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11.
Three new sterol sulfates, spheciosterol sulfates A-C (1-3), and the known sterol sulfate topsentiasterol sulfate E (4) have been isolated from the sponge Spheciospongia sp., collected in the Philippines. Structures were assigned on the basis of extensive 1D and 2D NMR studies as well as analysis by HRESIMS. Compounds 1-4 inhibited PKCzeta with IC50 values of 1.59, 0.53, 0.11, and 1.21 microM, respectively. In a cell-based assay, 1-4 also inhibited NF-kappaB activation with EC50 values of 12-64 microM.  相似文献   
12.
AIM: To assess the role of transperineal sonography (TPS) in the diagnosis of placenta previa in the third trimester and to compare it with transabdominal sonography (TAS). METHODS: Seventy-five suspected cases of placenta previa were subjected to TAS with half full bladder and to the TPS with empty bladder to visualize the inner surface of the cervix and inferior edge of the placenta. The presence or absence of placenta previa was confirmed at delivery. RESULTS: TAS depicted the inferior edge of placenta in 98.7% of cases compared to 96% with TPS. Internal cervical os was visualized in 98.7% with TAS compared to 100% with TPS. Placenta previa was confirmed at delivery in 74 cases with one false positive in TPS, six false positive in TAS. The positive predictive value (PPV) value in the diagnosis of placenta previa was 92% with TAS compared to 98.6% with TPS. Accuracy of TPS in diagnosing placenta previa was 98.7%. PPV in the diagnosis of minor degree placenta previa was less 86.36% with TAS compared to TPS 100% though for major degree both are in agreement. CONCLUSION: TPS is a valuable procedure to compliment TAS in the diagnosis of placenta previa and helps to exclude false positive and to determine the mode of delivery, although it cannot replace TAS.  相似文献   
13.
Ovarian Sertoli-Leydig cell tumors are rare sex cord-stromal tumors, accounting for less than 1% of ovarian tumors. Majority of these tumors are benign and unilateral, only 3-5% are bilateral. These patients present with clinical features of virilization due to excessive secretion of testosterone from the tumor, however 50% may have no endocrine symptoms. We report a case of poorly differentiated Sertoli-Leydig cell tumour in a woman diagnosed during routine investigation of infertility. She had two spontaneous successful pregnancies after tumor excision laparoscopically.  相似文献   
14.
OBJECTIVE:: Genetic variants in 296 genes in regions identified through admixture mapping of hypertension, BMI, and lipids were assessed for association with hypertension, blood pressure (BP), BMI, and high-density lipoprotein cholesterol (HDL-C). METHODS:: This study identified coding SNPs identified from HapMap2 data that were located in genes on chromosomes 5, 6, 8, and 21, wherein ancestry association evidence for hypertension, BMI, or HDL-C was identified in previous admixture mapping studies. Genotyping was performed in 1733 unrelated African-Americans from the National Heart, Lung and Blood Institute's Family Blood Pressure Project, and gene-based association analyses were conducted for hypertension, SBP, DBP, BMI, and HDL-C. A gene score based on the number of minor alleles of each SNP in a gene was created and used for gene-based regression analyses, adjusting for age, age, sex, local marker ancestry, and BMI, as applicable. An individual's African ancestry estimated from 2507 ancestry-informative markers was also adjusted for to eliminate any confounding due to population stratification. RESULTS:: CXADR (rs437470) on chromosome 21 was associated with SBP and DBP with or without adjusting for local ancestry (P?相似文献   
15.
Sonography is widely used for evaluation of hand and wrist lesions. The easy accessibility, cost‐effectiveness, and good diagnostic accuracy of sonography coupled with the numerous benefits of real‐time imaging make it desirable. The aim of this article is to describe the typical sonographic appearances of lesions in the hand and wrist that are encountered frequently in routine clinical practice, such as inflammatory arthropathies, tumors, traumatic injuries, foreign bodies, and nerve entrapment syndromes. Relevant anatomy, scanning methods, and recent developments in musculoskeletal sonography are also discussed.  相似文献   
16.

Background

Transplantation of hearts retrieved from donation after circulatory death (DCD) donors is an evolving clinical practice.

Objectives

The purpose of this study is to provide an update on the authors’ Australian clinical program and discuss lessons learned since performing the world’s first series of distantly procured DCD heart transplants.

Methods

The authors report their experience of 23 DCD heart transplants from 45 DCD donor referrals since 2014. Donor details were collected using electronic donor records (Donate Life, Australia) and all recipient details were collected from clinical notes and electronic databases at St. Vincent’s Hospital.

Results

Hearts were retrieved from 33 of 45 DCD donors. A total of 12 donors did not progress to circulatory arrest within the pre-specified timeframe. Eight hearts failed to meet viability criteria during normothermic machine perfusion, and 2 hearts were declined due to machine malfunction. A total of 23 hearts were transplanted between July 2014 and April 2018. All recipients had successful implantation, with mechanical circulatory support utilized in 9 cases. One case requiring extracorporeal membrane oxygenation subsequently died on the sixth post-operative day, representing a mortality of 4.4% over 4 years with a total follow-up period of 15,500 days for the entire cohort. All surviving recipients had normal cardiac function on echocardiogram and no evidence of acute rejection on discharge. All surviving patients remain in New York Heart Association functional class I with normal biventricular function.

Conclusions

DCD heart transplant outcomes are excellent. Despite a higher requirement for mechanical circulatory support for delayed graft function, primarily in recipients with ventricular assist device support, overall survival and rejection episodes are comparable to outcomes from contemporary brain-dead donors.  相似文献   
17.
BACKGROUND: The association of antibody responses with both innate and acquired immunity to amebiasis indicate that CD4+ T cells play a role in protection against Entamoeba histolytica infection. To test this hypothesis, we compared the genotype frequencies of human leukocyte antigen (HLA) class II alleles in a cohort of Bangladeshi children intensively monitored for E. histolytica infection for a 3-year period. METHODS: Using logistic regression, we calculated the odds of disease by genotype and by haplotype. RESULTS: The DQB1*0601 heterozygous and homozygous genotypes were found in 55% of E. histolytica-negative children but in only 34% of E. histolytica-positive children (overall odds ratio, 2.39; 95% confidence interval [CI], 1.26-4.54). Children who were heterozygous for the DQB1*0601/DRB1*1501 haplotype were 10.1 times (95% CI, 2.02-50.6) more likely to be both E. histolytica negative and serum anti-lectin immunoglobulin G negative at baseline. Other DQB1 and DRB1 alleles (DQB1*0202, DQB1*0301, and DRB1*0701) were not associated with any of the clinical outcomes related to amebiasis. CONCLUSION: A potential protective association was observed with the HLA class II allele DQB1*0601 and the heterozygous haplotype DQB1*0601/DRB1*1501. This association may explain why amebiasis does not occur in some children who are exposed to the parasite and implicates HLA class II-restricted immune responses in protection against E. histolytica infection.  相似文献   
18.

Objective

To evaluate the impact of opioid controlled substance agreements (CSAs) enrollment on health care utilization.

Patients and Methods

We retrospectively evaluated health care utilization changes among 772 patients receiving long-term opioid therapy for chronic noncancer pain enrolled in a CSA between July 1, 2015, and December 31, 2015. We ascertained patient characteristics and utilization 12 months before and after CSA enrollment. Decreased utilization was defined as a decrease of 1 or more hospitalizations or emergency department visits and 3 or more outpatient primary and specialty care visits. Multivariate modeling assessed demographic characteristics associated with utilization changes.

Results

The 772 patients enrolled in an opioid CSA during the study period had a mean ± SD age of 63.5±14.9 years and were predominantly female, white, and married. The CSA enrollment was associated with decreased outpatient primary care visits (odds ratio [OR], 0.16; 95% CI, 0.14-0.19) and increased diagnostic radiology services (OR, 1.22; 95% CI, 1.02-1.47). After CSA enrollment, patients with greater comorbidity (Charlson Comorbidity Index score >3) were more likely to have reduced hospitalizations (adjusted OR, 2.8; 95% CI, 1.3-6.0; P=.008), reduced outpatient primary care visits (adjusted OR, 2.0; 95% CI, 1.2-3.2; P=.005), and reduced specialty care visits (adjusted OR, 2.0; 95% CI, 1.2-3.3; P=.006).

Conclusion

For patients receiving long-term opioid therapy for chronic noncancer pain, CSA enrollment is associated with reductions in primary care visits and increased radiologic service utilization. Patients with greater comorbidity were more likely to have reductions in hospitalizations, outpatient primary care visits, and outpatient specialty clinic visits after CSA enrollment. The observational nature of the study does not allow the conclusion that CSA implementation is the primary reason for these observed changes.  相似文献   
19.
20.
The aim of the present study was to develop a probioticated cucumber juice by optimizing the concentration of prebiotic (inulin), stevia (Stevia rebudiana) and inoculum (Lactobacillus plantarum) by varying one factor at a time. Cucumber juice with 2% prebiotic had a pH 3.76, acidity 0.239%, total sugars 198.2 μg/mL, reducing sugars 102.3 μg/mL and microbial viability of 1.36 × 108 colony forming units (CFU)/mL, respectively. The juice with 3% stevia had a pH 3.59, acidity 0.388%, total sugars 214 μg/mL, reducing sugars 156.7 μg/mL and microbial viability of 6.7 × 107 CFU/mL, respectively. The juice with 3% inoculum size had a pH 3.82, acidity 0.39%, total sugars 128.3 μg/mL, reducing sugars 198.6 μg/mL and microbial viability of 3.5 × 108 CFU/mL, respectively. Maximum growth of the probiotic (L. plantarum) in the cucumber juice was obtained at the end of 48 h of fermentation for 2% prebiotic, 3% stevia and 3% inoculum size without much changes in nutritional and organoleptic properties. The probiotic strain namely L. plantarum proved its ability and suitability to ferment cucumber juice. The growth of the probiotic in the cucumber juice was found maximum with 2% prebiotic, 3% stevia and 3% inoculum size at the end of 48 h of fermentation with minimal changes in nutritional value and organoleptic characteristics with a good shelf life at 4 °C in polyethylene terephthalate bottles.  相似文献   
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