In eukaryotes, P-type adenosine triphosphatases (ATPases) generate the plasma membrane potential and drive secondary transport systems; however, despite their importance, their regulation remains ...poorly understood. We monitored at the single-molecule level the activity of the prototypic proton-pumping P-type ATPase Arabidopsis thaliana isoform 2 (AHA2). Our measurements, combined with a physical nonequilibrium model of vesicle acidification, revealed that pumping is stochastically interrupted by long-lived (~100 seconds) inactive or leaky states. Allosteric regulation by pH gradients modulated the switch between these states but not the pumping or leakage rates. The autoinhibitory regulatory domain of AHA2 reduced the intrinsic pumping rates but increased the dwell time in the active pumping state. We anticipate that similar functional dynamics underlie the operation and regulation of many other active transporters.
To examine whether a cardiac rehabilitation programme in a community based setting for patients with intermittent claudication (IC) affects walking ability, quality of life, and changes in health ...behaviour. The trial investigated a cross sector cardiovascular rehabilitation programme compared with usual care for patients having non-operative management.
The trial allocated 118 patients, with 1:1 individual randomisation to either an intervention or control group. Data were collected at a department of vascular surgery and at a healthcare centre in Denmark. The rehabilitation intervention consisted of usual care plus 12 weeks of exercise training, pedometer, health education, and text messages. The primary outcome was maximum walking distance at six months measured by treadmill walking test. The secondary outcomes were maximum walking distance at 12 months and pain free walking distance measured by treadmill walking test, healthy diet, level of physical activity, and quality of life (QoL) at six and 12 months.
In the intervention group, 46 participants were analysed, with 47 in the control group. Following three months of rehabilitation, a 37% difference (95% CI 1.10 – 1.70; p = .005) was found between groups in maximum walking distance at six and 12 months, in favour of the intervention group. The same positive effect was found in physical activity, QoL, and healthy diet, but was not statistically significant in pain free walking distance and smoking.
A specialised community based cardiac rehabilitation programme for patients with IC showed statistically and clinically significant effects on maximum walking distance, physical activity, quality of life, and healthy diet, but not on pain free walking distance and smoking, compared with usual care without rehabilitation.
Aim
The aim of the study was to describe long‐term subjective and objective results of pelvic floor reconstruction using an absorbable biological mesh after extralevator abdominoperineal excision ...(ELAPE) for low rectal cancer.
Method
Records of 53 patients who had an ELAPE with reconstruction of the pelvic floor with a Permacol® mesh between August 2007 and August 2011 were reviewed. Thirty‐one of the patients were called for interview and clinical examination.
Results
Three (6%) patients developed perineal hernia, 11 had fistulae (nine of which were treated successfully), four patients had a perineal abscess and four patients had superficial wound infections. Removal of the mesh was necessary in one case, while another patient needed implantation of a new mesh. In 13 of the 31 interviewed patients, long‐term pain was present, but resolved after a median of 8 months (3–56). No major sitting or movement disabilities were encountered. Three‐year survival was 82%, and no local recurrences were found.
Conclusion
Pelvic floor reconstruction with a biological mesh is a feasible solution when performing ELAPE for low rectal cancer, although long‐term pain is a frequent complication.
Objective The long‐term results are presented on total survival, cancer‐specific survival and recurrence in 143 consecutive patients treated with transanal endoscopic microsurgery (TEM) for ...adenocarcinoma of the rectum.
Method Four Danish centres established in 1995 a database for registration of all TEM procedures. Data were supplemented from pathology reports and death certificates were checked in the Danish patient registry. Data were analysed with multivariance regression and survival analysis.
Results The T stage was as follows: T1 50%, T2 33%, T3 14%, and stage unknown 3%. TEM was performed with curative intent in 43%, for compromise in 52% and for palliation in 5%. Five‐year total survival was 66% and 5‐year cancer‐specific survival 87%. Cancer‐specific survival for T1 was 94%. The significant predictors for total survival were age and tumour size. For cancer‐specific survival T stage, radical resection, tumour size and recurrence were significant predictors. Eighteen per cent had recurrence and 15% had immediate reoperation.
Conclusion The TEM provides good long‐term results for pT1 cancers. In old patients and patients with co‐morbidity TEM may provide acceptable long‐term results for T2 cancers. Tumours larger than 3 cm should not be treated with TEM for cure.
The bathymetry of Baffin Bay, with shallow sills both to the north and south, creates a relatively isolated body of deep polar water, unique among the Arctic Seas. During 263 trawl hauls completed ...during October 1999 and September to November 2001, 116 fish species were collected in Davis Strait and the southern Baffin Bay (61°44.1′ N73°52.8′ N, depths of 1451484 m). The abundance data for the 80 benthic species were used for analyses of the fish fauna diversity and fish assemblages. As a first step, seven assemblages were found by a standard type of cluster analysis. A Bayesian multinomial logit model was then applied to calculate vectors of probabilities defining the likelihood of each haul belonging to each of the seven clusters. The spatial distribution of the conditional probabilities for each cluster (assemblage) was mapped by means of a geostatistical tool. Each assemblage was further defined by indicator species, depth, and temperature. Four of the assemblages were found in Baffin Bay, two in Davis Strait and one mainly in Davis Strait but scattered into Baffin Bay.
The objective of this study was to present short-term results of transanal endoscopic microsurgery (TEM) of rectal adenocarcinomas registered in a national database.
A Danish TEM group was ...established in 1995. The group organized a database for prospective and consecutive registration of all TEM procedures. The perioperative course of all rectal cancers treated with TEM and registered in this database is analysed.
One hundred forty-two patients had TEM for rectal cancer. In 43%of the patients, the cancer diagnosis was not recognized before TEM. Eighty-five percent of all tumors were classified as benign based on macroscopic appearance; on digital rectal examination, 35% were benign, rectal ultrasound classified 15% as benign, and the preoperative biopsy was benign in 36%. Forty-three cancers (29%) were classified as low risk cancers. High ages were an indication for TEM in 22% and concurrent disease in 21%. Minor complications were encountered in 39 cases, major complications in 4 cases, and 1 patient died within 30 days.
All larger rectal tumors should be evaluated for malignancy before treatment, even if TEM is the only surgical option, due to high age and comorbidiy. Rectal ultrasound appears to produce the fewest false negative results, but it should be combined with biopsies and clinical evaluation. Multiple biopsies may be beneficial in the case of larger adenomas. When resecting large sessile tumors, there is a considerable risk of incomplete radicality. The short term mortality and morbidity of TEM is low even in old patients with comorbidiy.
Samples of 150 narwhals obtained in different years from two West Greenland areas, Avanersuaq and Uummannaq, were compared for concentrations of and regional differences in heavy metals and ...organochlorines and stable-carbon and nitrogen isotopes. Cadmium, Hg, and Se concentrations increased in the first 3–4 years of the animal's life, after which no dependence on age was observed. Females had significantly higher concentrations of Cd in all tissues and of Hg and Se in liver than males. No consistent difference in metal levels between narwhals from Avanersuaq and Uummannaq was found. Year-to-year variation in metal levels at one location was larger than the geographical variation. Metal levels were within the range of previous published results for narwhals from Arctic Canada. Organochlorine (OC) concentrations in blubber of narwhals were dependent on age and sex. Females showed decreasing OC concentration in the first 8–10 years, while for males increases were detected in the first few years of life, after which the concentrations became stable. Few statistical differences in mean OC concentrations among individuals were observed. However, narwhals from Avanersuaq in 1993 had the lowest levels, indicating a temporal decrease of ∑PCBs. ∑PCBs, DDTs, HCHs and toxaphenes seem to be at similar levels in West Greenland and Arctic Canada, which can be explained by the close winter distributions of populations as well as large ranges in concentrations, time span, number of analyses and the size/age composition of the data. PCB and DDT concentrations in West Greenland narwhals were half those found in East Greenland and Svalbard. Stable-carbon isotope ratios in muscle of 150 narwhals showed a decreasing trend in the first year when they gradually reduced their dependency on mother's milk, after which they became relatively stable. δ
15 N values were significantly higher in samples from Uummannaq in 1993 compared to samples from Avanersuaq in 1984 and 1985 indicating that the diet of the narwhals in Uummannaq was at a higher trophic level. However, only a few significant correlations were found between stable isotope ratios and metal and OC concentrations.
We present optical and near-infrared follow-up observations of the X-ray flash (XRF) of 2003 July 23. Our observations in the R band cover the temporal range from 4.2 hr to 64 days after the ...high-energy event. We also present the results of multicolor imaging extending to the K band on three epochs. The light curve of the R-band afterglow the first week after the burst is similar to the light curve for long-duration gamma-ray bursts (GRBs), i.e. a broken power law with a late time slope of alpha ~ 2.0 (F sub( nu ) proportional t super(-alpha)). Furthermore, the spectral energy distribution (SED) has a power-law (F sub( nu ) proportional nu super(- beta )) shape with slope beta ~ 1.0. However, the decay slope at t < 1 day is shallow, consistent with zero. This is in qualitative agreement with the prediction that XRFs are off-axis classical GRBs. After the first week there is a strong bump in the light curve, which peaks at around 16 days. The SED after the peak becomes significantly redder. We discuss the possible interpretations of this bump and conclude that an underlying supernova is the most likely explanation since no other model appears consistent with the evolution of the SED. Finally, we present deep spectroscopy of the burst both in the afterglow and in the bump phase. A firm upper limit of z = 2.3 is placed on the redshift of XRF 030723 from the lack of Lyalpha forest lines in the spectrum of the afterglow. The lack of significant absorption and emission lines in either of the two spectra excludes a spectroscopic redshift determination.
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