Aortic valves are antigenic but less so than myocardium

An aqueous methanol extract from green tea showed potent acetyl-CoA carboxylase inhibitory activity. An active compound was isolated from the extract and identified as (-)-epigallocatechin gallate by instrumental analyses. The IC50 value of (-)-epigallocatechin gallate was 3.1 x 10(-4) M. Among tea catechins and related compounds, nearly equal activity was found in (-)-epigallocatechin gallate and (-)-epicatechin gallate, whereas (+)-catechin, (-)-epicatechin, (-)-epigallocatechin, gallic acid and methyl gallate each had no inhibitory activity. These results indicate that the 3-O-gallate group of the catechin structure was necessary for this activity. (-)-Epigallocatechin gallate inhibited triglyceride accumulation in 3T3-L1 cells at a concentration of 1.0 x 10(-7) M or higher.     

Why women are less likely than men to commit suicide

Major depression forms the background of upwards of half of all suicides. Women are twice as likely as men to experience major depression, yet women are one fourth as likely as men to take their own lives. Current and past explanations of this paradox are built on androcentric assumptions that women are deficient in some way. The reverse may be true where suicide is concerned. Men value independence and decisiveness, and they regard acknowledging a need for help as weakness and avoid it. Women value interdependence, and they consult friends and readily accept help. Women consider decisions in a relationship context, taking many things into consideration, and they feel freer to change their minds. It is argued here that women derive strength and protection from suicide by virtue of specific differences from men. Factors that protect women from suicide are opposite to vulnerability factors in men.     

Speech characteristics associated with the Furlow palatoplasty as compared with other surgical techniques

Reported here are the results of a retrospective study of the speech outcome for 63 cleft subjects who had Furlow repairs compared with 20 subjects who had other procedures. The two groups of children were similar in cleft type, sex, and race. The same two surgeons repaired the palates in both groups, and the same two speech pathologists with high reliability examined the children at least 5 years postoperatively using the Pittsburgh Weighted Values for Speech Symptoms Associated with VPI (velopharyngeal incompetence). Subjects who had had Furlow repairs were superior on measures of hypernasality, articulation, and total speech scores; and fewer pharyngeal flaps were required by Furlow subjects. These findings suggest the need for randomized, double-blind investigations comparing outcome of the Furlow procedure with the intravelar veloplasty, the V-Y pushback, and other specified procedures.     

Subchronic dietary toxicity of strychnine: bobwhite quail are less sensitive than mallard ducks

PURPOSE: This study was undertaken to evaluate in vivo the effect of recombinant hirudin (r-hirudin [HBW 023]), a potent thrombin inhibitor, on the process of microvascular thrombus formation and recanalization. METHODS: Thrombosis was induced photochemically in distinct arterioles (n = 25) and venules (n = 30) of the ear of 16 hairless hr/hr mice (8 to 10 weeks old, 25 to 30 g of body weight). r-Hirudin (1 mg/kg of body weight) was administered intravenously directly before thrombus induction; saline-treated animals served as controls. Thrombus formation (i.e., first platelet deposition at the endothelial lining [FPD]; inner luminal diameter reduction to 50% [D/2]; complete vessel occlusion [CVO]), vessel recanalization, microcirculatory parameters, and leukocyte-endothelial cell interaction were analyzed by means of intravital fluorescence microscopy. RESULTS: Hirudin significantly delayed the process of thrombus formation compared with saline-treated controls in both arterioles (FPD: 381 +/- 80 vs 137 +/- 25 seconds, P < 0.05; D/2: 627 +/- 49 vs 501 +/- 71 seconds; CVO: 925 +/- 78 vs 854 +/- 60 seconds) and venules (FPD: 173 +/- 11 vs 59 +/- 4 seconds; D/2: 342 +/- 54 vs 228 +/- 27 seconds; CVO: 541 +/- 85 vs 344 +/- 43 seconds; P < 0.05). In addition, r-hirudin-treated animals showed an increased rate of vessel recanalization at 24 hours after thrombus induction (arterioles: 54% [7 of 13] vs 0% [0 of 12], P < 0.05; venules: 77% [10 of 13] vs 53% [9 of 17]), whereas microcirculatory parameters and leukocyte-endothelial cell interaction were not affected. CONCLUSION: Our data indicate that r-hirudin not only counteracts the process of thrombus formation but also promotes vessel recanalization, thus supporting its use in clinical microvascular surgery.     

Antenatal steroids are associated with less need for blood pressure support in extremely premature infants

OBJECTIVE: To determine if antenatal steroids decrease the amount of blood pressure support required by extremely premature infants between 23 and 27 weeks' gestation. DESIGN: Retrospective cohort study. SETTING: Texas Children's Hospital neonatal intensive care unit from January 1986 to December 1991. PARTICIPANTS: Two hundred forty premature infants between 23 and 27 weeks' gestation who survived at least 48 hours. MAIN OUTCOME MEASURES: The amount of blood pressure support received in the form of dopamine and colloid. Secondary analysis investigated differences in mortality, respiratory support requirements, the incidence of intraventricular hemorrhage, necrotizing enterocolitis, infection, retinopathy of prematurity requiring surgery, and the length of hospitalization. RESULTS: During the first 48 hours of life, premature newborns exposed to antenatal corticosteroids were less likely to receive dopamine for blood pressure support (47% vs 67%), and if they did, the amount of dopamine expressed as a dopamine score was less than that received by those infants not exposed to antenatal corticosteroids (281 +/- 240 vs 407 +/- 281). Those exposed to antenatal corticosteroids also had a lower mortality rate (8% vs 24%) and lower respiratory support requirements. The incidence of grade 3 or 4 intraventricular hemorrhage was 8% in infants exposed to antenatal corticosteroids and 17% in infants not exposed. No difference was found in the incidence of necrotizing enterocolitis, infection, or retinopathy of prematurity requiring surgery, or length of hospitalization. CONCLUSION: Receipt of antenatal corticosteroids is associated with less need for blood pressure support during the first 48 hours after birth in premature infants between 23 and 27 weeks' gestation.     

Total hip arthroplasty performed without cement in patients with femoral head osteonecrosis who are less than 50 years old

Seventy-two cementless total hip arthroplasties were performed by a single surgeon in 58 patients with the diagnosis of femoral head osteonecrosis. All patients were less than 50 years old (mean, 37 years). The mean follow-up was 84 months with a minimum of 48 months. Good-to-excellent results were maintained at final follow-up in 94% of the hips. Revision rate was 1.5% each for the cups and the stems. Mechanical failure rate was 7.6% for the cups, and 6% for the stems. If the results were analyzed excluding the data from the group of patients who received the Mittelmeier prostheses, the mechanical failure rates for the cups was 0% and for the stems was 4.2%. The probability of survival for the entire series using revision as the endpoint was 96.9% at 11 years. Survival probability decreased to 88.5% if radiographic failures were included. Excluding the Mittelmeier prostheses, survival probability was estimated to be 100% for the cups using both revision and radiographic failures as endpoints; for the stems, the survival probability was 98.0% using revision as the endpoint and 95.8% including radiographic failures. Femoral osteolysis was observed in 1.5% of the hips. No hip had acetabular osteolysis. No measurements of polyethylene wear were attempted in this study. These results appeared superior to total hip arthroplasties done with early cementing techniques in this population of young patients with femoral head osteonecrosis.     

H-reflexes are less depressed following muscle stretch in spastic spinal cord injured patients than in healthy subjects

The size of the soleus H-reflex was measured after a slow (17 deg/s) passive stretch of ankle plantarflexors and compared to its control size without muscle stretch in ten neurologically healthy subjects and in six spastic spinal-cord-injured patients. Two seconds after the end of the stretch, the size of the H-reflex was reduced to about 30% of its pre-stretch size in the healthy subjects. The depression remained for 10-15 s. In the spastic, spinal-cord-injured patients, stretch caused significantly less reduction in the size of the H-reflex. The H-reflex also regained its pre-stretch size much faster than in healthy subjects. We suggest that the smaller depression of the H-reflex observed in spastic patients may be involved in the pathophysiology of spasticity.     

Social justifications for moral emotions: When reasons for disgust are less elaborated than for anger.

In the present research, we tested the unreasoning disgust hypothesis: moral disgust, in particular in response to a violation of a bodily norm, is less likely than moral anger to be justified with cognitively elaborated reasons. In Experiment 1, participants were asked to explain why they felt anger and disgust toward pedophiles. Participants were more likely to invoke elaborated reasons, versus merely evaluative responses, when explaining their anger, versus disgust. Experiment 2 used a between-participants design; participants explained why they felt either anger or disgust toward seven groups that either violated a sexual or nonsexual norm. Again, elaborated reasons were less prevalent when explaining their disgust versus anger and, in particular, when explaining disgust toward a group that violated a sexual norm. Experiment 3 further established that these findings are due to a lower accessibility of elaborated reasons for bodily disgust, rather than inhibition in using them when provided. From these findings, it can be concluded that communicating external reasons for moral disgust at bodily violations is made more difficult due to the unavailability of those reasons to people. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Prevalence of Cyclospora species and other enteric pathogens among children less than 5 years of age in Nepal

Stools from 124 Nepalese children aged 6 to 60 months with diarrhea were examined for organisms of the coccidian genus Cyclospora and for other enteric pathogens. Enterotoxigenic Escherichia coli, Giardia Lamblia, Campylobacter species, Cyclospora species, and Cryptosporidium species were the most common pathogens identified. Cyclospora species were detected in none of 74 children < 18 months of age compared with 6 (12%) of 50 children > or = 18 months of age (P = 0.004).     

IS6110 homologs are present in multiple copies in mycobacteria other than tuberculosis-causing mycobacteria

A surgical technique for safe early repair of ventricular septal rupture is described. The technique consists of exclusion of the infarcted area, septal stabilization, and remodeling of the left ventricle with an internal two-patch method. This technique is simple and reliable, and it appeared favorable in an elderly patient group. Six of 7 patients were treated with good results.     

Initiation of protein synthesis in mammalian cells with codons other than AUG and amino acids other than methionine

Protein synthesis is initiated universally with the amino acid methionine. In Escherichia coli, studies with anticodon sequence mutants of the initiator methionine tRNA have shown that protein synthesis can be initiated with several other amino acids. In eukaryotic systems, however, a yeast initiator tRNA aminoacylated with isoleucine was found to be inactive in initiation in mammalian cell extracts. This finding raised the question of whether methionine is the only amino acid capable of initiation of protein synthesis in eukaryotes. In this work, we studied the activities, in initiation, of four different anticodon sequence mutants of human initiator tRNA in mammalian COS1 cells, using reporter genes carrying mutations in the initiation codon that are complementary to the tRNA anticodons. The mutant tRNAs used are aminoacylated with glutamine, methionine, and valine. Our results show that in the presence of the corresponding mutant initiator tRNAs, AGG and GUC can initiate protein synthesis in COS1 cells with methionine and valine, respectively. CAG initiates protein synthesis with glutamine but extremely poorly, whereas UAG could not be used to initiate protein synthesis with glutamine. We discuss the potential applications of the mutant initiator tRNA-dependent initiation of protein synthesis with codons other than AUG for studying the many interesting aspects of protein synthesis initiation in mammalian cells.     

More children are unable to get dental care than any other single health service

True congenital peripheral aneurysms of the cerebral arteries are rare and may constitute a special entity. We report a rare case of nonmycotic peripheral aneurysm of the posterior cerebral artery (PCA) found in association with aneurysms of distal middle cerebral artery (MCA), junction between basilar artery (BA) and superior cerebellar artery (SCA) and MCA trunk. Our present case was a 37-year-old man with a history of abrupt loss of consciousness. Cerebral angiography revealed a right PCA aneurysm originating at the junction between the trunk of the PCA and the posterior temporal branch, and also aneurysms of the right distal MCA, at the right BA-SCA junction and at the trunk of right MCA just distal to the anterior temporal artery. Distal PCA aneurysm causing subarachnoid hemorrhage was successfully clipped and all the other aneurysms were treated in a one-stage procedure. Pathological examination of the surgically excised distal PCA aneurysmal sac demonstrated no infectious etiology. There have not been any similar cases showing an association of vascular anomalies with distal PCA aneurysm. This is the only reported case with the association of nonmycotic peripheral aneurysms involving the MCA and PCA.     

Inguinal hernia--which method leads to the goal? Endoscopic and open surgical procedures are available

In recent years, the methods available for repair of inguinal hernia have greatly expanding, resulting in confusion as to what constitutes a suitable choice. Is it to be laparoscopy or open surgery, plastic mesh yes or no, general anesthesia or local anesthesia? Bassini's operation has now been ousted by the Shouldice procedure, which is suitable for all primary forms of hernia. The Lichtenstein procedure is readily and rapidly carried out under local anesthesia, making it suitable for use in multimorbid and old patients; the recurrence rate is low. The laparoscopic approach can be recommended for patients who, for private or occupational reasons need to be up and about again as soon as possible. It is also particularly suitable for the treatment of recurrent hernias or for the simultaneous repair of bilateral hernias. Disadvantages are the high costs, a lack of long-term results and unusual complications that are not seen in open surgery.     

A case of acquired petrous cholesteatoma associated with insidious middle ear infection treated by staging the surgical procedures

STUDY OBJECTIVE: To compare the efficacy of preincision wound infiltration with bupivacaine to wound infiltration at the end of the operation. DESIGN: A prospective, randomized, double-blind study. SETTING: University medical center. PATIENTS: 56 ASA status I and II women scheduled for abdominal hysterectomy were randomly assigned to one of three treatment groups. INTERVENTIONS: Group 1 (control) received no local anesthetic infiltration. Group 2 received subcutaneous infiltration with 40 ml of bupivacaine 0.5% (pH 6.9) 15 minutes prior to incision. Group 3 received wound infiltration with a similar solution at the end of surgery. Anesthesia was induced with thiopental 3.0 mg/kg i.v., droperidol 50 micrograms/kg i.v., and sufentanil 0.5 microgram/kg i.v. and maintained with nitrous oxide 67% in oxygen and sufentanil 0.1 microgram/kg IV boluses as required. Postoperative pain was treated with morphine via a patient-controlled analgesia delivery system for 24 hours, followed by oral hydrocodone for 3 days. MEASUREMENTS AND MAIN RESULTS: The opioid consumption was recorded for 4 days postoperatively. Pain scores were measured at 4 to 8-hour intervals using 100 mm visual analog scales. There was no difference in either the opioid analgesic requirements or the pain scores between the three study groups. CONCLUSIONS: Wound infiltration, either preincision or postincision, had no clinically significant effect on the pain scores or analgesic requirements following abdominal hysterectomy.     

Surgical procedures associated with risk of ovarian cancer

BACKGROUND: This historical cohort study was conducted to examine the relationship between gynaecological surgery and ovarian cancer risk. METHODS: Women were included if they had had tubal ligation, hysterectomy, or unilateral ovariectomy in Ontario between March 1979 and April 1993. The cohort was linked to the Ontario Cancer Registry and the Ontario mortality file. Person-years in the cohort were accumulated until death, the removal of both ovaries, a diagnosis of ovarian cancer, or the end of the study period 31 December 1993. Observed cancers were compared to expected based on Ontario age- and calendar period-specific incidence rates. RESULTS: For tubal ligation and hysterectomy, fewer ovarian cancers were observed than were expected by age, calendar year of procedure, and length of follow-up; the observed/expected ratios were generally statistically significant. In contrast, no protective effect was evident for unilateral ovariectomy; in fact statistically significant excess cancers were seen in early follow-up periods. Observed/expected ratios were nearly identical and somewhat protective for the two strata defined by whether or not the ovaries were visualized. Disruption of the ovarian pathway conferred a protective effect, while no disruption significantly increased risk. CONCLUSIONS: The data do not support screening bias although short-term follow-up data indicate the possibility of detection bias. The long-term follow-up data, as well as the data on pathway disruption, are consistent with the hypothesis that the surgical procedures themselves may produce a protective effect against ovarian cancer, through alteration of the hormonal environment and/or by physical destruction of a carcinogen's route to the ovary.