Distribution of HPV-16 and HPV-18 from the Patients Attending At Mymensingh Medical College Hospital by Newly Developed Oncoprotein Detection Assay.

Cervical cancer is one of cause of death in women in many developing countries. Persistent infection with Human Papilloma Virus (HPV), primarily high risk types 16 and 18, is recognized as a causal and essential factor for the development of cervical cancer. The objective of this cross sectional observational study is to detect the distribution of HPV-16 and HPV-18 among Onco E6 positive cases. Following universal safety precautions a total of 180 endocervical swabs were collected from Colposcopy clinic of Obstetrics and Gynaecology Department of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from January 2016 to December 2016. Laboratory work was done in the department of Microbiology, Mymensingh Medical College. E6 strip test is an immunochromatographic test based on the detection of HPV-E6 oncoprotein in cervical swab samples. Onco E6 cervical test was done on 180cases. Among them 60% were VIA positive and 120% were VIA negative. From this VIA positive cases 12(16.25%) were On E6 cervical test positive and from VIA negative cases 3(2.5%) were positive by this On E6 cervical test. From this 12 Onco E6 cervical test positive cases 10(%) were HPV-16 and 2(%) were HPV-18 and from VIA negative cases 3 were only HPV-16 by this test. Histopathological test done on 35 suspected cases and out of 08 cervical carcinoma cases 07 were positive by this Onco E6 cervical test which was also HPV-16 type. It may be concluded that HPV-16 is most prevalent type to cause cervical cancer and by this newly developed protein detection assay will be helpful to reduce over treatment and save many lives.

Perspectives on telemedicine to improve stroke treatment.

Stroke is the number three cause of death and the most common cause of adult disability in the United States. Few patients receive the only established effective therapy, intravenous tissue plasminogen activator. Failure to treat may occur due to several reasons, a crucial one being the lack of acute neurologic coverage, particularly in rural settings. In this article we review the difficulties encountered by patients needing immediate care to access stroke specialists. To overcome this delay in patient care, telemedicine technology for acute stroke care is recommended. We track the emergence and evolution of "telestroke" from initial telephone consultation, to point-to-point, hub-and-spoke networks, to web-based site-independent telestroke systems. We detail the emerging evidence for the safety and efficacy of these remote telestroke systems through observational studies (TEMPiS and REACH). Lastly, we discuss areas where telestroke could potentially expand to provide more complete stroke care beyond the acute thrombolysis phase, as well as its potential to improve clinical research and the need for cost-effective research. We conclude that telestroke is currently the most practical solution to any setback faced by stroke specialists with respect to low thrombolytic rates.

The effect of shortening and varus collapse of the femoral neck on function after fixation of intracapsular fracture of the hip: a multi-centre cohort study.

We have studied the effect of shortening of the femoral neck and varus collapse on the functional capacity and quality of life of patients who had undergone fixation of an isolated intracapsular fracture of the hip with cancellous screws. After screening 660 patients at four university medical centres, 70 patients with a mean age of 71 years (20 to 90) met the inclusion criteria. Overall, 66% (46 of 70) of the fractures healed with > 5 mm of shortening and 39% (27 of 70) with > 5 degrees of varus. Patients with severe shortening of the femoral neck had significantly lower short form-36 questionnaire (SF-36) physical functioning scores (no/mild (<5 mm) vs severe shortening (> 10 mm); 74 vs 42 points, p < 0.001). A similar effect was noted with moderate shortening, suggesting a gradient effect (no/mild (< 5 mm) vs moderate shortening (5 to 10 mm); 74 vs 53 points, p = 0.011). Varus collapse correlated moderately with the occurrence of shortening (r = 0.66, p < 0.001). Shortening also resulted in a significantly lower EuroQol questionnaire (EQ5D) index scores (p = 0.05). In a regression analysis shortening of the femoral neck was the only significant variable predictive of a low SF-36 physical functioning score (p < 0.001).

Molybdenum disulfide nanowires and nanoribbons by electrochemical/chemical synthesis.

Molybdenum disulfide nanowires and nanoribbons have been synthesized by a two-step, electrochemical/chemical synthetic method. In the first step, MoO(x) wires (a mixture of MoO(2) and MoO(3)) were electrodeposited size-selectively by electrochemical step-edge decoration on a highly oriented pyrolytic graphite (HOPG) surface. Then, MoO(x) precursor wires were converted to MoS(2) by exposure to H(2)S either at 500-700 degrees C, producing "low-temperature" or LT MoS(2) nanowires that were predominantly 2H phase, or above 800 degrees C producing "high-temperature" or HT MoS(2) ribbons that were predominantly 3R phase. The majority of these MoS(2) wires and ribbons were more than 50 microm in length and were organized into parallel arrays containing hundreds of wires or ribbons. MoS(2) nanostructures were characterized by X-ray photoelectron spectroscopy, scanning and transmission electron microscopy, selected area electron diffraction, X-ray diffraction, UV-visible absorption spectrometry, and Raman spectroscopy. HT and LT MoS(2) nanowires were structurally distinct: LT MoS(2) wires were hemicylindrical in shape and nearly identical in diameter to the MoO(x) precursor wires from which they were derived. LT MoS(2) wires were polycrystalline, and the internal structure consisted of many interwoven, multilayer strands of MoS(2); HT MoS(2) ribbons were 50-800 nm in width and 3-100 nm thick, composed of planar crystallites of 3R-MoS(2). These layers grew in van der Waals contact with the HOPG surface so that the c-axis of the 3R-MoS(2) unit cell was oriented perpendicular to the plane of the graphite surface. Arrays of MoS(2) wires and ribbons could be cleanly separated from the HOPG surface and transferred to glass for electrical and optical characterization. Optical absorption measurements of HT MoS(2) nanoribbons reveal a direct gap near 1.95 eV and two exciton peaks, A1 and B1, characteristic of 3R-MoS(2). These exciton peaks shifted to higher energy by up to 80 meV as the wire thickness was decreased to 7 nm (eleven MoS(2) layers). The energy shifts were proportional to 1/ L( parallel)(2), and the effective masses were calculated. Current versus voltage curves for both LT and HT MoS(2) nanostructures were probed as a function of temperature from -33 degrees C to 47 degrees C. Conduction was ohmic and mainly governed by the grain boundaries residing along the wires. The thermal activation barrier was found to be related to the degree of order of the crystallites and can be tuned from 126 meV for LT nanowires to 26 meV for HT nanoribbons.

Comminuted fractures of the iliac wing.

PURPOSE: Comminuted iliac fractures are uncommon and difficult to treat. The purpose of this study is to further delineate the fractures, to present a management protocol, and to evaluate the results of treatment. DESIGN: Retrospective clinical study. SETTING: Level one trauma center at Harborview Medical Center. PATIENTS: During a sixty-eight-month period, 695 patients with pelvic ring disruptions were treated at a level one trauma center. Thirteen (1.9%) of these patients had a severely comminuted iliac fracture. All patients were men, ranging in age from twenty to eighty years (mean, 38 years). These patients were polytraumatized and had a mean Injury Severity Score of 23. Eleven of the thirteen patients had severe iliac and flank degloving injuries. Five patients had open fractures, one with fecal contamination requiring diverting colostomy. Six patients with clinical signs of hemodynamic instability had local arterial injuries associated with their fractures. All five patients with extension of the fracture into the greater sciatic notch were found to have a local arterial injury on angiography. One patient had a lumbosacral plexopathy on the fractured side. Four patients had traumatic brain injuries. INTERVENTION: All thirteen patients were treated operatively. Routine pelvic external fixation was not possible because of the iliac comminution. Stable internal fixation was accomplished by an anterior iliac surgical exposure using lag screw and plate combinations. The open wounds and degloving injuries were treated with irrigation, debridement, and closed suction drainage. MAIN OUTCOME MEASUREMENTS: Healing and stability of fixation were assessed clinically and on pelvic radiographs. RESULTS: Comminuted iliac fractures were divided into two patient groups, according to associated pelvic ring disruption. Follow-up evaluations were available for all patients at a mean of eighteen months after injury. There were no deaths. All of the fractures healed clinically and radiographically. In one patient, fecal contamination caused a polymicrobial wound infection, and this patient had an associated delay in union of the fracture. Another patient with an open fracture developed a deep wound infection. Both infections responded to local management and antibiotics. There were no complications associated with the degloving injuries. CONCLUSIONS: Comminuted iliac fractures occur in two distinct patterns and are associated with numerous local injuries that complicate management. Management protocols should include early open reduction and stable internal fixation. Traumatic open wounds should not be closed primarily. Primary closure with closed suction drainage is effective in the management of associated degloving injuries. Extension of the fracture into the greater sciatic notch warrants further evaluation with pelvic angiography.

Consumer use of St. John's wort: a survey on effectiveness, safety, and tolerability.

Despite its poorly described pharmacology, effectiveness, and safety, use of St. John's wort (SJW) is largely unsupervised and unexplored, and can potentially lead to adverse outcomes. We conducted a telephone survey of 43 subjects who had taken SJW to assess demographics, psychiatric and medical conditions, dosage, duration of use, reason for use, side effects, concomitant drugs, professional consultation, effectiveness, relapse, and withdrawal effects. Most subjects reported taking SJW for depression, and 74% did not seek medical advice. Mean dosage was 475.6+/-360 mg/day (range 300-1200 mg/day) and mean duration of therapy was 7.3+/-10.1 weeks (range 1 day-5 yrs). Among 36 (84%) reporting improvement, 18 (50%) had a psychiatric diagnosis. Twenty (47%) reported side effects, resulting in discontinuation in five (12%) and one emergency room visit. Two consumers experienced symptoms of serotonin syndrome and three reported food-drug interactions. Thirteen consumers experienced withdrawal symptoms and two had a depressive relapse. These data suggest the need for greater consumer and provider awareness of the potential risks of SJW in self-care of depression and related syndromes.

Antidepressant overdoses and resultant emergency department services: the impact of SSRIs.

Suicide is a major source of morbidity and mortality in patients with mental illness. The selective serotonin reuptake inhibitors (SSRIs) and other newer nontricyclic antidepressants appear to have less clinically significant toxicity in overdose, resulting in lower costs of treatment when compared with tricyclic antidepressant (TCA) overdoses. The resource utilization and cost of treatment for SSRI overdoses may not be less if (1) these agents are commonly ingested with other potentially toxic substances, or (2) health care practices have not changed in response to the apparent greater safety of SSRIs. This study evaluates demographic variables of antidepressant overdoses to determine whether differences exist in treatments and monitoring. Additionally, this study evaluates costs associated with care and the impact of co-ingestants on those same factors.

Immunophenotypic analysis of HL-60 cells during basophilic differentiation.

Differentiation along specific myeloid lineages may be accompanied by characteristic cell surface marker changes. We have examined leukemic HL-60 cell changes under conditions which induce basophilic differentiation. An increased surface expression of CD35, CD11b, and decreased expression of CD15 was found by flow cytometry during the 5-day induction period. Further investigation revealed two cell populations after 5 days in vitro: (i) a CD35-positive population (61% of cells present) containing a significant number of CD15-negative cells, and (ii) a CD15-positive/CD35-negative population. The CD35-positive subset appears to account for the majority of the basophilic cells induced under these conditions, as measured by histamine content and metachromatic staining. In addition, this subset contains a small number of early monocytic cells (CD14 and CD23 positive). The expression of CD11b is variably found on the CD15-positive/ CD35-negative subset of induced cells. These results suggest that CD35 and CD15 surface immunophenotyping can be used to map steps involved in myeloid development. A role for CD35 and CD15 in early basophil differentiation is proposed.

Longitudinal analysis of abnormal involuntary movements in long-term clozapine-treated patients.

As part of a prospective efficacy and safety monitoring system, patients receiving clozapine are assessed monthly for dyskinetic events (DE), using the Abnormal involuntary Movement Scale (AIMS). Longitudinal analysis of 45 patients revealed 20 with baseline DE, 7 who developed emergent DE after a negative baseline assessment, and 18 patients with no DE symptoms throughout treatment with clozapine. Eight of the 20 patients with baseline DE were assessed to resolution of symptoms, with an average time of 261 +/- 188 days; 5 were evaluated until complete resolution of symptoms (AIMS = 0), with an average time of 691 +/- 462 days. The average time to onset of DE in emergent DE patients was 238 +/- 179 days, and the average time to resolution was 347 +/- 179 days after diagnosis. Four patients attained complete resolution with an average time of 629 +/- 293 days after diagnosis. It appears this emergent type of dyskinesia is different from other currently described dyskinesias. Overall, of the 27 patients having DE at any point in treatment, 15 of 27 (56%) had resolution of symptoms and 10 of 27 (37%) had complete resolution of DE. Clinicians should be aware of the utility of clozapine in dyskinesia and the extended time frame of response.

Electrodeposited defect chemistry superlattices.

Nanometer-scale layered structures based on thallium(III) oxide were electrodeposited in a beaker at room temperature by pulsing the applied potential during deposition. The conducting metal oxide samples were superlattices, with layers as thin as 6.7 nanometers. The defect chemistry was a function of the applied overpotential: High overpotentials favored oxygen vacancies, whereas low overpotentials favored cation interstitials. The transition from one defect chemistry to another in this nonequilibrium process occurred in the same potential range (100 to 120 millivolts) in which the rate of the back electron transfer reaction became significant. The epitaxial structures have the high carrier density and low electronic dimensionality of high transition temperature superconductors.

Scanning tunneling microscopy of electrodeposited ceramic superlattices.

Cleaved cross sections of nanometer-scale ceramic superlattices fabricated from materials of the lead-thallium-oxygen system were imaged in the scanning tunneling microscope (STM). The apparent height differences between the layers were attributed to composition-dependent variations in local electrical properties. For a typical superlattice, the measured modulation wavelength was 10.6 nanometers by STM and 10.8 nanometers by x-ray diffraction. The apparent height profile for potentiostatically deposited superlattices was more square than that for galvanostatically deposited samples. These results suggest that the composition follows the applied potential more closely than it follows the applied current. The x-ray diffraction pattern of a superlattice produced under potential control had satellites out to the fourth order around the (420) Bragg reflection.

Electrodeposited ceramic superlattices.

Ceramic superlattices have been produced by electrodeposition with modulation wavelengths in the range from 5 to 10 nanometers. The TlaPbbOc/TldPbeOf superlattices were deposited from a single aqueous solution at room temperature, and the layer thicknesses were galvanostatically controlled. The films showed strong preferred orientation and distinct first-order satellites around the Bragg reflections in the x-ray diffraction pattem. The modulation wavelengths calculated from the satellite spacings were in agreement with those calculated from Faraday's law. Because the modulation wavelengths are of electron mean free path dimensions, this dass of degenerate semiconductor metal-oxide superlattices may exhibit thickness-dependent quantum optical, electronic, or optoelectronic effects.

Interactions of hemopoietic cytokines on differentiation of HL-60 cells. Nerve growth factor is a basophilic lineage-specific co-factor.

Nerve growth factor (NGF) is a neurotropic polypeptide which has broad biological activity other than support of growth and survival of sympathetic, sensory and central neurons. NGF promotes rat mast cell hyperplasia in vivo and human granulopoiesis in vitro, selectively augmenting basophil/mast cell differentiation in the presence of T cells or conditioned medium derived from a human T cell line (Mo-CM), a source of granulocyte-macrophage colony-stimulating factor (GM-CSF). NGF also synergizes with GM-CSF to promote human basophil/mast cell differentiation in both methylcellulose and suspension cultures of myeloid progenitors. In the current studies, we examined the interactions of NGF and several cytokines considered to be involved in human basophil/mast cell and eosinophil growth and differentiation, including interleukin (IL)-3, IL-4, IL-5, GM-CSF and granulocyte colony-stimulating factor (G-CSF). NGF synergistically enhanced IL-5 induced dose-dependent increases in histamine content and basophilic cell differentiation of myeloid leukemic HL-60 cells, but was only additive to similar effects of IL-3. In contrast, IL-4 and G-CSF did not promote basophilic differentiation of HL-60 cells in the presence or absence of NGF. Various combinations of GM-CSF, G-CSF, IL-3, IL-4 and IL-5 could not reproduce the synergy observed between NGF and either IL-5 or GM-CSF. NGF appears to represent a class of lineage-specific co-factors, in this case being involved in GM-CSF- or IL-5-induced basophilic lineage differentiation, thus contributing to tissue inflammation or repair.

CD-ROM MEDLINE training: a survey of medical school libraries.

Most medical school libraries are attempting to provide some form of training for the CD-ROM MEDLINE user, according to this survey conducted in 1989. User guides and vendor-produced tutorials are helpful but are not usually a major aspect of the training. The training sessions vary considerably in length as well as number of attendees, with individualized training being the most widespread. Few facilities offer advanced classes. A core list of training topics has been identified. Evaluation of the training has been done in only a small percentage of the libraries.

Identification of 5-hydroxytryptamine1D binding sites in human brain membranes.

High-affinity, specific 3H-5-hydroxytryptamine (5-HT) binding was analyzed in membrane homogenates of human frontal cortex, caudate, and globus pallidus. 5-HT1A and 5-HT1C binding sites were pharmacologically blocked using 100 nM 8-hydroxy-N,N-dipropyl-2-aminotetralin (8-OH-DPAT) and 100 nM mesulergine, respectively. The majority of 5-HT1 sites remained in each of the three brain regions under these conditions. The pattern of nucleotide interactions with these binding sites (GppNHp = GTP = GDP greater than GMP = adenine nucleotides) suggests a possible linkage to a G protein. RU 24969 competition studies confirmed the absence of 5-HT1B binding sites in human cortex, caudate, and globus pallidus. Drug interactions with putative 5-HT1D binding sites in bovine caudate membranes correlated significantly with their affinities for human membrane recognition sites labeled by 3H-5-HT in the presence of 100 nM 8-OH-DPAT + 100 nM mesulergine. We conclude that the majority of 3H-5-HT labeled recognition sites in human cortex, caudate, and globus pallidus represent 5-HT1D binding sites.

Factors influencing basophilic differentiation of HL-60 cells.

Lineage-specific hematopoietins apparently act in concert with multipotent factors in an orderly sequence of growth and differentiation. We have used the human acute promyelocytic leukemia cell line HL-60 to examine basophilic differentiation, using radioenzymatic assay of histamine content as an end point. Recombinant human interleukin 1 (rhIL-1), rhIL-2, rhIL-4, and recombinant human alpha and gamma interferons did not stimulate basophilic differentiation either in the presence or absence of sodium butyrate, an important cofactor for induction of differentiation. In contrast, rhG-CSF (granulocyte colony-stimulating factor), rhGM (granulocyte-macrophage) CSF, rhIL-3, rhIL-5, nerve growth factor, conditioned medium (CM) from the hairy T cell leukemic line Mo, and nasal polyp epithelial CM stimulated significant increases in histamine content in HL-60 cells at day 5 in vitro. GM-CSF did not account for all of the basophilic differentiating activity in Mo-CM. The data suggest that a unique, lineage-specific, basophilic cell differentiation factor is produced by T cells and point to the possible diagnostic and therapeutic relevance of in situ hematopoietic mechanisms in human respiratory disease.

Human basophilic cell differentiation promoted by 2.5S nerve growth factor.

In liquid cultures of human cord blood mononuclear cells, the activities of the 2.5S nerve growth factor (NGF) inducing basophil and eosinophil differentiation were investigated. Various concentrations of immunopurified 2.5S NGF derived from murine submaxillary glands were added to cultures with or without conditioned medium from a human T cell line (Mo-CM), which has previously been shown to produce activities stimulating granulocyte-macrophage colonies. Addition of NGF led to significant increases in differentiation of basophilic cells accompanied by histamine synthesis at 2 weeks in vitro; eosinophil differentiation was not increased in these cultures. In addition, NGF could be shown to amplify basophil differentiation induced by Mo-CM, and the activity of NGF inducing basophil differentiation was dependent on the presence of T lymphocytes. These results indicate that NGF stimulates T-lymphocyte-dependent basophilic cell differentiation from human cord blood progenitors and may in this way support differentiation of basophils or mast cells in vivo at sites of allergic tissue inflammation.

Acetate Synthesis from H(2) plus CO(2) by Termite Gut Microbes.

Gut microbiota from Reticulitermes flavipes termites catalyzed an H(2)-dependent total synthesis of acetate from CO(2). Rates of H(2)-CO(2) acetogenesis in vitro were 1.11 +/- 0.37 mumol of acetate g (fresh weight) h (equivalent to 4.44 +/- 1.47 nmol termite h) and could account for approximately 1/3 of all the acetate produced during the hindgut fermentation. Formate was also produced from H(2) + CO(2), as were small amounts of propionate, butyrate, and lactate-succinate. However, H(2)-CO(2) formicogenesis seemed largely unrelated to acetogenesis and was believed not to be a significant reaction in situ. Little or no CH(4) was formed from H(2) + CO(2) or from acetate. H(2)-CO(2) acetogenesis was inhibited by O(2), KCN, CHCl(3), and iodopropane and could be abolished by prefeeding R. flavipes with antibacterial drugs. By contrast, prefeeding R. flavipes with starch resulted in almost complete defaunation but had little effect on H(2)-CO(2) acetogenesis, suggesting that bacteria were the acetogenic agents in the gut. H(2)-CO(2) acetogenesis was also observed with gut microbiota from Prorhinotermes simplex, Zootermopsis angusticollis, Nasutitermes costalis, and N. nigriceps; from the wood-eating cockroach Cryptocercus punctulatus; and from the American cockroach Periplaneta americana. Pure cultures of H(2)-CO(2)-acetogenic bacteria were isolated from N. nigriceps, and a preliminary account of their morphological and physiological properties is presented. Results indicate that in termites, CO(2) reduction to acetate, rather than to CH(4), represents the main electron sink reaction of the hindgut fermentation and can provide the insects with a significant fraction (ca. 1/3) of their principal oxidizable energy source, acetate.