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The human genome contains 61 codons encoding 20 amino acids. Synonymous codons representing a given amino acid are decoded by a set of transfer RNAs (tRNAs) called isoacceptors. We report the surprising observation that two isoacceptor tRNAs that decode synonymous codons become modulated in opposing directions during breast cancer progression. Specifically, tRNA

The purpose of this study is to assess the efficacy of lymphoscintigraphy-guided neck dissection (LSG-ND) in the treatment of N0 oral squamous cell carcinoma.A retrospective cohort study of patients with N0 oral squamous cell carcinoma (SCC) who had either LSG-ND or neck dissection (ND) at our institution between 2008 and 2020.Eighty-seven patients met criteria with N0 oral squamous cell carcinoma with no previous treatment or neck surgery (27 LSG-ND, 60 ND). Sentinel lymph nodes were identified on the contralateral side in 14.8% of patients with unilateral tumors in the LSG-ND group, with 22.2% of cases with unexpected lymphatic drainage outside ipsilateral levels I-III. No recurrences to date have occurred in the LSG-ND cohort, while 13.3% of patients with ND had regional recurrence (p = 0.04).LSG-ND provides a greater ability to identify occult metastatic disease with a significant reduction in regional recurrence in N0 oral SCC.

The main cost incurred in the production of concrete paving blocks is the cost of the cement-based binders. In addition, there is the environmental cost of quarrying and processing of these primary materials. Gypsum-based industrial by-products have been identified as alternative sources of cement. These materials have little or no production cost and their reuse negates the need for disposal, offering a more sustainable material for the production of paving blocks. Laboratory trials have investigated the properties of red gypsum, derived as a coproduct associated with titanium dioxide manufacture, mixed with pulverised-fuel ash, ground granulated blastfurnace slag, lime and basic steel slag. An assessment of samples was made using unconfined compressive strength after 28 days curing. It was found that a red gypsum ground granulated blastfurnace slag mix achieved the highest unconfined compressive strength (up to 39 MPa) and was selected for further investigation. Two binders, composed primarily of red gypsum and ground granulated blastfurnace slag, were mixed with sand and pea gravel to make 100 mm concrete cubes and compared with Portland cement for uniaxial compressive strength, stiffness and workability. The red gypsum-based binder compared favourably with Portland cement, indicating that there is potential to integrate red gypsum into concrete block mixes.

Congenital diaphragmatic hernia (CDH) is a developmental anomaly that results in significant mortality and morbidity. The underlying etiology is poorly understood. Insights will arise from an understanding of the mechanisms by which the teratogen nitrofen induces CDH in rodent models. In this study, we use in vitro cell assays in conjunction with whole animal rodent studies to test hypotheses regarding nitrofen's mechanism of action. The first component examined the interaction of nitrofen with various aspects of the retinoid signaling pathway including uptake proteins, binding proteins, receptors, conversion, and degradation enzymes. The second component examined the interactions of nitrofen and vitamins A, C, and E to test the hypothesis that nitrofen was functioning as an antioxidant to interfere with retinoid signaling. Third, we performed a series of experiments examining the interaction of nitrofen and thyroid signaling. Collectively, the data suggest that the primary aspect of retinoid signaling affected by nitrofen is via inhibition of the rate-limiting enzymes controlling retinoic acid synthesis. Retinoid signaling perturbations do not appear to involve oxidative effects of nitrofen. Any substantial roles of nitrofen-induced perturbations of thyroid hormone signaling or receptor function are not supported.

Bilateral Group A streptococcal endogenous endophthalmitis following routine gynaecological surgery

The correction of paediatric traumatic aphakia remains a controversial topic. This study examines retrospectively the visual outcome in 32 children with uniocular traumatic cataracts. Fifteen received intraocular lens implants following lensectomy, and 17 received aphakic contact lenses. Age range was 2-14 1/2 years at the time of injury. The maximum follow-up time was 13 years. Twenty-four children obtained a good visual result (6/5 to 6/18). These were equally divided between those receiving intraocular lens implants and those with contact lenses. Factors adversely affecting visual outcome are discussed. These include complex trauma, delay in referral for lensectomy, inadequate postoperative correction of aphakia, contact lens difficulties and problems with occlusion therapy. Although aphakic correction with intraocular lens implants may require several subsequent surgical procedures such as capsulotomy, we advise early lensectomy and intraocular lens implantation where possible, particularly in young children with traumatic cataracts. This eliminates contact-lens-associated problems and maximises the chance of good visual outcome and retention of stereoscopic vision.

Six cases of chronic endophthalmitis following extracapsular cataract extraction and lens implantation are reviewed. All were referred for tertiary management by one surgeon over a period of just over 2 years. In two of the cases coagulase negative staphylococci were isolated and in three Propionibacterium spp were retrieved. In the remaining case a mixed growth of coagulase negative staphylococci and Propionibacterium acnes was cultured. The surgical management, microbiological results, and eventual visual outcome are discussed. To our knowledge, this is the first documented outbreak of chronic pseudophakic endophthalmitis with commensal organisms from a single centre.

Comparison of perioperative outcomes and recurrence in patients undergoing primary surgical treatment for endometrial cancer by robotics, laparoscopy, vaginal/laparoscopy, or laparotomy approaches.Prospective analysis of 67 patients undergoing robotic surgery for endometrial cancer between March 2004 and December 2007. Comparison was made with similar patients operated between November 1999 and December 2006 by laparoscopy (37 cases), laparotomy (99 cases) and vaginal/laparoscopy approach (vaginal hysterectomy, bilateral adnexectomy/laparoscopic lymphadenectomy) (47 cases) and matched by age, body mass index (BMI), histological type and International Federation of Gynecologists and Obstetricians (FIGO) staging.Mean operating times for patients undergoing robotic, laparoscopy, vaginal/laparoscopy or laparotomy approach were 181.9, 189.5, 202.7 and 162.7 min, respectively (p = 0.006); mean blood loss was 141.4, 300.8, 300.0 and 472.6 ml, respectively (p0.001); mean number of nodes was 24.7, 27.1, 28.6, and 30.9, respectively (p = 0.008); mean length of hospital stay was 1.9, 3.4, 3.5 and 5.6 days, respectively (p0.001). There were no significant differences in intra- or postoperative complications among the four groups. The conversion rate was 2.9% for robotics and 10.8% for the laparoscopy group (0.001). There were no differences relative to recurrence rates among the four groups: 9%, 14%, 11% and 15% for robotics, laparoscopy, vaginal/laparoscopy, and laparotomy, respectively.Robotics, laparoscopy and vaginal/laparoscopy techniques are preferable to laparotomy for suitable patients with endometrial cancer. Robotics is preferable to laparoscopy due to a shorter hospital stay and lower conversion rate and preferable to vaginal/laparoscopy due to a reduced hospitalization.

This study evaluates the role of intraocular lens exchange procedures in the management of major implant-related complications. Medical records of 30 patients undergoing intraocular lens exchange at the Leeds General Infirmary from 1 January 1984 to 30 November 1991 were reviewed. Details of their primary implantation surgery, intervening ophthalmic history, lens exchange surgery and outcome were analysed. Follow-up ranged from 3 to 210 weeks. Seventy-six per cent of cases achieved final visual acuity of 6/12 or better. Visual acuity improved in 60%, worsened in 6.6% and was unchanged in 33.4% compared with pre-operative levels. Three patients had cystoid macular oedema, 3 ocular hypertension, 2 bullous keratopathy, 1 chronic anterior uveitis and 1 patient developed a retinal detachment. This approach to managing major implant-related complications gives good visual results. There is a significant complication rate but the risk-benefit ratio justifies the use of the technique.

Cultures were established from neonatal rat muscle cells, satellite cells, and L6 myoblasts and changes in protein metabolism were determined as development proceeded. For all three cell types, culture protein content increased with increasing myotube content. The beta-adrenergic agonist clenbuterol (added to a final concentration of 10(-7) M) significantly stimulated fusion (as indicated by creatine kinase activity) in neonatal muscle cultures and also increased culture protein content. This was associated with a stimulation in both the fractional (ks, percentage/day, +13%, P less than .05) and absolute (As, micrograms/day, +19%, P less than .05) rates of protein synthesis within 24 h after drug administration. At 48 h, As was increased by 42% above that of controls (P less than .01). In contrast, in satellite cell cultures, clenbuterol had no consistent effects on either protein accretion, creatine kinase activity, or protein synthesis (ks and As). Similarly, the drug had no stimulatory effect on protein synthesis and protein accretion in L6 myoblast or L6 myotube cultures (and no effect in neonatally derived fibroblast cultures). It is concluded that the fusion response to clenbuterol and, therefore, changes in protein metabolism and protein accretion are greatly dependent on the origin and genetic integrity of muscle cells.

Mid-term outcomes of penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK)

Objective. Behcet's disease (BD) is a rare multisystem disorder characterized by vasculitis. At present, there are no laboratory markers that correlate well with the clinical activity in BD. This has led to the development of an instrument (BD Current Activity Form) to measure activity. Scoring is based on the history of new clinical features present over the preceding 4 weeks prior to assessment. Standardized questions were developed for all parts of the form. The face validity of the proforma was determined following worldwide collaboration with physicians and ophthalmologists managing patients with BD. The aim of this study was to evaluate the interobserver reliability of this form. Methods. Nineteen patients fulfilling the International Study Group criteria for BD were randomly allocated, questioned and examined independently on the same day by five physicians experienced in BD. Results. There was good agreement between the physicians' rating of oral [intraclass correlation coefficient (ICC) = 0.87] and genital (ICC = 0.95) ulceration, skin involvement (ICC = 0.62 for pustules and ICC = 0.66 for erythema nodosum), arthritis (ICC = 0.62), headache (ICC = 0.80), large vessel (kappa = 0.53), nervous system (kappa = 0.61) and eye involvement (kappa = 0.77). There was poor agreement for the question relating to the presence of bloody diarrhoea (ICC = 0.28). There was significant bias in the rating of fatigue by one of the physicians (F = 5.2, P = 0.001). Conclusion. Overall, this instrument has good interobserver reliability for assessing general disease activity. We therefore suggest that this proforma has a place in routine clinical monitoring of patients with BD, as well as assessing outcome in therapeutic trials.

We report a case of chronic myeloid leukaemia initially presenting with a vitreous haemorrhage associated with bilateral retinal and optic disc neovascularization. The literature is briefly reviewed and the probable reasons for the observed microcirculatory disturbances are discussed.

The effect of the nerve derived peptide, calcitonin gene related peptide (CGRP) on myoblast fusion/differentiation was studied in rat myogenic cell cultures, using creatine kinase activity as an index of fusion. Addition of CGRP at 10(-7) M to myoblast cultures resulted in an enhancement of kinase activity after 11 days of treatment. This response was not accompanied by increased protein content of cultures implying an effect primarily on fusion rather than on myotube growth/size. Neither was it a direct effect on enzyme activity alone since no increase in creatine kinase activity occurred when CGRP was added to mature myotube cultures. These data suggest a role for CGRP in the myoblast fusion process itself and raise questions as to its importance in the growth and development of muscle in vivo.

Ratings of perceived exertion (RPE) were examined in six low- (LAN) and eight moderate- (MAN) altitude natives during exercise at their residence (home) altitude (366 m and 2,200 m, respectively) and 1-4 wk later following 2-d decompression to 4,270 m (447 mm Hg). Cardiorespiratory, plasma lactate, and differentiated RPE measures were obtained at exercise intensities representing 35, 55, 75, 85, and 100% VO2peak. In general, cardiorespiratory and plasma lactate values were similar in LAN and MAN at their residence altitudes and during hypobaric hypoxia. However, the decrease in VCO2 was greater (P0.05) in LAN than MAN. At their residence altitudes, both LAN and MAN reported local RPE values that were greater (P0.05) than central ratings at the moderate to high exercise intensities. At 447 mm Hg, central and local RPE were similar in LAN. However, there was a significant correlation between acute mountain sickness (AMS) symptoms and central RPE (r = 0.875) across the five exercise intensities in LAN. The differences between the central and local RPE noted in MAN during their residence testing also persisted at 447 mm Hg. Thus, differentiated ratings of perceived exertion were similar in MAN at their residence altitude and at 4,270 m, but not in LAN subjects. Several factors, including AMS, may have contributed to this group difference in the RPE response.

The presence of fine epithelial deposits in a whorled pattern (cornea verticillata) as a consequence of treatment with amiodarone is well documented. We present a case of amiodarone keratopathy in a grafted cornea which is atypical in that the orientation of the pattern is rotated through nearly 90 degrees to that normally observed. This observation runs counter to the hypothesis that cornea verticillata is a manifestation of the line of lid closure. We speculate on the mechanism directing the migrational pathways of epithelial cells.

Cultures were established from neonatal rat muscle cells, satellite cells, and L6 myoblasts and changes in protein metabolism were determined as development proceeded. For all three cell types, culture protein content increased with increasing myotube content. The beta-adrenergic agonist clenbuterol (added to a final concentration of 10(-7) M) significantly stimulated fusion (as indicated by creatine kinase activity) in neonatal muscle cultures and also increased culture protein content. This was associated with a stimulation in both the fractional (ks, percentage/day, +13%, P less than .05) and absolute (As, micrograms/day, +19%, P less than .05) rates of protein synthesis within 24 h after drug administration. At 48 h, As was increased by 42% above that of controls (P less than .01). In contrast, in satellite cell cultures, clenbuterol had no consistent effects on either protein accretion, creatine kinase activity, or protein synthesis (ks and As). Similarly, the drug had no stimulatory effect on protein synthesis and protein accretion in L6 myoblast or L6 myotube cultures (and no effect in neonatally derived fibroblast cultures). It is concluded that the fusion response to clenbuterol and, therefore, changes in protein metabolism and protein accretion are greatly dependent on the origin and genetic integrity of muscle cells.

1. When rats were fed with clenbuterol for 7 days skeletal muscle mass increased by 21% in the tonic soleus and phasic plantaris muscles and a 16% hypertrophy of the heart was also induced. Fenbufen, fed to rats for the same period, blocked the hypertrophy of the heart but not that of the skeletal muscles. 2. When feeding of fenbufen commenced 3 days before the administration of clenbuterol, plasma prosta-glandin F2 alpha (PGF2 alpha) was reduced by 79%; there was again no effect of fenbufen on clenbuterol-induced increases in the RNA or protein content of plantaris, nor in the increased area of fast or slow twitch fibres in the soleus. In the heart the clenbuterol-induced increases in the RNA (+21%) and protein content (+20%) were totally inhibited. 3. The effects of clenbuterol on heart muscle appear to be mediated by a cyclo-oxygenase metabolite of arachidonic acid whilst the effects on skeletal muscle are not.

Objective To investigate the outcome of secondary intra-ocular lens implantation. Neither a requirement for vitreous surgery nor previous complicated eye surgery/trauma was considered necessarily to be a contra-indication. Design Retrospective Study. Recruitment was achieved by examination of operating theatre records. Setting Teaching Hospital. Patients 52 out of 54 consecutive cases in whom a secondary lens had been implanted from 1982-1989 under the care of one consultant (BAN). Interventions The medical records of all patients were reviewed and data collected for 52 of the total of 54 patients. Main outcome measures Visual acuity and major complications. Results 77% of eyes retained the same Snellen visual acuity or better than that pre-operatively and 88% were within one line or better. The Mann Whitney U-test showed that neither vitreous manipulation at the time of secondary lens implantation nor a previous history of trauma had a significant effect on the change between pre- and post-operative Snellen visual acuity. Only one patient developed a retinal detachment and eight had cystoid macula oedema although in only one patient did this account for a final decrease in post-operative visual acuity of more than one line. The most common complication was an intense post-operative uveitis (35%) leading in some cases to indefinite low dose topical steroid treatment (21%). Conclusions This technique gives good visual results, even in the disorganised eye, providing the vitreous is adequately managed. However there is a significant complication rate which should be discussed with the patient before undertaking surgery.

Atlantic cod, Gadus morhua, were maintained on different ration levels or starved to produce a variety of growth rates. The in vivo rates of protein synthesis and degradation were determined for the whole fish and various tissues. As ration level, and hence growth rates, increased, both whole-animal protein synthesis and degradation rates increased linearly; growth occurred because of the preponderance of synthesis over degradation. On average, a 300-g cod growing at 1.0%∙d−1synthesised 1.25 g of protein with 0.4 g of this protein remaining as growth. The proportion of total protein synthesis which was retained as growth increased with increasing growth rate; at a maximum growth rate of 2%∙d−1, over 40% of the protein synthesised was retained as growth. The ranking of the tissues in terms of fractional rates of protein synthesis was liver > gills > intestine > spleen > ventricle > stomach > gonads > white muscle. The white muscle, gills, liver, stomach, spleen, and ventricle all showed similar patterns of increased protein synthesis with increased growth rate. The white muscle has the highest efficiency of retention of protein and accounts for 40% of the total protein accretion per day. In starving fish there was a constant level of protein synthesis, irrespective of the rate of weight loss. However, degradation rates increased in the whole animal and in white muscle as the rate of weight loss increased.

Restructured beef steaks were made from chuck meat that was flaked (6 mm) or sliced at various thicknesses (2.5, 5.0 or 7.5 mm). Each formulation was mixed for 5, 10, 15 or 20 min, pressed into logs, frozen and cut into steaks. Steaks were evaluated for fat and moisture contents, cooking characteristics, and sensory attributes. Slice thickness had little effect on sensory properties; however, the restructured steaks were significantly more tender and possessed a more desirable texture and flavor than the intact chuck steaks. Restructured steaks made from meat that was mixed for 5 or 10 min were significantly more tender and received higher texture desirability and overall palatability ratings than restructured steaks made from meat that was mixed for 15 or 20 min.

Seven male runners (21--42 years) were examined before and after the 1976 Boston Marathon to provide data concerning the cardio-respiratory and perceptual recovery from the performance. Treadmill runs, 30 min in duration, were administered 1 week prior to the marathon and 2--3, 6--7 and 13--15 days following. Treadmill speed was held constant and based on each runner's planned race pace. Maximal performance data were collected 1 week before and 2 weeks after the race. Data were analyzed using a 2-way ANOVA (4 thirty min run data collection periods and 3 exercise time points--5, 15 and 30 min) and "t" tests. Treatment effects were not observed for either HR or VE, however, perceived exertion (RPE) was significantly elevated 2--3 and 6--7 days post-marathon and VO2 was significantly lower at 13--15 days. HR and RPE showed significant time effects indicating a non-steady state response. None of the maximal test variables were significantly displaced. All variables were returned to pre-marathon levels by 13--15 days except VO2 which was lower. Aerobic capacity was not a limiting factor in the recovery from a marathon run. Muscle soreness and stiffness seem to be related to the increased perceptual ratings following a marathon run.

Recent advances in neonatal intensive care have led to a much improved survival rate in very low birth weight infants (under 1,500 g). A group of such children was examined and found to have a low incidence of serious visual or general handicap, but severe retrolental fibroplasia (RLF) affects a significant number.

A Kashmiri family with 3 members affected by a congenital sensory and autonomic neuropathy and corneal opacification is described. The 3 affected cases were offspring of consanguinous marriages in two generations; autosomal recessive inheritance is therefore probable. Pain and temperature sensation was lost in the limbs with a resulting mutilating acropathy. Sudomotor function was also impaired. Motor function, tendon reflexes, kinaesthetic sensation and sensory nerve action potentials were normal. Sural nerve biopsy showed a selectively reduced small myelinated nerve fibre population. Corneal histology revealed neurotrophic keratitis. The classification of the hereditary sensory and autonomic neuropathies is discussed. This family represents a previously unrecognized variant.

Six low-altitude natives (LAN) (373 m or less, aged 19-25 yr) and eight moderate-altitude natives (MAN) (1830-2200 m, aged 19-23 yr) were studied at both their residence (home) altitude (740 Torr and 587 Torr, respectively) and in a hypobaric chamber at a simulated altitude of 4270 m (447 Torr). Following a 2-d adaptation period, subjects performed an incremented test on the cycle ergometer until voluntary exhaustion. Significantly (P less than 0.05) greater differences in percent change of maximum exercise variables (total exercise time, exercise intensity, VO2, VCO2, VE/VO2 and HR) were noted in the LAN group than in the MAN group, going from their residence altitude to 447 Torr. The decrement in VO2max was 15% in the MAN group compared to 34% in the LAN group. The anaerobic threshold (% VO2max), estimated from VE BTPS measurements, was similar in both groups at residence altitude and at 447 Torr. In the morning prior to exercise testing at 447 Torr, LAN subjects reported greater (P less than 0.001) symptoms of acute mountain sickness (AMS) than MAN subjects. Our results indicate that, with respect to maximum exercise performance, moderate-altitude natives are at an advantage during early adaptation to hypobaric hypoxia.

Serum aldosterone, cortisol, and electrolyte concentration, and urinary aldosterone and electrolyte excretion responses were examined in seven low-altitude natives (LAN) (373 m or less, aged 19-25 yr) and nine moderate-altitude natives (MAN) (1,830-2,200 m, aged 19-23 yr) for 2 d at their own residence (home) altitude (PB 740 or 585 mm Hg, respectively) and later for 2 d during decompression at a simulated altitude of 4,270 m (PB 447 mm Hg). The LAN group demonstrated higher (p less than 0.05) serum cortisol concentrations and respiration rates, and lower (p less than 0.05) serum aldosterone and potassium, and urinary aldosterone, sodium, and potassium concentrations at certain times during decompression compared to their home responses. Moderate-altitude native responses, on the other hand, were generally unchanged. Manifestations of acute mountain sickness at PB 447 mm Hg were also significantly greater in the LAN group. Thus, it appears that the MAN subjects were influenced less by the drop in ambient oxygen tension associated with PB 447 mm Hg.

In order to investigate potential sources for the bacterial contamination of intraocular lenses, specimens were taken for culture from a variety of sites. A swab from the lid margin, the operating room air, an intraocular lens which was allowed to rest on the eye, and the sodium hyaluronate were cultured during routine intercapsular lens implant surgery on 31 patients. Positive cultures were obtained from six intraocular lenses. Subtyping by three independent methods showed that isolates from five of these lenses were indistinguishable from bacteria cultured from the air. In the case of the sixth lens a bacterial isolate from the lid margin matched with that from the lens. Staphylococcus epidermidis was cultured from four lenses; Staphylococcus haemolyticus was also isolated from one of these four lenses and the remaining two lenses produced isolates of Staphylococcus aureus.

Submaximal and maximal exercise responses were examined in persons (age, 19-30 years) residing at a moderate altitude for different periods of time. Long-term residents (LTR; 44 males, 11 females) had lived continuously between 1,830 and 2,200 m for 2 years or longer before testing. Short-term residents (STR; 22 males, 30 females), previously lowlanders, arrived at 2,200 m within 10 to 21 days before testing. Incremented tests on a motor-driven treadmill were performed until voluntary exhaustion. Cardiorespiratory measures and ratings of perceived exertion (RPE) were examined at 60% and 100% of maximal oxygen uptake (VO2max). With the exception of minute ventilation (VE), which was higher (p less than 0.05) in STR females, maximal responses were comparable in STR and LTR females. All maximal responses were similar in STR and LTR males. Both VE and RPE at 60% VO2max were significantly higher in STR males and females than in their LTR counterparts. Plasma lipid responses to the maximal exercise may indicate a greater contribution of the triglyceride pool of adipose tissue to fatty acid mobilization during exercise in the LTR compared to STR male subjects.

Experience in the investigation and treatment of eleven patients with the peripheral corneal melting syndrome is described. It is considered that short-term treatment with non-corticosteroid immunosuppressive regimes should be tried in patients with severe progressive disease which may not respond to other methods of treatment.

Ten healthy male university students pedaled a bicycle ergometer (Monark) for three sessions each lasting 30 minutes. Each subject worked at an individually predicted work load corresponding to approximately 40% of maximal aerobic capacity. The same predicted work load was conducted at 24 degrees C, 44 degrees C and 54 degrees C for each subject. For practical purposes, the results reveal approximately a one beat per minute increase in exercise heart rate for each 1 degree C increase in ambient temperature above neutral (24 degrees C). The practice of exercising cardiac patients in hot ambient temperatures which produce potentially hazardous heart rate levels was challenged. Seasonal reevaluation of exercise heart rate prescriptions is of importance. Hopefully, these findings will also be of some importance to various community gymnasiums and to self-motivated joggers.