Trogodišnji trend promjena tjelesne pripremljenosti i indeksa tjelesne mase u učenika u dobi od 12 do 16 godina s ekstremnim indeksima tjelesne mase

The aim of this study was to investigate a three-year development in BMI and physical fitness of schoolchildren aged 12-16 years with extreme weight status. Taiwan Physical Fitness Test Battery, assessing aerobic fitness (1600-meter walk/run test), power (standing long jump), muscular endurance (sit-up), and flexibility (sit-and-reach) in 16,945 boys, was implemented in September from the year 2006 till 2008. Overweight and underweight were defined by the baseline BMI data values that fall within the highest and lowest 5% of their age population, whereas the BMI data values that fall within one standard deviation of the mean was considered “normal” in this study. The results showed that BMI of schoolchildren in 2006 was ~2–3 kg/m2 above the national average reported in 1993. All physical fitness components in the overweight group were substantially poorer than those in the normal group. Yet, these fitness parameters were improved over the three years in all groups. BMI in the underweight group increased at a faster rate than that in the normal and overweight groups. No difference was found in the jumping distance between the underweight and normal groups. Aerobic fitness in the underweight group was superior but flexibility and muscular endurance were slightly lower than those in the normal group. BMI of Taiwan schoolchildren increased substantially from 1993 to 2006 but leveled off from 2006 to 2008. Underweight schoolchildren during the growing period should not a priori be considered as physically weaker or unfit individuals.Cilj je ovog istraživanja bio ustanoviti trogodišnji trend razvoja indeksa tjelesne mase (ITM) i tjelesne pripremljenosti u učenika, u dobi između 12 i 16 godina, s ekstremnim vrijednostima tjelesne težine. Tajvanski sklop testova za tjelesnu pripremljenosti (Taiwan Physical Fitness Test Battery), koja uključuje procjenu aerobne pripremljenosti (test hodanja/ trčanja na 1600 metara), eksplozivne snage (skok u dalj s mjesta), mišićne izdržljivosti (podizanje trupa iz ležanja na leđima) i fleksibilnosti (sjed-i-dohvat), primijenjen je od 2006 do 2008 godine u mjesecu rujnu na uzorku od 16.945 dječaka. Preteški (overweight) i prelagani (underweight) ispitanici bili su definirani prema inicijalnoj vrijednosti ITM-a za dobnu skupinu populacije ispitanika kao oni koji se ubrajaju među 5% s najvišim odnosno najnižim vrijednostima ITM. Ispitanici koji su se nalazili unutar jedne standardne devijacije smatrali su se „normalnima“. Rezultati su pokazali da je ITM tajvanskih učenika u 2006. godini bio za ~2–3kg/m2 veći od nacionalnog prosjeka objavljenog 1993. godine. Sve varijable tjelesne pripremljenosti u grupi prekomjerno teških bile su značajno lošije u odnosu na rezultate koje su postigli ispitanici u normalnoj grupi. Ipak, rezultati su se u svim mjerenim varijablama u svim grupama poboljšali tijekom 3 godine mjerenja. ITM je u grupi nedovoljno teških porastao većom brzinom nego u grupama normalnih i prekomjerno teških učenika. Nije utvrđena značajna razlika u rezultatima skoka u dalj s mjesta između grupa nedovoljno teških i normalnih ispitanika. Nedovoljno teški ispitanici imali su najbolje rezultate u aerobnoj izdržljivosti u odnosu na ostale grupe, dok su u fleksibilnosti i mišićnoj izdržljivosti bili nešto slabiji nego ispitanici u normalnoj grupi. ITM je u tajvanske djece značajno porastao u razdoblju od 1993. do 2006. godine, ali je i stagnirao u razdoblju od 2006. do 2008. godine. Nedovoljno teška djeca ne bi se smjela a priori smatrati fizički slabijom ili nespremnom tijekom perioda odrastanja

Identification of the genetic determinants of Salmonella enterica serotype Typhimurium that may regulate the expression of the type 1 fimbriae in response to solid agar and static broth culture conditions

<p>Abstract</p> <p>Background</p> <p>Type 1 fimbriae are the most commonly found fimbrial appendages on the outer membrane of <it>Salmonella enterica </it>serotype Typhimurium. Previous investigations indicate that static broth culture favours <it>S</it>. Typhimurium to produce type 1 fimbriae, while non-fimbriate bacteria are obtained by growth on solid agar media. The phenotypic expression of type 1 fimbriae in <it>S</it>. Typhimurium is the result of the interaction and cooperation of several genes in the <it>fim </it>gene cluster. Other gene products that may also participate in the regulation of type 1 fimbrial expression remain uncharacterized.</p> <p>Results</p> <p>In the present study, transposon insertion mutagenesis was performed on <it>S</it>. Typhimurium to generate a library to screen for those mutants that would exhibit different type 1 fimbrial phenotypes than the parental strain. Eight-two mutants were obtained from 7,239 clones screened using the yeast agglutination test. Forty-four mutants produced type 1 fimbriae on both solid agar and static broth media, while none of the other 38 mutants formed type 1 fimbriae in either culture condition. The flanking sequences of the transposons from 54 mutants were cloned and sequenced. These mutants can be classified according to the functions or putative functions of the open reading frames disrupted by the transposon. Our current results indicate that the genetic determinants such as those involved in the fimbrial biogenesis and regulation, global regulators, transporter proteins, prophage-derived proteins, and enzymes of different functions, to name a few, may play a role in the regulation of type 1 fimbrial expression in response to solid agar and static broth culture conditions. A complementation test revealed that transforming a recombinant plasmid possessing the coding sequence of a NAD(P)H-flavin reductase gene <it>ubiB </it>restored an <it>ubiB </it>mutant to exhibit the type 1 fimbrial phenotype as its parental strain.</p> <p>Conclusion</p> <p>Genetic determinants other than the <it>fim </it>genes may involve in the regulation of type 1 fimbrial expression in <it>S</it>. Typhimurium. How each gene product may influence type 1 fimbrial expression is an interesting research topic which warrants further investigation.</p

Experiences with a simple laparoscopic gastric tube construction

BACKGROUND: Minimally invasive esophagectomy (MIE) is a complex operation, and the detailed optimal surgical procedure has not been well described. Our aim was to evaluate use of a simple method of laparoscopic gastric tube construction as minimally invasive surgery for patients with esophageal cancer. METHODS: We performed a retrospective review of 26 consecutive patients who underwent MIE for esophageal cancer in the Koo Foundation Sun Yat-Sen Cancer Center between September 2009 and August 2011. Perioperative data and postoperative complications were statistically analyzed. RESULTS: The patient group consisted of 22 men and 4 women. MIE was performed successfully in all patients. The mean operative time was 430.4 ± 60.6 minutes, and the mean estimated operative blood loss was 135.0 ± 97.8 mL. There were no cases of conversion to open surgery during the procedure. The postoperative complication rate was 53.8%, and there was no surgical mortality. CONCLUSIONS: We recommend this novel method of total laparoscopic staplized formation of gastric tube to facilitate gastric pull-up

Correlation of virulence genes to clinical manifestations and outcome in patients with Streptococcus dysgalactiae subspecies equisimilis bacteremia

Background/PurposeStreptococcus dysgalactiae subsp. equisimilis (SDSE) is increasingly recognized as a human pathogen responsible for invasive infection and streptococcal toxic shock syndrome (STSS). The pathogen possesses virulence genes that resemble those found in Streptococcus pyogenes (GAS). We analyzed the association between these specific toxic genes, clinical presentations, and outcome in patients with SDSE infections.MethodsPatients (older than 18 years) with community-acquired invasive bacteremia caused by SDSE bacteremia who were undergoing treatment at China Medical University Hospital from June 2007 to December 2010 were included in this study. Multiplex polymerase chain reaction was performed to identify virulence genes of the SDSE isolates. Demographic data, clinical presentations, and outcome in patients with SDSE infections were reviewed and analyzed.ResultsForty patients with 41 episodes of SDSE bacteremia were reviewed. The median age of the patients with SDSE infection was 69.7 years; 55% were female and 78% had underlying diseases. Malignancy (13, 33%) and diabetes mellitus (13, 33%) were the most common comorbidities. The 30-day mortality rate was 12%. Compared with the survivors, the non-survivors had a higher rate of diabetes mellitus (80% vs. 26%), liver cirrhosis (60% vs.11%), shock (60% vs.17%), STSS (60% vs. 8%), and a high Pittsburgh bacteremia score >4 (40% vs. 6%). Most isolates had scpA, ska, saga, and slo genes, whereas speC, speG, speH, speI, speK, smez, and ssa genes were not detected. speA gene was identified only in one patient with STSS (1/6, 17%). All isolates were susceptible to penicillin, cefotaxime, levofloxacin, moxifloxacin, vancomycin, and linezolid.ConclusionIn invasive SDSE infections, most isolates carry putative virulence genes, such as scpA, ska, saga, and slo. Clinical SDSE isolates in Taiwan remain susceptible to penicillin cefotaxime, and levofloxacin