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RNA polymerase II (Pol II) C-terminal domain (CTD) is known to have crucial roles in regulating transcription. CTD has also been highly recognized for undergoing phase separation, which is further associated with its regulatory functions. However, the molecular interactions that the CTD forms to induce clustering to drive phase separations and how the phosphorylation of the CTD affects clustering are not entirely known. In this work, we studied the concentrated solutions of two heptapeptide repeat (2CTD) models at different phosphorylation patterns and protein and ion concentrations using all-atom molecular dynamics simulations to investigate clustering behavior and molecular interactions driving the cluster formation. Our results show that salt concentration and phosphorylation patterns play an important role in determining the clustering pattern, specifically at low protein concentrations. The balance between inter- and intrapeptide interactions and counterion coordination together impact the clustering behavior upon phosphorylation.

Extracellular vesicles, including exosomes, are small extracellular vesicles that range in size from 30 nm to 10 μm in diameter and have specific membrane markers. They are naturally secreted and are present in various bodily fluids, including blood, urine, and saliva, and through the variety of their internal cargo, they contribute to both normal physiological and pathological processes. These processes include immune modulation, neuronal synapse formation, cell differentiation, cancer metastasis, angiogenesis, lymphangiogenesis, progression of infectious disease, and neurodegenerative disorders like Alzheimer's and Parkinson's disease. In recent years, interest has grown in the use of exosomes as a potential drug delivery system for various diseases and injuries. Importantly, exosomes originating from a patient's own cells exhibit minimal immunogenicity and possess remarkable stability along with inherent and adjustable targeting capabilities. This review explores the roles of exosomes in angiogenesis, lymphangiogenesis, and nerve repair with a specific emphasis on these processes within the cornea. Furthermore, it examines exosomes derived from specific cell types, discusses the advantages of exosome-based therapies in modulating these processes, and presents some of the most established methods for exosome isolation. Exosome-based treatments are emerging as potential minimally invasive and non-immunogenic therapies that modulate corneal angiogenesis and lymphangiogenesis, as well as enhance and accelerate endogenous corneal nerve repair., (Copyright © 2024. Published by Elsevier Inc.)

In this work, we prepared a well-aligned palladium oxide nanowire (PdO NW) array using the lithographically patterned Pd nanowire electrodeposition (LPNE) method followed by subsequent calcination at 500 °C. Sensitization with platinum (Pt) nanoparticles (NPs), which were functionalized on PdO NWs through a simple reduction process, significantly enhanced the detection capability of the Pt-loaded PdO NWs (Pt-PdO NWs) sensors toward hydrogen gas (H 2 ) at room temperature. The well-distributed Pt NPs, which are known chemical sensitizers, activated the dissociation of H 2 and oxygen molecules through the spillover effect with subsequent diffusion of these products to the PdO surface, thereby transforming the entire surface of the PdO NWs into reaction sites for H 2 . As a result, at a high concentration of H 2 (0.2%), the Pt-PdO NWs showed an enhanced sensitivity of 62% (defined as Δ R/ R air × 100%) compared to that (6.1%) of pristine PdO NWs. The Pt-PdO NWs exhibited a response time of 166 s, which was 2.68-fold faster than that of pristine PdO NWs (445 s). In addition, the Pt-PdO NWs responded to a very low concentration of H 2 (10 ppm) with a sensitivity of 14%, unlike the pristine PdO NWs, which did not exhibit any response at that concentration. These outstanding results are mainly attributed to a homogeneous decoration of Pt NPs on the surface of well-aligned PdO NWs. In this work, we demonstrated the potential suitability of Pt-PdO NWs as a highly sensitive H 2 sensing layer at room temperature.

The oxygen, O 2 , in air interferes with the detection of H 2 by palladium (Pd)-based H 2 sensors, including Pd nanowires (NWs), depressing the sensitivity and retarding the response/recovery speed in air-relative to N 2 or Ar. Here, we describe the preparation of H 2 sensors in which a nanofiltration layer consisting of a Zn metal-organic framework (MOF) is assembled onto Pd NWs. Polyhedron particles of Zn-based zeolite imidazole framework (ZIF-8) were synthesized on lithographically patterned Pd NWs, leading to the creation of ZIF-8/Pd NW bilayered H 2 sensors. The ZIF-8 filter has many micropores (0.34 nm for gas diffusion) which allows for the predominant penetration of hydrogen molecules with a kinetic diameter of 0.289 nm, whereas relatively larger gas molecules including oxygen (0.345 nm) and nitrogen (0.364 nm) in air are effectively screened, resulting in superior hydrogen sensing properties. Very importantly, the Pd NWs filtered by ZIF-8 membrane (Pd NWs@ZIF-8) reduced the H 2 response amplitude slightly (ΔR/R 0 = 3.5% to 1% of H 2 versus 5.9% for Pd NWs) and showed 20-fold faster recovery (7 s to 1% of H 2 ) and response (10 s to 1% of H 2 ) speed compared to that of pristine Pd NWs (164 s for response and 229 s for recovery to 1% of H 2 ). These outstanding results, which are mainly attributed to the molecular sieving and acceleration effect of ZIF-8 covered on Pd NWs, rank highest in H 2 sensing speed among room-temperature Pd-based H 2 sensors.

The 1-methyl-4-phenyl-pyridinium ion (MPP(+)), an active metabolite of the neurotoxin, N-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP), induces death in rat pheochromocytoma (PC12) cells, suggesting a cell model of Parkinson's disease (PD). However, most of the toxic mechanisms remain illusive. In this study, we have found that MPP(+) induced apoptotic cell death in PC12 cells as measured by the MTT assay and annexin V-FITC staining. Besides, MPP(+) also resulted in decreased mitochondrial membrane potential and increased mitochondrial free radical formation as imaged by the staining of TMRE or MitoSOX, respectively, confirming the neurotoxic effect of MPP(+) by interfering with mitochondrial functions. Western blot analysis indicated that MPP(+) differentially regulated the expressions and over-oxidation of thioredoxin systems and peroxiredoxins. Since these enzymes are known to prevent oxidative stress and apoptosis, these evidences could be regarded as a novel neurotoxic mechanism of MPP(+) and also provide an alternative view of developing drug therapies for PD., (Copyright 2010 Elsevier Ltd. All rights reserved.)

Background/aims: Esophageal transection in the Modified Sugiura procedure is advocated by some authors, but considered unnecessary by others. We compared the effectiveness of the Modified Sugiura procedure to our simplified Sugiura procedure that omits esophageal transection for the emergency treatment of bleeding esophagogastric varices., Methodology: From January 1999 to September 2004 we treated 51 patients with cirrhosis of the liver and bleeding esophagogastric varices. All patients had failed management with emergency endoscopy treatment or balloon tamponade with vasopressin infusion. The patients were randomly divided into two groups and underwent the Modified Sugiura procedure with or without esophageal transections., Results: There were no significant differences in age, gender, cause of cirrhosis, or Child-Pugh classification between the two groups. The preoperative hemoglobin levels, preoperative and intraoperative transfusion volume, mortality, morbidity, and days of hospitalization showed no significant differences between the groups. The operative time was shorter with the simplified Sugiura procedure. The 1-3 year survival rates and the rebleeding rates did not differ significantly between the two groups., Conclusion: Both treatments are effective emergency procedures for bleeding esophagogastric varices. Our simplified Sugiura procedure is an effective treatment for bleeding esophagogastric varices and requires a shorter operating time than the Modified Sugiura procedure.

Sentinel node biopsy using patent blue dye in breast cancer is a well-documented procedure to assess the axillary status. We presented an unusual and previously unreported complication of simple blue angioedema over bilaterally periorbital tissue after blue dye injection.

Behçet's disease accompanied by intestinal involvement is called intestinal Behçet's disease. The intestinal ulcers of Behçet's disease are usually multiple and scattered and tend to perforate easily, so that many patients require emergency operation. The aim of this study is to determine the extent of surgical resection necessary to prevent reperforation and to point out the findings of concurrent oral and genital ulcers and multiple intestinal perforations in all patients of our series. During a 25-year study period, information of 125 Behçet's disease cases was gathered. Among the 82 patients who were diagnosed with intestinal Behçet's disease, 22 cases had intestinal perforations needing emergency laparotomy. We investigated and analyzed these cases according to the patients' demographic characteristics, clinical presentations, laboratory data, and surgical outcome. There were 14 men and 8 women ranging from 22 to 65 years of age. Nine cases were diagnosed preoperatively, and the diagnoses were confirmed in all 22 cases during the surgical intervention. Surgical resection was performed in every patient, with right hemicolectomy and ileocecal resection in 11 cases, partial ileum resection in 8 cases with two reperforations, and ileocecal resection in 3 cases with one reperforation.

Aim: To assess the incidence of and risk factors for gallstone disease (GSD) among type 2 diabetics in Kinmen, Taiwan., Methods: A screening program for GSD was performed by two specialists who employed real-time abdominal ultrasound to examine the abdominal region after patients had fasted for at least eight hours. Screening, which was conducted in 2001, involved 848 patients diagnosed with type 2 diabetes. After exclusion of 63 subjects with prevalent GSD, 377 participants without GSD were invited in 2002 for a second round of screening. A total of 281 (74.5%) subjects were re-examined., Results: Among the 281 type 2 diabetics who had no GSD at the first screening, 10 had developed GSD by 2002. The incidence was 3.56% per year (95% CI: 1.78% per year-6.24% per year). Using a Cox regression model, age (RR = 1.07, 95% CI: 1.00-1.14), waist circumference (RR = 1.12, 95% CI: 1.01-1.29), and ALT (RR = 1.13, 95%CI: 1.01-1.26) appeared to be significantly correlated with development of GSD., Conclusion: Older age is a known risk factor for the development of GSD. Our study shows that greater waist circumference and elevated ALT levels are also associated with the development of GSD among type 2 diabetics in Kinmen.

Aim: To explore the prevalence of gallstone disease (GSD) in Taiwan and condition-associated factors related to it., Methods: We studied a total of 2386 healthy adults (1235 males and 1151 females) voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected., Results: The overall prevalence of GSD among this study-population was 5.3%, including 1.7% (n=40) having a single stone, 2.3% (n=55) having multiple stones, and 1.3% (n=31) having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age (P<0.0001). Females exhibited a greater prevalence of multiple stones than did males (3.0% vs 1.7%, P=0.04). Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD: older age (40-49 years vs < 40 years, OR=1.63 [95% CI: 0.76-3.48], 50-59 years vs < 40 years, OR=4.93 [95% CI: 2.43-9.99], 60-69 years vs < 40 years, OR=6.82 [95% CI: 3.19-14.60], > or = 70 years vs < 40 years, OR=10.65 [95% CI: 4.78-23.73]), higher BMI (> or = 27 kg/m2 vs < 24 kg/m2, adjusted OR=1.74 [95% CI: 1.04-2.88]), and higher FPG (> or = 126 mg/dL vs < 110 mg/dL, OR=1.71, 95%CI: 1.01-2.96)., Conclusion: Older age (> or = 50 years), obesity (BMI > or = 27 kg/m2), and type 2 diabetes (FPG > or = 126 mg/dL) are associated with the prevalence of GSD.

Ectopic pancreas is an uncommon condition and is usually found in the gastrointestinal tract, such as stomach, duodenum and jejunum. However, ectopic pancreas in the ampulla of Vater is rare and its clinical presentations may be similar to periampullary cancer. It is difficult to diagnose preoperatively. We present such a case where the diagnosis was proven postoperatively. Our patient, a 51-year-old man, presented with epigastric pain, jaundice, weight loss and abnormal laboratory data. Imaging study, including abdominal sonography, abdominal computerized tomography with contrast and endoscopic retrograde cholangiopancreatography, showed a mass protruding into the ampulla of Vater. The mass was resected and histological examination revealed an ectopic pancreas. The patient presented with symptoms of periampullary tumor but the imaging study did not reveal an obvious lesion for us consider the possibility of ectopic pancreas. Surgical excision is indicated for symptomatic cases., (Copyright (c) 2006 S. Karger AG, Basel)

Aim: To explore the association of serum insulin, insulin resistance, and beta-cell dysfunction with gallstone disease (GSD) in type 2 diabetics., Methods: We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and beta-cell dysfunction (HOMA beta-cell)., Results: We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4(th) vs 1(st) quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4(th) vs 1(st) quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA beta-cell function was significantly related to decreased risk of GSD [4(th) vs 1(st) quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA beta-cell was observed among males., Conclusion: Serum insulin, insulin resistance, and beta-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.

The physician assistant (PA) is a relatively new medical specialty that developed to manage the shortage of resident physicians and to ensure that patients receive high-quality health care in today's increasingly complex and demanding medical environment. PAs in Taiwan are not governed by laws and regulations, and the absence of legislation to define their roles and responsibilities can lead to confusion in the work environment and potential communication barriers with coworkers and supervising physicians. The purpose of this exploratory study was to examine the environmental and sociodemographic factors that influence job satisfaction and job-related communication among PAs in Taiwan. The data source, a self-administered mail survey, was sent to 196 PAs working within medical facilities in northern, central, and southern Taiwan. The response rate to the survey was 71.01%. There was a strong correlation between communication satisfaction and job satisfaction among respondents. The PAs' overall position in the hospital, relationships with coworkers (doctors, nurses, and other medical staff), and ability to perform his or her duties while working with the supervising physician were the major environmental factors that influenced job and communication satisfaction. In addition, the number of working years and marital status were important demographic factors influencing job satisfaction. Demographic and environmental factors influencing job satisfaction are analyzed, and ways in which the roles and responsibilities of PAs can be clarified, strengthened, and improved are discussed in an overall effort to provide management strategies for the current PA system in Taiwan.

Aim: To explore any gender-related differences in prevalence of and condition-associated factors related to an elevated serum alanine aminotransferase (ALT) level amongst residents of Kinmen, Taiwan., Methods: A total of 11,898 of a potential 20,112 regional residents aged 30 years or more completed a related questionnaire that was carried out by the Yang-Ming Crusade between 1991 and 1994 inclusively, with blood samples being collected by public nurses. The overall questionnaire response rate was 59.3% (52.4% for males and 66.0% for females)., Results: The prevalence of an elevated serum ALT level for this sub-population was found to be 7.2%, the prevalence revealing a statistically significant decrease with increasing population age (P<0.0001). Males exhibited a greater prevalence of elevated serum ALT level than did females (9.4% vs 5.3%, P<0.0001). Using multiple logistic regression analysis, in addition to male gender, a younger age, greater waist circumference, presence of type-2 diabetes and hyperuricemia were the significant factors associated with an elevated serum ALT level for both males and females. Gender-related differences as regards associated factors were also revealed. For males, obesity was significantly related to an elevated serum ALT level (OR = 1.28, 95%CI: 1.00-1.66) but this was not so for females (OR = 1.09, 95%CI: 0.84-1.42). Hypertriglyceridemia (OR = 1.80, 95%CI: 1.36-2.39) and hyperuricemia (OR = 1.61, 95%CI: 1.03-2.52) were significantly related to elevated serum ALT levels only for females., Conclusion: Several gender-related differences were noted pertaining to the prevalence of and relationship between obesity, hypertriglyceridemia and hyperuricemia and elevated serum ALT level in the present study.

Activin is known to play an important regulatory role in reproduction, including pregnancy. To further examine the role and signaling mechanism of activin in regulating placental function, the steady-state level of activin type I receptor (ActRI) mRNA in immortalized extravillous trophoblasts (IEVT) cells was measured using competitive PCR (cPCR). An internal standard of ActRI cDNA for cPCR was constructed for the quantification of ActRI mRNA levels in IEVT cells. ActRI mRNA levels were increased in a dose-dependent manner by activin-A with the maximal effect observed at the dose of 10 ng/ml. Time course studies revealed that activin-A had maximal effects on ActRI mRNA levels at 6 hours after treatment. The effects of activin-A on ActRI mRNA levels was blocked by follistatin, an activin binding protein, in a dose-dependent manner. In addition, inhibin-A inhibited basal, as well as activin-A-induced ActRI mRNA levels. These findings provide evidence, for the first time, that activin-A modulates ActRI mRNA levels in human trophoblast cells.

In the present study, we examined the expression of activin receptor (ActR) mRNAs in human ovary and placenta. Primers specific for two type I and two type II activin receptors (ActR-I, ActR-IB, ActR-II, and ActR-IIB) were used in polymerase chain reaction (PCR) to amplify cDNAs prepared from granulosa-luteal cells, placental tissues and isolated trophoblast cells. PCR products with the expected sizes for ActR-I, ActR-IB, ActR-II, and ActR-IIB mRNAs were detected in freshly dissociated and 5-day cultured granulosa-luteal cells; and in trophoblast cells from both first trimester and term placentas. The identity of these PCR products were confirmed by Southern blot hybridization, as well as cloning and sequencing. These results suggest that multiple activin receptors are present in human ovary and placenta and may mediate activin function in these tissues. The demonstration of activin receptor mRNAs in granulosa-luteal and trophoblast cells further supports the notion that activin is an important local regulator in the human ovary and placenta.

Data from the National Practitioner Data Bank were examined to assess malpractice payments in the Lower Rio Grande Valley in comparison with those for Texas and the United States as a whole. The Valley was found to have a high rate of malpractice payments when considered on a per physician basis and on a per unit of utilization basis, but an average rate when considered on a population basis. A number of possible explanations (such as the "bad apple" theory, the "settlement for convenience" theory, the case distribution theory, the physician qualifications theory, and the foreign medical graduate theory) were examined to explain the Valley's observed rate of malpractice payments per physician. No explanations are particularly satisfactory. More research is needed, but indications suggest that the observed rate may be driven more by the activities of some attorneys than by the actions of Valley physicians.

For management of obstruction of the extrahepatic portal trunk in patients with healthy livers, we designed an end-to-side anastomosis between the proximal splenic vein and the umbilical portion of the left intrahepatic portal vein and performed a splenectomy to relieve portal hypertension, treat hypersplenism, and restore hepatic portal flow. To our knowledge, no other procedure more adeptly restores original hepatic blood flow. Creation of an anastomosis between the coronary vein and umbilical portion of the left intrahepatic portal vein is an alternative method.

Two cases of carcinoid tumors, considered to be probably hepatic in origin, occurring in a 53-year-old man and a 69-year-old woman are reported. In both cases no endocrine syndrome appeared, and an alternative primary source of the tumor was not found in case two, despite an intensive search at operation. The neoplasms in both cases were soft, firm, brown-pink and well-encapsulated. They were composed of small uniform cells, that had distinct borders and grew in insular, nests, trabeculae and strands that were separated by a delicate fibrous stroma. Stains of argentaffin and argyrophil showed strong positivity in both cases. The immunohistochemical and ultrastructural studies all demonstrated characteristics of a carcinoid. The postoperative recovery was good. They have remained well 5 years later in case 1 and 3 years in case 2 after surgical treatment. Literature concerning this rare condition is also reviewed.

Inflammatory pseudotumor (IPT) of the liver is an extremely rare benign tumor. Only 12 cases have so far been reported in the English literature. The etiology and pathogenesis of IPT remain obscure. We herein present an additional case of IPT of the liver with occlusive endophlebitis in a 36-year-old female. Immunohistochemical studies demonstrated the polyclonal nature of the plasma cells in the tumor, including IgA, IgM, IgG, kappa and lambda. The inflammatory pseudotumor should be kept in mind in the differential diagnosis of hepatic space-occupying malignant lesions.

Inflammatory pseudotumor (IPT) of the spleen is an extremely rare benign lesion. We herein report an additional case of a 64-year-old man with IPT of spleen to compare with seven cases previously reported in the literature. However, the immunohistochemical studies has demonstrated to polyclonality of plasma cells which was comparable to these seven previously reported cases. The clinical and pathological findings, as well as the possibilities of etiology and pathogenesis are also described.

A case is reported of Maffucci's Syndrome with multiple enchondromata involving the left ring finger and subcutaneous haemangiomata in the left thenar eminence, treated by surgical excision.

A case is reported of late ulno-volar carpometacarpal dislocation of the left little finger, treated by open reduction and internal fixation.

A case is reported of traumatic dislocation to the carpometacarpal joint of the left thumb, treated by ligament reconstruction.