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Purpose Erectile dysfunction and COVID-19 share similar risk factors, including vascular disruption of integrity, cytokine release, cardiovascular disease, diabetes and obesity. The aim of this study was to investigate the association between erectile dysfunction and COVID-19 patients. Methods Odds ratio for erectile dysfunction in patients with a history of COVID-19 with and without comorbidities were calculated using a patients' registry platform i2b2. ICD-10 diagnoses codes were accessed for queries and data were analyzed using logistic regression. Results Patients with COVID-19 were 3.3 times more likely to have erectile dysfunction with 95% CI (2.8, 3.8). The association became stronger with odds ratio 4.8 (95% CI (4.1, 5.7)) after adjusting for age groups. The odds ratio remained the same after adjusting for smoking status with 3.5 (95% CI (3.0, 4.1)). After adjusting for race, COVID-19 patients were 2.6 (95% CI (2.2, 3.1)) times more likely to have erectile dysfunction. The odds ratio were 1.6, 1.8, 1.9 and 2.3 after adjusting for respiratory disease, obesity, circulatory disease and diabetes, respectively. Conclusion COVID-19 and erectile dysfunction are strongly associated even after adjustment for known risk factors and demographics.

This article presents a novel decoupling technique for the circularly polarized multiple-inputmultiple- output (CP-MIMO) system composed of Guoshaped patch antennas. A comparative study has been conducted on antenna performance as a function of packing distance before and after applying the technique. A prototype of two-element Guo-shaped patch MIMO at a small inter-element spacing of 12.5 mm has devised aiming for the 5G new radio n38 (2.57-2.62 GHz) applications. Simulation reinforced with experimental results confirmed the effectiveness of the proposed technique, whereas the two Guo-shaped patch elements packed in such small spacing can be operated independently. Both the envelope correlation coefficient and diversity gain are approaching their ideal values.

Previously published data on the association between the XRCC1 Arg194Trp polymorphism and thyroid cancer (TC) remain controversial. To clarify the association between the XRCC1 Arg194Trp polymorphism and susceptibility to TC, a meta-analysis of case–control studies was conducted. We systematically searched PubMed and CNKI to identify relevant studies. Pooled odds ratios (ORs) of various genetic models were estimated using fixed and random effects models. Heterogeneity was detected by Q-statistic, and the Egger’s test was used to evaluate the publication bias. A total of seven eligible studies for the XRCC1 Arg194Trp polymorphism (1500 patients and 2358 controls) were included in this meta-analysis. The results of our study failed to suggest an association between the Arg194Trp polymorphism and susceptibility of TC. However, in the subgroup analyses by ethnicity, the OR was 0.82 (C allele vs. T allele, 95% CI 0.68–0.98; P = 0.24 for heterogeneity) among the Chinese population. Nevertheless, no significant differences were observed in the Caucasian population in any genetic model. This study suggested that the C allele of XRCC1 had an 18% significantly decreased risk of TC in Chinese, and there were no significant associations among Caucasians under all genetic models.

Background Statins remain a standard treatment for acute coronary syndrome (ACS) patients. We aimed to determine the association between different dosages of in-hospital statins and the prognoses among patients receiving percutaneous coronary intervention (PCI). Methods NSTE-ACS patients were retrospectively enrolled from January 2010 to December 2014 from five centres in China. Patients receiving either atorvastatin or rosuvastatin during their hospitalizations were included. All the patients were categorized into high-dose statin group (40mg atorvastatin or 20mg rosuvastatin) or low-dose statin group (20mg atorvastatin or 10mg rosuvastatin). In-hospital events and long-term all-cause death was recorded. Results Of the 7,008 patients included in the study, 5,248 received low-dose intensive statin (mean age: 64.28±10.39; female: 25.2%), and 1,760 received high-dose intensive statin (mean age: 63.68±10.59; female: 23.1%). There was no significant difference in in-hospital all-cause death between the two groups (adjusted OR, 1.27; P=0.665). All-cause death was similar between the two groups during the long-term follow-up period (30-day: adjusted HR, 1.28; P=0.571; 3-year: adjusted HR, 0.83; P=0.082). However, there was a robust association between the high-dose statin and the reduction in in-hospital dialysis (adjusted OR, 0.11; P=0.030). Conclusions The in-hospital high-dose intensive statin is not associated with lower risks of in-hospital or follow-up all-cause death in NSTE-ACS patients undergoing PCI. Considering the robust beneficial effect of in-hospital dialysis, an individualized high-dose intensive statin can be rational in specified populations. Univariate and multivariate analyses Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Science and Technology Planning Project of Guangzhou City athe China Youth Research Funding

Traditional trial-and-error tuning of uncertain parameters in global atmospheric general circulation models (GCMs) is time consuming and subjective. This study explores the feasibility of automatic optimization of GCM parameters for fast physics by using short-term hindcasts. An automatic workflow is described and applied to the Community Atmospheric Model (CAM5) to optimize several parameters in its cloud and convective parameterizations. We show that the auto-optimization leads to 10 % reduction of the overall bias in CAM5, which is already a well-calibrated model, based on a predefined metric that includes precipitation, temperature, humidity, and longwave/shortwave cloud forcing. The computational cost of the entire optimization procedure is about equivalent to a single 12-year atmospheric model simulation. The tuning reduces the large underestimation in the CAM5 longwave cloud forcing by decreasing the threshold relative humidity and the sedimentation velocity of ice crystals in the cloud schemes; it reduces the overestimation of precipitation by increasing the adjustment time in the convection scheme. The physical processes behind the tuned model performance for each targeted field are discussed. Limitations of the automatic tuning are described, including the slight deterioration in some targeted fields that reflect the structural errors of the model. It is pointed out that automatic tuning can be a viable supplement to process-oriented model evaluations and improvement.

Aim To evaluate prospectively the performance of combining morphological and arterial spin labelling (ASL) magnetic resonance imaging (MRI) for detecting pseudocapsule defects in renal cell carcinoma (RCC), and to predict renal capsule invasion confirmed histopathologically. Materials and methods Twenty consecutive patients with suspicious renal tumours underwent MRI. Renal ASL imaging was performed and renal blood flow was measured quantitatively. The diagnostic performance of T2-weighted images alone, and a combination of T2-weighted and ASL images for predicting renal capsule invasion were assessed. Results Twenty renal lesions were evaluated in 20 patients. All lesions were clear cell RCCs (ccRCCs) confirmed at post-surgical histopathology. Fifteen ccRCCs showed pseudocapsule defects on T2-weighted images, of which 12 cases showed existing blood flow in defect areas on perfusion images. To predict renal capsule invasion, the sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 71.4%, 86.7%, 100%, respectively, for T2-weighted images alone, and 92.3%, 100%, 100%, 87.5%, respectively, for the combination of T2-weighted and ASL images. Conclusion ASL images can reflect the perfusion of pseudocapsule defects and as such, the combination of T2-weighted and ASL images produces promising diagnostic accuracy for predicting renal capsule invasion.

BACKGROUND AND PURPOSE: Intracerebral hemorrhage accounts for 6.5%–19.6% of all acute strokes. Initial intracerebral hemorrhage volume and expansion are both independent predictors of clinical outcomes and mortality. Therefore, a rapid, unbiased, and precise measurement of intracerebral hemorrhage volume is a key component of clinical management. The most commonly used method, ABC/2, results in overestimation. We developed an interactive segmentation program, SegTool, using a novel graphic processing unit, level set algorithm. Until now, the speed, bias, and precision of SegTool had not been validated. MATERIALS AND METHODS: In a single stroke academic center, 2 vascular neurologists and 2 neuroradiologists independently performed a test-retest experiment that involved repeat measurements of static, unchanging intracerebral hemorrhage volumes on CT from 76 intracerebral hemorrhage cases. Measurements were made with SegTool and ABC/2. True intracerebral hemorrhage volumes were estimated from a consensus of repeat manual tracings by 2 operators. These data allowed us to estimate measurement bias, precision, and speed. RESULTS: The measurements with SegTool were not significantly different from the true intracerebral hemorrhage volumes, while ABC/2 overestimated volume by 45%. The interrater measurement variability with SegTool was 50% less than that with ABC/2. The average measurement times for ABC/2 and SegTool were 35.7 and 44.6 seconds, respectively. CONCLUSIONS: SegTool appears to have attributes superior to ABC/2 in terms of accuracy and interrater reliability with a 9-second delay in measurement time (on average); hence, it could be useful in clinical trials and practice.

The traditional two-dimensional (2D) digital image correlation (DIC) method often leads to results without enough accuracy due to the out-of-plane motions of the specimens in the deformation measurements of plate specimens. To remove the effects of the out-of-plane motions, a compensation method for the 2D DIC method has been developed. The compensation method sharply improves the measuring accuracy of the 2D DIC method. However, the existing compensation method often deduces compensation parameters with strong fluctuations. To solve these problems, an improved compensation method is proposed. The proposed method employs an extra single camera calibration to determine the distortion parameters so that the corresponding coefficient matrix is not affected by the experimental noise. For simplicity, the extensometer line measurement is taken as an example to compare the measuring accuracy of the two compensation methods. Static experiments have been carried out to analyze effects of different measuring parameters. Tensile experiments indicate that the measuring results of the improved compensation method are not only comparative with the results measured by the 3D DIC method but also accord with the results of the strain gage. Besides, a real-time extensometer measuring system with a measurement accuracy of 5 μe at a rate of 28 fps, has been developed.

Casestudy Epstein-Barr virus (EBV)-associated peripheral T-cell lymphomas are a group of aggressive neoplasms with a geographic predilection for South America and Asia, but are very rare in Western populations. Results We report a case of a 74-year-old Caucasian female who presented with pancytopenia and B symptoms with EBV-IgG detected on admission. Past medical history included: ITP, chronic urticaria, and recently diagnosed myelodysplastic syndrome (MDS) on bone marrow biopsy one month prior to admission. Excisional biopsies of an enlarged right neck lymph node (repeated within 6 months) and right axillary lymph node five years ago were negative for a lymphoproliferative disorder at the time. Repeated bone marrow biopsy, performed during the current admission, confirmed the diagnosis of MDS, with scattered T-cells without aberrant immunophenotype. Despite aggressive treatment from multiple specialties, the patient deteriorated and expired four weeks later from complications of MDS. At autopsy, there was diffuse lymphadenopathy involving the mediastinum, axilla, pelvis and peripancreatic fat. Lymph node sections demonstrated nodal architecture effacement by diffuse, vaguely nodular lymphoid infiltrates. Histologically, the infiltrates were composed of medium to large lymphocytes with round to slight irregular nuclei, rare Reed-Sternberg-like multinucleated cells, clumped chromatin, and indistinct nucleoli. Individual cell necrosis was abundant with mitotic figures readily identifiable. Immunohistochemistry revealed CD2+ CD3+ neoplastic T-cells that co-express MUM1 and a subset of CD30, while negative for CD4, CD5, CD8, CD56, ALK1, and TDT. EBV-encoded RNA in-situ hybridization was focally positive. The final postmortem diagnosis was peripheral T-cell lymphoma, not otherwise specified (NOS), with focal EBV positivity. Conclusion Co-existence of a de-novo MDS and non-Hodgkin lymphoma without any prior chemotherapeutic exposure is a highly unusual finding, although MDS-like presentations can occur with EBV-associated lymphomas. Peripheral T-cell lymphoma, NOS is an aggressive lymphoma and EBV positivity has been found correlated with a poor prognosis. This case demonstrates how postmortem examination remains an important tool in clinical- pathological correlation and highlights the potential pathogenetic role EBV plays in MDS and T-cell lymphoma.

Background Systemic lupus erythematosus (SLE is a chronic autoimmune disease that systemically affects several important organs[.1 Lupus nephritis (LN is one of the most severe complications of SLE[.2 Exosomes are important mediators of biological information and play a part in the occurrence and development of various diseases including LN[.3 Objectives The aim of study was to find whether exosomes participate in the pathogenesis of lupus nephritis. Methods We studied 10 patients with SLE but no LN,10 patients with LN and 10 healthy people which are in line with the SLE classification criteria of American College of Rheumatology diagnostic (ACR) in 1997 and the LN pathological classification of ISN and RPS in 2003. Exosomes were isolated from the serum by ultracentrifugation and confirmed by transmission electron microscope and western blot. The internalisation of exosomes was detected by immunofluorescence Then exosomes were injected into MRL/lpr mouse via the tail vein and co-cultured with mesangial cells. Flow cytometry was used to detect the alteration of cell cycle. The cell proliferation was determined by CCK-8 assay. The inflammatory cytokines (TNF-α, IL-6) and collagen I level in medium supernatant by ELISA, signal pathway by immunoblotting. Additionally, High-throughput sequencing was used to detect the expression of miRNAs in exosomes. Results The proteinuria and the percent of kidney crescent formation index of LN group was significantly high than oher three groups. Exosomes can be absorbed by mesangial cells quickly. The secrection of inflammatory cytokines and collagen Iof LN group were higher than NLN and control group(p Conclusions LN exosomes can enhance the proliferation and secrection of mesangial cells in which PI3K/AKT pathway is actived. This tip us exosomes may involve in the pathogenesis of LN. References [1] Shen B, Tan W, Feng G, He Y, Liu J, Chen W, Huang X, Da Z, Xu X, Liu H, Gu Z. The correlations of disease activity, socioeconomic status, quality of life, and depression/anxiety in Chinese patients with systemic lupus erythematosus. Clinical & developmental immunology2013;270878. [2] Chafin CB, Reilly CM. MicroRNAs implicated in the immunopathogenesis of lupus nephritis. Clinical & developmental immunology2013;430239. [3] Abels ER, Breakefield XO. Introduction to Extracellular Vesicles: Biogenesis, RNA Cargo Selection, Content, Release, and Uptake. Cellular and molecular neurobiology2016. Acknowledgements The Natural Science Foundation of China under Grant (81202368), The Natural Science Foundation of China under Grant (81471603) Disclosure of Interest None declared

Background Endothelin-1 (ET-1) induces pain-like behavior in animals and man by activating the Gq protein-coupled receptor endothelin-A (ETA). Activation of ETA receptors on nociceptor membranes evokes intracellular calcium transients and alters membrane Na+ and K+ channel and TRPV1 currents, leading to neuronal hyper-excitability manifested by spontaneous and evoked pain behaviors in vivo. In addition to blocking sodium channels, local anesthetics inhibit the Gq protein-coupled signaling of several inflammatory and pro-algesic mediators. In this study, we aimed to investigate the actions of local anesthetics on ETA-mediated increases in intracellular calcium in ND7/104 model sensory neurons. Methods Increases in intracellular calcium were measured by the fluorescent indicator fura-2 in a sensory neuron-derived cell line (ND7/104), which endogenously expresses ETA receptors. Effects of lidocaine and bupivacaine, along with their respective membrane-impermeant derivatives QX-314, LEA-123 and LEA-124, on peak calcium responses to ET-1 were measured. Results Bupivacaine suppressed ET-1 responses in a concentration-dependent and non-competitive manner with an IC50 of 3.79 ± 1.63 mM. Bupivacaine (6 mM) reduced the Emax for ET-1 from 50.07 ± 1.91 mM to 27.30 ± 2.92 mM. The actions of bupivacaine occurred quickly and were rapidly reversible. Membrane-impermeant analogs of bupivacaine (LEA-123 and LEA-124, 6 mM) were without effect, as was lidocaine (10 mM) and its quaternary derivative QX-314 (10 mM). Conclusion Bupivacaine inhibits ETA-mediated calcium transients at clinically relevant concentrations through an intracellular target. The anti-inflammatory and analgesic actions of bupivacaine may be at least partially due to its inhibitory action on Gq-coupled receptors, including ETA.

Kinesin-1 is a kind of motor protein responsible for intracellular transportation and has been studied in a variety of tissues. However, its roles in cartilage development are not clear. In this study, a kinesin-1 heavy chain (Kif5b) knockout mouse model is used to study the functions of kinesin-1 in the cartilage development. We developed a multimodal nonlinear optical (NLO) microscope system integrating stimulated Raman scattering (SRS), second harmonic generation (SHG) and two-photon excited fluorescence (TPEF) to investigate the morphological and biomedical characteristics of fresh tibial cartilage from normal and mutant mice at different developmental stages. The combined forward and backward SHG imaging resolved the fine structure of collagen fibrils in the extracellular matrix of cartilage. Meanwhile, the chondrocyte morphology in different zones of cartilage was visualized by label-free SRS and TPEF images. The results show that the fibrillar collagen in the superficial zone of cartilage in postnatal day 10 and 15 (P10 and P15) knockout mice was significantly less than that of control mice. Moreover, we observed distorted morphology and disorganization of columnar arrangement of chondrocytes in the growth plate cartilage of mutant mice. This study reveals the significant roles of kinesin-1 in collagen formation and chondrocyte morphogenesis.

AIM To determine whether using HbA1c for screening and management could be confounded by age differences, whether age effects can be explained by unrecognized diabetes and prediabetes, insulin resistance or postprandial hyperglycaemia, and whether the effects of aging have an impact on diagnostic accuracy. METHODS We conducted a cross-sectional analysis in adults without known diabetes in the Screening for Impaired Glucose Tolerance (SIGT) study 2005-2008 (n=1573) and the National Health and Nutrition Examination Survey (NHANES) 2005-2006 (n=1184). RESULTS Both glucose intolerance and HbA(1c) levels increased with age. In univariate analyses including all subjects, HbA(1c) levels increased by 0.93 mmol/mol (0.085%) per 10 years of age in the SIGT study and by 1.03 mmol/mol (0.094%) per 10 years in the NHANES; in both datasets, the HbA(1c) increase was 0.87 mmol/mol (0.08%) per 10 years in subjects without diabetes, and 0.76 mmol/mol (0.07%) per 10 years in subjects with normal glucose tolerance, all P

The fractional type Cattaneo heat conduction equation and the associated thermal stress equation are established for studying the thermal and related stress behavior of the short pulse laser heating. With the Laplace transform method, the analytical solution of the temperature distribution and thermal stress field are derived. Compared to the classical Fourier heat transfer model and the standard C-V one, the results of the present model show the thermal diffusion feature as well as the thermal wave behaviour, which is more realistic. Furthermore, the influences of the fractional order parameter on the thermal and related stress behavior are discussed. The thermal velocity, thermal variation rate and the peak value of the temperature and the thermal stress depend on the fractional order parameter. The fractional type Cattaneo heat model and associated thermal stress exhibit the non-local nature.

We developed a multimodal nonlinear optical (NLO) microscope system by integrating stimulated Raman scattering (SRS), second harmonic generation (SHG) and two-photon excited fluorescence (TPEF) imaging. The system was used to study the morphological and biochemical characteristics of tibial cartilage in a kinesin-1 (Kif5b) knockout mouse model. The detailed structure of fibrillar collagen in the extracellular matrix of cartilage was visualized by the forward and backward SHG signals, while high resolution imaging of chondrocytes was achieved by capturing endogenous TPEF and SRS signals of the cells. The results demonstrate that collagen fibrils in the superficial surface of the articular cartilage decreased significantly in the absence of Kif5b. The distorted morphology along with accumulated intracellular collagen was observed in the Kif5b-deficient chondrocytes, indicating the critical roles of kinesin-1 in the chondrocyte morphogenesis and collagen secretion. The study shows that multimodal NLO imaging method is an effective approach to investigate early development of cartilage.

Operating a superconducting single-electron transistor near a double Cooper-pair resonance allows it to achieve a charge-detection sensitivity of just 3.6 times the ultimate quantum limit.

Zn-ion-implantation to a dose of 1 × 1017 ions/cm2 was performed on ZnO thin films deposited on fused silica glass substrates by the sol–gel technique. After ion implantation, Zn-implanted ZnO films were annealed in air at different temperatures from 500 to 900 °C. The effects of ion implantation and post-thermal annealing on the structural and optical properties of the ZnO films were investigated by X-ray diffraction (XRD), photoluminescence (PL) and optical absorption measurements. XRD reveals that diffraction peaks recover at ∼700 °C. Optical absorption measurements show that the absorption edge blueshifts when the annealing temperature is below 600 °C while redshifts when the annealing temperature exceeds 600 °C. Urbach energy decreases with increasing the annealing temperature from 500 to 600 °C while increases from 600 to 900 °C. PL results showed that both near band edge (NBE) excitonic UV emission and defect related deep level emission (DLE) increased with increasing annealing temperatures from 500 to 900 °C.

ZnO thin films were first prepared by the sol–gel process, and then Ge ions were implanted into the ZnO films. The effects of ion implantation on the structural and optical properties of the ZnO films were investigated by X-ray diffraction, photoluminescence (PL), and optical transmittance measurements. Measurement results showed that the intensity of the (002) diffraction peak was decreased and the full width at half maximum was narrowed. PL emission was greatly extinguished after Ge ion implantation. Both the near band edge (NBE) excitonic UV emission at 391 nm and the defect related deep level emission centered at 470 nm in the visible region were decreased after Ge ion implantation. NBE peak and the absorption edge were observed to have a blueshift toward higher energy.

ZnO:Al thin films doped with different aluminum concentrations were deposited on (0001) sapphire substrates by the sol-gel technique. Thermal annealing of ZnO:Al films was carried out in an argon ambient at various annealing temperatures from 600 to 950 degrees C. The effects of thermal annealing and dopant concentration on the optical properties of ZnO:Al thin films were investigated. It is found that near band edge UV emission is enhanced by increasing the annealing temperature and dopant concentration. But defect-related deep-level emission decreases with the increasing dopant concentration and thermal annealing has little influence as the deep-level emission. The optical band gap of ZnO:Al films increases from 3.21 to 3.25 eV on increasing the dopant concentration from 0.01% to 1%. The optical transmittance decreases in the visible region, while it increases in the ultraviolet region with an increase in the annealing temperature. (c) 2006 Elsevier B.V. All rights reserved.

The tremendous acoustic signal exiting during the plasma arc cutting process includes a lot of information about this process and has a close relation with cut quality. To investigate the relationship between the plasma arc cutting acoustic and cut quality, a number of experiments have been carried out. In the present study, cut quality by plasma arc is described by top and bottom kerf widths, bevel angle, and attached dross state, and the relationship between the evaluation items for cut quality and the SPL (sound pressure level) of the cutting acoustic is investigated in detail. It is shown that the SPL reaches a maximum as the bottom kerf width equals the diameter of the plasma arc potential core. The attached dross and kerf widths in a state of free dross obviously affect the low and high frequency components of the plasma arc cutting acoustic, respectively. These results also suggest the possibility of designing an acoustic-based monitoring system for the plasma arc cutting process.

Background: Thyroplasty type I, as introduced by Isshiki and colleagues almost 30 years ago, has become the gold standard of improving glottal incompetence caused by unilateral vocal fold paralysis. Intraoperative assessment of the adequacy of glottal closure is subjective and based on the perceptual judgment of vocal quality and degree of improvement in glottal gap size. Objective/Hypotheses: The primary purpose of this study was to investigate whether the intraoperative measurement of maximum phonation time (MPT) is an adequate predictor of voice outcome after thyroplasty type I. To assess this possibility, it was necessary to evaluate the effect of body posture (seated vs. supine) and anesthesia (none vs. light sedation) on the measure of MPT. Study Design: A prospective study of 20 individuals with unilateral vocal fold paralysis was undertaken. Methods: Subjects were assessed at three time points: pre-, intra-, and postoperatively across parameters of breathiness rating, glottal gap size, glottal flow rate, and MPT. Results: Results indicated that MPT was significantly lower in the supine versus seated position. In addition, light sedation resulted in a trend toward lower MPT that was not statistically significant. Finally, the intraoperative measurement of MPT, although lower than a 1-month postoperative measurement, was significantly predictive of the outcome. Conclusions: The intraoperative measure of MPT appears to be an adequate predictor of the postoperative outcome.

The sound emitted during plasma arc cutting is closely related to the cutting conditions including cutting speed, arc current, operating gas flowrate, torch standoff height, nozzle shape, etc., and it therefore contains useful information for the evaluation of the plasma arc cutting process. The present work investigates the characteristics of the sound emitted during plasma arc cutting under various cutting conditions, using fast Fourier transformation and probability statistical analyses. An acoustic model of plasma arc cutting, having two jet sound sources, is proposed to interpret this sound. The sensitive frequency band of the cutting sound and the relationship between the cutting sound and the conditions are then revealed. It is shown that the cutting sound is a random signal readily affected by cutting conditions, and its energy is concentrated in the high frequency field and originates mainly from the mixing region of the first sound source and the mixing and transition regions of the seco...

Medialization thyroplasty (type I) has become the gold standard to improve glottic closure due to unilateral vocal fold paralysis. A newer injection method utilizing homologous collagen from cadaveric human tissue has been described as an attractive alternative as no donor site is required, there is a very low risk of hypersensitivity, and the intact, acellular collagen fibers may suffer a reduced long-term reabsorption rate. Preliminary results on eight patients comparing presurgical and postsurgical parameters (perceptual, stroboscopic, acoustic, and aerodynamic) revealed comparable results when compared with a control group of individuals, age- and sex-matched, that had undergone standard medialization thyroplasty (type I). Further study is needed to assess the long-term results with this minimally invasive method of vocal fold medialization.

Background Human epidermal growth factor receptor 2 (HER2) Ile655Val polymorphism may affect the efficacy of trastuzumab treatment of breast cancer. Patients and methods HER2 Ile655Val polymorphism was determined in 4167 patients with primary breast cancer using a polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) assay. We investigated the associations between the HER2 Ile655Val polymorphism and clinical outcomes in women with HER2-negative breast cancer and with HER2-positive breast cancer who received trastuzumab or who did not. Results At a median follow-up of 44 months, HER2 Ile655Val polymorphism was not significantly associated with survival either in the entire study population of 4167 patients or in 2976 HER2-negative breast cancer patients. Among 816 HER2-positive patients who received adjuvant chemotherapy and/or endocrine therapy without trastuzumab treatment, patients with the Val/Ile or the Val/Val genotype had a significantly worse disease-free survival (DFS) and distant DFS (DDFS) than those with the Ile/Ile genotype (DFS, adjusted hazard ratio [HR] 1.5; 95% confidence interval [CI] 1.0–2.3; P = 0.037; DDFS, adjusted HR 1.9; 95% CI 1.2–2.9 P = 0.005). In contrast, among 212 HER2-positive patients who received chemotherapy in combination with trastuzumab treatment, patients with the Val/Ile or the Val/Val genotype had a significantly better DFS and DDFS than those with the Ile/Ile genotype (5-year DFS, 100% versus 83%; P = 0.008; 5-year DDFS, 100% versus 89%; P = 0.031). Conclusions HER2 Ile655Val polymorphism affects the function of HER2 gene only restricted in HER2-positive breast cancers. HER2-positive breast cancer patients with the Val variant have an aggressive phenotype, but are sensitive to trastuzumab treatment.

Brain injury in meningitis occurs in part as a consequence of leukocyte migration and activation. Leukocyte integrins are pivotal in the inflammatory response by mediating adhesion to vascular endothelium and extracellular matrix proteins. We have demonstrated that moderate hypothermia early in the course of meningitis decreases leukocyte sequestration within the brain parenchyma. This study examines whether hypothermia alters neutrophil integrin expression in a rabbit model of bacterial meningitis. Prior to the induction of meningitis, peripheral blood samples were obtained and the neutrophils isolated. Sixteen hours after inducing group B streptococcal meningitis, animals were treated with antibiotics, IV fluids, and mechanically ventilated. Animals were randomized to hypothermia (32–33°C) or normothermia conditions. After 10 hours of hypothermia or normothermia, neutrophils were isolated from the blood and cerebral spinal fluid (CSF), stained for β1 and β2 integrins, and analyzed using flow cytometry. Cerebral spinal fluid neutrophil β1 integrin expression was significantly decreased in hypothermic animals. Beta-1 integrins can assume a higher affinity or "activated" state following inflammatory stimulation. Expression of "activated" β1 integrins was also significantly decreased in hypothermic animals. Beta2 CSF neutrophil integrin expression was decreased in hypothermic animals, but failed to reach significance. These data suggest hypothermia may attenuate extravasated leukocyte expression of both total and "activated" β1 integrins.

Blood fibrinogen concentrations and glutamic-pyruvic transaminase activities of 66 adult cancer inpatients (aged 22–70 years) were determined both before and after one or two chemotherapy regimens. The percentage of hepatoma patients with abnormal blood fibrinogen levels (< 1.5 or > 6.0 g/l) was higher (64.3% of 14 patients) than that in other cancer categories (19.2% of 52 patients). The mean blood fibrinogen concentrations of male (3.5 g/l) and female (4.5 g/l) cancer patients were higher than those previously reported for healthy humans (2.8 and 2.9 g/l, respectively). After chemotherapy, blood fibrinogen concentrations decreased in patients whose primary tumours were surgically removed (from 4.8 to 3.2 g/l) but increased (from 3.0 to 4.8 g/l) in those who did not undergo surgery. Glutamic-pyruvic transaminase activities did not appear to be related to blood fibrinogen levels. We conclude that the increase in mean blood fibrinogen levels of cancer patients is probably related to tumour growth. Different mechanisms may operate in patients with hepatoma.

Singing requires exquisite coordination between the respiratory and phonatory systems to efficiently control glottal airflow. Asymptomatic singing students underwent pulmonary function testing (PFT), videostrobolaryngoscopic examination, and measures of glottal efficiency (maximum phonation time [MPT], glottal flow rate [GFR], and phonation quotient [PQ]) performed in both a sung and spoken tone. Pulmonary function and glottal efficiency values were within reported normative data for professional singers. However, sung tones were made with significantly higher GFR and PQ and lower PQ than spoken tones. The mean GFR was not related to the degree of glottal closure (by videostrobolaryngoscopy) or underlying pulmonary support.