized controlled trial in 187 kidney transplant recipients to evaluate the impact of VGCV dosing and renal function on the development of CMV infection. Results and conclusion The results demonstrate that the following variables were independent risk factors for the development of CMV infection: high-risk CMV serostatus (donor positive/recipient negative; hazard ratio [ HR] 1.4, 95% confidence interval [ CI] 1.46-5.28, P = 0.002); anti-thymocyte globulin induction therapy ( HR 2.1, 95% CI 1.08-4.07, P = 0.028); higher mean tacrolimus trough concentration ( HR 1.4, 95% CI 1.09-1.74, P = 0.007); creatinine clearance <60 mL/min ( HR 3.4, 95% CI 1.64-6.85, P = 0.001); and body weight >80 kg ( HR 2.1, 95% CI 1.05-4.37, P = 0.037). VGCV dosing was appropriate for most patients, in those who did and did not develop CMV infection. These results strongly suggest that the currently recommended dose adjustments of VGCV dosing based on estimated renal function calculated using ideal body weight may underestimate the renal function of overweight patients and indirectly result in underexposure of overweight patients to VGCV. Based on these findings, further VGCV pharmacokinetic analyses are warranted in kidney transplant recipients with moderate-to-severe renal dysfunction. [ABSTRACT FROM AUTHOR]

Band alignment of resistive random access memory (RRAM) switching material Ta2O5 and different metal electrode materials was examined using high-resolution X-ray photoelectron spectroscopy. Schottky and hole barrier heights at the interface between electrode and Ta2O5 were obtained, where the electrodes consist of materials with low to high work function ([uppercase_phi_synonym]m,vac from 4.06 to 5.93 eV). Effective metal work functions were extracted to study the Fermi level pinning effect and to discuss the dominant conduction mechanism. An accurate band alignment between electrodes and Ta2O5 is obtained and can be used for RRAM electrode engineering and conduction mechanism study. [ABSTRACT FROM AUTHOR]

SUMMARY Background Significant efforts have been made towards bacterial risk minimization by limiting the chance of bacteria entering into collected blood, detecting its presence and eliminating them by pathogen reduction technology. Improved skin disinfection and the use of diversion pouch are effective upstream measures to reduce the risk of bacterial sepsis. Here we report on our experience with the use of blood bags with diversion pouch. Materials and methods An observational study was performed to compare the bacterial contamination rate for two periods of time, i.e. before and after introduction of diversion pouch into blood bags. The incidence of bacterial contamination was monitored by the existing bacterial surveillance programme using pooled samples from 5 units of random donor platelets underwent aerobic culture in the BacT/ ALERT 3D system. Results Between 1 June 2004 and 31 May 2006 (blood bag without diversion pouch), 50 (0·0213%) out of 234 252 units of random donor platelets were found to have bacteria on culture whereas 15 (0·0057%) isolates out of 262 156 units were found from 1 June 2007 to 31 May 2009 (after diversion pouch was introduced). Overall, there was an 85% reduction in bacterial contaminated risk due to skin flora ( P < 0·0001) but an increasing trend of detection of non skin flora such as Streptococcus bovis was noted. Conclusion Integration of diversion pouch into blood bags to divert the first 30 mL blood during blood collection on top of the current skin disinfection protocol can significantly reduce the risk of bacterial contamination. [ABSTRACT FROM AUTHOR]

Diabet. Med. 28, 1272-1276 (2011) Abstract Aims Icodextrin is a glucose polymer used to maintain an osmotic gradient in peritoneal dialysis. Metabolites of icodextrin are known to cause overestimation of blood glucose in glucose meters using glucose dehydrogenase/pyrroloquinolinequinone systems. The aim of this study is to determine the extent of icodextrin interference in glucose meters using the newer glucose dehydrogenase/NAD or glucose oxidase systems. This has not been established previously. Methods Fasting blood samples ( n = 4) were spiked with either one icodextrin metabolite (maltose, maltotriose or maltotetraose) or a combination, at various blood concentrations expected during dialysis. Samples were tested in triplicate on: five glucose-meters, a Radiometer® (glucose oxidase/hydrogen peroxide) and laboratory (hexokinase) analysers. Each meter was also tested on blood from six patients undergoing dialysis. Accuracy was evaluated as % Bias = [(meter glucose - laboratory glucose)/laboratory glucose] × 100. Results A single icodextrin metabolite affected glucose measurements and, in combination, the interferences were additive in the two Accu-Chek® and Optium® Xceed meters by > 10%. Amongst these meters, the Optium Xceed 5-s machine was less affected. Meters using glucose oxidase were least affected by interference. A similar trend in interference was observed in vivo. Conclusion While meters using glucose dehydrogenase/NAD are less affected by icodextrin metabolites, interference can still be demonstrated. The degree of interference can vary in different glucose meters using this enzyme/cofactor system, as seen in the Optium Xceed machines. Icodextrin is an important source of interference that sometimes even experienced professionals are unaware of and which leads to clinically significant errors in insulin dose adjustment. Awareness of this interference and selection of the most appropriate glucose meters are crucial to minimize this hazard. [ABSTRACT FROM AUTHOR]

BACKGROUND: Short-term aerobic bacterial culture (STABC) has been used routinely in Hong Kong since 1998 to reduce bacterial contamination in platelet concentrates (PCs) with good results. With more countries implementing routine aerobic and anaerobic cultures of PCs, a prospective study was conducted to determine the value of anaerobic culture to STABC. STUDY DESIGN AND METHODS: PC tested by STABC was used as control. Twenty milliliters of the PC selected for this study was aliquoted and pooled for 7 days aerobic and anaerobic culture. If the initial culture was positive, samples retrieved from the original PC and their associated components were cultured for confirmation and microbiologic identification. RESULTS: A total of 10,035 PC units (2007 pools) were tested. The confirmed positive rates by aerobic and anaerobic cultures per pool were 3 (0.15%) and 13 (0.65%), respectively, which was equivalent to an increased yield from 0.03 to 0.13 percent of PC if anaerobic culture was added. Of the 10 bacteria detected by anaerobic culture only, 9 were found to be Propionibacterium acnes and the remaining one Peptostreptococcus sp. Their mean detection time from inoculation was 92.16 hours (range, 50.4-124.8 hr). CONCLUSION: Addition of anaerobic culture to our routine STABC would significantly increase the detection rate of bacterial contaminated PC. However, since only slow-growing bacteria were detected, and because their clinical significance was uncertain, it is concluded that there was no clear justification to introduce anaerobic culture locally if 5-day shelf life for PCs was to be maintained. [ABSTRACT FROM AUTHOR]

Evidence of LRRK2 haplotypes associated with Parkinson’s disease (PD) risk was recently found in the Chinese population from Singapore, and a common LRRK2 missense variant, Gly2385Arg, was independently detected as a putative risk factor for PD in the Chinese population from Taiwan. To test the association between the Gly2385Arg variant in a large case-control sample of Chinese ethnicity from Singapore, and to perform functional studies of the wild type and Gly2385Arg LRRK2 protein in human cell lines. In a case-control study involving 989 Chinese subjects, the frequency of the heterozygous Gly2385Arg genotype was higher in PD compared to controls (7.3 vs. 3.6%, odds ratio = 2.1, 95% CI: 1.1–3.9, P = 0.014); these values yield an estimated population attributable risk (PAR) of ∼4%. In a multivariate logistic regression analysis with the disease group (PD vs. controls) as the dependent variable and the genotype as an independent factor with adjustments made for the effect of age and gender, the heterozygous Gly2385Arg genotype remained associated with an increased risk of PD compared to wild type genotype (odds ratio = 2.67, 95% CI: 1.43–4.99, P = 0.002). The glycine at position 2385 is a candidate site for N-myristoylation, and the Gly2385Arg variant replaces the hydrophobic glycine with the hydrophilic arginine, and increases the net positive charge of the LRRK2 WD40 domain. In transfection studies, we demonstrated that both the wild type and Gly2385Arg variant LRRK2 protein localize to the cytoplasm and form aggregates. However, under condition of oxidative stress, the Gly2385Arg variant was more toxic and associated with a higher rate of apoptosis. Our study lends support to the contention that the Gly2385Arg is a common risk factor for PD in the Chinese population. Our bioinformatics and in-vitro studies also suggest that the Gly2385Arg variant is biologically relevant and it might act through pro-apoptotic mechanisms. [ABSTRACT FROM AUTHOR]

The expression of depression in Asian temporomandibular disorder (TMD) patients may differ from that of their Caucasian counterparts. This study examined the prevalence of depressive symptoms and their association with non-specific physical symptoms (NPSs) reporting in Asian patients. Two hundred and fifty-five Asian TMD patients (68 males; 187 females) with a mean age of 33.0 years were selected for this study. Research diagnostic criteria (RDC)/TMD history questionnaire was input directly into computers by patients using the NUS TMDv.1.1 software. Symptom Checklist 90 (SCL-90) depression and NPS scales were generated online and automatically archived for statistical analysis. Data were subjected to ANOVA/Scheffe's test and Pearson's correlation at significance level 0.05 and 0.01, respectively. 43.1 and 50.6% of the patients scored moderate-to-severe on the depression and NPS scales, respectively. The percentage of patients with diffuse physical symptoms remained high (45.5%), even after pain items were excluded from the computation. NPS scores ranged from 0.34 to 1.64, while depression scores ranged from 0.27 to 1.21. A significant and positive correlation ( r = 0.74) was observed between depression and NPS scores. The prevalence of depressive symptoms and NPSs was lower in Asian TMD patients. Psychological distress experienced by female Asian TMD patients was comparable to their male counterparts. Results also suggest that depressive symptomatology is associated with the reporting of multiple NPSs. J Oral Pathol Med (2004) 33: 305–10 [ABSTRACT FROM AUTHOR]

This study investigated the clinical temporomandibular disorders (TMD), pain-related disability and psychological status of TMD patients using a computerized on-line TMD diagnostic system (NUS TMD v1·1). A total of 107 patients (32 male, 75 female) referred to the TMD clinics at the National Dental Centre and National University Hospital participated in this study. The mean age of the predominantly Chinese population (82·2%) was 30·8 years (range from 12 to 64 years). The history questionnaire and clinical examination were input directly into computers by patients and clinicians. A `Summary of Findings' was then immediately generated by the program based on Axis I and II rules. The data was subsequently exported to SPSS for statistical analysis. About 20·6% of the patients had myofascial pain but only 7·5% experienced limited mandibular opening associated with myofascial pain. The majority of patients (> 80%) did not suffer from disc displacements (right and left joints). The frequency of arthralgia was also low (right joint 8·4%; left joint 7·5%) and only one patient had osteoarthosis of the TMJ. About 78·5% of the patients had low disability with almost equal distribution between low and high intensity pain, 27·1% of the patients were moderately depressed and 11·2% had severe depression. No significant difference in limitations related mandibular functioning scores was observed between normal/depressed patients and between patients with the different graded chronic pain severity classification. The three most frequent jaw disabilities were: eating hard foods (77·6%), yawning (75·7%) and chewing (64·5%). NUS TMD v1·1 is an extremely useful tool in the diagnosis/research of clinical TMD. [ABSTRACT FROM AUTHOR]

Prospective randomized clinical trials have shown the effectiveness of combined adjuvant 5-fluorouracil-based chemotherapy and radiotherapy after surgical resection of rectal cancer. To assess toxicity of this therapy, prospective data were collected from 236 Asian rectal cancer patients treated with combined 5-fluorouracil-based chemotherapy and radiotherapy after surgery. Almost 82% of patients completed planned therapy. Grade 3 and 4 diarrhea, stomatitis, and granulocytopenia occurred in approximately 18-21% of patients. There were two treatment-related deaths from granulocytopenia and sepsis. With median follow-up of 3.5 years, median disease-free and overall survival was 75 and 88 months, respectively. In conclusion, combined adjuvant 5-fluorouracil-based chemotherapy and radiotherapy after surgical resection of rectal cancer is tolerable in Asian patients with moderate toxicity. [ABSTRACT FROM AUTHOR]

Docetaxel has a response rate of greater than 30% in first-line treatment of Western patients with advanced non-small cell lung cancer (NSCLC). The goal of this open-label, phase II study was to evaluate the activity and safety profile of docetaxel in Asian patients with inoperable untreated stage III NSCLC. Docetaxel was given at 100 mg/m[sup 2] as a 1-h infusion every 3 weeks. Prophylactic dexamethasone was given to reduce hypersensitivity reactions and edema. Thirty-five patients were enrolled in the study. The response rate was 34% (95% CI, 19%-50%) according to intent-to-treat analysis. No complete response was observed. Twenty-four patients (69%) had grade 3 or 4 neutropenia in cycle 1, and febrile neutropenia was seen in 12 patients. Six patients (17%) experienced mild fluid retention. Docetaxel is an active agent in first-line treatment of Asian patients with locally advanced NSCLC, with the main toxicity being neutropenia. Fluid retention was a minor problem in this study. [ABSTRACT FROM AUTHOR]

Conclusions The TT method could be used together with the RCOG guideline for differentiating IUP from CSP between 4.9-11.9 weeks of gestation. To determine the diagnostic performance of the Royal College of Obstetricians and Gynaecologists (RCOG) guideline and the Timor-Tritsch method (TT method), as well as the combined criteria in the diagnosis of Caesarean scar pregnancy (CSP). [Extracted from the article]

The favourable experience with the combination regimen of vinorelbine, ifosfamide and cisplatin (NIP) in patients with metastatic non-small cell lung cancer (NSCLC) has led to a protocol assessing this regimen as an induction treatment in patients with stage III unresectable NSCLC, followed by thoracic radiotherapy with concurrent daily cisplatin as a radiosensitizer. Two cycles of NIP were administered 21 days apart; each cycle comprised i.v. vinorelbine 25 mg/m[sup 2] on days 1 and 8, i.v. ifosfamide 3 g/m[sup 2] on day 1 with MESNA as uroprotection, and i.v. cisplatin 50 mg/m[sup 2] on day 1. Radical thoracic radiotherapy commenced on day 43 to a total dose of 64 Gy and i.v. cisplatin 6 mg/m[sup 2] was given concurrently prior to each fraction of radiation as a sensitiser. Two more cycles of NIP were given to patients who responded favourably to the induction treatment about 2 weeks after completion of radiation. Between July 1995 and July 1997, 44 patients were treated with this protocol. This treatment schedule was generally well tolerated. Grade 3-4 neutropenia occurred in 50% of the patients and neutropenic sepsis was seen in 8. Grade 3-4 oesophagitis was uncommon. Most of the patients were able to complete the induction and concurrent chemoradiotherapy phase. Major response occurred in 75% of the patients with 2 (4.5%) complete responses (CR). A total of 6 patients achieved CR after chemoradiotherapy. At a median follow-up of 35 months, the median overall survival for all patients was 15 months with a 3-year survival rate of 24%. The median overall survival for stage IIIA patients was 19 months with a 3-year survival rate of 39% in contrast to 13 months' median overall survival and only 15% 3-year survival rate for stage IIIB. The NIP regimen results in a high response rate in NSCLC and this treatment programme seems to benefit selected patients with stage III disease. [ABSTRACT FROM AUTHOR]

GeTe materials were characterized using x-ray photoelectron spectroscopy in both the amorphous and crystalline states. Valence and conduction band alignments relative to a SiO2 reference were measured to allow the GeTe band diagram, work function, and electron affinity to be inferred. Hole barrier heights was also studied for several metal/GeTe systems (metal=Al,Ni,W) to extract the charge neutrality level of these interfaces for GeTe in both the crystalline and amorphous states. Near perfect Fermi-level pinning was observed for crystalline GeTe in contact with all of the metals with much less pinning observed for amorphous GeTe. [ABSTRACT FROM AUTHOR]

A GeTe reconfigurable phase change switch for radio frequency applications is presented. Low ON state resistance (180 Ω) and large dynamic range (7×103 X) were achieved through low resistance electrode design and high current. A partial crystallization and partial reamorphization model is proposed to explain the differences between the measured and calculated device ON (set) and OFF (reset) state resistances, respectively. The dependency between ON state resistance and reset current was estimated using a first order thermal design in steady state which suggests lower reset current by choosing materials of lower melting temperature and structures with better thermal isolation. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about the relative contribution of genetic and environmental factors in Parkinson's disease.