We could predict good responders to vagus nerve stimulation: a surrogate marker by slow cortical potential shift

Publication date: Available online 15 June 2017
Source:Clinical Neurophysiology
Author(s): Borgil Bayasgalan, Masao Matsuhashi, Tomoyuki Fumuro, Haruhiko Nohira, Naoki Nakano, Koji Iida, Masaya Katagiri, Akihiro Shimotake, Riki Matsumoto, Takayuki Kikuchi, Takeharu Kunieda, Amami Kato, Ryosuke Takahashi, Akio Ikeda
ObjectiveWe investigated whether vagus nerve stimulation (VNS) induces a positive shift of slow cortical potentials (SCPs) in patients with >50% seizure reduction (responders) but not in non-responders.MethodsWe analyzed routine clinical electroencephalograms (EEGs) from 24 patients who were undergoing seizure treatment by VNS. The patients were divided into 2 groups by hardware time constant (TC) of EEG: the TC 10-s group (10 patients) and TC 2-s group (14 patients). We compared SCPs at 5 electrodes (Cz and adjacent ones) between the 2 states of VNS: during stimulation and between stimulations. Seizure reduction was independently judged. Correlation between SCP (positivity or not) and seizure reduction (>50% or not) was estimated.ResultsIn the TC 10-s group, the correlation between SCP and seizure reduction was significant (p < 0.05) (i.e., both good results in 4 and both negative results in 5). In TC 2-s group, the correlation between SCP and seizure reduction was not significant (p = 0.209).ConclusionsA positive shift of SCP recorded by using a TC of 10 s could be a surrogate marker for VNS response.SignificanceSCP could be a biomarker of good responders to VNS.



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Subclinical white matter lesions and medial temporal lobe atrophy are associated with EEG slowing in a memory clinic cohort

Publication date: Available online 15 June 2017
Source:Clinical Neurophysiology
Author(s): Milica G. Kramberger, Katarina Giske, Lena Cavallin, Ingemar Kåreholt, Thomas Andersson, Bengt Winblad, Vesna Jelic
ObjectiveThe aim of the study was to describe the relationship between electroencephalographic (EEG) findings obtained by standardised visual analysis, subclinical white matter lesions (WML) and brain atrophy in a large memory clinic population.MethodsPatients with Alzheimer's disease (AD, n = 58), mild cognitive impairment (MCI, n = 141), subjective cognitive impairment (SCI, n = 194) had clinical, MRI based WML severity and regional atrophy assessments, and routine resting EEG recording. Background activity (BA) and episodic and continuous abnormalities were assessed visually in EEG.ResultsWML (p = 0.006) and atrophy in medial temporal regions (MTA) (p = <0.001) were associated with slower BA in all diagnoses. WML were associated in SCI with total episodic EEG abnormalities (p = 0.03).ConclusionsEEG is associated with subclinical WML burden and cortical brain atrophy in a memory clinic population.SignificanceEven the standard visually assessed EEG can complement a memory clinic diagnostic workup.



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Real-world, single-centre experience of apremilast for the treatment of moderate to severe psoriasis

http://ift.tt/2rCX7qy

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: An observational study in 29 countries.

BACKGROUND: Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES: To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN: This was a prospective international 1-week observational study using the 'Assess Respiratory Risk in Surgical Patients in Catalonia risk score' (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING: Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES: The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS: A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg-1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P

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Women awaken faster than men after electroencephalogram-monitored propofol sedation for colonoscopy: A prospective observational study.

BACKGROUND: Sedation for colonoscopy using intravenous propofol has become standard in many Western countries. OBJECTIVE: Sex-specific differences have been shown for general anaesthesia in dentistry, but no such data existed for gastrointestinal endoscopy. DESIGN: A prospective observational study. SETTING: An academic teaching hospital of Hannover Medical School. PATIENTS: A total of 219 patients (108 women and 111 men) scheduled for colonoscopy. INTERVENTION: Propofol sedation using electroencephalogram monitoring during a constant level of sedation depth (D0 to D2) performed by trained nurses or physicians after a body-weight-adjusted loading dose. MAIN OUTCOME MEASURES: The primary end-point was the presence of sex-specific differences in awakening time (time from end of sedation to eye-opening and complete orientation); secondary outcome parameters analysed were total dose of propofol, sedation-associated complications (bradycardia, hypotension, hypoxaemia and apnoea), patient cooperation and patient satisfaction. Multivariate analysis was performed to correct confounding factors such as age and BMI. RESULTS: Women awakened significantly faster than men, with a time to eye-opening of 7.3 +/- 3.7 versus 8.4 +/- 3.4 min (P = 0.005) and time until complete orientation of 9.1 +/- 3.9 versus 10.4 +/- 13.7 min (P = 0.008). The propofol dosage was not significantly different, with some trend towards more propofol per kg body weight in women (3.98 +/- 1.81 mg versus 3.72 +/- 1.75 mg, P = 0.232). CONCLUSION: The effect of sex aspects should be considered when propofol is used as sedation for gastrointestinal endoscopy. That includes adequate dosing for women as well as caution regarding potential overdosing of male patients. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT02687568). (C) 2017 European Society of Anaesthesiology

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Rocuronium is more hepatotoxic than succinylcholine in vitro.

BACKGROUND: The development of liver failure is a major problem in critically ill patients. The hepatotoxicity of many drugs, as one important reason for liver failure, is poorly screened for in human models. Rocuronium and succinylcholine are neuromuscular blocking agents used for tracheal intubation and for rapid-sequence induction. OBJECTIVE: We used an in-vitro test with a permanent cell line and compared rocuronium and succinylcholine for hepatotoxicity. DESIGN: In-vitro study. SETTING: A basic science laboratory, University Hospital Rostock, Germany. MATERIAL/(PATIENTS): The basic test compound is the permanent human liver cell line HepG2/C3A. In a standardised microtitre plate assay the toxicity of different concentrations of rocuronium, succinylcholine and plasma control was tested. INTERVENTIONS: After two incubation periods of 3 days, the viability of cells (XTT test, lactate dehydrogenase release and trypan blue staining), micro-albumin synthesis and the cytochrome 1A2 activity (metabolism of ethoxyresorufin) were measured. MAIN OUTCOME MEASURES: Differences between rocuronium and succinylcholine were assessed using the Kruskal-Wallis one-way test and two-tailed Mann-Whitney U test. RESULTS: Rocuronium, but not succinylcholine, led to a significant dose-dependent decrease of viability, albumin synthesis and cytochrome 1A2 activity of test cells. CONCLUSION: An in-vitro test with a cell line showed hepatotoxicity of rocuronium that was dose-dependent. Further studies are needed to investigate the underlying mechanisms of the effects of rocuronium on hepatic cellular integrity. TRIAL REGISTRATION: Not suitable. (C) 2017 European Society of Anaesthesiology

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Doctor says you are cured, but you still feel the pain. Borrelia DNA persistence in Lyme disease

Publication date: Available online 15 June 2017
Source:Microbes and Infection
Author(s): Jorge Cervantes
Lyme disease is a zoonosis caused by infection with Borrelia burgdorferi (Bb). A great amount of research has attempted to elucidate the mechanisms by which Bb causes inflammation and chronic symptomatology in some patients. Patients often seek unconventional treatments that lack scientific evidence, as medical care is unable to effectively explain and treat their illness. Bb-DNA can persist for long periods of time in some individuals, even after antibiotic therapy. Herein, scientific rationale is presented for a new therapeutic approach against remaining bacterial DNA, and/or increasing the ability of human macrophages to remove extracellular Bb DNA.



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Long-term contextual memory in infant rats as evidenced by an ethanol conditioned tolerance procedure

Publication date: 14 August 2017
Source:Behavioural Brain Research, Volume 332
Author(s): Stefanía Castelló, Juan Carlos Molina, Carlos Arias
Conditioned tolerance can be conceptualized as a particular case of Pavlovian conditioning in which contextual cues play the role of the conditioned stimulus. Although the evidence is contradictory, it is frequently assumed that long-term contextual conditioning in pre-weanling rats is weak or even absent. This hypothesis comes from and is sustained mainly by behavioral studies that explored different contextual effects in 16–18day-old rats using a fear-conditioning paradigm, but their conclusions are stated in terms of an immature (hippocampal-dependent) declarative memory system. The main goal of the present manuscript was based on a recent antecedent from our laboratory, to analyze whether context-dependent tolerance induced by ethanol during the pre-weanling period persists over time. Results showed that the context was able to modulate ethanol-induced tolerance in 2- and 3-week-old rats. Interestingly, contextual conditioned tolerance was stronger (in terms of persistence) during the third than during the second postnatal week. When subjects were tested 8days after training, when the context presumably lost its influence over tolerance, the opposite effect emerged (sensitization). These results are important for the ethanol literature, adding new evidence of long-term retention of ethanol effects acquired during infancy, whilst also showing striking ontogenetic differences in the sensitivity to ethanol between the 2nd and 3rd postnatal weeks. Importantly, contextual information modulates the expression of these ethanol effects even eight days after training, a result that is particularly relevant to the discussion of the ontogeny of contextual memory.



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Restraint stress enhances alcohol intake in adolescent female rats but reduces alcohol intake in adolescent male and adult female rats

Publication date: 14 August 2017
Source:Behavioural Brain Research, Volume 332
Author(s): Aranza Wille-Bille, Ana Ferreyra, Martina Sciangula, Florencia Chiner, Michael E. Nizhnikov, Ricardo Marcos Pautassi
Adolescents may be more sensitive to stress-induced alcohol drinking than adults, which would explain the higher prevalence of alcohol abuse and dependence in late adolescence than in adulthood. The present study analyzed the impact of restraint stress on the initiation of alcohol intake across 2 weeks of intermittent, two-bottle choice intake in male and female adolescent rats and adult female rats. Restraint stress significantly increased alcohol intake and preference in female adolescent rats but decreased alcohol intake and preference in male adolescent and female adult rats. The effects of restraint stress on alcohol intake were mitigated in adolescent females following administration of the κ opioid receptor antagonist norbinaltorphimine. Adolescent but not adult female rats that were subjected to restraint stress spent more time on the open arms of the elevated plus maze. Female adolescents exposed to stress also exhibited greater risk-taking behaviors in a concentric square field test compared with non-stressed controls. These results indicate age- and sex-related differences in the sensitivity to alcohol-stress interactions that may facilitate the initiation of alcohol use in female adolescents. The facilitatory effect of stress on alcohol intake was related to greater exploratory and risk-taking behaviors in young females after stress exposure.



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Role of static fluid MR urography in detecting post urinary diversion complications

Publication date: Available online 16 June 2017
Source:Alexandria Journal of Medicine
Author(s): Amr Farouk Ibrahim Moustafa, Tamer M. Abd el Rahman, Amr Abd Elfattah Hassan Gadalla, Karam Gaber Mohamed, Ahmed Morsi Moustafa Fahmy, Sameh Abd AlAziz Zaki Hanna
Aim of workThe aim of the study was to assess the diagnostic performance of static MR urography in detection of post cystectomy complications & the ability of static fluid MR urography in visualization of urinary tract segments.Material & methodsWe prospectively reviewed 21 MR urograms with urinary diversion. The most common surgical procedures included Ileal conduit & Ileocecal neobladder diversion.Magnetic resonance urography examinations were performed with 1.5-T MR scanners. T2 weighted (static fluid) MR urography techniques were done, in addition to conventional T1- and T2-weighted axial and coronal sequences. Urinary tract was divided in different parts: pelvicalyceal systems, upper, mid and lower ureteric segments & the reservoir or conduit Imaging features of the urinary collecting systems were evaluated for their visualization and complications detection.ResultsT2-weighted MR urography could demonstrate 95% of urinary tract segments & together with conventional MR sequences all urinary tract segments can be visualized. Urinary diversion related complications were encountered included in 15 patients (71.4%) & no urological complications were seen in 6 patients (28.6%).ConclusionComprehensive T2-weighted MR urography is an effective imaging method for the visualization of the urinary system and detection of early and late postoperative complications in patients with urinary diversion.



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Socio-demographic and clinical factors predicting time to presentation for children with pneumonia in Ilorin, Nigeria

Publication date: Available online 16 June 2017
Source:Alexandria Journal of Medicine
Author(s): Rasheedat M. Ibraheem, Mohammed B. Abdulkadir, Aishat A. Gobir, Wahab B.R. Johnson
BackgroundPneumonia is a major contributor to morbidity and mortality in children, and the time to presentation is a recognized contributor towards disease severity and outcome.ObjectivesThe current study aimed to explore the influence of some socio-demographic and clinical factors in children with pneumonia on the time to presentation at a health facility in Ilorin, North Central Nigeria.Materials and methodA prospective cross-sectional study of 167 children with pneumonia was done. The duration of the various symptoms and first presentation to a health facility was obtained. Time to presentation was categorized as 0–2days (early), 3–5days (intermediate) and greater than five days (late). Multinomial logistic regression analysis was used to identify significant predictors of either early or intermediate presentation compared with late presentation. A p-value of less than 0.05 was considered significant.ResultsFifty-one (30.5%) children with pneumonia had an early presentation, 73 (43.7%) had intermediate presentation and 43 (25.7%) were late in presentation. Predictors of early presentation were younger age (OR 0.96, 95%CI 0.93–0.99), higher respiratory rates (OR 1.03, 95%CI 1.01–1.06) and bronchopneumonia (OR 6.93, 95%CI 1.52–31.63). Predictors of intermediate presentation were families with few number of children (OR 0.73, 95%CI 0.57–0.92) and bronchopneumonia (OR 3.41, 95%C.I. 1.02–11.38).ConclusionInfancy and families with few children are socio-demographic features that are likely to determine early-to-intermediate presentation of children with pneumonia while high respiratory rates and bronchopneumonia are disease related factors that predict early presentation.



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Kaempferol increases levels of coenzyme Q in kidney cells and serves as a biosynthetic ring precursor

Publication date: September 2017
Source:Free Radical Biology and Medicine, Volume 110
Author(s): Lucía Fernández-del-Río, Anish Nag, Elena Gutiérrez Casado, Julia Ariza, Agape M. Awad, Akil I. Joseph, Ohyun Kwon, Eric Verdin, Rafael de Cabo, Claus Schneider, Jorge Z. Torres, María I. Burón, Catherine F. Clarke, José M. Villalba
Coenzyme Q (Q) is a lipid-soluble antioxidant essential in cellular physiology. Patients with Q deficiencies, with few exceptions, seldom respond to treatment. Current therapies rely on dietary supplementation with Q10, but due to its highly lipophilic nature, Q10 is difficult to absorb by tissues and cells. Plant polyphenols, present in the human diet, are redox active and modulate numerous cellular pathways. In the present study, we tested whether treatment with polyphenols affected the content or biosynthesis of Q. Mouse kidney proximal tubule epithelial (Tkpts) cells and human embryonic kidney cells 293 (HEK 293) were treated with several types of polyphenols, and kaempferol produced the largest increase in Q levels. Experiments with stable isotope ¹³C-labeled kaempferol demonstrated a previously unrecognized role of kaempferol as an aromatic ring precursor in Q biosynthesis. Investigations of the structure-function relationship of related flavonols showed the importance of two hydroxyl groups, located at C3 of the C ring and C4′ of the B ring, both present in kaempferol, as important determinants of kaempferol as a Q biosynthetic precursor. Concurrently, through a mechanism not related to the enhancement of Q biosynthesis, kaempferol also augmented mitochondrial localization of Sirt3. The role of kaempferol as a precursor that increases Q levels, combined with its ability to upregulate Sirt3, identify kaempferol as a potential candidate in the design of interventions aimed on increasing endogenous Q biosynthesis, particularly in kidney.

Graphical abstract

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Soft Tissue Reconstruction of Large Spinal Defects: A 12-year Institutional Experience.

Background: Radical spinal resections can lead to considerable defects requiring soft tissue reconstruction. The purpose of this study was to review our institutional experience of over a decade with reconstruction of spinal defects and identify risk factors predictive of wound complications, particularly focusing on timing of reconstruction with ablative surgery. Methods: We retrospectively reviewed patients who underwent spinal resection and required soft tissue reconstruction from 2002-2014. Patient characteristics, operative details, and complication rates were collected. Logistic regression was performed to identify risk factors for wound complications. Results: Of 289 reconstructions performed in 259 patients, 64 cases (22.1%) had major wound complications requiring reoperation. Lumbosacral defects were the most common location (43.6%) and paraspinous muscle flaps were the preferred reconstructive method used for all defect regions. A total of 224 reconstructions (77.5%) were performed immediately at time of spinal surgery, and 65 (22.5%) were performed in delayed fashion as result of wound complications from previous spinal surgery. Patients with immediate reconstructions required significantly fewer instrumentation removal rates (0.9% v. 4.6%, p=0.043), unplanned reoperations (0.5 v. 1.3, p

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3D Cone Beam Computed Tomography Volumetric Outcomes of rhBMP-2/demineralized bone matrix vs Iliac Crest Bone Graft for Alveolar Cleft Reconstruction*.

Background: Recent studies indicate that recombinant human bone morphogenetic protein (rhBMP-2) in a demineralized bone matrix scaffold (MS) is a comparable alternative to iliac bone autograft in the setting of secondary alveolar cleft repair. Post-reconstruction occlusal radiographs demonstrate improved bone stock when rhBMP-2/MS is used, but lack the capacity to evaluate bone growth in three dimensions. This study uses cone beam computed tomography (CBCT) to provide the first clinical evaluation of volumetric and density comparisons between these two treatment modalities. Methods: A prospective study was conducted with 31 patients and 35 repairs of the alveolar cleft over a two-year period. Twenty-one repairs utilized rhBMP-2/MS while 14 repairs utilized iliac bone grafting. Postoperatively, occlusal radiographs were obtained at 3 months to evaluate bone fill; CBCT images were obtained at 6-9 months to compare volumetric and density data. Results: At 3 months, postoperative occlusal radiographs demonstrate that 67% of patients receiving rhBMP-2/MS had complete bone fill of the alveolus, vs 56% of patients in the autologous group. In contrast, CBCT data shows 31.6% (95% CI: 24.2- 38.5%) fill in the rhBMP-2/MS group compared with 32.5% (95% CI: 22.1-42.9%) in the autologous population. Density analysis demonstrated identical average values between the rhBMP-2/MS and iliac bone crest group (1.38g/cc). Conclusions: These data demonstrate comparable bone regrowth and density values following secondary alveolar cleft repair using rhBMP-2/MS vs. autologous iliac bone graft. CBCT provides a more nuanced understanding of true bone regeneration within the alveolar cleft that may contribute to the information provided by occlusal radiographs alone. (C)2017American Society of Plastic Surgeons

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The Whitaker Classification of Craniosynostosis Outcomes: An Assessment of Inter-Rater Reliability.

Purpose: The Whitaker classification (WC) is a simple and widely used system for describing aesthetic outcomes after craniosynostosis surgery. The purpose of this study is to evaluate its inter-rater reliability for patients who have undergone frontal-orbital surgery. Methods: A retrospective review of patients with craniosynostosis who underwent surgical intervention at a tertiary referral center was conducted. Inclusion criteria were: single-suture craniosynostosis, surgical intervention before age two years, and photographs taken prior to revisions between 5 and 20 years of age. Thirteen craniofacial surgeons independently reviewed the subject's photographs and assigned WC. Inter-rater reliability was assessed with Cohen's kappa. Results: Twenty-nine subjects were included. Average ages at surgery and the time of post-operative photographs were 0.8 years, and 12.8 years, respectively. The [kappa] value for all 13 raters was 0.1567 (p

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Discussion: Gynecomastia Classification for Surgical Management: A Systematic Review and Novel Classification System.

No abstract available

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Academic Productivity, Knowledge, and Education in Plastic Surgery: The Benefit of the Clinical Research Fellow.

Summary: Academic research productivity is limited by strenuous resident and faculty schedules, yet is imperative to the growth and success of our discipline. We report institutional experience with our clinical research fellowship model, providing two positions per year. A critical analysis of research productivity was performed for all trainees, faculty, and research fellows from 2000-2015. All articles in-print were individually collected to identify academic appointment at time of publication for the authors. Academic productivity was determined by number of peer-reviewed publications, podium presentations, and h-index. Podium presentations at two national and one regional plastic surgery meetings were collected. Academic fate of previous research fellows was also noted. Overall, 18 faculty, 38 fellows, 41 residents, and 8 research fellows were included. During the 16-year time-frame, 484 articles were published in print. Notably, 92 articles were published from 2000-2007 and 392 articles were published from 2008-2015 (p=0.0066), demonstrating linear growth after instituting the research fellowship. Additionally, 33 articles were published from 2002-2004 pre-leadership change, 47 from 2005-2007 post- leadership change but pre-fellowship, and 58 from 2008-2010 in the first few years of the fellowship (p=0.0204). Overall, 39.9% of publications appeared in PRS, with a total of 77 different peer-reviewed journal inclusions. AAPS, ASPS, and NESPS podium presentations totaled 143 between 2005-2015. Of the 8 previous fellows who applied into integrated and independent programs, 100% have matched. Incorporation of a formalized research fellowship into a plastic surgery program can drastically increase clinical research contribution in a reproducible fashion. (C)2017American Society of Plastic Surgeons

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Facial Contouring by Targeted Restoration of Facial Fat Compartment Volume: The Midface.

No abstract available

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Discussion: Gynecomastia classification for surgical management: A systematic review and novel classification system.

No abstract available

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Symmetry restoration at rest after masseter-to-facial nerve transfer: Is it as efficient as smile reanimation?.

Background: Masseter-to-facial nerve transfer is a highly efficient technique for reanimating paralyzed muscle and has been reported to restore facial symmetry at rest. However, no systematic studies have been performed, and the effects of preoperative droop oral commissure on postoperative symmetry at rest have rarely been reported. Methods: The authors retrospectively analyzed 35 patients with masseteric-facial nerve anastomosis and assessed the quality and quantity of the dynamic recovery and the oral commissure symmetry at rest. The dynamic and static effects were then compared. Results: All of the patients' Terzis scores were increased post-operatively, and over half of the patients presented restored symmetrical smiles (Terzis scores of 4 or 5). The postoperative symmetry scale of oral commissure at rest improved in 18 of 35 patients. Both the mean postoperative AD-OCE (altitude difference of oral commissure excursion) and the postoperative AD-OCP (altitude difference of bilateral oral commissure position) were decreased compared to preoperative values. The preoperative symmetry had a significant effect on the postoperative AD-OCP. The effects of the dynamic and static symmetry improvements were transformed to a comparable factor '[alpha]'. The dynamic [alpha] was significantly greater than static [alpha]. Conclusions: Masseter-to-facial nerve transfer is a reliable technique for smile reanimation. However, it has only a limited effect on the improvement of symmetry at rest. Assessing the preoperative symmetry of oral commissure at rest can be used to predict postoperative outcomes, and patients with severely droop oral commissure (symmetry scale III or IV) should receive static suspension. (C)2017American Society of Plastic Surgeons

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Sequential matched analysis of racial disparities in breast cancer hospitalization outcomes among African American and White patients

Publication date: August 2017
Source:Cancer Epidemiology, Volume 49
Author(s): Kemi Ogunsina, Gurudatta Naik, Neomi Vin-Raviv, Tomi F. Akinyemiju
BackgroundThe purpose of this study is to determine if racial disparities in inpatient outcomes persist among hospitalized patients comparing African American and White breast cancer patients matched on demographics, presentation and treatment.MethodsA total of 136,211 African American and White breast cancer patients from the Healthcare Cost and Utilization Project − Nationwide Inpatient Sample (HCUP-NIS) database, matched on demographics alone, demographics and presentation or demographics, presentation and treatment were studied. Conditional logistic regression was conducted to evaluate post-surgical complications, length of stay and in-hospital mortality outcomes. Analysis was further stratified by age (≤65 years and >65years) to evaluate whether disparities were larger in younger or older patients. All analysis was conducted using SAS 9.3.ResultsWhite women had significantly shorter hospital length of stay when matched on demographics (β=−0.87, p-value=<0.0001), demographics and presentation (β=−0.63, p-value=<0.0001), and demographics, presentation and treatment (β=−0.51, p-value=<0.0001) compared with African Americans. White women also had lower odds of mortality compared with African American women when matched on demographics (OR: 0.72, 95% CI: 0.65-0.79), demographics and presentation (OR: 0.77, 95% CI: 0.71-0.85), or matched on demographics, presentation and treatment (OR: 0.80, 95% CI: 0.73-0.88). The racial difference observed in length of stay and mortality was larger in the age group ≤65 years compared with >65yearsConclusionAfrican American women experienced higher odds of inpatient mortality and longer length of stay compared with White women even after accounting for differences in demographics, presentation and treatment characteristics.



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Microsurgical Hepatic Artery Reconstruction Using Ikuta A-II Double Clamp

Summary: We performed hepatic artery (HA) reconstruction on 24 patients between January 2010 and October 2016. Six of 24 patients used an Ikuta type A-II vascular clamp (A-II group). The mean age was 38.0 years (range, 1–61 years). There was no blood leakage at the anastomosed site in any of the patients. No patients required an additional vascular clamp, and none developed HA thrombosis. Eighteen of 24 patients used a conventional vascular clamp. The mean age was 36.1 years (range, 1–65 years; conventional group). Sixteen of 18 patients required an additional vascular clamp due to blood leakage from the HA. There was no significant difference between the 2 groups in mean age or diameter of the recipient HA. However, there was a significant difference in the proportion of patients who required an additional vascular clamp (n

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New paradigms for the Hedgehog signaling network in mammary gland development and breast Cancer

Publication date: Available online 15 June 2017
Source:Biochimica et Biophysica Acta (BBA) - Reviews on Cancer
Author(s): Teresa Monkkonen, Michael T. Lewis
The Hedgehog signaling network regulates organogenesis, cell fate, proliferation, survival, and stem cell self-renewal in many mammalian tissues. Aberrant activation of the Hedgehog signaling network is present in ~25% of all cancers, including breast. Altered expression of Hedgehog network genes in the mammary gland can elicit phenotypes at many stages of development. However, synthesizing a cohesive mechanistic model of signaling at different stages of development has been difficult. Emerging data suggest that this difficulty is due, in part, to non-canonical and tissue compartment-specific (i.e., epithelial, versus stromal, versus systemic) functions of Hedgehog network components. With respect to systemic functions, Hedgehog network genes regulate development of endocrine organs that impinge on mammary gland development extrinsically. These new observations offer insight into previously conflicting data, and have bearing on the potential for anti-Hedgehog therapeutics in the treatment of breast cancer.



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Heightened Sympathetic Arousal is demonstrated by Skin Conductance Responsivity to Auditory Stimuli in a Small Cohort of Neonates with Opiate Withdrawal

Publication date: Available online 15 June 2017
Source:Brain Research Bulletin
Author(s): Christiana N Oji-Mmuo, Fumiyuki Chin Gardner, Kim K Doheny
To determine the effects of auditory stimulus on skin conductance (SC) in infants with severe neonatal abstinence syndrome (NAS) that required morphine treatment (MT) compared with NAS infants that did not require morphine treatment (non-MT). We prospectively enrolled opiate-exposed term infants without polysubstance exposure. Skin conductance responses to an auditory stimulus (ringing a bell for 3seconds) near the time of discharge were obtained. Skin conductance was measured before, during, and after the stimulus. Non-parametric tests were used to determine between group and within phase differences. Infants were off MT at the time of SC measurement in response to an auditory stimulus. In a 2-group comparison of MT vs. non-MT infants, there was significantly higher SC responsivity to an auditory stimulus (p <0.05) in the MT group as compared with the non-MT group near discharge. The mean +SE peak morphine dose was 0.85+0.20mg/kg/day in the MT group. The mean Length of Stay (LOS) was 32 vs. 7 (p <0.05) days respectively, for the MT vs. the non-MT group. Our preliminary data suggest that in infants with severe NAS symptoms, higher sympathetic arousal in response to an auditory stimulus persists at discharge, underscoring the need for ongoing evaluation and specialized care at home.



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Corrigendum to “Involvement of autophagy in connexin 40 reduction in the late phase of traumatic brain injury in rats” [Brain Res. Bull. 131 (2017) 100–106]

Publication date: Available online 15 June 2017
Source:Brain Research Bulletin
Author(s): Wei Chen, Yijun Guo, Wenjin Yang, Ping Zheng, Jinsong Zeng, Wusong Tong




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Cerebral ischemia/repefusion injury: from bench space to bedside

Publication date: Available online 15 June 2017
Source:Brain Research Bulletin
Author(s): Z. Nagy, S. Nardai
While stroke research represents the primary interface between circulation and brain research, the hemostasis system also carries a pivotal role in the mechanism of vascular brain injury. The complex interrelated events triggered by the energy crisis have a specific spatial and temporal pattern arching from the initial damage to the final events of brain repair. The complexity of the pathophysiology make it difficult to model this disease, therefore it is challenging to find appropriate therapeutic targets. The ever-persistent antagonism between the positive results of drug candidates in the experimental stroke models and the failures of the clinical trials prompts changes in the research strategy, especially in the field of potential neuroprotective therapies. System biology approach could initiate new directions in the future for both preclinical and clinical research.Incentive methods aimed at anti-apoptosis mechanisms and the augmentation of post-ischemic brain repair could benefit the facts, that these processes can be targeted much longer following the cell-necrosis in the hyper-acute phase. Sequential monitoring of candidate genes and proteins responsible for stroke progression and post-stroke repair seems to be useful both in therapeutic target-identification, and in clinical testing. Understanding the mechanism behind the effect of selegiline and other drugs capable of activating the anti-apoptotic gene expression could help to find new approaches to enhance the regenerative potential in the remodeling of neuronal and microvascular networks.



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Drug induces depression-like phenotypes and alters gene expression profiles in Drosophila

Publication date: Available online 15 June 2017
Source:Brain Research Bulletin
Author(s): Ming-Di Jiang, Ya Zheng, Jia-Lin Wang, Yu-Feng Wang
BackgroundMajor depressive disorder (MDD) is a severe mental illness that affects more than 350 million people worldwide. However, the molecular mechanisms of depression are currently unclear. Studies suggest that Drosophila and humans have similar depression-like symptoms under pressure. In this research, we choose Drosophila melanogaster as the animal model to explore the molecular mechanisms that trigger depression.ResultsWe found that feeding D. melanogaster with the medium containing Levodopa or Chlorpromazine could induce depression-like phenotypes in both behavioral and biochemical biomarkers, including significantly decreased food intake, mating frequency, serotonin (5-HT) concentration, and increased malondialdehyde (MDA) concentration as well as reduced activity of superoxide dismutase (SOD). Moreover, the progeny of Chlorpromazine-treated flies also showed these depression-like features. By RNA-seq technology, we identified 467 gens that were differentially expressed between Chlorpromazine treated (CPZ) and control male flies [fold-change of ≥2 (q-value <5%)]. When comparing CPZ with control flies, 312 genes were upregulated and 155 genes downregulated. Differential expression of genes related to metabolic pathway, Parkinson's disease, Huntington's disease, Alzheimer's disease and lysozyme pathways were observed. Quantitative reverse transcriptase PCR (qRT-PCR) confirmed that 19 genes are differentially expressed in CPZ and control male flies.ConclusionsLevodopa, or Chlorpromazine can induce depression-like phenotypes in D. melanogaster regarding changes of appetite and sexual activity, and some key biochemical markers. A total of 467 genes were identified by RNA-seq analysis to have at least a 2-fold-change in expression between CPZ and control flies, including genes involved in metabolism, neurological diseases and lysozyme pathways. Our data provide additional insight into molecular mechanisms underlying depressive disorders in humans and may also contribute to clinical treatment.



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Pre-adolescent and adolescent mice are less sensitive to the effects of acute nicotine on extinction and spontaneous recovery

Publication date: Available online 15 June 2017
Source:Brain Research Bulletin
Author(s): Munir Gunes Kutlu, Dana Zeid, Jessica M. Tumolo, Thomas J. Gould
Adolescence is a period of high risk for the initiation of nicotine product usage and exposure to traumatic events. In parallel, nicotine exposure has been found to age-dependently modulate acquisition of contextual fear memories; however, it is unknown if adolescent nicotine exposure alters extinction of fear related memories. Age-related differences in sensitivity to the effects of nicotine on fear extinction could increase or decrease susceptibility to anxiety disorders. In this study, we examined the effects of acute nicotine administration on extinction and spontaneous recovery of contextual fear memories in pre-adolescent (PND 23), late adolescent (PND 38), and adult (PND 53) C57B6/J mice. Mice were first trained in a background contextual fear conditioning paradigm and given an intraperitoneal injection of one of four doses of nicotine (0.045, 0.09, 0.18, or 0.36mg/kg, freebase) prior to subsequent extinction or spontaneous recovery sessions. Results indicated that all acute nicotine doses impaired extinction of contextual fear in adult mice. Late adolescent mice exhibited impaired extinction of contextual fear only following higher doses of acute nicotine, and extinction of contextual fear was unaffected by acute nicotine exposure in pre-adolescent mice. Finally, acute nicotine exposure enhanced spontaneous recovery of fear memory, but only in adult mice. Overall, our results suggest that younger mice were less sensitive to nicotine's impairing effects on extinction of contextual fear and to nicotine's enhancing effects on spontaneous recovery of contextual fear memory.



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Scoparone attenuates hepatic stellate cell activation through inhibiting TGF-β/Smad signaling pathway

Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Xing Liu, Xiuxia Zhao
Activation of hepatic stellate cells (HSCs) plays a critical role in liver fibrosis. Scoparone, a major constituent isolated from Artemisia capillaris, was reported to possess hepatoprotective effect. However, the role of scoparone in liver fibrosis remains unknown. In the present study, we investigated the effects of scoparone on liver fibrosis in HSCs. Our results demonstrated that scoparoene inhibited the proliferation of HSCs exposed to transforming growth factor (TGF)-β1. In addition, scoparoene significantly suppressed TGF-β1-induced the expression of α-smooth muscle actin (α-SMA) and collagen I in HSC-T6 cells, as well as attenuated the expression of NADPH oxidase (NOX) isoforms expression and ROS production in TGF-β1-stimialted HSC-T6 cells. Mechanistically, scoparoene suppressed the phosphorylation level of Smad3 in TGF-β1-stimialted HSC-T6 cells. In conclusion, these findings showed that scoparone significantly inhibited the proliferation and activation of HSCs through the inactivation of TGF-β/Smad signaling pathway. These data provide that scoparone may have potential to treat liver fibrosis.



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Antihypertensive and vasodilator effects of methanolic extract of Inula viscosa: Biological evaluation and POM analysis of cynarin, chlorogenic acid as potential hypertensive

Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Zineb Hakkou, Alexandre Maciuk, Veronique Leblais, Nour Elhouda Bouanani, Hassane Mekhfi, Mohammed Bnouham, Mohammed Aziz, Abderrahime Ziyyat, Abdur Rauf, Taibi Ben Hadda, Usama Shaheen, Seema Patel, Rodolphe Fischmeister, Abdelkhaleq Legssyer
Background: Inula viscosa L. (Asteraceae) is a medicinal plant widely used as a folk medicine in oriental Morocco, to treat hypertension. The antihypertensive effect of the methanolic extract obtained from I. viscosa leaves was evaluated in hypertensive L-NAME rats. Systolic blood pressure (SBP) was measured using a non-invasive indirect tail-cuff plethysmographic method. Four groups of rats were used: a control group; a hypertensive group treated with L-NAME (32mg/kg/day); a positive control group treated with L-NAME plus enalapril (15mg/kg/day) as a reference antihypertensive agent; and a group treated with L-NAME plus MeOH-extract (40mg/kg/day).Methods: Treatment with L-NAME alone caused a progressive increase in SBP. After 4 weeks, the value of SBP reached 160±2mmHg which shows the installation of hypertension. Enalapril prevented the increase in SBP, which remained normal at 123±1mmHg after 4 weeks of treatment. The administration of MeOH-extract along with L-NAME prevented the increase in SBP as well, which remained constant at 115±1mmHg after 4 weeks of treatment.In ex-vivo models, MeOH-extract produced a relaxation of pre-contracted ring aorta (54 ± 2% of relaxation at 3g/L). But, when the rings were denuded, MeOH-extract failed to relax pre-contracted rings of aorta. Phytochemical study of I. viscosa MeOH-extract revealed the presence of phenolic compounds, such as cynarin and chlorogenic acid.Results: The present results suggest that I. viscosa MeOH-extract has an antihypertensive, predominantly mediated by an endothelium-dependent vasodilatory effect. Cynarin and chlorogenic acid, which have a strong vasorelaxant effect may be involved in the antihypertensive effect of the plant extract. The bioinformatic POM analysis confirms the therapeutic potential of cynarin and chlorogenic acids as inhibitors of various biotargets. Based on the results, the coordination of these phytochemicals with calcium and transition metals should be studied, for better scope at antihypertensive drug development.

Graphical abstract

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Saponins extracted from Dioscorea collettii rhizomes regulate the expression of urate transporters in chronic hyperuricemia rats

Publication date: September 2017
Source:Biomedicine & Pharmacotherapy, Volume 93
Author(s): Liran Zhu, Yifan Dong, Sha Na, Ru Han, Chengyin Wei, Guangliang Chen
ObjectiveThe current study aimed to investigate whether the saponins, bioactive component of effects of D. collettii, could reduce the serum uric acid level in a hyperuricemic mouse via regulation of urate transporters.MethodsChronic hyperuricemia model was established by combine administration of adenine (100mg/kg) and ethambutol (250mg/kg). In the model group, the serum uric acid (SUA), urine uric acid (UUA) volume, and 24-h UUA values increased significantly, while the uric acid clearance rate (CUr) and creatinine clearance rate (CCr) values decreased. Further, the model groups showed significantly lower expression of organic anion transporter 1 (OAT1) and organic anion transporter 3 (OAT3) and significantly higher expression of renal tubular urate transporter 1 (URAT1), glucose transporter 9 (GLUT9) and URAT1 mRNA than the normal control group.ResultsSaponins administration was found to have a dose-dependent effect, as evidenced by the increase in the 24-h UUA, CUr and CCr values; the decrease in SUA; the decrease in the renal expression of URAT1 mRNA and URAT1 and GLUT9 proteins; and the increase in the renal expression of the OAT1 and OAT3 proteins.ConclusionThe saponins extracted from D. collettii rhizomes had an obvious anti-hyperuricemic effect through downregulation of the URAT1 mRNA and the URAT1 and GLUT9 proteins and upregulation of the OAT1 and OAT3 proteins.



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The Evolution of Clinical Trials in Oncology: Defining Who Benefits from New Drugs Using Innovative Study Designs

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MALDI (matrix assisted laser desorption ionization) Imaging Mass Spectrometry (IMS) of skin: Aspects of sample preparation

Publication date: 1 November 2017
Source:Talanta, Volume 174
Author(s): Cristiana Santos de Macedo, David M. Anderson, Kevin L. Schey
MALDI (matrix assisted laser desorption ionization) Imaging Mass Spectrometry (IMS) allows molecular analysis of biological materials making possible the identification and localization of molecules in tissues, and has been applied to address many questions on skin pathophysiology, as well as on studies about drug absorption and metabolism. Sample preparation for MALDI IMS is the most important part of the workflow, comprising specimen collection and preservation, tissue embedding, cryosectioning, washing, and matrix application. These steps must be carefully optimized for specific analytes of interest (lipids, proteins, drugs, etc.), representing a challenge for skin analysis. In this review, critical parameters for MALDI IMS sample preparation of skin samples will be described. In addition, specific applications of MALDI IMS of skin samples will be presented including wound healing, neoplasia, and infection.

Graphical abstract

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A novel calibration strategy based on background correction for quantitative circular dichroism spectroscopy

Publication date: 1 November 2017
Source:Talanta, Volume 174
Author(s): Qi Zuo, Shun Xiong, Zeng-Ping Chen, Yao Chen, Ru-Qin Yu
When using circular dichroism (CD) spectroscopy for quantitative analysis, the samples to be analyzed must be free of light-absorbing interferences. However, in real-world samples, the presence of background absorbers is practically unavoidable. The difference in the matrices between the real-world samples to be analyzed and the standard samples (on which either univariate or multivariate calibration model was built) would result in systematic errors in the quantification results of CD spectroscopy. In this contribution, a novel calibration strategy for quantitative CD spectroscopic analysis was proposed. The main idea of the proposed calibration strategy is to project the CD spectra of both the standard samples and the real-world sample to be analyzed onto a projection space orthogonal to the space spanned by the background CD spectrum of the real-world sample and then build a multivariate calibration model on the transformed CD spectra of the standard samples. The performance of the proposed calibration strategy was tested and compared with conventional univariate and multivariate calibration methods in the quantification of Pb²⁺ in cosmetic samples using CD spectroscopy in combination with a G-quadruplex DNAzyme (e.g. PS2.M). Experiments results revealed that the proposed calibration strategy could mitigate the influence of the difference in the matrices between the standard samples and cosmetic samples and realized quantitative analysis of Pb²⁺ in cosmetic samples, with precision and accuracy comparable to atomic absorption spectroscopy. The proposed calibration strategy has the features of simplicity and effectiveness, its combination with CD spectroscopic probes can realize accurate and precise quantification of analytes in complex samples using CD spectroscopy.

Graphical abstract

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2-aminopurine probe in combination with catalyzed hairpin assembly signal amplification for simple and sensitive detection of microRNA

Publication date: 1 November 2017
Source:Talanta, Volume 174
Author(s): Chan Liu, Sifang Lv, Hang Gong, Chunyan Chen, Xiaoming Chen, Changqun Cai
A quencher-free and enzyme-free fluorescent sensor was proposed to simply and sensitively detect miRNA via the target catalyzed hairpin assembly (CHA) signal amplification in combination with 2-aminopurine (2-AP) molecular beacon (MBs). This sensor contains two DNA hairpins termed as H1 and H2. H1 labeled by 2-AP needs no quenchers because 2-AP can be quenched through its stacking interaction with the adjacent bases. H2 is partially complementary to H1. In the presence of the target microRNA (miRNA), H1 is unfolded and produces the DNA/RNA complexes, enhancing the fluorescent signal. Then, the RNA of the DNA/RNA complexes can be displaced by H2 and the free miRNA can interact with another H1, resulting in the significant fluorescence enhancement of the system. This signal amplification process is enzyme-free, making the sensor more simple and cost effective. The detection limit of this sensor could be as low as 3.5pM. We further applied this assay to monitor the overexpressed miRNA-21 from human breast cancer cells to confirm its applicability. The proposed sensor could be used as a simple and sensitive platform for target miRNA detection, holding great potential for convenient monitoring of different miRNA biomarkers for early diagnosis of various cancers.

Graphical abstract

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Liquid-based and conventional cytology for bronchial washings/bronchoalveolar lavages in the diagnosis of malignancy - An institutional experience

Abha Thakur, Pooja Bakshi, Gagandeep Kaur, Kusum Verma

Journal of Cytology 2017 34(3):127-132

Background: Liquid-based cytology (LBC) has been developed as an alternative for conventional cytology (CC) in cervical smears. It is now increasingly being used all over the world for cervical cancer screening. However, its role and diagnostic accuracy in bronchial wash (BW)/bronchoalveolar lavage (BAL) specimens remains undetermined. Aims: To assess and compare the diagnostic performance and accuracy of LBC with CC for detecting malignancy in bronchial specimens. Settings and Design: This was a retrospective analytical hospital-based study. Materials and Methods: Bronchial specimens (BW/BAL) received over a period of 4.5 years were reviewed. The samples were processed by CC from June 2010 to September 2012 (2.25 years) and by LBC from October 2012 to December 2014 (2.25 years). Data were retrieved from the records of cytology laboratory and compared among both the groups. Detection rate for histologically or cytologically verified samples was calculated. Results: A total of 559 cases verified by histological and cytological follow-up were evaluated. These included 247 CC cases and 312 LBC cases. The positive diagnostic rate for malignancy in CC was 28.6% whereas that for LBC was 32.9%. The negative diagnostic rates were 66.5% and 66.3% for CC and LBC, respectively. However, unsatisfactory rates had shown a good reduction from 4.4% in CC to 0.6% after LBC introduction. The smears showed more homogeneous distribution of cells with elimination of obscuring factors such as blood, inflammation, and mucus. Conclusions: The diagnostic accuracy of LBC was slightly better than CC. The unsatisfactory rates showed reduction in LBC preparation. Thus, LBC is a viable alternative to CC and has the advantages of standardization of preparation with decrease in unsatisfactory rates.

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Ceruminous adenoma: A rare tumor diagnosed on cytology with histological correlation

Rumpa Das, Gorakh Nath, Sangita Bohara, Shivanjali Raghuvanshi

Journal of Cytology 2017 34(3):168-170

Ceruminous adenoma (CA) is a rare, benign tumor of the ceruminous gland found in the cartilaginous part of the external auditory canal (EAC). The tumor is diagnosed on histopathology and shows a characteristic dual population of luminal epithelial cells and basal myoepithelial cells. However, CA can be diagnosed on fine-needle aspiration cytology (FNAC) prior to surgery and the cytopathologist should be well aware of its cytological findings to avoid any misdiagnosis. The tumor shows an excellent prognosis with possible recurrence and malignant transformation. The present case emphasizes the cytological features of CA, which have been scantily described in the literature and highlights the role of cytopathologists in preoperative diagnosis.

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Role of cell block in cytopathologic evaluation of image-guided fine needle aspiration cytology

Elizabath P Mathew, Vijayalakshmi Nair

Journal of Cytology 2017 34(3):133-138

Context: Fine needle aspiration cytology (FNAC) of superficial or deep-seated lesion is an increasingly common practice, eliminating time consuming and costly diagnostic procedures and providing rapid and safe diagnosis. Aims: To assess utility of cell block preparation method in increasing sensitivity of cytodiagnosis in deep-seated image-guided FNACs. Settings and Design: This was a hospital-based observational study conducted in the Department of Pathology, over a period of one and a half years. Materials and Methods: A total of 46 cases of abdomino-pelvic and intrathoracic masses subjected to guided FNACs were included. Along with conventional smears, cell blocks were prepared by using AAF (95% Ethanol 34 ml + formalin 4 ml + Glacial acetic acid 2 ml) as fixative agent. Statistical Analysis Used: Done using MedCalc Version 12.7.5.0 to find out the sensitivity, specificity, and diagnostic accuracy of conventional smears and cell blocks. Results: The sensitivity, specificity, and diagnostic accuracy of cell blocks in our study was 71.11%, 100%, and 71.73%, respectively. The figures for FNA smears were 62.22%, 100%, and 63.04%, respectively. Conclusions: Cell block technique by AAF fixative is a simple, inexpensive procedure. Cell block method allows the recovery and processing of minute amounts of cellular material, facilitating better classification of tumor when reviewed along with cytological smears, the ability to obtain many sections for immunostains and other studies to be performed akin to paraffin sections produced in histopathology.

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Tuberculous mastitis diagnosed on cytology - case report of a rare entity

Riti Tushar Kanti Sinha, Aniruna Dey, Seema Agarwal

Journal of Cytology 2017 34(3):162-164

Tuberculous mastititis is a rare clinical entity and usually affects women from the Indian subcontinent. It often mimics breast carcinoma and pyogenic breast abscess. Fine needle aspiration cytology (FNAC) is a very essential diagnostic tool when other routine laboratory investigations are not helpful in reaching to the conclusion. Tuberculosis (TB) of the breast is an uncommon presentation of TB even in countries where the incidence of pulmonary and extrapulmonary TB is high. Radiological imaging is not diagnostic.

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Cytomorphological patterns of tubercular lymphadenitis and its comparison with Ziehl-Neelsen staining and culture in eastern up. (Gorakhpur region): Cytological study of 400 cases

Shaila K Mitra, Rajiv K Misra, Priyanka Rai

Journal of Cytology 2017 34(3):139-143

Background: Tuberculous lymphadenitis is most common cause of lymphadenopathy in developing countries. Although enormous literature is available on various aspects of the disease including cytological patterns and its incidence in others parts of India and in other countries, only limited literature is available regarding its incidence and morphological spectrum on cytology in eastern parts of Uttar Pradesh in Gorakhpur region. Aim: The present study was undertaken to estimate the incidence of tuberculous lymphadenitis in our settings along with its morphological spectrum on cytology as well as to determine the utility of culture of fine needle aspirates in addition to cytology and Ziehl–Neelsen (ZN) staining. Material and Methods: Four hundred cases of superficial lymphadenopathy were subjected to fine needle aspiration cytology (FNAC), and in case, smears were stained with Hematoxylin and eosin (H and E), Giemsa, and ZN stain and categorized into three cytomorphological patterns. All the aspirates were inoculated on two sterile Lowenstein Jensen (LJ) medium. Result: Out of 400 cases of consecutive lymph nodes aspirated, 180 cases (45%) showed features of tuberculous lymphadenitis. Smears revealed epithelioid granulomas with caseous necrosis in maximum cases (40%). On statistical analysis, difference between group I and group II was found to be significant (P < 0.05); while comparison between groups II and III as well as between groups I and III was found to be statistically insignificant. Overall, acid fast bacilli positivity was seen in 51.6% of the cases. Conclusion: FNAC has been proved very safe, highly sensitive, and first line investigation in diagnosing tubercular lymphadenitis. The sensitivity can be further be increased by complementary cytomorphology with acid fast staining. Diagnostic accuracy can further be increased by culture.

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Fine needle aspiration cytology diagnosis of metastatic malignant diffuse type tenosynovial giant cell tumor

Prashant Ramteke, Venkat K Iyer, Karan Madan, Shivanand Gamangatti, Asit R Mridha

Journal of Cytology 2017 34(3):174-176

Tenosynovial giant cell tumors (TGCTs) arise from the synovium of joint, bursa, and tendon sheath, and are classified into localized and diffuse types. Diffused type often affects the large joint, and has more recurrence, metastasis, and malignant transformation potential compared to the localized type. Malignant diffused TGCT (D-TGCT) usually occurs as a large tumor (>5 cm), in older patients, and its histopathologic features include necrosis, cellular anaplasia, prominent nucleoli, high nuclear cytoplasmic ratio, brisk mitosis, discohesion of tumor cells, paucity of giant cells, and a diffuse growth pattern. At least five of these criteria are required for the histopathologic diagnosis of malignant TGCT because the benign TGCT also shares many of these morphological features. We describe the cytomorphologic features of a malignant D-TGCT from an unusual case of pulmonary metastasis in an adult patient. Fine needle aspiration cytologic features of malignant D-TGCT have not been described earlier in the English literature.

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Malignancy rate in thyroid nodules categorized as atypia of undetermined significance or follicular lesion of undetermined significance - An institutional experience

Smita Chandra, Harish Chandra, Sampan S Bisht

Journal of Cytology 2017 34(3):144-148

Introduction: Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) of Bethesda system for reporting thyroid cytopathology has emerged as most controversial category due to its heterogeneity and inconsistent usage. Initially associated risk of malignancy was estimated to be about 5–15%, but eventually different results have been obtained across institutions due to variable follow-ups and interpretation. The present study was conducted to evaluate the rate of malignancy along with appropriate management in this category. Materials and Methods: The study included AUS/FLUS cases diagnosed over period of 4 years on thyroid fine needle aspiration cytology (FNAC). Detailed clinical history and radiological examination were recorded along with follow-ups and management of all cases. Histopathology was available for cases which underwent surgery due to high clinical suspicion, worrisome radiological features or two consecutive AUS/FLUS reports. Results: The incidence of AUS/FLUS was 6.4% with repeat FNAC done in 39.6%, immediate surgery in 49.2% and follow-up without intervention in 11.1% cases. The overall malignancy rate was 28.5% with most common malignancy being follicular variant of papillary carcinoma (FVPC). Malignancy rate was more in cases (24.1%) which morphologically showed atypical nuclear features in comparison to architectural atypia. Conclusion: AUS/FLUS is associated with higher risk of malignancy than previously anticipated. Surgical intervention may have greater implication than repeat FNAC in appropriate management of this category. Substratification of this category according to nuclear features and architecture may be more useful in predicting malignancy risk and reducing the variability in the group.

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Intestinal GIST masquerading as an ovarian mass: Diagnosed on FNAC

Surbhi Goyal, Vinod K Arora, Mohit K Joshi, Navjeevan Singh, Gita Radhakrishnan

Journal of Cytology 2017 34(3):159-161

The preoperative diagnosis of metastatic intestinal gastrointestinal stromal tumors (GIST) on cytology can be quite difficult at times. The present case characterizes the cytomorphological and immunocytochemical features of GIST, emphasizing the utility of fine-needle aspiration cytology (FNAC) in the evaluation of spindle cell tumors of gastrointestinal tract. An accurate and early diagnosis of GIST affects the treatment, primarily allowing the use of tyrosine kinase inhibitors in unresectable or metastatic cases. Presence of highly cellular fragments of spindle-to-oval cells with variable degree of pleomorphism, atypia, and necrosis supplemented by immunocytochemistry can render a cytological diagnosis of GIST in dilemmatic clinical situations. Our case highlights the diagnostic role of FNAC in the evaluation of a pelvic mass, which was clinicoradiologically misdiagnosed as ovarian carcinoma.

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Modified ultrafast Papanicolaou staining technique: A comparative study

Moni Thakur, Venkateswara Rao Guttikonda

Journal of Cytology 2017 34(3):149-153

Introduction: Ultrafast Papanicolaou stain (UFP) was introduced as a hybrid of Romanowsky and Papanicolaou (PAP) stain. It enhances the quality and reduces the time. In the present study, a modified staining technique was adapted where Gill's Hematoxylin was replaced by Harris Hematoxylin. Aims: The aim of the study was to assess the use of the modified ultrafast Papanicolaou (MUFP) stain for fine needle aspiration cytology (FNAC) of head and neck swellings in comparison with the routine PAP stain, hematoxylin and eosin (H and E), and Giemsa. Materials and Methods: Forty FNACs of head and neck swellings were collected. FNAC procedure was performed by standard method; two smears were fixed in 95% propanol and stained with PAP and H and E. Two smears were air dried, 1 was stained with Giemsa, and 1 was rehydrated with normal saline, fixed in alcoholic formalin, and stained with MUFP. Four parameters were considered and scored background, cell morphology, nuclear staining, and overall staining pattern). Results: The quality of MUFP smears were better when compared to routine PAP, H and E, and Giemsa, and was statistically significant by Wilcoxon matched pair test. Conclusions: MUFP stain in comparison to routine PAP, H and E, and Giemsa provides an excellent and suitable alterative in cytological staining for the study of various organs.

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Anaplastic large cell lymphoma: A great mimic on cytology

Mona A Agnihotri, Kanchan S Kothari, Leena P Naik, Sharada Patil

Journal of Cytology 2017 34(3):165-167

Anaplastic large cell lymphoma (ALCL) is a T-cell lymphoma, accounting for <5% of non-Hodgkin's lymphoma. Cutaneous involvement can be primary or secondary arising in systemic ALCL. The diagnostic feature in both is the presence of pleomorphic, CD30 positive hallmark cells. We present a case of ALCL in a 19-year-old male presenting as an ulcerated scalp swelling. Clinical impression was actinomycosis or scrofuloderma. Cytology smears showed large dispersed pleomorphic cells with hyperlobated nuclei and multinucleated giant cells. The differentials considered were ALCL, rhabdomyosarcoma, and poorly differentiated carcinoma. Immunocytochemistry (ICC) showed positivity for leukocyte common antigen (LCA) and CD30 while negativity for desmin, favoring ALCL. Computed tomography (CT) showed a lytic paravertebral lesion. Subsequently, both paraspinal and scalp lesions were biopsied and immunochemistry confirmed the diagnosis of ALCL. Thus, cutaneous involvement in ALCL can resemble inflammatory and other neoplastic lesions clinically and cytologically. Hence, a high index of suspicion and ICC can aid in the correct diagnosis on fine needle aspiration cytology (FNAC).

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Warthin-Finkeldy cells - A soft indicator in cytodiagnosis of Kimura

Manoj G Madakshira, Rajat Bajaj, Khushdeep Kaur

Journal of Cytology 2017 34(3):154-155



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Sarcoma in urine cytology; an extremely rare entity: A report of two cases

Suvradeep Mitra, Gurwinder Kaur, Nandita Kakkar, Priya Singh, Pranab Dey

Journal of Cytology 2017 34(3):171-173

Primary sarcomas of the urinary bladder or prostate are extremely rare entities. The rarity and lack of awareness makes it difficult for the cytologists to detect the spindle cell lesions in urine for malignant cytology. The literature available for the detection of urinary tract sarcomas is little. Here, we report the urine cytology findings of two interesting cases of urinary bladder and prostatic leiomyosarcoma.

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Role of fine-needle aspiration cytology in diagnosis of disseminated histoplasmosis in an immunocompetent patient: A case report

Sagarika Samantaray, Sasmita Panda, Sashibhusan Dash, Niranjan Rout

Journal of Cytology 2017 34(3):156-158

Histoplasmosis is a mycotic infection caused by dimorphic fungus, Histoplasma capsulatum. The organisms are usually found within the cells (macrophages). This organism mostly affects lungs in immunocompetent individuals and disseminated forms are seen in immunocompromised cases. Here, we describe a case of disseminated histoplasmosis in an immunocompetent, 35-year-old female with lymphadenopathy diagnosed by fine-needle aspiration cytology and cell block.

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Hodgkin's lymphoma masquerading as suppurative lymphadenitis

Meghna Singh, Jitendra Chaudhary

Journal of Cytology 2017 34(3):177-178



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Indirect sinusoidal vibrations induces an acute increase in explosive strength

Publication date: August 2017
Source:Journal of Electromyography and Kinesiology, Volume 35
Author(s): Leandro V. de Paula, Pedro V.S. Moreira, Rudolf Huebner, Leszek A. Szmuchrowski
The purpose of this study was to examine the acute effect of indirect vibration on neuromuscular responses and fatigue resistance (electromyographic activity - EMG and force) during isometric exercise. Nineteen healthy men (age=22.4±2.7years; body mass=76.4±12.9kg, height=175±6.7cm) performed isometric elbow flexion exercises in three experimental treatments: only isometric exercise (control - CON); isometric exercise with the addition of sinusoidal vibrations (SVE1; frequency=20Hz, displacement=3.55±0.54mm); and isometric exercise with the addition of sinusoidal vibrations with frequency variation (SVE2; frequency=20±3Hz, displacement=3.6±0.8mm). The peak of the rate of EMG rise (RER) and the root mean square of biceps brachii during the first 200ms (RMS200bic) were significantly higher in SVE1 (RMS200bic, 25.57±11.70%MVC; RER, 266.91±130.16%MVCs⁻¹) than CON (RMS200bic, 19.31±8.19%MVC; RER, 169.15±65.98%MVCs⁻¹). Regarding force, in SVE1, compared to CON, significant increases were observed in peak of rate of force development (CON, 643.96±192.57N/s; SVE1, 845.54±292.84N/s), rate of force development in the first 200ms (CON, 382.92±138,63N/s; SVE1, 501.09±147.46N/s), and impulse in 200ms (CON, 8.56±3.56Ns; SVE1, 11.67±4.45Ns). The addition of indirect sinusoidal vibrations during exercise induced increases in the rate of force development (explosive strength), without affecting the peak force (maximal strength) and the ability to sustain strength production.



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Currently used organophosphate and brominated flame retardants in the environment of China and other developing countries (2000–2016)

Abstract

This review summarizes the environmental occurrence of new brominated flame retardants (NBFRs) and organophosphate compounds (OPs) in the environment of developing countries since 2000. The ban on the production and use of commercial formulations of polybrominated diphenyl ethers (PBDEs) have paved the way for the high use of NBFRs and OPs in consumer products to fulfill the fire safety regulations. Recent studies have shown that the ever increasing production volumes and extensive use of these chemicals as additive FRs and plasticizers have resulted into their ubiquitous occurrence in all environmental compartments. Although presumed to be safe for use and the environment, recent studies on their occurrence and persistence in the environment have raised questions. Due to the lack of awareness, research interest, and availability of technical facilities, limited scientific data is available on the occurrence of these chemicals in developing countries. In this study, we collected reported data and provide an overview of environmental occurrence of NBFRs and OPs in abiotic and biotic matrices of different developing countries. Finally, research gaps were identified with recommendations for future research work and would be useful towards the environmental management of these toxic chemicals.

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Biomarkers for the Management of Castration-Resistant Prostate Cancer: We Are Not There Yet

Abstract

In recent years, there has been a marked increase in the number of approved therapies that increase survival of patients with castration-resistant prostate cancer. Current treatment guidelines provide therapeutic management recommendations, but these are primarily based on clinical factors such as performance status or site of metastasis (bone vs. visceral), and not on underlying molecular or cellular features of disease that may predict response. The ability to tailor treatment based on molecular or cellular features of disease could potentially reduce the occurrence of unnecessary side effects and ineffective treatments, and thereby reduce both direct and indirect medical costs. As such, it is important to identify and validate new prognostic and predictive molecular biomarkers that can be used to direct cancer treatment. This review will focus on existing and potential biomarkers in the context of castration-resistant prostate cancer management and discuss the need for continued discovery and validation of new biomarkers and biomarker panels for prostate cancer.

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Acquired Resistance to Erlotinib in EGFR Mutation-Positive Lung Adenocarcinoma among Hispanics (CLICaP)

Abstract

Background

Lung cancer harboring epidermal growth factor receptor (EGFR) mutations and treated with EGFR tyrosine kinase inhibitors (TKIs) all eventually develop acquired resistance to the treatment, with half of the patients developing EGFR T790M resistance mutations.

Objective

The purpose of this study was to assess histological and clinical characteristics and survival outcomes in Hispanic EGFR mutated lung cancer patients after disease progression.

Patients and Methods

EGFR mutation-positive lung cancer patients (n = 34) with acquired resistance to the EGFR-TKI erlotinib were identified from 2011 to 2015. Post-progression tumor specimens were collected for molecular analysis. Post-progression interventions, response to treatment, and survival were assessed and compared among all patients and those with and without T790M mutations.

Results

Mean age was 59.4 ± 13.9 years, 65% were never-smokers, and 53% had a performance status 0–1. All patients received erlotinib as first-line treatment. Identified mutations included: 60% DelE19 (Del746–750) and 40% L858R. First-line erlotinib overall response rate (ORR) was 61.8% and progression free survival (PFS) was 16.8 months (95% CI: 13.7–19.9). Acquired resistance mutations identified were T790M mutation (47.1%); PI3K mutations (14.7%); EGFR amplification (14.7%); KRAS mutation (5.9%); MET amplification (8.8%); HER2 alterations (5.9%, deletions/insertions in e20); and SCLC transformation (2.9%). Of patients, 79.4% received treatment after progression. ORR for post-erlotinib treatment was 47.1% (CR 2/PR 14) and median PFS was 8.3 months (95% CI: 2.2–36.6). Median overall survival (OS) from treatment initiation was 32.9 months (95% CI: 30.4–35.3), and only the use of post-progression therapy affected OS in a multivariate analysis (p = 0.05).

Conclusions

Hispanic patients with acquired resistance to erlotinib continued to be sensitive to other treatments after progression. The proportion of T790M+ patients appears to be similar to that previously reported in Caucasians.

http://ift.tt/2rBrY6U

Zonisamide inhibits monoamine oxidase and enhances motor performance and social activity

Publication date: Available online 15 June 2017
Source:Neuroscience Research
Author(s): Maiko T. Uemura, Takeshi Asano, Rie Hikawa, Hodaka Yamakado, Ryosuke Takahashi
Zonisamide (ZNS) is an effective drug for not only motor symptoms but also non-motor symptoms in Parkinson's disease. However, the actions of ZNS as an anti-Parkinsonian drug are not well understood. To clarify the actions of ZNS in vivo, we administered ZNS to mice and examined the effects on neurotransmitter metabolism and behaviors, focusing on motor and non-motor symptoms. Administration of ZNS decreased dopamine (DA) turnover in various brain regions, including the striatum. In behavioral tests, ZNS enhanced locomotor activity and novelty seeking in the open field test, light-dark transition test, and the social interaction test. Consistent with these results of DA metabolism in ZNS-treated mice, monoamine oxidase activity was significantly inhibited by ZNS in primary neurons and astrocytes. Collectively, these data suggest that ZNS inhibits monoamine oxidase activity and decreases DA turnover, which increases locomotor activity and novelty seeking in mice. ZNS is potentially useful to improve not only motor symptoms but also neuropsychiatric non-motor symptoms such as apathy in PD.



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PRELIM II(EDI BOARD)

Publication date: May 2017
Source:Neuroscience Research, Volume 118





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Cutting-edge approaches to unwrapping the mysteries of sleep

Publication date: May 2017
Source:Neuroscience Research, Volume 118
Author(s): Yu Hayashi, Shigeyoshi Itohara




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Contents

Publication date: May–June 2017
Source:Médecine & Droit, Volume 2017, Issue 144





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Editorial Board

Publication date: May–June 2017
Source:Médecine & Droit, Volume 2017, Issue 144





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The Importance of Facts and the Role of Academic Publishers in Today's World—A Publisher's View

J reconstr Microsurg 2017; 33: ix-ix
DOI: 10.1055/s-0037-1600099

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

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Incidence of Parathyroid Disorders in an Indian Adult Male Population: A 25 year follow up study

Abstract

Context and Objective

Detailed information on the epidemiology of parathyroid disorders in India is lacking. Most of the available data pertain to primary hyperparathyroidism (PHPT) rather than the overall burden of parathyroid disorders. We studied the incidence of parathyroid disorders in a cohort of service personnel followed for a long duration.

Design, setting and patients

The data for this retrospective, descriptive epidemiological study were derived from the electronic medical records (EMR) of health care personnel enrolled between 1990 and 2015. Subjects were recruited between the ages of 17 and 20 years in good health and the data pertaining to parathyroid disorders were derived from the EMR.

Main outcomes measures

We calculated the incidence rates per person-years of parathyroid disorders using appropriate statistical methods.

Results

Our analysis includes 51,217 participants (median age 33, range 17 – 54 years) with a mean follow up of 12.5 years. Yearly evaluation of the data gave a cumulative follow up duration of 613,925 person-years. PHPT was diagnosed in 37 and hypoparathyroidism in 16 patients, giving incidence rates of 6 and 2.6 per 100,000 person-years respectively. Only one patient was diagnosed with pseudohypoparathyroidism (0.16 per 100,000 person-years). Out of the 37 patients with PHPT, 16 (43%) developed post-surgical hypoparathyroidism.

Conclusion

Our cohort had a low incidence of PHPT when compared to western populations. Long term epidemiological studies are essential to identify the demographic trends of metabolic bone disorders in India.

This article is protected by copyright. All rights reserved.

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Perception and practices of tobacco smoking among medical students in the Nile Delta, Egypt

Abstract

This study was conducted to identify medical students' perception and practices towards tobacco smoking, as well as to identify factors affecting their adoption to smoking habit, among medical students in the Nile Delta. From December 2014 to February 2015, a questionnaire-based cross-sectional study was conducted at the four faculties of medicine in the Nile Delta. A total of 1715 students were targeted from the 2nd to 6th academic years to represent different levels of knowledge, awareness, and the influence of medical education on their attitude towards smoking. 5.6 and 1.2% of the students reported being smokers and ex-smokers, respectively, with a higher prevalence among 6th-year students, 40% of them reported to be involved with substance abuse. In general, medical students had positive antismoking attitude. The prevalence of smoking among medicine students was not high. However, there is a need to address smoking cessation programs during their study.

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Steroid Delivery to the Frontal Sinus Opening With a Bioabsorbable Implant vs. a Bioabsorbable Nasal Dressing

Condition:   Chronic Rhinosinusitis (Diagnosis)
Interventions:   Device: Bioabsorbable steroid releasing sinus implant;   Device: Bioabsorbable nasal dressing impregnated with steroid
Sponsor:   University of Rochester
Not yet recruiting - verified June 2017

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Submucosa/Mucosal Pharyngeal Flap Trial

Condition:   Velopharyngeal Insufficiency
Interventions:   Procedure: Mucosa/submucosa Pharyngeal Flap;   Procedure: Standard of Care Pharyngeal Flap
Sponsor:   Lawson Health Research Institute
Not yet recruiting - verified June 2017

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Clinical Study of Concurrent Radiotherapy With Concurrent Chemotherapy for Locally Advanced Nasopharyngeal Carcinoma

Conditions:   Gastrointestinal Toxicity;   Blood / Bone Marrow Toxicity
Interventions:   Drug: Lobaplatin;   Device: linear accelerator
Sponsor:   Fifth Affiliated Hospital, Sun Yat-Sen University
Recruiting - verified June 2017

http://ift.tt/2rvRhw6

Autologous Muscle Derived Cells for Gastro-Intestinal Repair (AMDC-GIR) for Tongue Dysphagia

Condition:   Oropharyngeal Dysphagia
Intervention:   Drug: Autologous Muscle Derived Cells for Gastro-Intestinal Repair (AMDC-GIR)
Sponsors:   Peter Belafsky, MD;   Cook MyoSite
Recruiting - verified June 2017

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Thyroid High-Impact Articles

FREE ACCESS through June 29, 2017.
Read now:

Latest Impact Factor: 5.515
The Official Journal of: American Thyroid Association

Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for Differentiated and Anaplastic Thyroid Cancer (Eighth Edition): What Changed and Why?
R. Michael Tuttle, Bryan Haugen, Nancy D. Perrier 

Racial Disparities in Differentiated Thyroid Cancer: Have We Bridged the Gap?
Syed A. Shah, Mohamed A. Adam, Samantha M. Thomas, Randall P. Scheri, Michael T. Stang, Julie A. Sosa, Sanziana A. Roman

Serial Neck Ultrasonographic Evaluation of Changes in Papillary Thyroid Carcinoma During Pregnancy
Hye-Seon Oh, Won Gu Kim, Suyeon Park, Mijin Kim, Hyemi Kwon, Min Ji Jeon, Jeong Hyun Lee, Jung Hwan Baek, Dong Eun Song, Tae Yong Kim, Young Kee Shong, Won Bae Kim

Identification of Three Novel Fusion Oncogenes, SQSTM1/NTRK3, AFAP1L2/RET, and PPFIBP2/RET, in Thyroid Cancers of Young Patients in Fukushima
Keita Iyama, Michiko Matsuse, Norisato Mitsutake, Tatiana Rogounovitch, Vladimir Saenko, Keiji Suzuki, Mai Ashizawa, Chiyo Ookouchi, Satoshi Suzuki, Hiroshi Mizunuma, Toshihiko Fukushima, Shinichi Suzuki, Shunichi Yamashita

Postoperative Outcomes in Graves' Disease Patients: Results from the Nationwide Inpatient Sample Database
Gustavo A. Rubio, Tulay Koru-Sengul, Tanaz M. Vaghaiwalla, Punam P. Parikh, Josefina C. Farra, John I. Lew

Changes in Hepatic TRβ Protein Expression, Lipogenic Gene Expression, and Long-Chain Acylcarnitine Levels During Chronic Hyperthyroidism and Triiodothyronine Withdrawal in a Mouse Model
Kenji Ohba, Rohit Anthony Sinha, Brijesh Kumar Singh, Liliana Felicia Iannucci, Jin Zhou, Jean-Paul Kovalik, Xiao-Hui Liao, Samuel Refetoff, Judy Chia Ghee Sng, Melvin Khee-Shing Leow, Paul Michael Yen

The post Thyroid High-Impact Articles appeared first on American Thyroid Association.

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Clinical Thyroidology for the Public – Highlighted Article

From Clinical Thyroidology for the Public: Exposure to radiation occurs with many imaging studies (like CT scans) and medical treatments (like radiation therapy for cancer). When radiation exposure involves the head and neck areas directly, the thyroid is exposed and there is an increased risk for the development of thyroid cancer in the future. Read More….

We welcome your feedback and suggestions. Let us know what you want to see in this publication.

Feedback & Suggestions

The post Clinical Thyroidology for the Public – Highlighted Article appeared first on American Thyroid Association.

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Toxicity assessment of five emerging pollutants, alone and in binary or ternary mixtures, towards three aquatic organisms

Abstract

Despite a growing scientific attention on ecological impact of emerging pollutants (EPs) such as pharmaceuticals, personal care products, and pesticides, knowledge gaps remain regarding mixture toxicity and effects on aquatic organisms. Several EPs were screened in seawater (Normandy, France), and the ecotoxicity of five compounds, chosen on their occurrence in ecosystems and use worldwide, was assessed and were the biocides methylparaben (MP) and triclosan (TCS), a pesticide degradation product (AMPA), and the pharmaceuticals venlafaxine (VEN) and carbamazepine (CBZ). The acute or sub-chronic toxicity, alone or in binary/ternary mixtures of three of them (CBZ, AMPA, and MP), was assessed on one marine and two freshwater organisms: Crassostrea gigas, Pseudokirchneriella subcapitata, and Daphnia magna. TCS and AMPA were, respectively, the most (EC₅₀ < 1 mg L⁻¹) and the least (EC₅₀ > 50 mg L⁻¹) toxic chemicals for the four endpoints (algal growth inhibition, daphnia immobilization, oyster embryotoxicity, and metamorphosis). The anxiolytic VEN (EC₅₀ < 1 mg L⁻¹) was particularly toxic to oyster larvae showing sensitivity difference between freshwater and marine organisms. If all the mixtures appeared to be in the same range of toxicity, the joint-toxic effects mainly led to synergistic or antagonistic interactions compared to single-compound toxicity. The data also highlighted species-dependent differing models of toxicity and underscored the need for an awareness of cocktail effects for better ecological risk assessment.

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Is intralesional resection suitable for central grade 1 chondrosarcoma: a systematic review and updated meta-analysis

Publication date: Available online 14 June 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Xi Chen, Lingjia Yu, Huiming Peng, Jiang Chao, Canhua Ye, Shibai Zhu, Wenwei Qian
BackgroundThe surgical choice for grade 1 chondrosarcoma has been debated for decades. Intralesional resection can minimize the damage caused by surgery and offer better functional outcome. However, controversy remains about whether it will result in higher rates of local recurrence and metastasis, fewer complications, and better functional outcome compared with resection with wide margin. This systematic review and updated meta-analysis therefore compared intralesional resection and resection with wide margin in terms of local recurrence, metastasis, complications, and functional outcome.MethodsMedline, Embase, and the Cochrane Library were comprehensively searched in December 2016 to identify studies comparing intralesional resection and resection with wide margin for central grade 1 chondrosarcoma. Data of interest were extracted and analyzed using Review Manager 5.3.ResultsTen studies involving 394 patients were included, with 214 patients who had intralesional resection and 180 patients who had resection with wide margin for grade 1 chondrosarcoma. Intralesional resection was associated with lower complication rates (P<0.0001) and better Musculoskeletal Tumor Society score (MSTS). There were no significant differences in terms of overall local recurrence (P=0.27), local recurrence based on adjuvant therapies (P=0.22), local recurrence in studies that included lesions of the hand, foot, pelvis, and axial skeleton (P=0.55), and metastasis (P=0.74) between groups.ConclusionIntralesional resection provides lower complications and better functional outcome with no significant increase in the risk of recurrence and metastasis. We think it is a suitable treatment for central grade 1 chondrosarcoma.



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Polysaccharides from Epimedium koreanum Nakai with immunomodulatory activity and inhibitory effect on tumor growth in LLC-bearing mice

Publication date: Available online 14 June 2017
Source:Journal of Ethnopharmacology
Author(s): Chengcheng Wang, Liang Feng, Jiayan Su, Li Cui, Dan Liu, Jun Yan, Chuanlin Ding, Xiaobin Tan, Xiaobin Jia
Ethnopharmacological relevance:Epimedium koreanum Nakai is documented as tonic herbal in China for over a thousand years and has the potential to enhance the body's immunity according to the theory of traditional Chinese medicine. Polysaccharides are one of the most important effective compounds in Epimedium koreanum Nakai. Accumulating evidence indicated polysaccharides derived from traditional Chinese medicine have potent immune-enhancing properties and relatively nontoxic effects in cancer treatment. However, information about immunological regulation in tumor of Epimedium koreanum Nakai polysaccharides is limited and the reports of purification, characterization of polysaccharides have remained less. The purpose of our study was to further investigate the active polysaccharides from Epimedium koreanum Nakai by evaluating the immune-regulation activities in tumor-bearing mice and provide reasonable explanation for traditional application.Materials and methodsWe firstly purified Epimedium koreanum polysaccharide (EPS) from crude extracts and evaluated EPS in vitro using immunological experiments including maturation and Ag presentation function of DCs, CD4 T-cell differentiation and secretion of anti-cancer cytokines. In LLC-bearing mice model, we investigated its antitumor activities through evaluation of tumor cell proliferative activity, calculation of immune organ indexes and relative host immune system function tests.ResultsResults showed that EPS (180×10⁴Da) was composed of mannose (Man), rhamnose (Rha), glucuronic acid (GlcUA), galactosamine (GalN), glucose (Glc), galactose (Gal), arabinose (Ara) and fructose (Fuc). Chemical composition assay indicated EPS was a fraction with 28.20% uronic acid content. FT-IR suggested the presence of pyraoid ring in EPS and SEM displayed smooth surface embedded by several pores. Moreover, Our study suggested EPS could remarkably stimulate macrophages to secrete substantial anti-cancer cytokines and promote maturation as well as Ag presentation function of DCs. Strikingly, CD4 T-cell differentiation and increased INF-γ production stimulated by EPS–activated macrophages were observed in the research. Furthermore, EPS exhibited prominent antitumor activities through regulating host immune system function in LLC-bearing mice. Taken together, experimental findings suggested EPS could be regarded as a potential immune-stimulating modifier for cancer therapy.ConclusionOur studies demonstrated the polysaccharide (180×10⁴Da) purified from Epimedium koreanum Nakai could promote maturation and Ag presentation function of DCs, increase the level of immunomodulatory cytokines and activate CD4 T-cell differentiation. Furthermore, it may inhibit the tumor growth in LLC-bearing mice through regulating host immune system function

Graphical abstract

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The added value of the CSF cleft on ADC in distinguishing extra-axial from intra-axial tumors

Publication date: September–October 2017
Source:Clinical Imaging, Volume 45
Author(s): Junyoung Kim, Chang-Ki Hong, Sang Hyun Suh, Woo Sang Jung, Sung Jun Ahn
We investigated whether the CSF cleft sign on ADC maps is beneficial for differentiating extra-axial tumors from intra-axial tumors. Seventy-seven intracranial tumor patients were reviewed. Visual grades of CSF cleft sign on T2WI and ADC were compared. The diagnostic performance of CSF cleft sign using ADC plus T2WI was compared with that using T2WI alone. A CSF cleft was more easily visualized on ADC (P<0.01). The diagnostic performance of CSF cleft sign significantly increased in accuracy of 85.7 to 96.1% (P<0.01) when ADC and T2WI were used together.



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Effects of injection velocity on microstructure, porosity and mechanical properties of a rheo-diecast Al-Zn-Mg-Cu aluminum alloy

Publication date: November 2017
Source:Journal of Materials Processing Technology, Volume 249
Author(s): Chao Xu, Junwen Zhao, An Guo, Hu Li, Guangze Dai, Xu Zhang
A semisolid slurry of Al-Zn-Mg-Cu alloy was prepared by adding 0.1wt.% Al-5Ti–1B master alloy and rheo-diecast with different injection velocities. The average size of the primary α-Al particles in the rheo-diecast parts decreased and its shape factor increased with the increase of the injection velocity. The microstructure was obtained with an average particle diameter of 52μm and a shape factor of 0.69 for the primary α-Al particles at 1.0ms⁻¹. With increasing injection velocity, porosity decreased to a minimum of 0.9%, at an injection velocity of 0.7ms⁻¹, and then increased with the increase in injection velocity. At this velocity, the maximum tensile strength and elongation of the rheo-diecast samples were achieved, which were 252MPa and 2.8%, respectively. After T6 heat treatment, the tensile strength and elongation of the samples were 403MPa and 2.1%, an increase and decrease of 60% and 25%, respectively, compared to the as-cast samples.



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Patch testing in psoriasis patients: results of a 30-year retrospective study

Abstract

Psoriasis and allergic contact dermatitis (ACD) are common, chronic T-lymphocyte mediated conditions. Although psoriasis patients are commonly referred for patch testing, there are conflicting views on the relationship between contact allergy and psoriasis. Previous studies have suggested ACD is less common in psoriasis¹ and that psoriatics are more difficult to sensitize^1,2,3.

This article is protected by copyright. All rights reserved

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Outcomes of radiation therapy for advanced T3/T4 non-melanoma cutaneous squamous cell and basal cell carcinoma

Abstract

Non-melanoma cutaneous squamous and basal cell carcinoma (NMSC) is common, and most patients present with early stage (T1/T2) NMSC, which has an excellent prognosis. However, a minority of NMSC patients present with an advanced stage (T3/T4) primary tumor, which may be surgically unresectable but potentially curable with radiation therapy (RT). Because advanced NMSC is rare, studies^1-5 examining the outcomes of RT for patients with T3/T4 tumors are limited. As the outcomes of RT in this patient cohort are unclear, this study was undertaken to examine survival in a large cohort of patients treated at our institution and to explore variables associated with survival outcomes.

This article is protected by copyright. All rights reserved.

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Atopic dermatitis and risk of hypertension, type-2 diabetes, myocardial infarction and stroke in a cross-sectional analysis from the Canadian Partnership for Tomorrow Project

Abstract

Background

Atopic dermatitis (AD) has been associated with cardiovascular risk factors and diseases, but epidemiologic studies to date have found conflicting results.

Objectives

We aimed to determine the associations of AD with hypertension, type-2 diabetes (T2D), myocardial infarction (MI) and stroke.

Methods

We conducted a cross-sectional analysis of baseline data from the Canadian Partnership for Tomorrow Project which includes Canadian residents aged 30-74 living in British Columbia, Alberta, Ontario, Quebec and the Atlantic Provinces. We excluded participants with incomplete data on AD, hypertension, T2D, MI or stroke, who had type-1 or gestational diabetes or who developed any of the outcomes at an age prior to a diagnosis of AD, leaving 259,119 participants in our analysis. We used logistic regression to calculate age and sex- and multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) between AD and subsequent hypertension, T2D, MI and stroke.

Results

AD was reported by 21,379 (8.4%) participants. A total of 52,787 cases of hypertension, 12,739 cases of T2D, 4,390 cases of MI and 2,235 cases of stroke were reported by participants at enrollment. In the multivariable-adjusted model, AD was associated with decreased odds (OR, 95% CI) of hypertension (0.87, 0.83-0.90), T2D (0.78, 0.71-0.84), MI (0.87, 0.75-1.00) and stroke (0.79, 0.66-0.95).

Conclusions

We did not find evidence of a positive association between AD and subsequent hypertension, T2D, MI or stroke; AD was inversely associated with these outcomes in our study. Given our findings and the conflicting literature, AD is likely not a major risk factor for cardiovascular disease.

This article is protected by copyright. All rights reserved.

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Investigation on the effect of sintering temperature on kaolin hollow fibre membrane for dye filtration

Abstract

Despite its extraordinary price, ceramic membrane can still be able to surpass polymeric membrane in the applications that require high temperature and pressure conditions, as well as harsh chemical environment. In order to alleviate the high cost of ceramic material that still becomes one of the major factors that contributes to the high production cost of ceramic membrane, various attempts have been made to use low cost ceramic materials as alternatives to well-known expensive ceramic materials such as alumina, silica, and zirconia in the fabrication of ceramic membrane. Thus, local Malaysian kaolin has been chosen as the ceramic material in this study for the preparation of kaolin hollow fibre membrane since it is inexpensive and naturally abundant in Malaysia. Due to the fact that the sintering process plays a prominent role in obtaining the desired morphology, properties, and performances of prepared ceramic membrane, the aim of this work was to study the effect of different sintering temperatures applied (ranging from 1200 to 1500 °C) in the preparation of kaolin hollow fibre membrane via dry/wet phase inversion-based spinning technique and sintering process. The morphology and properties of membrane were then characterised by SEM, AFM, FTIR, XRD, and three-point bending test, while the performances of membrane were investigated by conducting water permeation and Reactive Black 5 (RB5) dye rejection tests. From the experimental results obtained, the sintering temperature of 1400 °C could be selected as the optimum sintering temperature in preparing the kaolin hollow fibre membrane with the dense sponge-like structure of separation layer that resulted in the good mechanical strength of 70 MPa with the appreciable water permeation of 75 L/h m² bar and RB5 rejection of 68%.

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Distribution of potentially toxic elements (PTEs) in tailings, soils, and plants around Gol-E-Gohar iron mine, a case study in Iran

Abstract

This study investigated the concentration of potentially toxic elements (PTEs) including Al, As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Mo, Ni, Pb, Sb, V, and Zn in 102 soils (in the Near and Far areas of the mine), 7 tailings, and 60 plant samples (shoots and roots of Artemisia sieberi and Zygophylum species) collected at the Gol-E-Gohar iron ore mine in Iran. The elemental concentrations in tailings and soil samples (in Near and Far areas) varied between 7.4 and 35.8 mg kg⁻¹ for As (with a mean of 25.39 mg kg⁻¹ for tailings), 7.9 and 261.5 mg kg⁻¹ (mean 189.83 mg kg⁻¹ for tailings) for Co, 17.7 and 885.03 mg kg⁻¹ (mean 472.77 mg kg⁻¹ for tailings) for Cu, 12,500 and 400,000 mg kg⁻¹ (mean 120,642.86 mg kg⁻¹ for tailings) for Fe, and 28.1 and 278.1 mg kg⁻¹ (mean 150.29 mg kg⁻¹ for tailings) for Ni. A number of physicochemical parameters and pollution index for soils were determined around the mine. Sequential extractions of tailings and soil samples indicated that Fe, Cr, and Co were the least mobile and that Mn, Zn, Cu, and As were potentially available for plants uptake. Similar to soil, the concentration of Al, As, Co, Cr, Cu, Fe, Mn, Mo, Ni, and Zn in plant samples decreased with the distance from the mining/processing areas. Data on plants showed that metal concentrations in shoots usually exceeded those in roots and varied significantly between the two investigated species (Artemisia sieberi > Zygophylum). All the reported results suggest that the soil and plants near the iron ore mine are contaminated with PTEs and that they can be potentially dispersed in the environment via aerosol transport and deposition.

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Ig-seq: Deep sequencing of the variable region of Atlantic salmon IgM heavy chain transcripts

Publication date: August 2017
Source:Molecular Immunology, Volume 88
Author(s): Aleksei Krasnov, Sven Martin Jørgensen, Sergey Afanasyev
Immunoglobulin M plays a key role in systemic protection of Atlantic salmon against pathogens. Until recent, studies have focused on antigen-specific antibodies and little is known about the IgM repertoire: its size, developmental changes and responses to antigens. We report the development of deep sequencing protocol to characterize the repertoire of IgM heavy chain variable region. Its structure and changes were examined at the early stages of life and after infection with virus of cardiac myopathy. Clonotypes are identified by the V and J gene segments and amino acid sequences of CDR3, which determine the contribution of the heavy chain to the antigen binding properties. A major fraction of transcripts are functional while the rest are either sterile (transcribed from noncoding parts of Ig loci) or include stop codons. Despite marked difference in frequencies of combinations of V and J genes, the size of repertoire is large. The IgM diversity steadily increases after hatch followed with temporal reduction during smoltification and recovery after seawater transfer. Most clonotypes are present only in one fish. However multiple transcripts in uninfected fish are produced exclusively from a small fraction of shared clonotypes. While only 4.7% of clonotypes are detected in three and more fish, they comprise 35% of transcripts. Increased frequencies of most abundant clonotypes were detected in the head kidney and blood at ten weeks after viral infection and all were shared. Occurrence of the same clonotypes in multiple individuals can be explained with either their simple structure or exposure to common antigens. Complexity of CDR3 assessed by contents of non complementary nucleotides is slightly lower in shared clonotypes but difference is small. High nucleotide diversity of CDR3 with identical amino acid sequences suggests selection.



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