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Background and purpose The mechanism of retinal ganglion cell and retinal nerve fiber layer loss in multiple sclerosis ( MS) remains unknown. This study aimed to investigate the association between temporal retinal nerve fiber layer ( tRNFL) thinning and disease activity in the brain determined by T2 lesions on magnetic resonance imaging ( MRI). Methods Fifty-five consecutive patients with relapsing-remitting MS and 25 controls were enrolled. All patients underwent annual optical coherence tomography and high-resolution MRI scans for tRNFL thickness and brain lesion volume analysis, respectively. Results Significant tRNFL thickness reduction was observed over the 3-year follow-up period at a relatively constant rate (1.02 μm/year). Thinning of tRNFL fibers was more prominent in younger patients ( P = 0.01). The tRNFL loss was associated with new MRI lesions in the optic radiations ( ORs). There was significantly greater tRNFL thinning in patients with new lesional activity in the ORs compared with patients with new lesions outside the ORs ( P = 0.009). Conclusions This study supports the notion that retrograde transneuronal degeneration caused by OR lesions might play a role in progressive retinal nerve fiber layer loss. In addition, the results of the study also indicate that the disease-related neurodegenerative changes in the retina start much earlier than the clinical diagnosis of MS. [ABSTRACT FROM AUTHOR]

Blockage of cohesive fine particles in a packed structure of large particles may happen in many industrial processes, of particular interests to ironmaking COREX technology. In this work, blockage behaviour of cohesive fine particles in a simplified packing structure is studied by means of discrete element method. The typical phenomena about effects of sticking force on descending velocity and blockage frequency is described. Two kinds of blockage mechanisms of fine particles in a packed bed of large particles are explored: mechanical interactions between fine particles will create arches on the pore throat and stop the flow; fine particles with high interparticle stickiness will adhere to the surface near the pore throat of the orifice, thus the sectional area of the flow channel will decrease. With the increase of sticking force, the descending velocity will decrease, while the frequency of the blockage increases. In addition, the effects of size ratio of fine particle to packing particle, mass flow rate and magnitude of the upward force (e.g. from a gas stream) on blockage behaviour are also discussed. The results show that increasing the size ratio, mass flow rate and external force will increase the frequency of the blockage. The study provides a fundamental understanding on blockage behaviour of cohesive fine particles in a packed bed, and is useful for industry processes' understanding and optimization. [ABSTRACT FROM AUTHOR]

BACKGROUND Although the safety of combination chemotherapy without primary tumor resection (PTR) in patients with stage IV colon cancer has been established, questions remain regarding a potential survival benefit with PTR. The objective of this study was to compare mortality rates in patients who had colon cancer with unresectable metastases who did and did not undergo PTR. METHODS An observational cohort study was conducted among patients with unresectable metastatic colon cancer identified from the National Cancer Data Base (2003-2005). Multivariate Cox regression analyses with and without propensity score weighting (PSW) were performed to compare survival outcomes. Instrumental variable analysis, using the annual hospital-level PTR rate as the instrument, was used to account for treatment selection bias. To account for survivor treatment bias, in situations in which patients might die soon after diagnosis from different reasons, a landmark method was used. RESULTS In the total cohort, 8641 of 15,154 patients (57%) underwent PTR, and 73.8% of those procedures (4972 of 6735) were at landmark. PTR was associated with a significant reduction in mortality using Cox regression (hazard ratio [HR], 0.45; 95% confidence interval [CI], 0.44-0.47) or PSW (HR, 0.46; 95% CI, 0. 44-0.49). However, instrumental variable analysis revealed a much smaller effect (relative mortality rate, 0.91; 95% CI, 0.87-0.96). Although a smaller benefit was observed with the landmark method using Cox regression (HR, 0.6; 95% CI, 0.55-0.64) and PSW (HR, 0.59; 95% CI, 0.54-0.64), instrumental variable analysis revealed no survival benefit (relative mortality rate, 0.97; 95% CI, 0.87-1.06). CONCLUSIONS Among patients with unresectable metastatic colon cancer, after adjustment for confounder effects, PTR was not associated with improved survival compared with systemic chemotherapy; therefore, routine noncurative PTR is not recommended. Cancer 2017;123:1124-1133. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]

This study evaluated provider satisfaction in a sample of colorectal cancer ( CRC) survivors with and without Lynch syndrome ( LS). Participants were case-case-matched CRC survivors with ( n = 75) or without ( n = 75) LS (mean age of 55; range: 27-93). Participants completed a mailed questionnaire assessing demographics, clinical characteristics, healthcare utilization, psychosocial variables, and provider satisfaction. LS CRC survivors reported lower provider satisfaction scores on three subscales of the Primary Care Assessment Survey: communication (78.14 vs. 83.96; P < 0.05), interpersonal treatment (78.58 vs. 85.30; P < 0.05), and knowledge of the patient (60.34 vs. 69.86; P < 0.01). Among LS CRC survivors, predictors for mean communication and trust subscale scores were location of treatment and socioeconomic status. Higher mean depression scores also were associated with trust, while social support predicted higher satisfaction with communication. Sporadic CRC survivor satisfaction is driven largely by age (communication, interpersonal treatment) and patient anxiety (communication), while seeing a provider more often was associated with increased satisfaction with knowledge of the patient. LS CRC survivors reported lower levels of provider satisfaction than sporadic CRC survivors. LS survivors who received care at The University of Texas MD Anderson Cancer Center, a comprehensive cancer center ( CCC), reported higher satisfaction than those receiving care at other institutions. Depressive symptoms and socioeconomic status may impact provider satisfaction ratings. Exploration of other potential predictors of provider satisfaction should be examined in this population. Additionally, further research is needed to examine the potential impact of provider satisfaction on adherence to medical recommendations in LS CRC survivors, particularly those being treated outside of CCCs. [ABSTRACT FROM AUTHOR]

This paper presents a multiple-layered microwave absorber using rice husk and carbon nanotube composite. The dielectric properties of each layer composite were measured and analysed. The different layer of microwave absorber enables to control the microwave absorption performance. The microwave absorption performances are demonstrated through measurements of reflectivity over the frequency range 2-18 GHz. An improvement of microwave absorption <−20 dB is observed with respect to a high lossy composite placed at bottom layer of multiple layers. Reflectivity evaluations indicate that the composites display a great potential application as wideband electromagnetic wave absorbers. [ABSTRACT FROM AUTHOR]

Glioblastoma is the most prevalent and lethal primary intrinsic tumor in the central nervous system. Glioblastoma stem cells (GSCs) reprogram the transcriptional and metabolic machinery to mediate therapeutic resistance to radiation. Understanding the regulatory mechanism of GSCs may inform novel approaches to improve the clinical outcome for glioblastoma patients. Nuclear pore complex (NPC) is an evolutionarily conserved structure that maintains the traffic between the nucleus and cytoplasm. In current study, we aim to interrogate the aberrant regulation of NPC in GSCs and develop novel targeted approach to sensitize GSC to radiation. Patient-derived GSCs were validated using functional assays. Transcriptional analysis of GSCs and matched differentiated glioblastoma cells (DGCs) were performed using RNA sequencing to identify aberrant regulatory pathways upregulated in GSCs. The clinical impact of target genes on patient survival was assessed using the glioblastoma dataset from The Cancer Genome Atlas (TCGA). Quantitative RT-PCR and Western blotting were performed to assess the relative expression between GSCs and DGCs. Radiation sensitivity was measured using Cs-137 irradiator. Validation of the stem-like function of target genes was performed using RNA interference followed by in vitro neurosphere formation assay and in vivo tumorigenesis with xenograft mouse model. 27 of the total 31 NPC genes were found to be upregulated in the primary glioblastoma patient specimens compared to non-tumor brain tissue in the TCGA dataset. Among them, a systematic approach combining transcriptional profiling and clinical validation linked nucleoporin 98 (NUP98) to a nexus between GSC phenotype and radiation resistance. GSCs preferentially express NUP98, which is essential for GSC maintenance and tumorigenesis in vitro and in vivo. RNA sequencing demonstrated that NUP98 regulates the expression of key DNA repair genes, including BRCA1, BRCA2, and RAD51. NUP98 forms a complex with the transcription factor P65, and directly stimulates the active transcription of genes involved in homologous recombination. Attenuation of NUP98 or P65 expression leads to the accumulation of unrepaired intrinsic DNA damage and sensitizes GSC to the treatment of ionizing radiation. Clinically, overexpression of NUP98 informs poor clinical outcome among patients with glioblastoma. Combining transcriptional discovery and clinical validation, we discovered that NUP98, an essential NPC component, maintains GSC proliferation and tumorigenesis through modulating the transcriptional control of homologous recombination pathway. Our results demonstrated a novel therapeutic approach of sensitizing GSC to radiation through targeting the nexus between aberrant transcriptional regulation and therapeutic resistance in stem-like glioma cells. [ABSTRACT FROM AUTHOR]

Presents a study which examined the field dependence of magnetic transitions in magnetic superconductors. Discussion on the anisotropy of the magnetic transitions; Requirement for field-induced weak ferromagnetic transitions; Details of the experimental techniques used.

Presents a study which examined the systematic variation of anomalous praseodymium (Pr) antiferromagnetic ordering temperature for two-CuO[sub2]-layer cuprate systems. Details of the experimental techniques used; Discussion on the systematic of anomalous Pr ordering.

In this study, we prepared a kind of composite solid polymer electrolyte (CSPE) based on montmorillonite (MMT) nano-clay fillers, lithium-bis(trifluoromethanelsulfonyl) (LiTFSI), polyvinylidenedifluoride (PVDF) and polyvinyl alcohol (PVA) copolymer by the casting method. Effect of the montmorillonite on ionic conductivity and electrochemical properties of the polymer electrolyte was demonstrated. The result CSPE obtained a higher ionic conductivity up to 4.31 × 10 −4 S cm −1 at room temperature when 4.0 wt% MMT was contained, and the maximum lithium ions transference number of 0.40 was achieved. Electrochemical performance of the polymer solid electrolyte was evaluated in Li/polymer electrolyte/LiFePO 4 coin cell. Good performance with low capacity fading on charge–discharge cycling was achieved, indicating the potential application of the as-prepared CSPE in lithium ion batteries. [ABSTRACT FROM AUTHOR]

Based on the analysis of precision moulding mechanism for cylindrical gears with arcuate tooth trace (arc gear), the equation for tooth flank of arc gear was derived preliminarily and the ideal concave and convex tooth flanks were got by MATLAB simulation to achieve graphics rendering. On this basis, with UG NX8.0, the accurate three-dimensional modelling of arc gear was established to be used for the finite element analysis. Then, for the problem that there is no standardised bending strength calculation formula of arc gear, with the aid of finite element method (FEM) this paper studied the relationship between tooth line radius and bending strength. With FEM analysis performed, it was confirmed that under the same conditions, the bending strength of arc gear could be significantly improved compared with that of spur gear and helical gear, and that variation curve of tooth root stress was obtained under the different tooth line radius. Therefore, the analysis method provides engineering applications value under the high-speed and heavy-load working conditions and theoretical basis for the strength theory and design of arc gear. [ABSTRACT FROM AUTHOR]

Upregulation of the embryonic M2 isoform of pyruvate kinase (PKM2) emerges as a critical player in the cancer development and metabolism, yet the underlying mechanism of PKM2 overexpression remains to be elucidated. Here we demonstrate that IGF-1/IGF-IR regulates PKM2 expression by enhancing HIF-1α-p65 complex binding to PKM2 promoter. PKM2 expression is regulated by miR-148a/152 suppression. PKM2 directly interacts with NF-κB p65 subunit to promote EGR1 expression for regulating miR-148a/152 feedback circuit in normal cells, but not in cancer cells because of the DNA hypermethylation of miR-148a and miR-152 gene promoters. The silencing of miR-148a/152 contributes to the overexpression of PKM2, NF-κB or/and IGF-IR in some cancer cells. We show that disruption of PKM2/NF-κB/miR-148a/152 feedback loop can regulate cancer cell growth and angiogenesis, and is also associated with triple-negative breast cancer (TNBC) phenotype, which may have clinical implication for providing novel biomarker(s) of TNBC and potential therapeutic target(s) in the future. [ABSTRACT FROM AUTHOR]

Objective: Studies in animal models have indicated that Pellino 1 is involved in inflammatory and autoimmune diseases, such as systemic lupus erythematosus (SLE). The current study was designed to determine whether PELI1 confers genetic susceptibility to SLE in humans, as assessed in a Chinese Han population. Methods: Blood samples were drawn from patients diagnosed with SLE and healthy volunteers. Three single nucleotide polymorphism (SNP) loci with a minor allele frequency of at least 0.05 were chosen to evaluate the correlation between PELI1 genotype and the incidence of SLE. Results: There was a significant difference in the frequency distribution of the rs329497 allele between the SLE patients and the healthy controls (A vs. G; Bonferroni corrected p = 0.036, odds ratio = 0.75, 95% confidence interval = 0.60–0.94). No differences in the genotype and allele frequencies of other SNP loci were observed between the two groups. Furthermore, the alleles and genotypes of the three SNPs were not associated with lupus nephritis. Conclusion: In the Chinese Han population, PELI1 SNPs may be associated with SLE susceptibility. [ABSTRACT FROM AUTHOR]

Kabuki or Niikawa-Kuroki syndrome ( KS) is a rare disorder with multiple malformations and recurrent infections, especially otitis media. This study aimed to investigate the genetic defects in Kabuki syndrome and determine if immune status is related to recurrent otitis media. Fourteen patients from 12 unrelated families were enrolled in the 9-year study period (2005-2013). All had Kabuki faces, cleft palate, developmental delay, mental retardation, and the short fifth finger. Recurrent otitis media (12/14) and hearing impairment (8/14) were also more common features. Immunologic analysis revealed lower memory CD19+ cells (11/13), lower memory CD4+ cells (8/13), undetectable anti- HBs antibodies (7/13), and antibody deficiency (7/13), including lower IgA (4), IgG (2), and IgG2 (1). Naïve emigrant lymphocytes, lymphocyte proliferation function, complement activity, and superoxide production in polymorphonuclear cells were all normal. All the patients had KMT2D mutations and 10 novel mutations of R1252X, R1757X,Y1998C, P2550R fs2604X, Q4013X, G5379X, E5425K, R5432X, R5432W, and R5500W. Resembling the phenotype of common variable immunodeficiency, KS patients with antibody deficiency, decreased memory cells, and poor vaccine response increased susceptibility to recurrent otitis media. Large-scale prospective studies are warranted to determine if regular immunoglobulin supplementation decreases the frequency of otitis media and severity of hearing impairment. [ABSTRACT FROM AUTHOR]

Both pelvic organ prolapse (POP) and osteoporosis are age-related diseases in older aged women. Both POP and bone metabolism may be associated with collagen metabolism. Our study determined the relationship between POP and bone mineral density (BMD) of the lumbar spine and femur neck in postmenopausal women. We selected 554 postmenopausal women (aged 50-79 years) and divided them into two groups (moderate to severe POP and absent to mild POP). We compared the BMDs of the lumbar spine and femur neck between the moderate to severe POP and absent to mild POP groups. Lumbar spine BMD was inversely correlated with POP severity (p = 0.001). However, after adjusting for age, time since menopause, height, weight, body mass index (BMI), and vaginal delivery, the BMDs of both the lumbar spine and femur neck were not significantly different between the moderate to severe POP and absent to mild POP groups (p = 0.583 and p = 0.305, respectively). A lower BMD is associated with increased fracture risk and we postulated that women with severe POP would have an increased risk of osteoporotic fracture. [ABSTRACT FROM AUTHOR]

Polycyclic aromatic hydrocarbons ( PAHs) are among the most toxic air pollutants in China. However, because there are unsubstantial data on indoor and outdoor particulate PAHs, efforts in assessing inhalation exposure and cancer risk to PAHs are limited in China. This study measured 12 individual PAHs in indoor and outdoor environments at 36 homes during the non-heating period and heating period in 2009. Indoor PAH concentrations were comparable with outdoor environments in the non-heating period, but were lower in the heating period. The average indoor/outdoor ratios in both sampling periods were lower than 1, while the ratios in the non-heating period were higher than those in the heating period. Correlation analysis and coefficient of divergence also verified the difference between indoor and outdoor PAHs, which could be caused by high ventilation in the non-heating period. To support this conclusion, linear and robust regressions were used to estimate the infiltration factor to compare outdoor PAHs to indoor PAHs. The calculated infiltration factors obtained by the two models were similar in the non-heating period but varied greatly in the heating period, which may have been caused by the influence of ventilation. Potential sources were distinguished using a diagnostic ratio and a mixture of coal combustion and traffic emission, which are major sources of PAHs. [ABSTRACT FROM AUTHOR]

Conventional semen analysis offers basic information on infertility; however, its clinical value in predicting fertility status is unclear. To establish an accurate diagnosis of male fertility, semen analysis under capacitation condition is necessary because only capacitated spermatozoa are capable of fertilizing oocytes. The objective of this study was to verify male fertility based on conventional semen analysis before and after capacitation, including the assessment of motility (%), motion kinematics, and capacitation status of spermatozoa. A computer-assisted sperm analysis system and chlortetracycline staining were applied to evaluate the motility parameters and capacitation status, respectively. To enable efficacy of the two methods for predicting fertility, correlation analysis was performed with the historic litter size. Our results showed that sperm motility (%), motion kinematics, and their variations before and after capacitation represented a statistical non-significant correlation with litter size. Litter size showed significant correlation with acrosome reaction ( AR) after capacitation ( r = 0.375), as well as differences (Δ) in AR ( r = 0.333) and capacitated (B) pattern ( r = −0.447) before and after capacitation. The overall accuracy of the assay for predicting litter sizes using the AR and differences (Δ) in the AR and B pattern was 70%. On the basis of these results, we propose that capacitation status of spermatozoa is a more reliable indicator for evaluating male fertility status compared to motility parameters. Therefore, we suggest that analysis of capacitation status in company with conventional semen analysis may accept to evaluate more accurate diagnosis or prognosis of male fertility. [ABSTRACT FROM AUTHOR]

Background Evaluation of the dosing flexibility and long-term efficacy of biological agents is limited. Objectives To evaluate the long-term efficacy and safety of ustekinumab with and without dosing adjustment in the 5-year PHOENIX 2 study. Methods Patients were randomized to placebo or ustekinumab (45 or 90 mg) at weeks 0, 4, then every 12 weeks; patients receiving placebo crossed-over at week 12. Dosing adjustments were permitted at/beyond week 28 for early adjusters (weeks 28 or 40 per response); late adjusters (during long-term extension per investigator judgement); and nonadjusters (maintained randomized treatment throughout the study). Efficacy and safety were evaluated through weeks 244 and 264, respectively. Results In the overall population, 70% (849 of 1212) of ustekinumab-treated patients completed treatment through week 244, with high proportions of patients responding to the 45-mg and 90-mg doses, respectively: 75% improvement in Psoriasis Area and Severity Index ( PASI 75) (76·5% and 78·6%) and PASI 90 (50·0% and 55·5%). Approximately 20% of patients were early adjusters, 30% were late adjusters and 50% were nonadjusters. Approximately half of the late adjusters initiated adjustments after already achieving PASI 75. Improved response was generally observed following dosing adjustments. Through week 264, safety event rates did not increase and event rates were generally comparable between dose groups and between patients with and without dosing adjustment. Conclusions Treatment with ustekinumab for up to 5 years was safe and effective. Improved response was generally demonstrated following dosing adjustments; further investigations are required to quantify actual incremental benefits. The results also suggest that some patients may desire treatment goals beyond PASI 75. [ABSTRACT FROM AUTHOR]

Background: With advances in multimodality therapy, colorectal cancer survivors are living longer. However, little is known about the quality of their long-term survival. We investigated the functional outcomes and symptoms among long-term survivors. Methods: A cross-sectional study of 1,215 long-term (>5 years) colorectal cancer survivors was conducted using a validated disease-specific questionnaire. Younger onset survivors (18-50 years) were matched 1:2 to later onset survivors (>50 years). Standardized mean scores were compared using one-way ANOVA. Key patient and treatment factors that impact function and symptoms were assessed by multivariate linear regression. Results: Eight hundred thirty survivors responded at an interval of 10.8 ± 3 years from diagnosis (68 % response rate). Younger onset survivors underwent more surgery (97.9 vs. 93.6 %, P < 0.001) and received more chemotherapy (86.1 vs. 77.7 %, P = 0.004). Anxiety, body image, sexual dysfunction, embarrassment by bowel movements, micturition problems, and impotence were significant concerns. Younger onset survivors reported worse anxiety, body image, and embarrassment with bowel movements, whereas later onset survivors highlighted sexual dysfunction, micturition problems, and impotence. Age at diagnosis was a key independent determinant of long-term function and symptoms. Conclusion: Long-term survivors of CRC face ongoing functional deficits and symptoms, and their survivorship experience differs by age. Age at diagnosis should serve as a basis for tailored, personalized survivorship care plans. [ABSTRACT FROM AUTHOR]

Sodium nitroprusside is a nitric oxide donor involved in the regulation of the motility, hyperactivation, capacitation, and acrosome reaction ( AR) of spermatozoa. However, the molecular mechanism underlying this regulation has not yet been elucidated. Therefore, this study was designed to evaluate the molecular basis for the effects of sodium nitroprusside on different processes in spermatozoa and its consequences on subsequent oocyte fertilization and embryo development. In this in vitro study, mouse spermatozoa were incubated with various concentrations of sodium nitroprusside (1, 10, and 100 μ m) for 90 min. Our results showed that sodium nitroprusside inhibited sperm motility and motion kinematics in a dose-dependent manner by significantly enhancing intracellular iron and reactive oxygen species ( ROS), and decreasing Ca2+, and adenosine triphosphate levels in spermatozoa. Moreover, short-term exposure of spermatozoa to sodium nitroprusside increased the tyrosine phosphorylation of sperm proteins involved in PKA-dependent regulation of intracellular calcium levels, which induced a robust AR. Finally, sodium nitroprusside significantly decreased the rates of fertilization and blastocyst formation during embryo development. Based on these results, we propose that sodium nitroprusside increases ROS production and precocious AR may alter overall sperm physiology, leading to poor fertilization and compromised embryonic development. [ABSTRACT FROM AUTHOR]

In this study, plasma nitrocarburizing at various temperatures in the range of 460–540 °C were carried out on M50NiL steel in order to improve wear properties. The nitrocarburizing temperature was optimized to obtain the best wear properties. The phase composition, microstucture and microhardness profiles of nitrocarburized layers of M50NiL steel were characterized by XRD, optical microscope and Vickers microhardness measurements, respectively. Pin-on-disc tribometer and SEM equipped with EDS were applied to measure friction and wear properties and analyze wear mechanisms involved. XRD results show that the amount of ɛ-Fe 2-3 (N,C) phase increased as the nitrocarburizing temperature rose form 460 °C to 500 °C and then decreased at 540 °C, while the amount of γ′-Fe 4 (N,C) phase increased as the treatment temperature rose. The hardness of the nitrocarburized layers showed an obvious improvement accompanied with the increasing nitrocarburizing temperature, and obtained the maximum surface hardness of 1287 HV at 540 °C. The results of wear tests carried out at various sliding speeds indicated that the wear mechanism depends on sliding speed rather than the nitrocarburizing temperature. With the increase of the sliding speed, the wear mechanism transfers from oxidation mode to abrasive mode. The gradually deceased wear rate of the specimen nitrocarburized at 500 °C with the increase of the sliding speed indicated the excellent wear resistance under high sliding speed condition. Therefore, 500 °C can be selected as an optimized nitrocarburizing temperature for M50NiL steel. [ABSTRACT FROM AUTHOR]

Highlights: [•] PN+LQ treatment results in thicker layer depth than single PN or LQ treatment. [•] The increase of layer depth is caused by the eutectoid point reduction due to introduction of N. [•] LQ treatment cause the brittle phase decomposed and the hardness redistributed of PN specimen. [•] PN+LQ specimen shows better wear resistance than the PN counterpart. [Copyright &y& Elsevier]

Abstract: Background: Routine microbiologic surveillance is a method of infection control, but its clinical significance in transplant recipients is not known. We analyzed microbiologic data to evaluate the influence of cultured microorganisms between the point of surveillance and infectious episodes in liver transplant recipients. Methods: We performed surveillance culture for sputum and peritoneal fluid in liver transplant recipients from January 2009 to December 2011, at the time of transplantation (T1), 5 days (T2), and 10 days (T3) postoperatively. Results: Of the 179 recipients, 32.9% had a positive sputum culture result and 37.4% had a positive peritoneal culture result during surveillance. In the culture surveillance of sputum, 37 organisms were isolated from 35 recipients at T1, and the most common organism was Staphylococcus aureus (n = 13). At T2, 45 organisms were isolated from 39 recipients, including Klebsiella pneumoniae (n = 10), S aureus (n = 8), and Acinetobacter baumannii (n = 6). At T3, 18 organisms were isolated from 15 patients, including Stenotrophomonas maltophilia (n = 5) and K pneumonia (n = 4). In the peritoneal fluid, 11 organisms were isolated from 10 recipients at T1, including Pseudomonas aeruginosa (n = 2) and Enterococcus species (n = 2). At T2, 39 organisms were isolated from 36 recipients, including coagulase-negative Staphylococcus species (CNS; n = 8) and Enterococcus species (n = 7). At T3, 54 organisms were isolated from 51 recipients, including CNS (n = 17) and Candida species (n = 8). Among the 59 patients with positive culture results for sputum surveillance, 16.9% developed pneumonia caused by the same organisms. Among the 67 patients with positive peritoneal fluid culture, 16.4% developed an intra-abdominal infection caused by the same organisms cultured. The recipients with positive surveillance culture had a higher risk of pneumonia (20.3% [12/59] vs 1.6% [2/120]; P < .001) and intra-abdominal infection (31.3% [21/67] vs 18.7% [21/112]; P = .05). Conclusions: Periodic microbiologic surveillance may be useful in the prediction of post-transplantation pneumonia and intra-abdominal infection and could offer a potential target for empirical antimicrobial therapy in cases of infection. [Copyright &y& Elsevier]

Purpose: The goal of this phase 1 trial was to determine the maximum tolerated dose (MTD) of concurrent capecitabine, bevacizumab, and erlotinib with preoperative radiation therapy for rectal cancer. Methods and Materials: Patients with clinical stage II to III rectal adenocarcinoma, within 12 cm from the anal verge, were treated in 4 escalating dose levels, using the continual reassessment method. Patients received preoperative radiation therapy with concurrent bevacizumab (5 mg/kg intravenously every 2 weeks), erlotinib, and capecitabine. Capecitabine dose was increased from 650 mg/m2 to 825 mg/m2 orally twice daily on the days of radiation therapy; erlotinib dose was increased from 50 mg orally daily in weeks 1 to 3, to 50 mg daily in weeks 1 to 6, to 100 mg daily in weeks 1 to 6. Patients underwent surgery at least 9 weeks after the last dose of bevacizumab. Results: A total of 19 patients were enrolled, and 18 patients were considered evaluable. No patient had grade 4 acute toxicity, and 1 patient had grade 3 acute toxicity (hypertension). The MTD was not reached. All 18 evaluable patients underwent surgery, with low anterior resection in 7 (39%), proctectomy with coloanal anastomosis in 4 patients (22%), posterior pelvic exenteration in 1 (6%), and abdominoperineal resection in 6 (33%). Of the 18 patients, 8 (44%) had pathologic complete response, and 1 had complete response of the primary tumor with positive nodes. Three patients (17%) had grade 3 postoperative complications (ileus, small bowel obstruction, and infection). With a median follow-up of 34 months, 1 patient developed distant metastasis, and no patient had local recurrence or died. The 3-year disease-free survival was 94%. Conclusions: The combination of preoperative radiation therapy with concurrent capecitabine, bevacizumab, and erlotinib was well tolerated. The pathologic complete response rate appears promising and may warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: The role of emergent palliative surgery in the setting of advanced malignancy remains a subject of controversy. Objective: The purpose of this study was to identify clinical predictors of outcome in patients with cancer who undergo nonelective abdominal surgery. Setting/Subjects: Individuals who underwent urgent and emergent abdominal operations between 2006 and 2010 at a tertiary cancer center were identified. Measurements: Analyses were performed to identify predictors of 30-day morbidity and mortality as well as overall survival (OS). A risk score was derived from predictors of OS. Results: Of 143 patients, 93 (65%) had active disease (AD; defined as evidence of malignancy at time of surgery). Thirty-day morbidity and mortality were 36.4% and 9.8%, respectively. Independent predictors of 30-day mortality included ASA score >3 ( p=0.009) and albumin <2.8 ( p=0.040). Median OS was 5.4 months in patients with AD and was not reached in patients without AD ( p<0.001). Independent predictors of decreased OS included AD; ASA >3; creatinine >1.3; and a tumor-related indication (i.e., bleeding, obstructing, or perforating tumor). A risk or palliative index (PI) score stratified patients into groups with discreet outcomes. Conclusions: Although AD did not predict 30-day morbidity, it was the dominant independent predictor of postoperative OS. In cancer patients undergoing emergency abdominal surgery, outcome is anticipated by disease status and other independent predictors of OS. [ABSTRACT FROM AUTHOR]

Highlights: [•] BIG1 is colocalized with synaptic marker synaptophysin in soma and partly in neurites. [•] BIG1 content increased with embryonic rat brain growth. [•] BIG1 siRNA inhibited neurite development in primary cultured cortical neuron. [•] Depletion or inhibition of BIG1 decreased the phosphorylation of PI3K–AKT and ERK. [•] We report a novel function of BIG1 in regulating neurite outgrowth. [Copyright &y& Elsevier]

BACKGROUND The current study was conducted to determine whether quantified pathologic response assessed as a percentage of residual tumor cells is predictive of recurrence-free survival (RFS) in patients with rectal cancer. METHODS The authors studied 251 patients with rectal adenocarcinoma who were treated with neoadjuvant chemoradiation and radical resection. Quantified pathologic response was defined as an estimated percentage of residual cancer cells in relation to the tumor bed: complete, no residual cancer cells; near-complete, ≤ 5% residual cancer cells; major, > 5%, and < 50% residual cancer cells; and minor, ≥ 50% residual cancer cells. The reproducibility of quantified pathologic response between 2 pathologists was assessed using tumors from 55 randomly selected patients who did not demonstrate a complete response. RESULTS Pathologic response was complete in 21% of patients, near-complete in 20% of patients, major in 37% of patients, and minor in 22% of patients. Nineteen percent of patients had ypT0N0 disease, 27% had ypT1-2N0 disease, 21% had ypT3-4N0 disease, and 33% had N+ disease. The 5-year RFS rates by category of quantified pathologic response were as follows: complete, 95%; near-complete, 88%; major, 69%; and minor, 61% ( P < .001). Major and minor response, high histologic grade, and perineural invasion were found to be significant predictors of decreased RFS on multivariate analysis. The 5-year RFS rates for patients with ypT3-4 or N+ disease were better for those with a near-complete response (94%) compared with those with a major (64%) or minor (61%) response ( P < .02). Moderate to substantial agreement was observed between the 2 pathologists (κ = 0.72). CONCLUSIONS Quantified pathologic response is a predictor of RFS in patients with rectal adenocarcinoma and stratifies patients with high pathologic stage disease. Cancer 2013;119:4231-4241. © 2013 American Cancer Society. [ABSTRACT FROM AUTHOR]

Abstract: Background: Educating medical students in surgical subspecialty fields can be challenging, and the optimal timing and curriculum remain unknown. Despite advocacy for earlier exposure, competing core clerkship rotations often leave little time for subspecialty fields. We report our experience with a novel, short, and focused curriculum in surgical oncology for the third-year medical students. Methods: A 2-wk (2009–2010) and a 4-wk (2010–2011) curriculum in surgical oncology were developed for the third-year students at a tertiary-referral cancer center, including formal didactics, rotation in clinical service of students' choosing (breast, gastrointestinal, endocrine, or melanoma), and case-based learning and presentation. Paired pre- and postrotation questionnaires were prospectively completed, including 20 items assessing knowledge and four items assessing experience. Grading was anonymous, and change in score was assessed by Wilcoxon signed-rank test. Results: Paired questionnaires from 47 students (2-wk rotation, n = 26; 4-wk rotation, n = 21) showed a median improvement of three points (21.4%) from pre- to posttests (P < 0.001). The improvement did not differ by the length of rotation or by the specific clinical service. Nearly all (93%) reported a positive and inspiring experience. The most valuable avenue of learning was reported as the time spent with resident or fellow or attending (92%), followed by self-directed reading (62%) and didactic lectures (28%). Conclusions: A short and focused curriculum in surgical oncology, including structured didactics and clinical rotation, had positive impact for the third-year students. Given the increasing work-hour limits, it is important to note that the time spent in the clinical setting continues to be ranked as the most educationally valuable by medical students. [Copyright &y& Elsevier]

BACKGROUND: The objective of the current study was to examine the impact of adherence to guidelines on stage-specific survival outcomes in patients with stage III and high-risk stage II colon cancer. The National Comprehensive Cancer Network (NCCN) has established working, expert consensus, and evidence-based guidelines for organ-specific cancer care, including care of patients with colon cancer. METHODS: Patients who were diagnosed with colon adenocarcinoma between 1998 and 2002 were selected from within the National Cancer Data Base. The cohort was limited to patients who received their first course of treatment at the reporting facility. Pathologic variables, including tumor depth, lymph node status, and evidence of metastatic disease, were used to restage patients, and the patients were divided into low-risk and high-risk categories on the basis of criteria defined by the NCCN. Relative survival rates were calculated for the entire cohort, stratified according to adherence versus nonadherence to NCCN treatment guidelines. RESULTS: In univariate analysis of treatment adherence patterns for both patient subgroups (high-risk stage II and stage III), several factors were associated with a higher rate of nonadherence in both groups, including older age ( P < .001); Medicaid, Medicare, or uninsured status versus private insurance ( P < .001); and subsequent treatment at a facility other than the facility at which the cancer was first diagnosed ( P < .001). In multivariate analysis, multiple factors were associated with differences in relative survival, although analyses that included the year of diagnosis did not demonstrate significant differences over time. CONCLUSIONS: The current study documented practice patterns in a heterogeneous population of patients with colon cancer and demonstrated a survival benefit for patients with stage III and high-risk stage II colon cancer who received treatment that adhered to NCCN guidelines. These data validate the current NCCN practice guidelines for colon cancer and support the concept of guideline-based metrics that can be compared across institutions to assess the quality of cancer care and to compare the quality of cancer care among institutions. Cancer 2013. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

Low-temperature heat capacity C( T) of the weakly electron-correlated SrNiGe 122-layer compound undergoes a superconducting transition with onset at 1.4 K and a bulk T=0.75 K, where heat-capacity jump ratio ΔC( T)/ γT=0.88-1.05. A small average superconducting energy gap E(ave)=2.21 kT=0.14 meV is derived for this multi-gap superconductor. Similar results for isostructural SrPdGe include T(onset)=3.5 K, bulk T of 2.92 K, ΔC( T)/ γT=0.70 and E(ave)=2.54 kT=0.64 meV. The higher T onset could be associated with stoichiometric 1:2:2 grains in the polycrystalline samples. In addition, deviations of E/ kT from the BCS ratio of 3.5 suggest that, just like their iron-based counterpart, these 122-layer germanides may also exhibit an unconventional, fully-opened multi-gap s-wave superconductivity. [ABSTRACT FROM AUTHOR]

Abstract: In the past several decades, tremendous progress has been achieved through developmental studies of the central nervous system structures such as the cerebral cortex. The septum, which receives reciprocal connections from a variety of brain structures, contains diverse projection neurons but few interneurons. However, the mechanisms underlying its development remain poorly understood. Here we show that the septum is organized into an onion skin-like structure composed of five groups of neurons. These neurons are parvalbumin, choline acetyltransferase, neuronal nitric oxide synthase, calretinin and calbindin immunoreactive. Using the BrdU birth-dating method, we found that these five groups of neurons in the septum are grossly generated following an outside-in pattern. Interestingly, the distinct molecular identities of these neuronal subtypes correspond to their heterogeneous subpallial origins. Using three specific transgenic mouse lines and focal in utero electroporation of Cre-reporter plasmid, we showed that septal neurons originate from not only local progenitor regions but also neighboring progenitor regions including the medial ganglionic eminence and preoptic area. Thus, the neuronal diversity of the septum is achieved through both temporal and spatial control. Our results also suggest that multiple neuronal subtypes arrive to the septum through both radial and tangential migration. Based on these findings, we proposed a novel developmental model involving multiple spatial–temporal origins of septal neurons. This study presents new perspectives for comprehensively exploring septal functions in brain circuits. [Copyright &y& Elsevier]

Background: Traditionally, for patients with colorectal cancer with resectable synchronous liver metastases, resections were performed separately. However, the safety and efficacy of simultaneous resection have been demonstrated in selected patients. The purpose of this study was to evaluate outcomes and economic implications of simultaneous and staged resections. Study Design: We conducted a retrospective cohort study of consecutive colorectal cancer patients with resectable synchronous liver metastases treated between 1993 and 2010, constructing a decision tree comparing simultaneous and staged resections. For generalizability, the analysis was conducted from a payer perspective, using costs derived from 2010 Medicare reimbursement. Decision models incorporated the severity-refined DRG complications (complicating condition/major complicating condition) modifiers. Sensitivity analyses used alternative models of DRG reimbursement. Results: There were 144 patients analyzed. Sixty (41.7%) underwent simultaneous resection and 84 (58.3%) underwent staged resection. Median overall survival did not differ between the simultaneous and the staged cohorts (66.3 vs 65.6 months, respectively), nor did the overall complication rate (38.3% vs 40.5%, respectively). Median total length of hospitalization was significantly shorter in the simultaneous cohort (8 vs 14 days; p = 0.001). In the base model, the simultaneous strategy cost less than the staged strategy ($20,983 vs $25,298 per case)—a savings of 17.1%. Sensitivity analyses examining alternative severity-refined DRG reimbursements demonstrated potential cost savings, in all but 1 extreme sensitivity analysis, ranging from 9.8% to 27.3% favoring simultaneous resection. Conclusions: The simultaneous resection strategy was oncologically equivalent and more cost efficient for patients with primary colorectal cancer presenting with resectable liver metastases. A reduction in overall length of hospital stay was an associated benefit. Future studies should explore the feasibility and clinical implications of policies to maximize the potential for simultaneous resection in this cohort of patients. [Copyright &y& Elsevier]

Summary Interleukin-10 (IL-10) is a cytokine with anti-inflammatory and B-cell-stimulating activity. IL-10 is expressed in human atherosclerotic plaques and studies have shown the involvement of IL-10 in the atherosclerotic process. The IL-10−1082G/A polymorphism is one of the most commonly studied polymorphisms in this gene because of its association with coronary heart disease (CHD) risks, but previous results have been conflicting. We performed a meta-analysis using six eligible case-control studies (including 14 data sets) with a total of 5006 patients and 3968 controls to summarize the existing data on the association between the IL-10−1082G/A polymorphism and CHD risk. Compared with the common IL-10−1082G/A GG genotype, the carriers of variant genotypes ( IL-10−1082GA/AA) had a 1.12-fold elevated risk of CHD (95% CI = 1.01-1.23, P = 0.03) under the dominant genetic model, as estimated using a random effect model. The effect of the IL-10−1082G/A polymorphism was further evaluated using stratification analysis. In the three disease of artery studies, with the variant genotypes had a not obvious increased risk of disease of artery (OR = 1.19, 95% CI = 0.98-1.44, P = 0.08) as estimated using a fixed effect model. Similar results were found in the nine myocardial infarction studies (OR = 1.13, 95% CI = 1.00-1.27, P = 0.05). It was also demonstrated that the increased risk of CHD associated with IL-10−1082G/A variant genotypes was more pronounced in Caucasians (OR = 1.12, 95% CI = 1.01-1.23, P = 0.03). Our meta-analysis suggests that the IL-10−1082G/A polymorphism genotypes (GA+AA) might be associated with an increased risk of CHD, especially in Caucasians. [ABSTRACT FROM AUTHOR]

We conducted a retrospective study to evaluate the outcome of 94 consecutive patients with high-risk hematological malignancies who received allo-PBSCT, following idarubicin (IDA)-intensified BUCY2 (IDA-BUCY2) myeloablative conditioning regimens (n=53) and BUCY2 conditioning regimens (n=41). IDA 15 mg/m2 once daily was administered by continuous infusion on days −11 to −9, followed by BU, 3.2 mg/kg in divided doses daily, on days −6 to −4, and i.v. injection of CY, 1.8 g/m2 once daily on days −3 to −2 in the IDA-BUCY2 group. The relapse rate in patients in the IDA-BUCY2 and BUCY2-conditioning regimens group was 18.9 and 39%, respectively (P=0.030). There was no significant difference in terms of TRM. The cumulative probabilities of OS and disease-free survival at 2 years for patients conditioned with the IDA-BUCY2 and BUCY2 regimens were 65.3% vs 46.8% (P=0.038), and 63.5% vs 43.4% (P=0.025), respectively. Multivariate analysis showed that IDA-BUCY2 regimens and limited chronic GVHD were the only two factors resulting in improved survival and reduced relapse rate. This retrospective study suggests that IDA-intensified BUCY2 may be substituted for BUCY2 as conditioning regimen for patients with high-risk hematological malignancies. [ABSTRACT FROM AUTHOR]

The effects of the turmeric ethyl acetate fraction (TEF) from the methanolic extract from Curcuma longa L. on lipid metabolism and underlying mechanisms of lipolysis were investigated in 3T3-L1 adipocytes. The intracellular lipid droplets were stained with Oil red O dye and quantified. Compared to the control, lipid accumulation was significantly decreased by 46.6% with treatment by TEF at the concentration of 20 microg/mL. The intracellular triglyceride (TG) level was also reduced by 37.9% at the concentration of 20 µg/mL. To determine the mechanism for TG content reduction, levels of glucose uptake and glycerol release were measured. Incubation of the 3T3-L1 adipocytes with TEF for 4 hours significantly lowered the cellular level of glucose in a dose-dependent manner. Furthermore, cellular expression of insulin-responsive glucose transporter (GLUT)-4 was decreased by 46%, indicating that reduced glucose uptake was due to a decrease in cellular GLUT-4 expression. In addition, the level of free glycerol released into the cultured medium was increased by 36.4% with the treatment by TEF. In subsequent measurements using quantitative real-time polymerase chain reaction, mRNA levels of hormone-sensitive lipase (HSL) and adipose TG lipase (ATGL) were elevated by 34.8% and 16.9%, respectively, at the concentration of 20 µg/mL. These results suggest that TEF partially inhibits lipogenesis by the suppression of glucose uptake via the decreased expression of cellular GLUT-4 and stimulates lipolysis through the induction of HSL and/or ATGL gene expression, resulting in the increased glycerol release. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Four new cases of stiff skin syndrome with unusual presentations," in the previous issue.

The fruits of Cornus officinalis have been used in traditional oriental medicine for treatment of inner ear diseases, such as tinnitus and hearing loss. In the present study, we investigated the protective effect of C. officinalis on hydrogen peroxide-induced cytotoxicity in HEI-OC1 auditory cells. The results from bioassay-guided fractionation of methanol extract of C. officinalis fruits showed that ursolic acid is a major active component. Ursolic acid (0.05-2 mug/ml) had protective effect against the HEI-OC1 cell damage and reduced lipid peroxidation in a dose-dependent manner. In addition, pre-treatment with ursolic acid significantly attenuated the decrease of activities of catalase (CAT) and glutathione peroxidase (GPX), but superoxide dismutase (SOD) activity was not significantly affected by ursolic acid. These results indicate that ursolic acid protects hydrogen peroxide-induced HEI-OC1 cell damage through inhibition of lipid peroxidation and induction of antioxidant enzymes, CAT and GPX, and may be one of the active components responsible for these effects of C. officinalis fruits. [ABSTRACT FROM AUTHOR]

A novel blue–green emitting phosphor Ba2ZnSi2O7: Eu2+ was prepared by a combustion synthesis (CS) method. An efficient green emission under conditions ranging from ultraviolet to visible light was observed. The emission spectrum shows a single intensive band centered at 503 nm, which corresponds to the 4 f65 d1→4 f7 transition of Eu2+. The excitation spectrum is a broad band extending from 260 to 465 nm, which matches the emission of ultraviolet light-emitting diodes (UV-LEDs). The critical quenching concentration of Eu2+ in Ba2ZnSi2O7:Eu2+ phosphor is about 0.05 mol. The corresponding concentration quenching mechanism is verified to be a dipole–dipole interaction. The value of the critical transfer distance is calculated as 19 Å, which is in good agreement with the value (20 Å) derived from the experimental data. [ABSTRACT FROM AUTHOR]

Aim: To differentiate glioblastoma (GBM) from solitary brain metastases (MET) using radiomic analysis.Materials and Methods: Two hundred and fifty-three patients with solitary brain tumours (157 GBM and 98 solitary brain MET) were split into a training cohort (n=178) and a validation cohort (n=77) by stratified sampling using computer-generated random numbers at a ratio of 7:3. After feature extraction, minimum redundancy maximum relevance (mRMR) and the least absolute shrinkage and selection operator (LASSO) were used to build the radiomics signature on the training cohort and validation cohort. Performance was assessed by radiomics score (Rad-score), receiver operating characteristic (ROC) curve, calibration, and clinical usefulness.Results: Eleven radiomic features were selected as significant features in the training cohort. The Rad-score was significantly associated with the differentiation between GBM and solitary brain MET (p<0.001) both in the training and validation cohorts. The radiomics signature yielded area under the curve (AUC) values of 0.82 and 0.81 in the training and validation cohorts to distinguish between GBM and solitary brain MET.Conclusions: The radiomics model might be a useful supporting tool for the preoperative differentiation of GBM from solitary brain MET, which could aid pretreatment decision-making. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents the results of an experimental study on the interfacial bond strength of glass fiber reinforced polymer (GFRP) bars in high-strength concrete cube. The experimental program consisted of testing 54 concrete cube specimens prepared according to CSA S802-02 standard. Two main parameters were considered in the experimental investigation: the compressive strength of concrete (from 25.6MPa to 92.4MPa) and the type of rebar (steel, sand-coated GFRP, and helically wrapped GFRP). The test results showed that the interfacial bond strength of the GFRP bars increased as the compressive strength of concrete increased. However, the increasing rate of the bond strength of the GFRP bars with respect to the concrete strength was much smaller than that of the steel bars. The concrete specimens were sawn in half after the test for a closer investigation of the actual mode of bond failure. Visual examination of the specimens showed that bond failure of the steel bar was caused by concrete crushing against the face of the ribs, while bond failure of the GFRP bars occurred not only in the concrete but also in the bars by delamination of the resin-rich outer layer from the fiber core. The average area of the delaminated resin-rich layer of the GFRP bar increased with increasing compressive strength of concrete. [Copyright &y& Elsevier]

Streptococcus mutans (S. mutans) is known as the causative bacteria in the formation of dental plaque and dental caries. The aim of this experiment was to investigate the effects of Cyperus rotundus (C. rotundus) tuber extract on the growth, acid production, adhesion, and water-insoluble glucan synthesis of S. mutans. The growth and acid production were reduced by the extract of C. rotundus in a dose dependent manner. The extract of C. rotundus markedly inhibited the adherence of S. mutans to saliva-coated hydroxyapatite beads (HAs). The adherence was repressed by more than 50% at the concentration of 0.5 mg/ml of the extract and complete inhibition was observed at the concentration of 4 mg/ml of the extract. On the activity of glucosyltransferase (GTFase) which synthesizes water-insoluble glucan from sucrose, the extract of C. rotundus showed more than 10% inhibition at a concentration of 2 mg/ml. These results suggest that C. rotundus may inhibit cariogenic properties of S. mutans. Further studies are necessary to clarify the active constituents of C. rotundus responsible for such biomolecular activities. [ABSTRACT FROM AUTHOR]

Background IFN-α has been shown to be effective against hematologic malignancies. However, it is ineffective against most solid tumors and has not been satisfactory because of its toxicity. Methods The NGR (Asn-Gly-Arg) peptide is a tumor-homing peptide. In order to increase the anti-tumor activity of IFN-α2a and lower the dose, we coupled a cyclic NGR peptide with the C terminus of IFN-α2a (named IFN-α2a-NGR). Results The fusion protein was expressed in E. coli and purified by ion-exchange chromatography. The purity of IFN-α2a-NGR was >98% and the final purification yield of IFN-α2a-NGR was approximately 18 mg/L. The anti-tumor efficacy and the binding ability of IFN-α2a-NGR with tumor vasculature were investigated in vitro and in vivo. Discussion Our study has demonstrated that the anti-tumor efficacy of IFN-α2a-NGR is significantly increased in comparison with IFN-α2a, and IFN-α2a-NGR could selectively target tumor vessels. These data indicate that the tumor-homing peptide (NGR) can enhance the therapeutic efficacy of IFN-α2a against tumors. [ABSTRACT FROM AUTHOR]

The results of colectomy and ileorectal anastomosis (IRA) in patients diagnosed by physiologic testing as having slow transit constipation (STC) have been reported. The durability of functional results and long-term quality of life (QoL) in these patients, however, has not been established. Between 1987 and 2002, 3670 patients were evaluated for constipation at our institution; 110 (3%) fulfilled the criteria for STC and underwent an IRA. Patients were prospectively followed and functional outcomes assessed annually by standardized questionnaires. After a median follow-up of 11 years, 104 eligible patients were mailed validated questionnaires to assess functional outcomes and QoL (Knowles-Eccersley-Scott Symptom [KESS] score, the Irritable Bowel Syndrome Quality of Life [IBS-QOL], and the SF-12 health survey). Prospectively assessed functional data was available on 85 of 104 (82%) eligible patients. At last follow-up, improvement of constipation and satisfaction with bowel function was reported by 98% and 85% of patients, respectively. Performance measures including social activity, household work, sexual life, and family relationships were reported to have improved or were not affected as a result of surgery by 75%, 86%, 81%, and 86% of the patients respectively. Fifty-nine patients (57%) responded to the study questionnaires. All 59 patients reported their constipation to be better since IRA, 83% did not require any medication, and 85% reported being satisfied with bowel function. The KESS scores of patients undergoing IRA for STC (median 6, range 0−35) were lower than reported scores of STC patients not operated upon (median 21, range 11−35, P < 0.001) indicating symptomatic improvement after surgery. Mean IBS-QOL scores were similar to reported scores of patients undergoing IRA for other conditions [80 (23) versus 84 (16)], P = 0.7). Mean SF-12 physical and mental summary scores were similar to reported SF-12 scores of the normal population (49.5 versus 50 and P = 0.70, 48.7 versus 50, P = 0.42, respectively). Ileorectal anastomosis in appropriately selected patients with slow transit constipation results in durable symptomatic relief and a long-term quality of life indistinguishable from the general population. [Copyright &y& Elsevier]

Steamed roots of Rehmannia glutinosa (R. glutinosa) have been traditionally used in Oriental medicine for the treatment of auditory diseases such as tinnitus and hearing loss. To investigate whether the ethanol extract of steamed roots of R. glutinosa (SRG) increases activity of antioxidant enzymes and the level of glutathione (GSH), we measured activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and glutathione reductase (GR) and GSH level in HEI-OC1 cells after treatment with 5-50 mug/ml of SRG. The SOD and CAT activities were significantly increased in the presence of SRG compared to the control group. Maximal activities of SOD and CAT were observed in these cells exposed to 10 mug/ml of SRG. The GPX activity also increased dramatically in response to the treatment with SRG in a dose-dependent manner. The GR activity was only increased in the presence of 50 mug/ml of SRG compared to the control group. The level of GSH gradually increased in the presence of 5-50 mug/ml of SRG. In the cytotoxicity test, 5-50 mug/ml of SRG did not show any significant cytotoxicity. These results suggest that the traditional use of R. glutinosa for the treatment of auditory diseases may be explained, in part, by activation of intracellular antioxidant enzyme systems. Further studies are necessary to clarify the active constituents of SRG responsible for such biomolecular activities. [ABSTRACT FROM AUTHOR]

The steamed root of Rehmannia glutinosa has been used in traditional Oriental Medicine for treatment of inner ear diseases, such as tinnitus and hearing loss. In the present study, we showed that the ethanol extract of steamed roots of Rehmannia glutinosa (SRG) protected HEI-OC1 auditory cells from cisplatin cytotoxicity in a dose-dependent fashion. In addition, to investigate the protection mechanism of SRG on cisplatin cytotoxicity towards HEI-OC1, we measured the effects of SRG on lipid peroxidation of cisplatin treated cells as well as scavenging activities against superoxide radical, hydroxyl radical, hydrogen peroxide, and DPPH radical. SRG (5-100mug/ml) had protective effect against the cisplatin-induced HEI-OC1 cell damage and reduced lipid peroxidation in a dose-dependent manner. Furthermore, SRG showed strong scavenging activity against superoxide radical, hydroxyl radical, hydrogen peroxide, and DPPH radical. These results indicate that SRG protects cisplatin-induced HEI-OC1 cell damage through inhibition of lipid peroxidation and scavenging activities of free radials. [ABSTRACT FROM AUTHOR]

Abstract: We attempted to characterize the genes expression of CD4+ T lymphocytes for the pathogenesis of systemic lupus erythematosus (SLE). Genomewide gene expression profiles of CD4+ T cells, which were isolated from the disease severe activity (T4-1s) and nonactivity (T4-2s) with an SLE patient by using long serial analysis of gene expression (LongSAGE). We picked out 289 genes matching to Unigene cluster with different expression more than four copies between T4-1s and T4-2s libraries and analyzed their roles from the collectedly published articles of PubMed by genes functional clustering. The genes functions were related to a diverse cellular process including: (1) most of these genes were associated with CD4+ T cells functions, particularly related to cellular developments; (2) Ras pathway genes as RANBP10, GMIP, RASGRP2 and ARL5 might be responsible for the abnormal development of CD4+ T cells of SLE; (3) HIG2, TCF7, KHSRP, WWP1, SMAD3, TLK2, AES, CCNI and PIM2 belong to Wnt/beta-catenin way, they could play roles in modulating proliferation and differentiation of T lymphocytes; (4) uncertain viral infections may initiate autoimmunity because high levels expression genes were detected in T4-1s such as TRIM22, IER2, ABCE1, DUT, G1P2, G1P3, HNRPUL1, EVER2, IFNAR1, TNFSF14, TMP21 and PVRL2; and (5) apoptosis relating genes as EIF3S8, SH3BGRL3, GPX4, TOSO, PFDN5, BIN1, XIAPAF1, TEGT and CUGBP2 may contribute to over uploading of selfantigens in SLE cells. Abnormalities findings of multiple genes expression involving with a variety of CD4+ T cells process might be meaningful to understanding the pathogenesis of SLE, and immature CD4+ T cells may be responsible for SLE. [Copyright &y& Elsevier]