Τρίτη, 23 Φεβρουαρίου 2016

How long does it take for blood to go all the way around the body?


Blood travels at three feet per second when it leaves the heart, but it slows down as it gets into smaller arteries and capillaries. It takes a minute to get around the body.

Heart pumps about 70 ml of blood out with each beat.70 beats a minute,So,about 4.9 litres of blood, which is almost your whole body’s worth of blood.So, in a minute, you will pump the entire blood volume around your body.



 Five quarts of blood per minute are transported around the body.

How long does the round trip take? A typical human body contains 5.6 liters (6 quarts) of blood. According to this page “The heart pumps about 2,000 gallons (7,571 liters) of blood a day through its chambers.”
2,000 gallons per day works out to 83 gallons per hour, or nearly 6 quarts per minute. So it takes about one minute for blood to make the round trip to the heart. If you are running fast, your heart is pumping more blood so the time would be less.


Ingrid SpielmanMaterial Engineer

There is roughly 5L of blood in the body, so we can say that a single cycle is when 5L of blood has passed completely through the body.

Blood Pressure

'average' resting blood pressure = 1/3 systolic + 2/3 diastolic = 1/3(115) + 2/3(75)
(this is because we can say that the heart beats 1/3 of the time and 2/3 of the time the arteries apply a force to move the blood)

Easy calculation #1:
resting heart rate is about 60bpm  but walking is around 80bpm
How much blood does a heart pump per beat? 
(70ml/heartbeat)*(70bpm)*(24hrs/day)*(60min/hr)*(1/1000 L/ml) = 7,056 L per day
(7,056 L/day)/(5L/Cycle) = 1,411 cycles per day


Easy calculation#2:
Go: http://users.rcn.com/jkimball.ma...

 5,600 ml/min total blood flow (I don't know how they got that value)
5,600*(24 hours/day)*(60 min/hour)* (1/1000 L/ml)= 8,064 L per day
8,064/5 = 1,612 cycles per day
You may want to do some weighted average of resting and non-resting blood flow to come up with a better answer. 

Complicated Calculation#3:
Poiseuille's Law (http://hyperphysics.phy-astr.gsu...)

We would use this because our flood flows through tube-like vessels in the body. 
  • pi = 3.14
  • the average radius of our vessels is on the order of capillary size which is roughly 5*10^-4cm. Capillaries limit blood flow since they are the smallest vessels in the body. They are about 5-10 micrometers in diameter. http://biology.about.com/od/anat...
HOWEVER, our body is like a giant circuit so all resistors are additive. This means that it is possible that the diameter should be determined over the entire range of vessel diameters in the body
AGAIN, this estimation may be incorrect because the blood may not travel through all blood vessels before going back to the heart. I'm not sure what parts should be added in series or parallel. 

Q = 3.14*(5*10^-4cm)^4*(120 mm Hg) / (8*(0.004  Pa.s)*(10^10cm))
Q = 7.36*10-20 cm^3/s ~ 10^-22 L/s
24hrs/day*60min/hr*60sec/min = 86400 sec/day
86400 sec/day *  10^-22 L/s = 8.64*10^-18 L per day

Apply to the International Health Workforce Awards 2016! Deadline 10th March https://t.co/U2AOmk7tMt

Apply to the International Health Workforce Awards 2016! Deadline 10th March https://t.co/U2AOmk7tMt

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Chemoradiation may increase survival for a subset of elderly head and neck cancer patients https://t.co/Choi6o9hZd

Chemoradiation may increase survival for a subset of elderly head and neck cancer patients https://t.co/Choi6o9hZd

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Photos: Cave Spring Middle School presents 'Seussical Jr.' - Roanoke Times


Roanoke Times

Photos: Cave Spring Middle School presents 'Seussical Jr.'
Roanoke Times
Alex Ferrell McNeil, Jr., 73, died Saturday, February 20, 2016, after an eight year fight with a rare salivary gland cancer. He was an inspiration to all; never wasting a moment in self-pity, depression, or complaint. He said they wouldn't change ...

and more »


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Coronary Thrombosis without Dissection following Blunt Trauma

Blunt trauma to the chest resulting in coronary thrombosis and ST elevation myocardial infarction (STEMI) is a rare but well-described occurrence in adults. Angiography in such cases has generally disclosed complete epicardial coronary occlusion with thrombus, indistinguishable from the findings commonly found in spontaneous plaque rupture due to atherosclerotic disease. In all previously reported cases in which coronary interrogation with intravascular ultrasound (IVUS) was performed in association with acute revascularization, coronary artery dissection was implicated as the etiology of coronary thrombosis. We present the first case report of blunt trauma-associated coronary thrombosis without underlying atherosclerosis or coronary dissection, as documented by IVUS imaging.

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Apoptosis through Death Receptors in Temporal Lobe Epilepsy-Associated Hippocampal Sclerosis

Seizure models have demonstrated that neuroinflammation and neurodegeneration are preponderant characteristics of epilepsy. Considering the lack of clinical studies, our aim is to investigate the extrinsic pathway of apoptosis in pharmacoresistant temporal lobe epilepsy (TLE) associated with hippocampal sclerosis (HS) patients, TLE(HS). By a specific death receptor-mediated apoptosis array plate, 31 upregulated targets were revealed in the sclerotic hippocampus from TLE(HS) patients. Amongst them are the encoding genes for ligands (FASLG, TNF, and TNFSF10) and death receptors (FAS, TNFRSF1A, TNFRSF10A, and TNFRSF10B). In addition, we evaluated the hippocampal relative mRNA expression of the two TNF receptors, TNFRSF1A and TNFRSF1B, in patients, being both upregulated (; and , resp.) when compared to the post mortem control group (). Our results have clearly suggested that three different death receptor apoptotic systems may be associated with the maintenance and progression of TLE-associated HS: (1) TNF-TNFRSF1A, (2) FASLG-FAS, and (3) TNFSF10-TNFRSF10A/B. Their effects on epilepsy are still scarcely comprehended. Our study points out to TNF and TNF receptor superfamily pathways as important targets for pharmacological studies regarding the benefits of an anti-inflammatory therapy in these patients.

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Probing into the Interaction of Nicotine and Bovine Submaxillary Mucin: NMR, Fluorescence, and FTIR Approaches

Nicotine, the important component of cigarette products, may have an impact on the oral environment after inhalation. The research of interaction between nicotine and bovine submaxillary mucin (BSM) contributes to understand the binding mechanism of nicotine and BSM, and the effects of nicotine on the structure and function of the mucin. NMR data demonstrated that the interaction between nicotine and BSM did exist, and it was pyrrolidyl ring of nicotine playing the major role in the binding. The quenching mechanisms of nicotine and BSM in different pH were different: for acidic environment, the quenching was dynamic; while it became static in the alkaline circumstance. Synchronous fluorescence spectra indicated that nicotine had effect on the microenvironment of the Trp rather than Tyr residue. Meanwhile, the impact of nicotine on the conformation of BSM was also confirmed by 3D fluorescence and FTIR spectra.

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Multidrug-Resistant Tuberculosis and Its Association with Adrenal Insufficiency: Assessment with the Low-Dose ACTH Stimulation Test

Background. Multidrug-resistant tuberculosis (MDR-TB) is a major public health care concern that affects the life of millions of people around the world. The association of tuberculosis and adrenal insufficiency is well known; however, it is thought to be less prevalent every time. A spike in TB incidence and a lack of evidence of this association in patients with MDR-TB call for reassessment of an illness (adrenal dysfunction) that if not diagnosed could seriously jeopardize patients’ health. Objective. To determine the prevalence of adrenocortical insufficiency in patients with MDR-TB using the low-dose (1 μg) ACTH stimulation test at baseline and at 6–12 months of follow-up after antituberculosis treatment and culture conversion. Methods. A total of 48 men or women, aged ≥18 years (HIV-negative patients diagnosed with pulmonary MDR-TB) were included in this prospective observational study. Blood samples for serum cortisol were taken at baseline and 30 and 60 minutes after 1 μg ACTH stimulation at our tertiary level university hospital before and after antituberculosis treatment. Results. Forty-seven percent of subjects had primary MDR-TB; 43.8% had type 2 diabetes; none were HIV-positive. We found at enrollment 2 cases (4.2%) of adrenal insufficiency taking 500 nmol/L as the standard cutoff point value and 4 cases (8.3%) alternatively, using 550 nmol/L. After antituberculosis intensive phase drug-treatment and a negative mycobacterial culture ( months) adrenocortical function was restored in all cases. Conclusions. In patients with MDR-TB, using the low-dose ACTH stimulation test, a low prevalence of mild adrenal insufficiency was observed. After antituberculosis treatment adrenal function was restored in all cases. Given the increasing and worrying epidemic of MDR-TB these findings have important clinical implications that may help clinicians and patients make better decisions when deciding to test for adrenocortical dysfunction or treat insufficient stimulated cortisol levels in the setting of MDR-TB.

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Sociodemographic and Lifestyle Determinants of Plasma Oxidative Stress Markers 8-OHdG and F2-Isoprostanes and Associations with Metabolic Syndrome

Background. Oxidative stress is increasingly important in health research. Therefore, it is necessary to understand which factors determine basal oxidative stress. This study examines the associations of various determinants with markers of oxidative DNA and lipid damage: 8-hydroxy-2′-deoxyguanosine (8-OHdG) and F2-isoprostanes. Methods. Data are from the Netherlands Study of Depression and Anxiety; 1117 subjects (18–65 years) without a current psychiatric diagnosis. Multivariable regression analyses were conducted with plasma levels of 8-OHdG and F2-isoprostanes (measured by LC/MS-MS) including sociodemographic, lifestyle, and sampling variables. Associations with metabolic syndrome (MetS) and chronic disease were examined. Results. 8-OHdG and F2-isoprostanes were weakly correlated ( = 0.06, = 0.045). Both were positively associated with age and cotinine (cigarette exposure); 8-OHdG was lower in females and after longer sample storage. F2-isoprostanes were higher in females, alcohol users, and in samples collected in spring and lower in supplement users and those with more education. Both markers were lower in fasting subjects. F2-isoprostanes, not 8-OHdG, were positively associated with MetS. Conclusion. The weak correlation between 8-OHdG and F2-isoprostanes suggests they reflect specific aspects of oxidative stress. Both markers are associated with a range of sociodemographic, lifestyle, and sampling determinants which should be considered in future research. F2-isoprostanes are associated with MetS.

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A Survey on the Effect of Livestock Production System and Finishing Diet on Sensory Characteristics of Foal Meat Using Generalized Procrustes Analysis

The influence of livestock production system [Freedom Extensive System (FES) versus Semi-Extensive System (SES)] and finishing feed (1.5 kg versus 3.0 kg of commercial feed in the finishing period) diet on sensory properties of foal meat using Generalized Procrustes Analysis (GPA) was studied. For this work, a total of 24 foals (8 from FES and 16 from SES) were used. Samples were evaluated by eight panelists for eight sensory attributes: colour, marbling, odour intensity, sweetness, springiness, hardness, chewiness, and juiciness. Data were analyzed using a GPA to minimize differences among testers. Highly appreciated sensory properties (odour intensity, red colour, marbling, and juiciness) were mostly associated with foals from the Semi-Extensive System. On the other hand, the three groups studied (FES, 1.5SES, and 3SES) were clearly recognized by panelists on the consensus configuration and they were clearly separated on the map. This study concluded that sensory characteristics of foal meat from a Semi-Extensive Production System with a finishing diet of 3 kg concentrate were more preferable than the other ones.

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A Multicast-Traffic-Oriented Energy-Saving Algorithm with a Hybrid Sleep Mode for EPONs

High energy consumption in Ethernet Passive Optical Networks (EPONs) has caused intense research on energy-saving methods in recent years. The most common method for EPON energy saving is to cause optical network units (ONUs) to sleep which are idle or low loaded. With the popularity of multimedia applications, the ONUs carry not only unicast traffic but also more and more multicast traffic. However, existing studies mainly focus on ONUs that support only unicast traffic. The many differences between multicast traffic and unicast traffic make it necessary to design novel energy-saving methods. This paper proposes a multicast-traffic-oriented energy-saving algorithm for EPONs, called the energy-saving algorithm for multicast traffic (ESMT). To save as much energy as possible, the proposed algorithm uses a hybrid sleep mode (composed of a deep sleep state and an independent sleep mode) in which not only can ONU enter a deep sleep state, but also the ONU transmitter and receiver can sleep independently. Simulation results show that the proposed algorithm, which is oriented to multicast traffic in EPONs, is more energy efficient than other algorithms.

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Ion Channels in Inflammatory Processes: What Is Known and What Is Next?



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Effect of Astragaloside IV on Neural Stem Cell Transplantation in Alzheimer’s Disease Rat Models

Stem cell-based therapy is a promising treatment strategy for neurodegenerative diseases such as Alzheimer’s disease (AD). However, the mechanism underlying the maintenance of renewal and replacement capabilities of endogenous progenitor cells or engrafted stem cells in a pathological environment remains elusive. To investigate the effect of astragaloside IV (ASI) on the proliferation and differentiation of the engrafted neural stem cells (NSCs), we cultured NSCs from the hippocampus of E14 rat embryos, treated the cells with ASI, and then transplanted the cells into the hippocampus of rat AD models. In vitro experimentation showed that 10−5 M ASI induced NSCs to differentiate into β-tubulin III+ and GFAP+ cells. NSCs transplantation into rat AD models resulted in improvements in learning and memory, especially in the ASI-treated groups. ASI treatment resulted in an increase in the number of β-tubulin III+ cells in the hippocampus. Further investigation showed that ASI inhibited PS1 expression in vitro and in vivo. The high-dose ASI downregulated the Notch intracellular domain, whereas the low-dose ASI increased Notch-1 and NICD. In conclusion, ASI treatment resulted in improvements in learning and memory of AD models by promoting NSC proliferation and differentiation partly through the Notch signal pathway.

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Prognostic Relevance of the Peritoneal Surface Disease Severity Score Compared to the Peritoneal Cancer Index for Colorectal Peritoneal Carcinomatosis

Background. Peritoneal Carcinomatosis Index (PCI) is a widely established scoring system that describes disease burden in isolated colorectal peritoneal carcinomatosis (CPC). Its significance may be diminished with complete cytoreduction. We explore the utility of the recently described Peritoneal Surface Disease Severity Score (PSDSS) and compare its prognostic value against PCI. Methods. The endpoints were overall survival (OS), progression-free survival (PFS), and survival less than 18 months (18 MS). Results. Fifty patients underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) for CPC from 2003 to 2014, with 98% achieving complete cytoreduction. Median OS was 28.8 months (95% CI, 18.0–39.1); median PFS was 9.4 months (95% CI, 7.7–13.9). Univariate analysis showed that higher PCI was significantly associated with poorer OS (HR 1.11; 95% CI, 1.03–1.20) and PFS (HR 1.09; 95% CI, 1.03–1.14). Conversely, PSDSS was not associated with either endpoint. Multivariate analysis showed that PCI, but not PSDSS, was predictive of OS and PFS. PCI was also able to discriminate survival outcomes better than PSDSS for both OS and PFS. There was no association between 18 MS and either score. Conclusion. PCI is superior to PSDSS in predicting OS and PFS and remains the prognostic score of choice in CPC patients undergoing CRS/HIPEC.

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A Case of Rituximab Use as an Induction and Maintenance of Remission in ANCA-Associated Vasculitis

Antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV) is a multisystem autoimmune disease affecting mainly microscopic blood vessels due to circulating autoantibodies against neutrophil cytoplasmic antigens. We report a case of a 57-year-old female patient presenting with hemoptysis, sinusitis, and conjunctivitis. Based on lung biopsy, the diagnosis of antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV) was established. She was put on rituximab as induction and maintenance therapy. She responded initially to rituximab as induction therapy but failed to respond in the maintenance course of the drug. Rituximab was stopped and mycophenolate mofetil was administered. She responded as laboratory c-ANCA titers turned negative and symptoms subsided. There are no randomized clinical trials addressing rituximab effect in induction and remission at the same time. This case report doubts the efficacy of the use of rituximab therapy for both induction and maintenance of remission at the same time, waiting for the results of the ongoing trials.

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Changes in Climate Extremes over North Thailand, 1960–2099

This study analyzes 24 climate extreme indices over North Thailand using observed data for daily maximum and minimum temperatures and total daily rainfall for the 1960–2010 period, and HadCM3 Global Climate Model (GCM) and PRECIS Regional Climate Model simulated data for the 1960–2100 period. A statistical downscaling tool is employed to downscale GCM outputs. Variations in and trends of historical and future climates are identified using the nonparametric Mann-Kendall trend test and Sen’s slope. Temperature extreme indices showed a significant rising trend during the observed period and are expected to increase significantly with an increase in summer days and tropical nights in the future. A notable decline in the number of cool days and nights is also expected in the study area while the number of warm days and nights is expected to increase. There was an insignificant decrease in total annual rainfall, number of days with rainfall more than 10 and 20 mm. However, the annual rainfall is projected to increase by 9.65% in the future 2011–2099 period compared to the observed 1960–2010 period.

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Ahead of print: Laparoscopy for the treatment of ovarian remnant syndrome in four dogs and two cats

Objective: To describe the clinical workup and laparoscopic treatment of ovarian remnant syndrome in dogs and cats. Material and methods: After confirming the diagnosis with some or all of the following tests – vaginoscopy with cytology, hormonal tests, and ultrasound – laparoscopic removal of the ovarian remnants was performed. A three-portal technique was used in the four dogs and a two-portal technique in the two cats. Results: All patients recovered well and were discharged the same day. No post-operative complications occurred in any patient. Conclusion and clinical relevance: Overall, in the hands of an experienced laparoscopic surgeon, laparoscopic removal of ovarian remnants appears to be a safe procedure in dogs and cats. In addition, laparoscopy offers the advantages of excellent visualization and a reduced morbidity for the patient. Careful case selection and complete pre-operative workup to rule out co-morbidities or underlying neoplasia are important. As with any laparoscopy the surgeon should always be prepared to convert to an open laparotomy if necessary....

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Ahead of print: Prävalenz und Risikofaktoren der felinen Hyperthyreose in einer Klinikpopulation ...

Ziel: Die feline Hyperthyreose ist eine häufige Endokrinopathie bei älteren Katzen. In früheren Studien wurden unausgewogene Ernährung, Schilddrüsen-Disruptoren, hohes Alter sowie fehlende Reinrassigkeit als Risikofaktoren diskutiert, ein endgültiger Auslöser bleibt jedoch unbekannt. Die Ziele dieser prospektiven Studie waren a) die Berechnung der Klinikprävalenz in einer Katzenpopulation in Süddeutschland, b) die Feststellung, wie häufig die Diagnose nach dem klinischem Verdacht bestätigt wurde und c) die Auswertung mutmaßlicher in- und extrinsischer Risikofaktoren anhand des Signalements der Katzen und eines Fragebogens. Methoden: Gesamt-Thyroxin (T4) wurde im Serum von 495 Katzen ≥ 8 Jahre gemessen und die Prävalenz mit einem 95%-Konfidenzintervall (95%-KI) berechnet. Abhängigkeiten zwischen Signalement und Hyperthyreose wurden durch den Student-T-Test, Chi-Square-Test und den Mann-Whitney U-Test analysiert. Das Signifikanzniveau lag bei 0,05. Zur Ermittlung extrinsischer Risikofaktoren diente ein logistisches Regressionsmodell. Ergebnisse: Bei 61 Katzen wurde eine Hyperthyreose diagnostiziert, was eine Prävalenz von 12,3% ergibt (95%-KI: 9,7–15,5). Ältere (p < 0,001) weibliche Katzen (p = 0,019; Odds Ratio 1,9) waren signifikant häufiger betroffen. Hauskatzen (Europäisch Kurz- und Langhaarkatzen) erkrankten häufiger als Rassekatzen (p = 0,016). Bei 164 Katzen wurde die Verdachtsdiagnose Hyperthyreose gestellt und in 20,1% (33/164) der Fälle verifiziert. In 2,4% (12/495) der Fälle war die erhöhte T4-Konzentration ein Zufallsbefund. Hyperthyreote Katzen wurden häufiger mit Nassfutter aus Aluminiumschalen (p < 0,013) gefüttert als nichthyperthyreote Katzen. Schlussfolgerung und klinische Relevanz: Ältere, weibliche Hauskatzen sind prädisponiert, an einer Schilddrüsenüberfunktion zu erkranken. Die Diagnose lässt sich häufig nach initialem klinischem Verdacht stellen, woraus in der Studienpopulation eine Prävalenz von 12,3% resultierte. Rückstände aus Aluminiumschalen oder das Nassfutter selbst scheinen eine Rolle in der Ätiopathogenese zu spielen....

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Tumore della laringe: microchirurgia con laser ad anidride carbonica - Corriere della Sera


Corriere della Sera

Tumore della laringe: microchirurgia con laser ad anidride carbonica
Corriere della Sera
«Nell'area testa-collo risiedono funzioni vitali non solo per la nostra sopravvivenza, come respirare e mangiare, ma anche per la nostra vita di relazione, come parlare o gustare - spiega Mohssen Ansarin, direttore del Programma Testa-Collo e Divisione ...



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IJERPH, Vol. 13, Pages 247: Heavy Metals in Surface Soils in the Upper Reaches of the Heihe River, Northeastern Tibetan Plateau, China

The upper reaches of the Heihe River have been regarded as a hotspot for phytoecology, climate change, water resources and hydrology studies. Due to the cold-arid climate, high elevation, remote location and poor traffic conditions, few studies focused on heavy metal contamination of soils have been conducted or reported in this region. In the present study, an investigation was performed to provide information regarding the concentration levels, sources, spatial distributions, and environmental risks of heavy metals in this area for the first time. Fifty-six surface soil samples collected from the study area were analyzed for Cr, Mn, Ni, Cu, Zn, As, Cd and Pb concentrations, as well as TOC levels. Basic statistics, concentration comparisons, correlation coefficient analysis and multivariate analyses coupled with spatial distributions were utilized to delineate the features and the sources of different heavy metals. Risk assessments, including geoaccumulation index, enrichment factor and potential ecological risk index, were also performed. The results indicate that the concentrations of heavy metals have been increasing since the 1990s. The mean values of each metal are all above the average background values in the Qinghai Province, Tibet, China and the world, except for that of Cr. Of special note is the concentration of Cd, which is extremely elevated compared with all background values. The distinguished ore-forming conditions and well-preserved, widely distributed limestones likely contribute to the high Cd concentration. Heavy metals in surface soils in the study area are primarily inherited from parent materials. Nonetheless, anthropogenic activities may have accelerated the process of weathering. Cd presents a high background concentration level and poses a severe environmental risk throughout the whole region. Soils in Yinda, Reshui daban, Kekeli and Zamasheng in particular pose threats to the health of the local population, as well as that of livestock and wildlife.

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IJERPH, Vol. 13, Pages 246: Effects of in Utero Exposure to Dicyclohexyl Phthalate on Rat Fetal Leydig Cells

Dicyclohexyl phthalate (DCHP) is one of the phthalate plasticizers. The objective of the present study was to investigate the effects of DCHP on fetal Leydig cell distribution and function as well as testis development. Female pregnant Sprague Dawley dams orally received vehicle (corn oil, control) or DCHP (10, 100, and 500 mg/kg/day) from gestational day (GD) 12 to GD 21. At GD 21.5, testicular testosterone production, fetal Leydig cell number and distribution, testicular gene and protein expression levels were examined. DCHP administration produced a dose-dependent increase of the incidence of multinucleated gonocytes at ≥100 mg/kg. DCHP dose-dependently increased abnormal fetal Leydig cell aggregation and decreased fetal Leydig cell size, cytoplasmic size, and nuclear size at ≥10 mg/kg. DCHP reduced the expression levels of steroidogenesis-related genes (including Star, Hsd3b1, and Hsd17b3) and testis-descent related gene Insl3 as well as protein levels of 3β-hydroxysteroid dehydrogenase 1 (HSD3B1) and insulin-like 3 (INSL3) at ≥10 mg/kg. DCHP significantly inhibited testicular testosterone levels at ≥100 mg/kg. The results indicate that in utero exposure to DCHP affects the expression levels of fetal Leydig cell steroidogenic genes and results in the occurrence of multinucleated gonocytes and Leydig cell aggregation.

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Pulmonary Hypertension Secondary to Partial Anomalous Pulmonary Venous Return in an Elderly

Background. Partial anomalous pulmonary venous return (PAPVR) is an uncommon congenital abnormality, which may present in the adult population. It is often associated with sinus venosus defect (SVD). The diagnosis and therapy for this condition may be challenging. Case Presentation. We describe a case of an elderly woman who presented with NYHA Class IV dyspnea and was suspected to have symptomatic pulmonary hypertension. She was later found to have anomalous right upper pulmonary vein return to the superior vena cava and associated SVD with bidirectional shunting. Therapeutic options were discussed and medical management alone with aggressive diuresis and sildenafil was adopted. Follow-up visits revealed success in the planned medical therapy. Conclusions. PAPVR is a rare congenital condition that may present during late adulthood. The initial predominant left-to-right shunting associated with this anomaly may go undetected for years with the gradual development of pulmonary hypertension and right heart failure due to right heart volume overload. Awareness of the condition is important, as therapy is time-sensitive with early detection potentially leading to surgical therapy as a viable option.

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Universal Superspace Unitary Operator for Some Interesting Abelian Models: Superfield Approach

Within the framework of augmented version of superfield formalism, we derive the superspace unitary operator and show its usefulness in the derivation of Becchi-Rouet-Stora-Tyutin (BRST) and anti-BRST symmetry transformations for a set of interesting models for the Abelian 1-form gauge theories. These models are (i) a one (0+1)-dimensional (1D) toy model of a rigid rotor, (ii) the two (1+1)-dimensional (2D) modified versions of the Proca and anomalous Abelian 1-form gauge theories, and (iii) the 2D self-dual bosonic gauge field theory. We provide, in some sense, the alternatives to the horizontality condition (HC) and the gauge invariant restrictions (GIRs) in the language of the above superspace (SUSP) unitary operator. One of the key observations of our present endeavor is the result that the SUSP unitary operator and its Hermitian conjugate are found to be the same for all the Abelian models under consideration (including the 4D interacting Abelian 1-form gauge theories with Dirac and complex scalar fields which have been discussed earlier). Thus, we establish the universality of the SUSP operator for the above Abelian theories.

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Quality Assessment of Artemether-Lumefantrine Samples and Artemether Injections Sold in the Cape Coast Metropolis

Most prescribers and patients in Ghana now opt for the relatively expensive artemether/lumefantrine rather than artesunate-amodiaquine due to undesirable side effects in the treatment of uncomplicated malaria. The study sought to determine the existence of substandard and/or counterfeit artemether-lumefantrine tablets and suspension as well as artemether injection on the market in Cape Coast. Six brands of artemether-lumefantrine tablets, two brands of artemether-lumefantrine suspensions, and two brands of artemether injections were purchased from pharmacies in Cape Coast for the study. The mechanical properties of the tablets were evaluated. The samples were then analyzed for the content of active ingredients using High Performance Liquid Chromatography with a variable wavelength detector. None of the samples was found to be counterfeit. However, the artemether content of the samples was variable (93.22%−104.70% of stated content by manufacturer). The lumefantrine content of the artemether/lumefantrine samples was also variable (98.70%–111.87%). Seven of the artemether-lumefantrine brands passed whilst one failed the International Pharmacopoeia content requirements. All brands of artemether injections sampled met the International Pharmacopoeia content requirement. The presence of a substandard artemether-lumefantrine suspension in the market should alert regulatory bodies to be more vigilant and totally flush out counterfeit and substandard drugs from the Ghanaian market.

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An Improved Metabolism Grey Model for Predicting Small Samples with a Singular Datum and Its Application to Sulfur Dioxide Emissions in China

This study proposes an improved metabolism grey model [IMGM] to predict small samples with a singular datum, which is a common phenomenon in daily economic data. This new model combines the fitting advantage of the conventional GM in small samples and the additional advantages of the MGM in new real-time data, while overcoming the limitations of both the conventional GM and MGM when the predicted results are vulnerable at any singular datum. Thus, this model can be classified as an improved grey prediction model. Its improvements are illustrated through a case study of sulfur dioxide emissions in China from 2007 to 2013 with a singular datum in 2011. Some features of this model are presented based on the error analysis in the case study. Results suggest that if action is not taken immediately, sulfur dioxide emissions in 2016 will surpass the standard level required by the Twelfth Five-Year Plan proposed by the China State Council.

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Autorenverzeichnis


Schweiz Z Ganzheitsmed 2016;28(suppl 1):V

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Anatomic characterization of prelemniscal radiations by probabilistic tractography: implications in Parkinson’s disease

Abstract

To characterize the anatomical connectivity of the prelemniscal radiations (Raprl), a white matter region within the posterior subthalamic area (PSA) that is an effective neurosurgical target for treating motor symptoms of Parkinson’s disease (PD). Diffusion-weighted images were acquired from twelve healthy subjects using a 3T scanner. Constrained spherical deconvolution, a method that allows the distinction of crossing fibers within a voxel, was used to compute track-density images with sufficient resolution to accurately delineate distinct PSA regions and probabilistic tractography of Raprl in both hemispheres. Raprl connectivity was reproducible across all subjects and showed fibers traversing through this region towards primary and supplementary motor cortices, the orbitofrontal cortex, ventrolateral thalamus, and the globus pallidus, cerebellum and dorsal brainstem. All brain regions reached by Raprl fibers are part of motor circuits involved in the pathophysiology of PD; while these fiber systems converge at the level of the PSA, they can be spatially segregated. Fibers of distinct and specific motor control networks are identified within Raprl. The description of this anatomical crossroad suggests that, in the future, tractography could allow deep brain stimulation or lesional therapies in white matter targets according to individual patient’s symptoms.



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Impact of total stent length after cobalt chromium everolimus-eluting stent implantation on 3-year clinical outcomes

Objectives

The objective was to assess whether total stent length (TSL) after cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation was associated with long-term clinical outcomes.

Background

The impact of TSL after CoCr-EES implantation on long-term clinical outcomes remained unclear.

Methods

A total of 1,007 consecutive patients with 1,382 lesions treated only with CoCr-EES were analyzed. Patients and lesions were divided into tertile group: TSL per patient (TSL-P) (PA [8–23 mm], n = 382; PB [23–46 mm], n = 312; and PC [46–204 mm], n = 313), and TSL per lesion (TSL-L) (LA [8–18 mm], n = 486; LB [18–28 mm], n = 475; and LC [28–140 mm], n = 421). The cumulative 3-year incidence of clinically driven target-lesion revascularization (CD-TLR) and definite stent thrombosis (ST) based on TSL-P and TSL-L groupings were accessed.

Results

After inverse probability of weighted adjustment, the cumulative 3-year incidence of CD-TLR for the TSL-P and TSL-L were higher in the PC and LC groups than in the other groups (hazard ratio [HR] 2.92, 95% confidence intervals [CI] 1.66–5.15, P < 0.001 vs. PA; HR 2.49, 95% CI 1.47–4.20, P < 0.001 vs. PB; HR 1.94, 95% CI 1.15–3.28, P = 0.01 vs. LA; HR 2.80, 95% CI 1.73–4.54, P < 0.001 vs. LB, respectively). No significant differences in the cumulative 3-year incidence of definite ST were observed in both TSL-P and TSL-L groups.

Conclusions

TSL after CoCr-EES implantation has significantly impact on CD-TLR rate through 3 years, but it is not associated with an increased incidence of definite ST. © 2016 Wiley Periodicals, Inc.



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A new specific device in transcatheter prosthetic paravalvular leak closure: A prospective two-center trial

Background

This study sought to compare various outcomes among a new specifically designed transcatheter paravalvular leak closure (TPVLC) device and the devices that are being utilized off-label.

Methods

Between April 2012 and January 2015, in a prospective two-center study, 52 patients who needed surgical reintervention due to a hemodynamically significant prosthetic paravalvular leak were studied. This study population was divided into two groups. Group I was composed of 32 patients who underwent paravalvular leak (PVL) closure with the currently available devices that are being utilized off-label, while group II consisted of 20 patients who were treated with the new specifically designed Occlutech PVL device.

Results

Demographic and clinical variables indicated a higher rate of atrial fibrillation (P = 0.027) and chronic obstructive airway disease (P = 0.009) in group II. The apical approach was the most commonly used intervention route used for group II (P = 0.019). The procedural success rate was 100% (29 of 29 leaks) in group II while the rate was 92% (39 of 42 leaks) in group I. However, more secondary events were observed in group I, but they did not reach statistical significance (8 vs. 1, P = 0.064).

Conclusions

With its high procedural success rate and encouraging outcome results, the Occlutech device seems to satisfy the expectations of a specifically designed PVL closure device. © 2016 Wiley Periodicals, Inc.



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Influence of smoking on the antiplatelet effect of clopidogrel differs according to clopidogrel dose: Insights from the GRAVITAS trial

Objective

To examine the influence of smoking on the antiplatelet effect of clopidogrel following percutaneous coronary intervention (PCI).

Background

Certain studies suggest smokers may have enhanced clopidogrel-induced platelet inhibition compared to non-smokers after PCI. Whether this is affected by clopidogrel dose is unknown.

Methods

In this study, we conducted an analysis of 5,429 patients in the Gauging Responsiveness With A VerifyNow P2Y12 Assay: Impact on Thrombosis and Safety (GRAVITAS) trial. Platelet reactivity was assessed 12–24 hr after PCI (baseline). Patients with high on-treatment platelet reactivity (OTR) (P2Y12 reaction units [PRU] ≥ 230) were randomized to clopidogrel 75 mg or 150 mg daily. Reactivity was subsequently assessed at 30-days, and 6-months. Patients were stratified by smoking status.

Results

Smoking was independently associated with lower PRU (P = 0.001), and smokers were less likely to have high OTR (odds ratio 0.80, 95% confidence interval 0.68–0.94; P = 0.006) at baseline. Among patients assigned to clopidogrel 75 mg, smokers had lower PRU and were less likely to still have high OTR at 30-days (P < 0.001) and 6-months (P < 0.001). However, in patients assigned clopidogrel 150 mg, PRU and high OTR did not differ by smoking status at any time. Tests demonstrated an interaction between smoking and dose at 30 days (P = 0.007), and a trend at 6-months (P = 0.098).

Conclusions

Smokers treated with clopidogrel exhibit reduced platelet reactivity and are less likely to have persistent high OTR than non-smokers. This difference is mitigated by clopidogrel 150 mg, indicating non-smokers may require double-dose therapy to achieve a similar antiplatelet effect after PCI. © 2016 Wiley Periodicals, Inc.



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Cover Image



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Issue Information – TOC



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RNA sequencing validation of the Complexity INdex in SARComas prognostic signature

Publication date: April 2016
Source:European Journal of Cancer, Volume 57
Author(s): Tom Lesluyes, Gaëlle Pérot, Marine Roxane Largeau, Céline Brulard, Pauline Lagarde, Valérie Dapremont, Carlo Lucchesi, Agnès Neuville, Philippe Terrier, Dominique Vince-Ranchère, Maria Mendez-Lago, Marta Gut, Ivo Gut, Jean-Michel Coindre, Frédéric Chibon
BackgroundPrognosis of metastatic outcome in soft tissue sarcomas is an important clinical challenge since these tumours can be very aggressive (up to 50% of recurring events). A gene expression signature, Complexity INdex in SARComas (CINSARC), has been identified as a better prognostic factor compared to the current international grading system defined by the Fédération Nationale des Centres de Lutte Contre le Cancer. Since CINSARC has been established on frozen tumours analysed by microarrays, we were interested in evaluating its prognostic capacity using next generation sequencing (NGS) on formalin-fixed, paraffin-embedded (FFPE) blocks to better fit laboratory practices.MethodsMetastatic-free survivals (training/validation approach with independent datasets) and agreement values in classification groups were evaluated. Also, RNA degradation threshold has been established for FFPE blocks and differences in gene expression due to RNA degradation were measured.ResultsCINSARC remains a strong prognostic factor for metastatic outcome in both microarray and RNA-seq technologies (P < 0.05), with similar risk-group classifications (77%). We defined quality threshold to process degraded RNA extracted from FFPE blocks and measured similar classifications with frozen tumours (88%).ConclusionThese results demonstrate that CINSARC is a platform and material independent prognostic signature for metastatic outcome in various sarcomas. This result opens access to metastatic prognostication in sarcomas through NGS analysis on both frozen and FFPE tumours via the CINSARC signature.



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3D printing of human organs on horizon

2016_02_22_13_18_01_371_3D_printer_word_Investigators are envisioning a brave new world in which functional 2D-printed...


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CAD finds breast cancer on negative DCE-MRI

2016_02_22_14_51_29_265_2016_02_23_breasA study using a new computer-aided detection (CAD) algorithm found breast cancers...


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Health Promotion in the Community: Impact of Faith-Based Lay Health Educators in Urban Neighborhoods

Abstract

Promoting wellness and providing reliable health information in the community present serious challenges. Lay health educators, also known as community health workers, may offer a cost-effective solution to such challenges. This is a retrospective observational study of graduates from the Lay Health Educator Program (LHEP) at Johns Hopkins Bayview Medical Center from 2013 to 2014. Students were enrolled from the surrounding community congregations and from the hospital’s accredited clinical pastoral education program. There were 50 events implemented by the lay health educators during the 2014–2015 time period, reaching a total of 2004 individuals. The mean time from date of graduation from the LHEP to implementation of their first health promotional event was 196 ± 76 days. A significant number of lay health educators implemented events within the first year after completing their training. Ongoing monitoring of their community activity and the clinical impact of their efforts should be a priority for future studies.



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Higher sleep variability is associated with poorer glycaemic control in patients with type 1 diabetes

Summary

Sleep disturbances have been linked to insulin resistance and poor glycaemic control in patients with type 2 diabetes. However, the data are limited in type 1 diabetes. Recently, varying day-to-day sleep schedules, i.e. sleep variability, have been associated with adverse metabolic profile in healthy individuals. This study explored whether sleep variability affects glycaemic control and insulin requirement in type 1 diabetes. Forty-one adult patients with type 1 diabetes wore an actigraphy for 5 nights. Standard deviation of sleep duration, efficiency and mid-sleep time were sleep variability parameters. Sleep apnoea risk and self-reported sleep quality were assessed by the Berlin questionnaire and Pittsburgh Sleep Quality Index. Haemoglobin A1c, diabetes complications and insulin regimen were obtained from medical records. After adjusting for neuropathic symptoms, sleep apnoea risk and poor self-reported sleep quality, higher sleep variability was significantly associated with poorer glycaemic control (standard deviation of sleep duration, = 0.100, = 0.004; and standard deviation of mid-sleep time, = 0.068, = 0.04). In addition, standard deviations of sleep duration and mid-sleep time were highly correlated, suggesting that participants changed their sleep duration along with sleep timing. After adjusting for covariates, the standard deviation of sleep duration (= 0.009) and standard deviation of mid-sleep time (= 0.012) were associated with higher insulin requirement. In summary, higher sleep variability, which likely reflects sleep deprivation alternating with sleep compensation along with shifts in their circadian timing, was associated with poorer glycaemic control and higher insulin requirement in patients with type 1 diabetes. Increased sleep regularity may improve metabolic control in type 1 diabetes.



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Duration of sleep at 3 years of age is associated with fat and fat-free mass at 4 years of age: the Southampton Women's Survey

Summary

Many studies have shown that shorter sleep duration in childhood is associated with higher body mass index (BMI), and have proposed that it is due to an effect of sleep on adiposity. There is little evidence about the association of sleep with fat-free mass. This study examined the association between child's sleep duration at age 3 years and fat and fat-free mass at 4 years of age in a prospective cohort study of 302 boys and 285 girls. Study participants were taking part in the Southampton Women's Survey, a longitudinal study of mothers and children from preconception onwards. Total sleep duration at age 3 years was derived from parental report of night sleep and nap duration. Body composition was assessed by Dual-energy X-ray Absorptiometry (DXA) at 4 years. Mean total sleep duration was 11.5 hours. In linear regression analyses, adjusted for potentially confounding factors (maternal educational attainment, prepregnancy BMI, smoking during pregnancy, child's gestational age at birth, age at DXA, sex, age last breastfed, dietary quality at 3 years, TV watching and hours actively on the move and parental social class), shorter sleep in hours was associated with higher BMI (kg/m2) [β: −0.2340, 95% confidence interval (CI): −0.373 to −0.096], a greater fat mass index (kg) (β: −0.1182, 95% CI: −0.218 to −0.018) and a greater fat-free mass index (kg) (β: −0.100, 95% CI: −0.185 to −0.015). Previous research suggested that the association between shorter sleep and higher body mass index is due to an effect on adiposity. Our findings are novel, suggesting that the relationship between sleep and BMI is also determined by an effect on muscle.



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Improved vigilance after sodium oxybate treatment in narcolepsy: a comparison between in-field and in-laboratory measurements

Summary

This two-centre observational study of vigilance measurements assessed the feasibility of vigilance measurements on multiple days using the Sustained Attention to Response Task and the Psychomotor Vigilance Test with portable task equipment, and subsequently assessed the effect of sodium oxybate treatment on vigilance in patients with narcolepsy. Twenty-six patients with narcolepsy and 15 healthy controls were included. The study comprised two in-laboratory days for the Maintenance of Wakefulness Test and the Oxford Sleep Resistance test, followed by 7-day portable vigilance battery measurements. This procedure was repeated for patients with narcolepsy after at least 3 months of stable treatment with sodium oxybate. Patients with narcolepsy had a higher Sustained Attention to Response Task error count, lower Psychomotor Vigilance Test reciprocal reaction time, higher Oxford Sleep Resistance test omission error count adjusted for test duration (Oxford Sleep Resistance testOMIS/MIN), and lower Oxford Sleep Resistance test and Maintenance of Wakefulness Test sleep latency compared with controls (all P < 0.01). Treatment with sodium oxybate was associated with a longer Maintenance of Wakefulness Test sleep latency (P < 0.01), lower Oxford Sleep Resistance testOMIS/MIN (P = 0.01) and a lower Sustained Attention to Response Task error count (= 0.01) in patients with narcolepsy, but not with absolute changes in Oxford Sleep Resistance test sleep latency or Psychomotor Vigilance Test reciprocal reaction time. It was concluded that portable measurements of sustained attention as well as in-laboratory Oxford Sleep Resistance test and Maintenance of Wakefulness Test measurements revealed worse performance for narcoleptic patients compared with controls, and that sodium oxybate was associated with an improvement of sustained attention and a better resistance to sleep.



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Arkansas Voters and Medical Marijuana - KARK


KARK

Arkansas Voters and Medical Marijuana
KARK
... as heroin, the Department of Health's National Cancer Institute is now “advising that cannabinoids are useful in treating cancer and its side effects by smoking, eating it in a baked product, drinking herbal teas, or even spraying it under the ...

and more »


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Not flavone-8-acetic acid (FAA) but its murine metabolite 6-OH-FAA exhibits remarkable antivascular activities in vitro.

Flavone-8-acetic acid (FAA) has been proved to be a potent vascular-disrupting agent in mice. Unfortunately, FAA did not produce any anticancer activity in clinical trials. Previously, we had reported that FAA is metabolized by mouse microsomes into six metabolites, whereas it was poorly metabolized by human microsomes, with fewer metabolites formed in lesser amounts. Especially, 6-OH-FAA was not formed by human microsomes. In this work, two major available metabolites, 4'-OH-FAA and 6-OH-FAA, were tested and compared with the parent compound FAA for their potential antivascular activities in vitro. The ability of the products to induce morphological changes, disrupt preformed capillaries of EA.hy926 endothelial cells and inhibit tubulin polymerization in vitro was assessed. The action mechanism was determined using the RhoA and Rac1 inhibitors. At 25 [micro]g/ml, 6-OH-FAA induced morphological changes and membrane blebbing, whereas 300 [micro]g/ml of FAA and 4'-OH-FAA slightly changed the morphology without inducing membrane blebbing. At 300 [micro]g/ml, 6-OH-FAA produced morphological changes that were 2.1-6.9-fold greater than that produced by FAA and 4'-OH-FAA, an effect that was consistent with its much greater inhibitory effect on tubulin polymerization compared with FAA and 4'-OH-FAA. 6-OH-FAA significantly disrupted the EA.hy926 cell capillaries. 6-OH-FAA activities were prevented in EA.hy926 cells pretreated with RhoA, but not Rac1, inhibitor. In this short communication we report for the first time that, in vitro, 6-OH-FAA, a mouse-specific FAA metabolite, exhibits significantly stronger antivascular activities compared with FAA and 4'-OH-FAA, which are mediated through the RhoA kinase pathway. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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I comici di Made in Sud protagonisti di "Mille note per la vita" - Il Denaro (Comunicati Stampa) (Blog)


I comici di Made in Sud protagonisti di "Mille note per la vita"
Il Denaro (Comunicati Stampa) (Blog)
Nicola Mozzillo (Direttore del Dipartimento Melanoma, Muscolo-Scheletrico e Testa-Collo del Pascale). ... Nel corso della serata Ascierto e Mozzillo hanno ricordato le finalità sociali della Fondazione Melanoma onlus (http://ift.tt/1QVZZV1), nata ...



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