Immunostaining for the tumour suppressor gene p16 product is a useful marker to differentiate melanoma metastasis from lymph-node nevus

Upon the introduction of extensive sampling protocols of sentinel node biopsies, pathologists are increasingly confronted with small melanoma metastases. Using conventional histology, it proves sometimes difficult or impossible to differentiate small melanoma metastases from lymph-node nevi. Loss of the tumour suppressor gene p16 has been shown to be associated with tumour progression of melanoma. We investigated nevus and melanoma cells for the presence of the product of the gene p16, using immunohistochemistry. All nevus cells, independent of their location (nodal or skin) displayed an extensive nuclear and cytoplasmic staining for p16. In contrast, all cells of melanoma metastases, except one skin metastasis, lacked nuclear staining for p16. These findings indicate that p16 is a reliable marker to distinguish lymph-node nevi from melanoma metastasi

Pesan-pesan budaya lagu-lagu pop dangdut dan pengaruhnya terhadap perilaku sosial remaja kota

Kesempatan untuk membicarakan maupun mempopulerkan lagu pop dangdut cukup luas. Bisa melalui penayangan di televisi baik swasta maupun pemerintah, melalui mass media surat kabru;majalah,tabloid, pagelaran langsung, hasil penelitian, seminru; bahkan akhir-akhir ini melaui popularitas pejabat-pejabat pemerintahan. Hal ini dapat dibenarkan, timbulnya niat seperti itu bukan ingin menyelaraskan diri dengan zaman, melainkan adanya keinginan untuk menyelamatkan maupun mengembangkan sebagian besar unsur budaya tradisional. Walaupun kenyataannya, sekarang musik dangdut sudah dipengaruhi oleh berbagai musik etnik lokal dan negara luar: Adanya penambahan unsur yang berasal dari luar dimaksudkan, agar persepsi orang tentang musik dangdut yang berbau kampungan mulai bekurang. Ahir-akhir ini orang masih melestarikan pendapat itu, bahwa musik dangdut adalah musik pinggiran kota atau musik orang yang status sosial ekonominya dari menengah ke bawah

Fibrin versus polyethylene glycol sealant: an experimental study in rabbits

Fibrin glue has been applied universally in general surgery as an adhesive, hemostatic, or embolizing agent. In reconstructive surgery, fibrin has been used mainly for nerve and microvascular repair or as a substitute for sutures in skin closure and skin grafting. Another area of increasing use is in face-lift surgery, where the goal is to improve hemostasis on the raw surfaces and to discourage the occurrence of major hematomas. However, as most components of the fibrin glue are derived from human or bovine plasma, they may cause allergic reactions and transmit infectious agents such as hepatitis or AIDS virus, or prions such as the Creutzfeldt-Jakob disease agent. With these risks in mind, we tested polyethylene glycol (PEG) sealant, a recently introduced and purely synthetic vascular sealant, as an alternative to fibrin glue. A 2 × 2cm subcutaneous pocket was created on the dorsal thighs of ten New Zealand White rabbits by an incision medial to the sciatic vein. The pockets were randomly filled with either 0.2ml of thawed fibrin glue or PEG sealant. After the operation, the thighs were inspected macroscopically for hematoma, seroma, or granuloma formation. Eleven weeks later, the animals were killed, and the fibrin and polyethylene glycol-filled pockets were harvested en bloc with the overlying skin and processed for histological examination. A swelling, viewed macroscopically, was visible at the experimental site in three thighs of the fibrin group, but in none of the PEG group. Only two specimens of the fibrin group and five specimens of the PEG group showed no signs of inflammation. All other specimens revealed signs of chronic or granulomatous inflammation, with no significant difference between the groups. This experimental study showed that 11weeks after application of either fibrin or PEG sealant, signs of chronic or even granulomatous inflammation were detectable in 2/3 of the specimens in the fibrin group and in approximately 50% of the specimens in the PEG group. Beyond the comparable potential of both sealants to induce inflammatory tissue reactions, PEG sealant has some notable advantages as it is purely synthetic and therefore carries no risk of transmission of viral pathogens or prions. The combination of this safety profile, the ease of application, and the consistently good reported hemostatic results obtained with PEG sealant makes it an interesting alternative to fibrin glue in plastic surger

Multiple bilateral asymmetrical deficiency of trunk muscles

Trunk muscles are an important source for pedicled and free flaps in reconstructive surgery. Unilateral deficiencies of trunk muscles are well known, either isolated or as part of Poland's syndrome. Bilateral muscular deficiencies and a "bilateral Poland anomaly” have also been sporadically reported, but this is rare. We report on an 82-year-old male cadaver with clinically obscure, asymmetric bilateral deficiencies of the majority of trunk muscles. There was a history of acute poliomyelitis in childhood. Histological examination of representative muscle samples of the trunk showed extensive muscle atrophy with fat and connective tissue replacement. This was compatible with the prior diagnosis of poliomyelitis. However, representative sections of the spinal cord failed to reveal the antecedent poliomyelitis. The possibility of subclinical bilateral deficiencies of trunk muscles has to be taken into account in patients with a history of poliomyelitis when planning reconstructions in cases of regional pedicled muscle transfers or free microvascular tissue transfers in reconstructive surger

Umsorgt werden und umsorgen - Leben mit mehreren Langzeiterkrankungen (Leila) : eine qualitative Studie zum Beitrag von APN in integrierter Versorgung

Hintergrund: Das Leben mit mehreren chronischen Krankheiten ist komplex und führt zu einer erhöhten Pflege- und Betreuungsbedürftigkeit. Zur Förderung der integrierten Versorgung wurde ein dreijähriges Projekt namens «Leben mit Langzeiterkrankung» (Leila) initiiert. Ziel: Das Projekt hatte zum Ziel, Leistungen von Pflegeexpertinnen in Advanced Practice Nursing (APN) für chronisch erkrankte Menschen in Zusammenarbeit mit Hausarztpraxen zu entwickeln. Folgende Fragestellungen wurden untersucht: 1. Wie erleben Patient(inn)en, Zuweisende und Pflegeexpertinnen APN das Leila-Dienstleistungsangebot? 2. Wie gestalten sich Zuweisungsprozesse? 3. Wie erleben die Beteiligten die Zusammenarbeit und die APN-Rollenausübung? Methode: Es wurde ein qualitativer Ansatz gemäß Grounded Theory nach Corbin und Strauss gewählt, um Erfahrungen mit Leila und Interaktionen der an Leila beteiligten Personen zu untersuchen. Dabei wurden 38 Interviews mit Patient(inn)en, die mit multiplen chronischen Krankheiten leben, deren betreuende Pflegeexpertinnen APN und zuweisenden Ärzt(inn)en durchgeführt und evaluiert. Ergebnisse: «Umsorgt werden und umsorgen» zeigte sich als zentrale Kategorie. Diese beschreibt wie auf die Patient(inn)en eingegangen wurde, sie einbezogen und ernst genommen wurden. Die Hauptkategorie «Den Alltag gestalten» zeigt, dass die Patient(inn)en lernten, mit den Folgen chronischer Erkrankungen im Alltag umzugehen. «Alle Ressourcen nutzen» legt dar, wie Potenziale und Stärken eingesetzt wurden. Schlussfolgerungen: Die Ergebnisse zu Zuweisungs- und Kooperationsprozessen ergaben, dass die APN-Rollenanerkennung und -ausübung noch ausgehandelt werden muss. Zukünftige APN-Angebote für diese Patient(inn)engruppe sollten nebst Ärztenetzwerken in weitere Dienstleistungen und die Spitex integriert werden. Background: Living with multiple chronic diseases is complex and leads to enhanced care needs. To foster integrated care a project called “Living with chronic disease” (Leila) was initiated. Aim: The aim was to develop an Advanced Practice Nursing (APN) service in collaboration with medical centers for persons who are living with multiple chronic diseases. The following research questions were addressed: 1. What are patients' experiences, referring physicians and APNs with the Leila-Service? 2. How are referral processes performed? 3. How do the involved groups experience collaboration and APN role development? Methods: A qualitative approach according grounded theory of Corbin and Strauss was used to explore the experiences with the Leila project and the interaction of the persons involved. 38 interviews were conducted with patients who are living with multiple chronic diseases, their APN's and the referring physicians. Results: The findings revealed “Being cared for and caring” as main category. The data demonstrated how patients responded to their involvement into care and that they were taken as serious partners in the care process. The category “organizing everyday life” describes how patients learned to cope with the consequences of living with multiple chronic diseases. “Using all resources” as another category demonstrates how capabilities and strengths were adopted. Conclusions: The results of the cooperation- and allocation processes showed that the APN recognition and APN role performance have to be negotiated. Prospective APN-services for this patient population should be integrated along with physician networks and other service providers including community health nursing

Bedeutung der Tierernährung für die Verwertung von Lebensmittel-Nebenprodukten

Die Nutztierhaltung steht aufgrund der Flächenkonkurrenz zwischen Lebens- und Futtermittelproduktion zunehmend in der Kritik. Insbesondere der Einsatz von Kraftfutter beim Milchvieh wird kontrovers diskutiert. Gleichzeitig fallen bei der Verarbeitung von pflanzlichen Urprodukten zu Lebensmitteln grössere Mengen Nebenprodukte an, welche kaum Eingang in die Humanernährung finden. Durch die Verfütterung an Nutztiere können die Nährstoffe der Nebenprodukte weiterhin für die Lebensmittelproduktion genutzt werden. Anhand der Anbau- und Importmengen von Urprodukten sowie der mittleren Lebensmittelausbeute wurde der jährliche Anfall an Nebenprodukten geschätzt. Das Verwertungspotential über die Hauptnutztierarten Schweine, Geflügel und Rindvieh wurde über den (Misch-)Futterkonsum der jeweiligen Tierart sowie den maximal möglichen Einsatz der Nebenprodukte im Futter ermittelt. Die bedeutendste Verwertung der schweizweit jährlich anfallenden 365 387 t pflanzlicher Nebenprodukte erfolgt im Mischfutter. In der Geflügelfütterung können 57 575 t und in der Schweineproduktion 138 123 t Nebenprodukte eingesetzt werden. Die verbleibenden rund 170 000 t oder 46 % der Nebenprodukte müssen über Tiere der Rindergattung verwertet werden, durch Einmischung in Ergänzungsfutter oder als Einzelfuttermittel. Die mengenmässig wichtigsten Nebenprodukte stammen aus der Mehlmüllerei mit total 142 681 t, wovon aufgrund von Einsatzbeschränkungen bei Schweinen und Geflügel rund 45 % oder 64 356 t in die Rindviehfütterung gelangen müssen. Da Mühlennebenprodukte kaum als Einzelfuttermittel eingesetzt werden, ist ein gewisser Kraftfutterverzehr für Tiere der Rindergattung hinsichtlich der Schliessung von Nährstoffkreisläufen notwendig

Clades of huge phages from across Earth's ecosystems.

Bacteriophages typically have small genomes1 and depend on their bacterial hosts for replication2. Here we sequenced DNA from diverse ecosystems and found hundreds of phage genomes with lengths of more than 200 kilobases (kb), including a genome of 735 kb, which is-to our knowledge-the largest phage genome to be described to date. Thirty-five genomes were manually curated to completion (circular and no gaps). Expanded genetic repertoires include diverse and previously undescribed CRISPR-Cas systems, transfer RNAs (tRNAs), tRNA synthetases, tRNA-modification enzymes, translation-initiation and elongation factors, and ribosomal proteins. The CRISPR-Cas systems of phages have the capacity to silence host transcription factors and translational genes, potentially as part of a larger interaction network that intercepts translation to redirect biosynthesis to phage-encoded functions. In addition, some phages may repurpose bacterial CRISPR-Cas systems to eliminate competing phages. We phylogenetically define the major clades of huge phages from human and other animal microbiomes, as well as from oceans, lakes, sediments, soils and the built environment. We conclude that the large gene inventories of huge phages reflect a conserved biological strategy, and that the phages are distributed across a broad bacterial host range and across Earth's ecosystems

Hypoxia and Ezrin Expression in Primary Melanoma Have High Prognostic Relevance

Hypoxia affects tumor aggressiveness and activates pathways associated with epithelial mesenchymal transition (EMT) which are crucial for tumor progress. In this study, the correlation of hypoxia and EMT with sentinel lymph node status and tumor-specific survival was investigated in primary melanomas. CD34 for capillary count and Hypoxia inducible factor-1α (HIF-1α) as hypoxia indicators as well as Ezrin and L1-Cell Adhesion Molecule (L1CAM), both critical proteins contributing to EMT, were analyzed using immunohistochemistry in 49 melanoma patients with long follow-up (F/U, mean 110 months; range 12-263 months). We found a significant correlation between Breslow tumor thickness and Ezrin expression (p = 0.018). L1CAM expression in primary melanoma was significantly associated with HIF-1α expression (p < 0.0001) and sentinel lymph node metastasis (p = 0.011). Furthermore, low capillary count, reflecting hypoxic condition, was significantly associated with Ezrin expression (p = 0.047) and decreased tumor-specific survival (p = 0.035). In addition, patients with high Ezrin expression in their primary melanoma had a dramatic loss of life early in their F/U period (mean survival time 29 months; range 15-44 month). Our results highlight the relevance of Ezrin, L1CAM and HIF-1α as prognostic markers in melanoma patients. Additionally, we demonstrate that hypoxia in primary melanoma affects EMT and is at least partly responsible for early metastatic dissemination