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Objective To evaluate whether there is an association between an intervention to reduce medical bed occupancy and performance on the 4-hour target and hospital mortality. Methods This before-and-after study was undertaken in a large UK District General Hospital over a 32 month period. A range of interventions were undertaken to reduce medical bed occupancy within the Trust. Performance on the 4-hour target and hospital mortality (hospital standardised mortality ratio (HSMR), summary hospital-level mortality indicator (SHMI) and crude mortality) were compared before, and after, intervention. Daily data on medical bed occupancy and percentage of patients meeting the 4-hour target was collected from hospital records. Segmented regression analysis of interrupted time-series method was used to estimate the changes in levels and trends in average medical bed occupancy, monthly performance on the target and monthly mortality measures (HSMR, SHMI and crude mortality) that followed the intervention. Results Mean medical bed occupancy decreased significantly from 93.7% to 90.2% (p=0.02). The trend change in target performance, when comparing preintervention and postintervention, revealed a significant improvement (p=0.019). The intervention was associated with a mean reduction in all markers of mortality (range 4.5–4.8%). SHMI (p=0.02) and crude mortality (p=0.018) showed significant trend changes after intervention. Conclusions Lowering medical bed occupancy is associated with reduced patient mortality and improved ability of the acute Trust to achieve the 95% 4-hour target. Whole system transformation is required to create lower average medical bed occupancy.

Small-angle neutron scattering (SANS) was used to investigate the spheroidization of cementite in pearlite upon annealing. Globally averaged information on the shape and size of cementite particles was collected by using the SANS profile analysis of 0.8 mass pct C pearlitic steel (0.8C) samples annealed at 973 K (700 °C) for 3.6 to 86.4 ks. The change in the total area of the ferrite–cementite interface or aspect ratio determined by ex situ SANS exhibits excellent correspondence with scanning electron microscopy observations. Then, in situ SANS data were collected during isothermal annealing of the 0.8C steel and the commercially available 0.45C carbon steel (JIS-S45C). The shape change of the cementite plate was monitored, and the spheroidization rate of the 0.8C steel was found to be faster than that of the 0.45C steel.

Energy-resolved neutron imaging at a pulsed source utilizes the energy-dependent neutron transmission, measured via time-of-flight, to extract quantitative information on the internal microstructure of an object in situ. These techniques, however, are currently limited by the count-rate capability of available imaging detector systems, resulting in long measurement times and reduced spatial resolution. At RADEN, we are building on our previous detector development work to provide nearly three times improvement in rate performance of our micro-pixel chamber based neutron imaging detector $(_{\mu }$ NID) by changing from 3 He to a boron-based neutron converter and optimizing the shape for a much reduced event size and maximized detection efficiency. We are also designing a new micro-pattern readout element with an additional readout axis to facilitate clean event separation under high-rate conditions. Proof-of-principle testing at RADEN of the $_{\mu }$ NID with a flat, $1.2{\mu }m$ thick $^{10}B$ conversion layer confirmed a spatial resolution of 0.45 to 0.5 mm and indicated an improvement in rate capacity up to 22 Mcps or more. Once the boron converter is optimized for detection efficiency, this detector will help to unlock the full potential of these energyresolved neutron imaging techniques at pulsed sources.

SummaryBackground Few studies have addressed prognostic markers and none has correlated molecular status and prognosis in vulvar melanomas. Objectives To evaluate the clinicopathological features of 95 cases of vulvar melanoma. Methods p53, CD117, Ki-67, neurofibromin, brafv600e and nrasq61r immunostains, and molecular analyses by either targeted next-generation or direct sequencing, were performed on available archival materials. Results Molecular testing detected mutations in KIT (44%), BRAF (25%), NF1 (22%), TP53 (17%), NRAS (9%) and TERT promoter (9%). Co-mutation of KIT and NF1 and of KIT and NRAS were identified in two and one cases, respectively. KIT mutations were significantly associated with better progression-free survival in univariate analyses. In multivariate analyses CD117 expression was significantly associated with better progression-free survival. Tumour thickness was significantly associated with worse progression-free and overall survival, and perineural invasion significantly correlated with reduced melanoma-specific survival and reduced overall survival. Cases were from multiple centres and only a subset of samples was available for molecular testing. Conclusions KIT mutations and CD117 overexpression are markers of better progression-free survival. In addition to its prognostic value, molecular testing may identify cases that might respond to targeted agents or immunotherapeutic approaches.

In situ neutron diffraction during annealing was performed for ultrafine-grained as-deposited and cold-rolled pure iron. Changes in the integrated intensity and full-width at half-maximum in the diffraction profiles during annealing were measured. EBSD measurements were performed before and after annealing to obtain microstructural change. Abnormal grain growth was clearly found at 673 K (400 °C) upon annealing; this observation corresponds to the hydrogen desorption behavior of the as-deposited specimen. The texture changes from {111}〈hkl〉 to {211}〈hkl〉 between 673 K and 873 K (400 °C and 600 °C) upon continuous heating. Such a texture change is postulated to decrease the Lankford value from 7.6 to 2.2. The 40 pct cold-rolled specimen exhibited a complicated textural evolution upon annealing, which was caused by the intrusion of recrystallization at deformation bands.

The Energy-Resolved Neutron Imaging System RADEN, located at the J-PARC Materials and Life Science Experimental Facility in Japan, is the world's first dedicated high-intensity, short-pulsed neutron imaging beam line. To carry out energy-resolved neutron imging at RADEN, we use cutting-edge detector systems employing micropattern detectors and data acquisition systems based on Field Programmable Gate Arrays to provide the necessary sub-μs time resolution, high counting rates, and event-by-event background rejection. One such detector, the Micro Pixel Chamber-based Neutron Imaging Detector (μNID), provides a spatial resolution of 120 μm (s), time resolution of 0.6 μs, 18% detection efficiency for thermal neutrons, and effective gamma sensitivity of less than 10−12. We have recently increased the rate capacity of the μNID from 600 kcps to more than 8 Mcps via an upgrade of the readout electronics and the introduction of a new gas mixture optimized for higher count rate, better spatial resolution, and higher detection efficiency. We are also developing new detection elements with strip pitches of 280 μm and 215 μm, down from 400 μm, with a corresponding improvement in the spatial resolution expected. Here, we present the progress of the ongoing development of the μNID, including the results of recent on-beam tests performed at RADEN.

Purpose/objectives To examine the experiences of compassion fatigue, burnout, and compassion satisfaction among oncology nurses in the United States and Canada. . Design Quantitative, descriptive, nonexperimental. . Setting Online survey with members from the Canadian Association of Nursing Oncology and the Oncology Nursing Society. . Sample 486 American and 63 Canadian practicing oncology nurses. . Methods The Professional Quality of Life (ProQOL) scale, version 5, and modified Abendroth Demographic Questionnaire were administered through FluidSurveys™, an online data collection instrument. Chi-square tests of independence were used to investigate associations between demographic characteristics, health, personal stressors, and work-related characteristics to experiences of compassion fatigue, burnout, and compassion satisfaction. Compassion fatigue was measured using the subscales of secondary traumatic stress and burnout. . Main research variables Compassion fatigue, burnout, and compassion satisfaction. . Findings Demographic characteristics were similar in American and Canadian participants, and both cohorts reported comparable levels of compassion fatigue, burnout, and compassion satisfaction. Perception of team cohesiveness within the workplace environment was found to be significant for both groups, as indicated by significant relationships in all three subscales of secondary traumatic stress, burnout, and compassion satisfaction in the ProQOL. . Conclusions Healthy and supportive work environments are imperative to nurses' health, well-being, and satisfaction. Improvements in the workplace can help prevent negative sequelae, as well as improve health outcomes for patients and nurses, decrease nurse turnover, and reduce healthcare expenditures. . Implications for nursing Findings can be used to implement institutional changes, such as creating policies and guidelines for the development of preventive interventions and psychosocial support for nurses.

This study aimed to determine the validity and reliability of the Actical accelerometer for measuring physical activity (PA) in preschool children of mixed ethnicity, compared with direct observation via a modified System for Observing Fitness Instruction Time (SOFIT) protocol and proxy parental reports (PA Logs). Fifty children in Hawai‘i wore wrist-mounted accelerometers for two 7-day periods with a washout period between each week. Thirty children were concurrently observed using SOFIT. Parents completed PA Logs for three days. Reliability and validity were measured by intra-class correlation coefficient and proportions of agreement concurrently. There was slight agreement (proportion of agreement: 82%; weighted Kappa=.17, P

The behavior of hydrogen in an ultrafine-grained electrodeposited pure iron with Lankford (r) value larger than 7.0 was studied by small angle neutron scattering (SANS) and thermal desorption spectroscopy (TDS). Nano-sized inhomogeneity consisting of hydrogen bubble exists in the deposited specimen. The bubble size increases a little by 673 K annealing and then all the bubbles disappear after 973 K annealing. With rolling at room temperature (RT), the bubble size and number density are found to decrease, which must be caused by the change in the status of hydrogen location during plastic deformation. Crystal rotation and grain coalescence are revealed to occur after rolling deformation from electron backscattered diffraction (EBSD) results.

Persistent infection with high-risk human papillomaviruses (HPVs) is the greatest risk factor for the development of HPV-associated cancers. In this study rabbits bearing persistent and potentially malignant papillomas were used to test the efficacy of vaccination with a recombinant DNA and/or vesicular stomatitis virus (VSV) targeting the cottontail rabbit papillomavirus (CRPV) E6 protein. Immune responses were primed with either vector and boosted twice with the homologous or heterologous E6 vector. Over the course of 18 weeks, E6 vaccination reduced papilloma volumes to one third the volume in the controls, and the rabbits boosted with an heterologous vector tended to mount stronger responses. Small and medium-sized papillomas responded significantly but only slightly better than large papillomas. Finally the initial papilloma burden per rabbit, ranging from 1000 mm3, was not prognostic of antitumor efficacy. In summary both E6 vaccines elicited significant therapeutic immunity, and their sequential use tended to be advantageous.

A new experimental technique to measure spatial distribution of small-angle neutron scattering (SANS) is proposed. Since SANS reflects the nanostructures of samples, high-efficiency mapping of the ...

We examine here the electropolymerization of electrochemically or chemically preoxidized catecholamines in glucose oxidase (GOx)-containing neutral solutions to efficiently immobilize the enzyme at Prussian blue-modified Au electrodes for sensitive amperometric biosensing of glucose. The electrochemical quartz crystal microbalance (EQCM) was used to track various electrode-modification processes. The optimized poly(dopamine)-based glucose biosensor displayed a sensitivity of 35 mu A mM(-1) cm(-2) and a limit of detection of 0.3 mu M at 0.7 V vs. SCE, and similar results were obtained at -0.05 V vs. SCE, which are obviously better than those from preoxidation-free conventional electropolymerization. The immobilized Cox retained high enzymatic specific activity, as quantified by UV-vis spectrophotometry and EQCM. L-Noradrenalin could similarly electropolymerize and the resultant enzyme film gave equivalent biosensing characteristics, but the electropolymerization of EP was less efficient and the resultant enzyme film showed notably poorer performance. (C) 2008 Elsevier B.V. All rights reserved.

The electrochemical quartz crystal microbalance (EQCM) technique was utilized to monitor in situ the adsorption of glucose oxidase (GOD) and the mixture of GOD and sodium dodecyl benzene sulfonate (SDBS) onto Au electrodes with and without modification of multiwalled carbon nanotubes (MWCNTs) or SDBS/MWCNTs composite, and the relationship between enzymatic specific activity (ESA) and direct electrochemistry of the immobilized GOD was quantitatively evaluated for the first time. Compared with the bare gold electrode at which a little GOD was adsorbed and the direct electrochemistry of the adsorbed GOD was negligible, the amount and electroactivity of adsorbed GOD were greatly enhanced when the GOD was mixed with SDBS and then adsorbed onto the SDBS/MWCNTs modified Au electrode. However, the ESA of the adsorbed GOD was fiercely decreased to only 16.1% of the value obtained on the bare gold electrode, and the portion of adsorbed GOD showing electrochemical activity exhibited very low enzymatic activity, demonstrating that the electroactivity and ESA of immobilized GOD responded oppositely to the presence of MWCNTs and SDBS. The ESA results obtained from the EQCM method were well supported by conventional UV-vis spectrophotometry. The direct electrochemistry of redox proteins including enzymes as a function of their biological activities is an important concern in biotechnology, and this work may have presented a new and useful protocol to quantitatively evaluate both the electroactivity and ESA of trace immobilized enzymes, which is expected to find wider applications in biocatalysis and biosensing fields.

Electrochemical quartz crystal impedance (QCI) technique was utilized to monitor in situ the adsorption of rutin (RT) onto a carbon nanotubes (CNTs)-modified gold electrode and to study the binding process of solution hemoglobin (Hb) to RT immobilized on the electrode. Time courses of the QCI parameters including crystal resonant frequency were simultaneously obtained during the RT adsorption and Hb-RT binding. In contrast to the negligible RT adsorption at a bare gold electrode, the modification by CNTs notably enhanced the amount of adsorption, and almost all of the adsorbed RT molecules were found to be electroactive. On the basis of the frequency response from the binding of adsorbed RT to solution Hb and the diminished electroactivity of adsorbed RT after the formation of the electrochemically inactive RT-Hb adduct, the average binding molar ratio of adsorbed RT to Hb was estimated to be 23.9:1, and the association constant (Ka) for the binding was estimated to be 2.87 x 106 (frequency) and 3.92 x 106 (charge) L mol-1, respectively. Comparable results were obtained from fluorescence quenching measurements in mixed solutions containing RT of fixed concentration and Hb of varying concentrations, demonstrating that the interfacial RT here behaved equivalently in the RT-Hb binding activity compared to that in solution. This work may have presented a new and general protocol involving CNTs to study many other electroactive natural antioxidants or drugs that are at the interface or in solution, their binding with proteins or other biomolecules, and changes of their antioxidant activity after the binding.

To report major postoperative complications in 1613 dogs with tibial tuberosity advancement (TTA).Retrospective case series.Dogs (n = 1613) with cranial cruciate ligament deficiency treated with TTA.Medical records of TTAs performed between December 2007-2013 were reviewed for age, sex, weight, contralateral stifle surgery, surgical approach, duration of preoperative lameness, presence of meniscal damage, concurrent patellar luxation and simultaneous bilateral TTA. Major postoperative complications were defined as surgical site infection (SSI) (superficial, deep, or organ/space), implant failure, fracture, patellar luxation, and meniscal tear.Major complications were recorded in 13.4% of cases. Superficial SSI (incisional irritation) was diagnosed in 6.9% cases, requiring only antimicrobial therapy. Other complications included postliminary medial meniscal tear (2% incidence), deep SSI (incisional dehiscence, 1.1%), implant failure (1%), patellar luxation (1.2%), fracture (0.9%), and organ/space SSI (septic arthritis, 0.4%). Dogs with normal menisci were less likely to develop postliminary meniscal tears if the medial meniscus was released at the time of TTA (P .0001). No association was detected between recorded parameters and complications, although dogs8 years old approached significance (P = .05) in terms of predisposition to major complications.Major complications after TTA are uncommon, even in dogs with concurrent patellar luxation or bilateral simultaneous procedures. In spite of its morbidity, medial meniscal release may prevent postliminary meniscal tears.

The neutron imaging and diffraction instruments at Materials and Life Science Experimental Facility (MLF) at J-PARC are expected to play an important role in the microstructure characteristic evaluation of steel materials further for industry application. Neutron transmission spectrum measured at a neutron imaging detector coupled with time-of-flight (TOF) method at a pulsed source, can quantitatively and non-destructively visualize the spatial distributions of the wider area by 2D mapping of textures and the microstructures information inside a relatively thicker material than the traditional electron, X-ray and neutron experiments. In this study, neutron imaging experiment was performed using NOBORU, BL10 of MLF at J-PARC. Four kinds of cast duplex stainless steel with ferrite and austenite microstructure were studied here, which were produced by different casting method at different temperature. Firstly, a two-dimensional scintillation detector using wavelength-shifting (WLS) fibers [1] with pixel size of 0.52mm × 0.52mm and illuminated area 55mm × 55mm was used for data collection. Then, measurement by Micro Pixel Chamber (μPIC)-based neutron imaging detector [2] having higher spatial resolution about 0.2mm was conducted. Data analysis code RITS (Rietveld Imaging of Transmission Spectra) [3] will be used for microstructure including crystalline phase, lattice strain, crystallite size, texture evaluation. This work was supported by Photon and Quantum Basic Research Coordinated Development Program from the Ministry of Education, Culture, Sports, Science and Technology, Japan.

With the continuous development of China's economy, the society needs a large number of high-level skilled personnel, while the majority of normal college graduates currently unable to meet the market or industry requirements for highly skilled personnel. To achieve the "demographic dividend" to" talent dividend "conversion, training objectives and training model is bound to change. There are some problems in normal college students' teaching skills training in most of our colleges and universities. The article points out skills training should be an integral training with theory penetration, and points out that it needs to reform from the training concept, training content system, improve the regulatory frame work and provide opportunities to practice and other aspects.

We report for the first time the effective catalytic electrooxidation of nicotinamide adenine dinucleotide (NADH) on the pencil 8B-scrawled gold electrode of an electrochemical quartz crystal microbalance (EQCM). The EQCM allowed us to quantitatively evaluate the catalytic activity of the pencil-scrawled Au electrode. With increasing the mass of modified pencil powders, the peak potential for NADH oxidation shifted negatively, with maximum shift of −0.35 V at saturated pencil modification; the NADH-oxidation peak current density (jp) was also notably increased, and the jp at saturated pencil modification was found to be larger than those at conventional pencil 8B and bare Au electrodes. Sensitive amperometric detection of NADH was achieved at the gold electrode with saturated pencil modification, with low detection potential (0.4 V versus SCE), low detection limit (0.08 μmol L−1) and wide linear range (0.2–710 μmol L−1). The fluoroelectrochemical measurements of NADH at bare and pencil-modified gold electrodes were also conducted with satisfactory results. The convenient and low-cost modification of pencil powders on the Au electrode may have presented a new functional surface of the EQCM, which is recommended for wider applications to bioelectrochemical studies, especially in view of the EQCM's capability of providing abundant in situ information in relevant processes.

This article addresses a connection between the Bradley and Terry [1952a. The rank analysis of incomplete block designs. I. The method of paired comparisons. Biometrika 39, 324–345] model and Cox [1972. Regression models and life-tables. J. Roy. Statist. Soc. B 24, 187–220 (with discussion)] proportional hazards model. We show that the partial likelihood of random variables that satisfy the stratified proportional hazards assumption of Cox [1972. Regression models and life-tables. J. Roy. Statist. Soc. B 24, 187–220 (with discussion)] coincides with the likelihood given by the Bradley–Terry (BT) model for rank order events. Such a connection not only allows many available software for the Cox model to be used for regression analysis based on the BT model, but also enables the new developments to fit certain rank order data by using ideas that stem from the Cox model and its extensions available in many recent literatures from survival analysis.

Polarized neutron imaging is an attractive method for visualizing magnetic fields in a bulk object or in free space. In this technique polarization of neutrons transmitted through a sample is analyzed position by position to produce an image of the polarization distribution. In particular, the combination of three-dimensional spin analysis and the use of a pulsed neutron beam is very effective for the quantitative evaluation of both field strength and direction by means of the analysis of the wavelength dependent polarization vector. Recently a new imaging instrument "RADEN" has been constructed at the beam line of BL22 of the Materials and Life Science Experimental Facility (MLF) at J-PARC, which is dedicated to energy-resolved neutron imaging experiments. We have designed a polarization analysis apparatus for magnetic field imaging at the RADEN instrument and have evaluated its performance.

Fine grained electro-deposited pure iron shows ultra-high Lankford value larger than 7. Tensile deformation behavior at room temperature was studied using in situ neutron diffraction and semi in situ scanning electron microscopy with electron back scatter diffraction (SEM/EBSD) observation. The characteristic deformation mechanism to bring high R value accompanying grain coalescence is made clear. The sheet was annealed to observe hydrogen behavior and grain growth using thermal desorption spectroscopy, small angle neutron scattering, in situ neutron diffraction and SEM/EBSD. The shape of grain was changed from needle-like shape to polygonal with annealing, leading to a decrease of R value.

Bainite transformation behavior was monitored using simultaneous measurements of dilatometry and small angle neutron scattering (SANS). The volume fraction of bainitic ferrite was estimated from the SANS intensity, showing good agreement with the results of the dilatometry measurements. We propose a more advanced monitoring technique combining dilatometry, SANS and neutron diffraction.

In this work, the anion exchange resin (AER) was modified with a layer of glucose oxidase (GOD) and poly(diallyldimethylammonium chloride) (PDDA), respectively, via layer-by-layer electrostatic self-assembling strategy. The PDDA and GOD modified AER (PDDA/GOD/AER) was then packed into a home-made amperometric cell for flow injection analysis (FIA) of glucose. This design simplified the setup by integrating the enzyme reactor into the amperometric cell. And the AER in the cell behaved bifunctional, it was not only the support of enzymes, but also an anti-interference tool due to its retention effect toward ascorbic acid (AA) and uric acid (UA). A platinum modified porous titanium (Pt/PTi) electrode was utilized in the cell as the working electrode (WE), due to its large effective surface area it could increase the response by 8.3 times as compared with the planar pure platinum electrode. The proposed biosensor was very sensitive (22.4 microA cm(-2) mM(-1)) in glucose quantification, and the linear range was from 1 micromol L(-1) to 2 mmol L(-1) with the detection limit of 0.8 micromol L(-1). The biosensor was used for serum glucose determination, and the result obtained was satisfying. This work may have provided a reference design of the amperometric cell which could be adopted in other enzymatic-FIA biosensors.

Persistent human papillomavirus (HPV)-associated benign and malignant lesions are a major cause of morbidity and mortality worldwide. Vaccination against HPV early proteins could provide an effective means of treating individuals with established infections. Recombinant vesicular stomatitis virus (VSV) vectors have been used previously to elicit strong humoral and cellular immune responses and develop prophylactic vaccines. We have shown that VSV vectors also can be used to elicit therapeutic immunity in the cottontail rabbit papillomavirus (CRPV)-rabbit model of high-risk HPV infection. In the present study, three new VSV vectors expressing the CRPV E1, E2, or E7 protein were produced and compared to the previously generated VSV-E6 vector for therapeutic efficacy. To determine whether vaccine efficacy could be augmented by simultaneous vaccination against two CRPV proteins, the four vaccines were delivered individually and in all possible pairings to rabbits 1 week after CRPV infection. Control rabbits received the recombinant wild-type VSV vector or medium only. Cumulative papilloma volumes were computed for analysis of the data. The analyses showed that VSV-based vaccination against the E1, E2, E6, or E7 protein significantly reduced papilloma volumes relative to those of the controls. Furthermore, VSV-based CRPV vaccination cured all of the papillomas in 5 of 30 rabbits. Of the individual vaccines, VSV-E7 was the most effective. The VSV-E7 vaccine alone was the most effective, as it reduced cumulative papilloma volumes by 96.9% overall, relative to those of the controls, and ultimately eliminated all of the disease in all of the vaccinees. Vaccine pairing was not, however, found to be beneficial, suggesting antigenic competition between the coexpressed CRPV proteins. These preclinical results, obtained in a physiologically relevant animal model of HPV infection, demonstrate that VSV vectors deserve serious consideration for further development as therapeutic antitumor vaccines.

We report a random disruption in the mouse genome that resulted in lethal paralysis in homozygous newborns. The disruption blocked expression of neurobeachin, a protein containing a BEACH (beigeandChediak-Higashi) domain implicated in synaptic vesicle trafficking and an AKAP (A-kinase anchor protein) domain linked to localization of cAMP-dependent protein kinase activity.nbea-null mice demonstrated a complete block of evoked synaptic transmission at neuromuscular junctions, whereas nerve conduction, synaptic structure, and spontaneous synaptic vesicle release were completely normal. These findings support an essential role for neurobeachin in evoked neurotransmitter release at neuromuscular junctions and suggest that it plays an important role in synaptic transmission.

To injvestigate the cerebral blood flow of patients with early syphilis.(99)Tc(m)-ECD as brain perfusion imaging agent was used in single photon emission computed tomography (SPECT) for 32 patients with early syphilis and 15 controls. Visual analyses were made on every BSPECT image.The 32 patients with early syphilis had general, patchy hypoperfusion of cerebral blood flow. Fourteen of the 32 patients had 48 episodes of marked patchy hypoperfusion of rCBF. The responsible areas of hypoperfusion in a patchy distribution involved the left frontal lobe (6 episodes), right frontal lobe (3), left parietal lobe (7), right parietal lobe (6), left temporal lobe (11), right temporal lobe (5), left occipital lobe (3), left basal ganglia (3), cerebellum (1), and nerve nuceus (1). No abnormality was found in the control group.Cerebral blood flow abnormalities exist in patients with early syphilis. General patchy hypoperfusion on SPECT imaging is common.

To study the cerebral blood flow perfusion imaging by single photon emission computed tomography (SPECT) in patients with early syphilis.SPECT was performed with (99m)Tc-ECD as imaging agent on 32 patients with early syphilis and 15 healthy controls. Visual analysis was made.Disseminated patchy radioactive rarefection mainly in cerebral cortex, suggesting hypoperfusion of regional cerebral blood flow, was shown in all patients. In particular 14 patients displayed multi-regional obvious hypoperfusion patches: 6 in left frontal lobe, 3 in right frontal lobe, 7 in left parietasal lobe, 6 in right parietal lobe, 11 in left temporal lobe, 5 in right temporal lobe, 3 in left occipital lobe, 3 in left basal ganglia, 1 in cerebellum, and 1 in intrecerebral nucleus. No abnormality was found in the controls.Cerebral blood flow abnormality exists in patient with early syphilis manifesting as patchy hypoperfusion in SPECT imaging.

The five genes of the human growth hormone (hGH) cluster are expressed in either the pituitary or placenta. Activation of the cluster is dependent on a locus control region (LCR) comprising pituitary- specific (HSI,II, −15 kb), placenta-specific (HSIV, −30 kb) and shared (HSIII, −28 kb; HSV, −32 kb) DNase I hypersensitive sites. Gene activation in the pituitary is paralleled by acetylation of a 32 kb chromatin domain 5′ to the cluster centered at HSI,II. In the present study we observed that acetylation of this region in placental chromatin was discretely limited to shared HSIII and HSV. Transgenic studies revealed placenta-specific activation of linked genes by a determinant (P-element) located 2 kb 5′ to each of the four placentally expressed genes. A localized peak of histone acetylation was observed at these P-elements in placenta but not pituitary. These data support a model for bifunctional action of the hGH LCR in which separate positive determinants, HSI,II and the P-elements, activate their respective target genes by tissue-specific recruitment of distinctly regulated histone acetyl transferase activities.

The human growth hormone (hGH) cluster contains five genes. The hGH-N gene is predominantly expressed in pituitary somatotropes, whereas the remaining four genes, the chorionic somatomammotropin genes (hCS-L, hCS-A, and hCS-B) and hGH-V, are expressed selectively in the placenta. In contrast, the mouse genome contains a single pituitary-specific GH gene and lacks any GH-related CS genes. Activation of the hGH transgene in the mouse is dependent on its linkage to a previously described locus control region (LCR) located −15 to −32 kilobases upstream of the hGH cluster. The sporadic, nonreproducible expression of hCS transgenes lacking the LCR suggests that they may be dependent on hGH LCR activity as well. To determine whether the hCS genes could be expressed with appropriate placental specificity, a series of five transgenic mouse lines carrying an 87-kilobase human genomic insert encompassing the majority of the hGH gene cluster and the entire contiguous LCR was established. All of the hGH cluster genes were appropriately expressed in each of these lines. High level expression of hGH was restricted to the pituitary and hCS to the labyrinthine layer of the placenta. The expression of the GH cluster genes in their respective tissues paralleled transgene copy numbers irrespective of the transgene insertion site in the host mouse genome. These studies have extended the utility of the transgenic mouse model for the analysis of the full spectrum of hGH gene cluster activation. Further, they support a role for the hGH LCR in placental hCS, as well as pituitary hGH gene activation, and expression.