Texture Segregation Causes Early Figure Enhancement and Later Ground Suppression in Areas V1 and V4 of Visual Cortex

Segregation of images into figures and background is fundamental for visual perception. Cortical neurons respond more strongly to figural image elements than to background elements, but the mechanisms of figure–ground modulation (FGM) are only partially understood. It is unclear whether FGM in early and mid-level visual cortex is caused by an enhanced response to the figure, a suppressed response to the background, or both.

We studied neuronal activity in areas V1 and V4 in monkeys performing a texture segregation task. We compared texture-defined figures with homogeneous textures and found an early enhancement of the figure representation, and a later suppression of the background. Across neurons, the strength of figure enhancement was independent of the strength of background suppression.

We also examined activity in the different V1 layers. Both figure enhancement and ground suppression were strongest in superficial and deep layers and weaker in layer 4. The current–source density profiles suggested that figure enhancement was caused by stronger synaptic inputs in feedback-recipient layers 1, 2, and 5 and ground suppression by weaker inputs in these layers, suggesting an important role for feedback connections from higher level areas. These results provide new insights into the mechanisms for figure–ground organization.

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Adolescent Development of Cortical and White Matter Structure in the NCANDA Sample: Role of Sex, Ethnicity, Puberty, and Alcohol Drinking

Brain structural development continues throughout adolescence, when experimentation with alcohol is often initiated. To parse contributions from biological and environmental factors on neurodevelopment, this study used baseline National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) magnetic resonance imaging (MRI) data, acquired in 674 adolescents meeting no/low alcohol or drug use criteria and 134 adolescents exceeding criteria. Spatial integrity of images across the 5 recruitment sites was assured by morphological scaling using Alzheimer's disease neuroimaging initiative phantom-derived volume scalar metrics. Clinical MRI readings identified structural anomalies in 11.4%. Cortical volume and thickness were smaller and white matter volumes were larger in older than in younger adolescents. Effects of sex (male > female) and ethnicity (majority > minority) were significant for volume and surface but minimal for cortical thickness. Adjusting volume and area for supratentorial volume attenuated or removed sex and ethnicity effects. That cortical thickness showed age-related decline and was unrelated to supratentorial volume is consistent with the radial unit hypothesis, suggesting a universal neural development characteristic robust to sex and ethnicity. Comparison of NCANDA with PING data revealed similar but flatter, age-related declines in cortical volumes and thickness. Smaller, thinner frontal, and temporal cortices in the exceeds-criteria than no/low-drinking group suggested untoward effects of excessive alcohol consumption on brain structural development.

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Does Exposure to Diagnostic Ultrasound Modulate Human Nerve Responses to Magnetic Stimulation?

Publication date: Available online 19 September 2016
Source:Ultrasound in Medicine & Biology
Author(s): Neil W. Bailey, Philip M. Lewis, Richard H.S. Thomson, Jerome J. Maller, Paul Junor, Paul B. Fitzgerald
Ultrasound (US) at diagnostic frequency and power is known to alter nerve potentials; however, the precise mechanism of action is unknown. We investigated whether US alters resting nerve potential to lower the threshold for magnetic nerve stimulation. Seventeen healthy subjects were recruited. For each subject, a 1.5 MHz US imaging probe was placed onto the elbow with the beam directed at the ulnar nerve. The probe was coupled to the skin using standard acoustic coupling gel as would be done for a routine clinical US scan. Ulnar nerve stimulation was performed simultaneously with magnetic stimulation (MS). Successful magnetic stimulation of the ulnar nerve was confirmed with nerve potentials measured by electromyography. There was no significant change in electromyography signal when MS was performed during US exposure. US at the diagnostic frequency and power tested does not alter nerve thresholds with MS. Testing at other frequencies is required, however, before US is negated as a technique to modify MS thresholds.



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Structural-Functional Relationship of Phenolic Antioxidants in Topical Skin Health Products

Abstract

Objectives

The present work analyzed the antioxidative activity of phenol-based antioxidants by using an Electron Spin Resonance method to predict the activity and stability of these antioxidants in cosmetic products.

Methods

The Antioxidative Power (AP) method was chosen to measure both the capacity and kinetics of an antioxidative reaction by detecting the DPPH (diphenylpicrylhydrazyl) radical. The antioxidative capacity (w_c) relates to the amount of free radicals that can be reduced, whereas the antioxidative reactivity (t_r) relates to the reaction speed and offers a fingerprinting of the redox state of the antioxidant molecules. Fifteen phenolic molecules, have been analyzed. They differed in the position of the hydroxyl groups and substituents on the aromatic ring. The AP of two distinct formulations containing hydroxytyrosol are presented as well as three phenol based antioxidants within the same formulation vehicle.

Results

The rate at which phenol (ArOH) reacts with DPPH radicals, defined by the term reactivity (t_r) in this paper, was dependent upon the bond dissociation enthalpy (BDE) of the OH bond. Molecules having weak OH bonds and consequently low BDE values showed high antioxidant reactivity. On the other hand, the capacity factor (w_c), which is the concentration of phenol required to reduce a fixed concentration of DPPH radical, depends on the number and position of hydroxyl groups. The results showed that ortho and para positions of the two hydroxyl groups are important for higher capacity. If one of the two hydroxyl-groups is blocked by methylation, both the antioxidative capacity and reactivity are reduced, mainly for ortho disubstituted compounds. The presence of a vinylic side chain improved reactivity and capacity tremendously. AP values may be useful in formulation design when identifying antioxidants that are likely to be physically and chemically stable. The importance of optimization of the formulation vehicle itself for a given antioxidant is also illustrated.

Conclusion

Based on the presented findings, it is possible to predict the antioxidative performance of a phenol-based molecule and its stability and oxidation-resistance within a cosmetic formulation. This is essential for antioxidant containing dermal formulations designed to combat skin ageing.

This article is protected by copyright. All rights reserved.

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Clinical and molecular cytogenetic studies in ten patients with hematological malignancies characterized by t(20;21)(q11;q11) resulted from del(20q)

Publication date: Available online 19 September 2016
Source:Cancer Genetics
Author(s): Chunxiao Wu, Jun Zhang, Shuxiao Bai, jianxin Yao, Huiying Qiu, Yongquan Xue, Suning Chen, Yafang Wu, Juan Shen, Jinlan Pan
This study reports on 10 patients with hematological malignances with t(20;21)(q11;q11) resulting from del(20q) (for example, der(20)del(20)(q11q13)t(20;21)(q11;q11) and der(21)t(20;21)(q11;q11)) and described their clinical features and the possible prognostic significance of this abnormality. The t(20;21)(q11;q11) was a rare but recurrent abnormality secondary to del(20q) besides i(20q-). The frequency of der(20)del(20)(q11q13)t(20;21)(q11;q11) among our patients with del(20q) was 2.4%. It was considered that the 20q deletion preceded translocation with chromosome 21. This abnormality is often cryptic, occurs predominantly in older men and is observed most often in myelodysplastic syndromes. Patients with this abnormality have an unfavorable prognosis, similar to patients with i(20q-). The molecular consequences of der(20)del(20)(q11q13)t(20;21)(q11;q11) may be different from patients with i(20q-). To the best of our knowledge this is the largest dataset published to date.



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The Head and Neck Tumor Biobank

Condition:   Head and Neck Squamous Cell Carcinoma
Intervention:  
Sponsor:   Maastricht Radiation Oncology
Recruiting - verified September 2016

http://ift.tt/2cxVF2b

Cytokeratin-positive fibroblastic reticular cell: a pitfall for dermatopathologists assessing lymph nodes for Merkel cell carcinoma

http://ift.tt/2cCmaZH

Oxidative stress responses in Wistar rats on subacute exposure to pharmaceutical wastewater

Abstract

Water pollution has been a major concern for agrarian societies like Pakistan. Pharmaceutical industries are amongst the foremost contributor to industrial waste. Present study addresses the generation of oxidative stress caused by 2 months exposure to pharmaceutical wastewater in rats and their response to oral treatment with vitamin E, a potent antioxidant. The rats were randomized into five groups (n = 5) named as negative control, pharmaceutical wastewater (PEW) 100 %, PEW 10 %, PEW 1 %, and PEW 100 % + vitamin E. Oxidative damage in rats was evaluated by estimation of the activities of total superoxide dismutase (T-SOD), catalase (CAT), and the concentration of hydrogen peroxide (H₂O₂) in the liver, kidney, and blood/plasma. Exposure to pharmaceutical wastewater significantly decreased the activities of T-SOD and CAT and concentration of H₂O₂ in the liver and kidney and blood/plasma. Exposure to 100 % pharmaceutical wastewater exhibited a maximum decline in T-SOD activity, and activity was reduced to only 63.57 U/mL, 32.65, and 43.57 U/mg of protein in the plasma, kidney, and liver, respectively. Exposure to wastewater minimized activity CAT to 89.25 U/g of hemoglobin, 54.36, and 62.95 U/mg of protein in the blood, kidney, and liver, respectively. Treatment with vitamin E significantly increased the activity of T-SOD and CAT. However, increase in concentration of H₂O₂ was also observed in vitamin E exposed rats. Histopathology of the kidney revealed coagulative necrosis of renal epithelial cells and peritubular congestion. Endocardium showed infiltration of inflammatory cells and cellular breakdown in some areas. Lung sections exhibited atelectasis and emphysema of alveoli suggesting decline in lung function. The anatomy of the liver was also compromised due to severe degeneration and cellular swelling. The present study concluded that pharmaceutical wastewater induced severe oxidative stress in Wistar rats and ensued in histopathological lesions in several vital organs suggesting its high toxicity. Non-enzymatic antioxidant vitamin E may ameliorate oxidative stress induced by pharmaceutical wastewater.

http://ift.tt/2cMHWUU

Hydrological controls on cascade reservoirs regulating phosphorus retention and downriver fluxes

Abstract

Many coastal rivers have a system of cascade reservoirs, but the role of these reservoirs in regulating nutrient transport from watershed to coast is still unknown. In this study, phosphorus (P) in surface water and top sediment was investigated along the North Jiulong River (southeast China) under three hydrological conditions (high flow, medium flow and low flow) in 2012–2013, and P dynamics in a cascade reservoir (Xipi Reservoir) were studied on a monthly scale. Results showed that the concentrations of dissolved reactive phosphorus (DRP) consistently decreased longitudinally in the upper river with the lowest values observed in the section of cascade reservoirs, likely due to tributary inputs and in situ uptakes. The decrease was most rapid during base flow when DRP was highest in the free-flowing river section and lowest in cascade reservoirs. Results from monthly monitoring on the Xipi Reservoir showed general downriver decreases in DRP, total particulate phosphorus (TPP) and total phosphorus (TP) in the riverine zone and transition zone. Mass balance results on an annual basis suggest that the Xipi Reservoir (lacustrine zone) was an overall sink for TPP (6 % retention) but somewhat a source of DRP (−0.3 %) with TP retention (1 %). Even scaled up to the whole cascade reservoir system, P retention was low compared with worldwide reservoirs, which we ascribe to the high P loading and short hydraulic residence time. Nevertheless, major processes controlling P retention in coastal rivers with cascade reservoirs varied from sedimentation in the dry-cold season to biotic transformation in the wet-warm season, thereby affecting loading and composition of P from watershed to the coast. This study highlights the hydrological controls on the role of cascade reservoirs in regulating P retention and downriver fluxes in different seasons.

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The effect of phytogenic feed additives to substitute in-feed antibiotics on growth traits and blood biochemical parameters in broiler chicks challenged with Salmonella typhimurium

Abstract

There is a growing concern over the use of antibiotics due to the increased resistance of pathogens in broiler. The present study was designed to find the comparative effect of an antibiotic, and some phytogenic on performance traits, blood biochemical parameters, and antioxidant status during starter phase exposed to Salmonella typhimurium challenge. A total of 560-day-old broiler chicks (Ross 308) were randomly allocated to seven treatments (eight replicates). Control (basal diet); T1, infected with Salmonella enterica subsp. typhimurium; T2, infected + avilamycin at the rate of 0.2 g/kg; T3, infected + essential oil of thymol; T4, infected + phytogenic; T5, infected + anti-Salmonella organic acid; and T6, infected + essential oils of thyme, anise, and other components. Body weight gain and feed conversion ratio (FCR) were significantly (P < 0.05) high in the T2 and T5 at the end of the first and the second week and similar to T4. During the second week, European production efficiency factor (EPEF) was also significantly (P < 0.05) high in T2, T4 and T5. Blood albumin increased significantly (P < 0.05) in birds of T2 in the first week, while during the second week, blood glucose and triglyceride concentration decreased significantly (P < 0.05) in T5. Blood ALT concentration decreased significantly (P < 0.05) in T6 compared to other treatments in the second week. Total antioxidant capacity (at the end of the second week) and thiobarbituric acid reactive substances (TBARS) did not change significantly. From the results of the present study, it was concluded that different feed additives could be substituted with antibiotics in the feed of broiler exposed to S. typhimurium challenge.

http://ift.tt/2cMHWnG

Quantifying PM 2.5 capture capability of greening trees based on leaf factors analyzing

Abstract

As PM_2.5 affect human health, it is important to target tree planting in the role of reducing air pollution concentrations. PM_2.5 capture capability of greening trees is associated with leaf morphology, while quantitative research is scanty. In this paper, the PM_2.5 capture capability of 25 species in Beijing and Chongqing were examined by a chamber device. Groove proportion, leaf hair, stomatal density, and stomata size were selected as indexes of leaf morphology. Results showed that groove proportion and stomata size significantly relate to PM_2.5 capture quantity, while no significantly positive correlations were found for leaf hairs and stomatal density. Broadleaf species are conducive to PM_2.5 capture for their rich leaf morphology and have an edge over coniferous in PM_2.5 capture per leaf area. However, coniferous had a larger PM_2.5 capture capability per tree due to the advantage of a large leaf area. Significant difference existed between the species in Beijing and Chongqing due to the different leaf morphology. Urban greening trees are diverse and the structures are complicated. Complex ecological environment may lead to different morphology characteristics. Climate and pollution conditions should be considered when greening.

http://ift.tt/2coNMhS

Tourism in Austria: biodiversity, environmental sustainability, and growth issues

Abstract

This study examined the long-run and causal relationships between international tourism, biodiversity loss, environmental sustainability, and specific growth factors under the premises of sustainable tourism in Austria, by using a consistent time series data from 1975 to 2015. The results reveal that inbound tourism, per capita income, and population density affected the potential habitat area while population density largely affected the food production in a country. Inbound tourism and population density both deteriorate the environmental quality in a form of increasing carbon dioxide (CO₂) emissions and fossil fuel energy consumption while per capita income reduces the fossil fuel energy consumption. Food exports increase per capita income, while food imports and population density both decrease economic growth. Inbound tourism and economic growth advance population density while forest area and food exports decrease the population density. The study supports growth-led tourism and growth-led food production in a country.

http://ift.tt/2cMI9r7

Photocatalytic degradation of NO/NO 2 gas injected into a 10-m 3 experimental chamber

Abstract

This paper investigates a new test method to assess the photocatalytic activity of plasterboards coated with a TiO₂ dispersion under real-world conditions. The degradation of nitrogen oxides NO_x (NO and NO₂) is studied and the photocatalytic efficiency under UV illumination is evaluated in a 10-m³ room after a constant gas injection. Two ultrafine TiO₂ dispersions are used: 0.85% TiO₂ and 5% TiO₂, and three types of gas are tested: an NO/NO₂ mixture (8/8 mol-ppm), NO (45 mol-ppm) and NO₂ (45 mol-ppm). The test method presented here is midway between laboratory and real-scale procedures and allows better control of the experimental parameters than a real field experiment. Testing a mixture of NO and NO₂ is a way to get closer to real-world conditions as air is polluted by various gases. This study focuses on the degradation of NO and NO₂ under UV illumination when two types of TiO₂ dispersions are used and highlights the difference in behaviour between these two molecules in terms of photocatalytic degradation. The results show that photocatalytic activity does not appear to be efficient to degrade NO₂ molecules. Another mechanism seems to be responsible for the reduction of the concentration of NO₂, namely adsorption. Encouraging results are obtained with NO molecules, which can be degraded by photocatalysis. The degradation observed is even greater with the more concentrated TiO₂ dispersion.

http://ift.tt/2coO5te

Identification of tonsillar CD4+CD25−LAG3+ T cells as naturally occurring IL-10-producing regulatory T cells in human lymphoid tissue

Publication date: Available online 18 September 2016
Source:Journal of Autoimmunity
Author(s): Shuji Sumitomo, Shinichiro Nakachi, Tomohisa Okamura, Yumi Tsuchida, Rika Kato, Hirofumi Shoda, Asayo Furukawa, Nobuo Kitahara, Kenji Kondo, Tatsuya Yamasoba, Kazuhiko Yamamoto, Keishi Fujio
IL-10-producing regulatory T cells (IL-10-producing Tregs) are one of the regulatory T cell subsets characterized by the production of high amounts of IL-10, the lack of FOXP3 expression and the strong immunosuppressive capabilities. IL-10-producing Tregs have been primarily reported as induced populations thus far, in part because identifying naturally occurring IL-10-producing Tregs was difficult due to the lack of definitive surface markers. Lymphocyte-activation gene 3 (LAG3) is a CD4 homologue that we have identified as being expressed on IL-10 producing Tregs. In human PBMC, LAG3 combined with CD49b efficiently identifies IL-10-producing Tregs. However, naturally occurring IL-10-producing Tregs in human secondary lymphoid tissue have not been described.In this report, we identified CD4⁺CD25⁻LAG3⁺ T cells in human tonsil. This T cell subset produced high amounts of IL-10 and expressed low levels of FOXP3. Surface markers and microarray analysis revealed that this is a distinct tonsillar CD4⁺ T cell subset. CD4⁺CD25⁻LAG3⁺ T cells expressed interleukin 10 (IL10), PR/SET domain 1 (PRDM1), and CD274 at high levels and chemokine receptor 5 (CXCR5) at low levels. CD4⁺CD25⁻LAG3⁺ T cells suppressed antibody production more efficiently than CD4⁺CD25⁺ T cells, and CD4⁺CD25⁻LAG3⁺ T cells induced B cell apoptosis. Moreover, analysis of humanized mice revealed that this cell subset suppressed a graft-versus-host disease (GVHD) reaction in vivo. Our study reveals the existence of naturally occurring IL-10-producing Tregs in human secondary lymphoid tissue and their function in immune regulation.



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Ensuring passivity and retrievability for immediate complete-arch implant-supported prostheses

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Aloisio Oro Spazzin, Bernardo Camargo, Atais Bacchi
This technique describes the fabrication of frameworks for immediate complete-arch implant-supported prostheses to ensure that the dimensional alterations that occur during the casting procedure do not interfere with passivity. As sectioning and soldering are not necessary, there is no delay in the fabrication process, and the framework is not weakened. Titanium abutments for interim screw-retained prostheses are prepared on the definitive cast, and framework waxing preserves the access holes to the screws. After casting, the framework is cemented on the prepared abutments. The proposed technique has been created to combine the advantages of cement-retained frameworks and the retrievability of screw-retained ones.



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Fabrication of a complete, removable dental prosthesis from a digital intraoral impression for a patient with an excessively tight reconstructed lip after oral cancer treatment: A clinical report

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Jong-Eun Kim, Nam-Hoon Kim, June-Sung Shim
This clinical report describes the management of a patient who had an excessively tight reconstructed lip because of oral cancer surgery and postoperative radiotherapy. The presented technique used an intraoral scanner for a preliminary impression and computer-aided design and computer-aided manufacturing (CAD-CAM) technology for preliminary laboratory procedures. This digital impression technique may reduce patient discomfort.



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Reducing the surface roughness of dental acrylic resins by using an eggshell abrasive material

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Stanley C. Onwubu, Anisa Vahed, Shalini Singh, Krishnan M. Kanny
Statement of problemExcessive surface roughness of denture base resins adversely impacts oral health.PurposeThe purpose of this in vitro study was to examine the abrasive potential of eggshell powder in reducing the surface roughness of denture base resins.Material and methodsThirty poly(methyl methacrylate) specimens were fabricated and polished with eggshell powders of different particle sizes and with pumice. The average surface roughness (Ra) after polishing was measured with a profilometer. Scanning electron microscope and optical electron microscope techniques were used to assess the surface roughness morphology of the specimens. ANOVA was used to analyze the Ra values. The Tukey honest significant differences and Bonferroni tests were used to identify differences between the 2 abrasive materials (α=.05).ResultsSignificant differences in the Ra values were observed between the fine and medium eggshell powder abrasives (P<.05). Similarly, significant differences were found between pumice and the fine eggshell powder abrasives (P<.001). No significant differences were found between pumice and the medium eggshell powder abrasive (P>.05). Specimens polished with pumice had the highest Ra values, whereas specimens polished with the fine eggshell powder abrasive had the lowest Ra values.ConclusionsBy connecting the Ra values to the threshold limit value of 0.2 μm, eggshell powder abrasive finished denture acrylic resin surfaces better than pumice.



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Erratum

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry





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Evaluation of correlations between frequencies of complete denture relines and serum levels of 3 bone metabolic markers: A cross-sectional pilot study

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Shweta Puri, Mathew T. Kattadiyil, Nishant Puri, Susan L. Hall
Statement of problemContinuous bone resorption is the primary reason for complete denture relines. Because resorption rates vary, the frequency at which individuals require relines also varies. Currently, there are no predictors to identify individuals at risk of frequent relines or to guide clinicians in decisions related to relines.PurposeThe purpose of this cross-sectional pilot study was to determine the utility of measuring bone metabolic markers (C-terminal telopeptide, osteocalcin, 25-OH hydroxy vitamin D) to predict the frequency of complete denture relines.Material and methodsOne hundred adult participants with complete dentures (either maxillary, mandibular, or both) participated in 1 dental clinic visit involving a dental examination and brief interview to obtain relevant medical and dental history, information on medication/supplement use, and 1 laboratory blood draw for the measurement of bone metabolic markers. Data were analyzed by using the Pearson correlation, independent Student t test, or analysis of variance (α=.05).ResultsSignificant correlations were found between the frequency of relines and C-telopeptide and osteocalcin levels but not with vitamin D or age. No significant associations with reline frequency and other factors (sex, race, presence or absence of diabetes, use of calcium and vitamin D supplements) were observed.ConclusionsElevated levels of bone turnover markers in individuals with edentulism were associated with increased frequency of denture relines.



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Marginal bone loss around dental implants with and without microthreads in the neck: A systematic review and meta-analysis

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Wenzhi Niu, Penglai Wang, Shaoyue Zhu, Zongxiang Liu, Ping Ji
Statement of problemWhether microthreads in the crestal portion can reduce the amount of marginal bone loss (MBL) around implants has not yet been determined.PurposeThe purpose of this systematic review was to investigate the marginal bone loss around dental implants with and without microthreads in the neck.Material and methodsThis review was based on the PRISMA guidelines. An electronic search with no restrictions on language was performed from inception to August 19, 2015, in PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Web of Sciences, and AMED (Ovid) databases. A manual search was also performed. Randomized clinical trials (RCTs) that compared the MBL between implants with and without microthreads in the neck were included. Qualitative synthesis and meta-analysis were performed. MBL was measured by using the mean difference (MD). Review Manager v5.3 software was used for meta-analysis (α=.05).ResultsFive articles were included in the qualitative synthesis, and 3 articles were included in the meta-analysis. Four studies found that a microthread design can significantly reduce MBL under functional loading, whereas 1 study found no significant difference. The homogeneity test of meta-analysis confirmed acceptable heterogeneity among the 3 studies (I²=0.49). A random-effects model was used. The result shows that MBL around implants with microthread design can be reduced significantly (P=.030; MD: −0.09; CI: −0.18 to −0.01).ConclusionsMeta-analysis showed that microthread design in the implant neck can reduce the amount of MBL; however, RCTs included in the review were few and the difference was small. In clinical practice, an implant with a roughened surface and microthreaded neck could be selected to maintain bone level.



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Influence of tongue position on the determination of tooth shade

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Thomas U. Klinke, Constanze Olms, Petr Pierk, Holger A. Jakstat, Wolfgang B. Hannak
Statement of problemDentists frequently use electronic devices to determine tooth color. However, neither the instructions for these devices nor the accompanying brochures refer to the environmental conditions required at the point of measurement.PurposeThe purpose of this multicenter prospective clinical study was to reveal whether a change in the oral background influences tooth color determination.Material and methodsStudents (N=42) at the dental clinic in Berlin, Leipzig, Greifswald and Olomouc (women n=27, men n=15) participated in this study. It was their first contact with the spectral photometer (Easyshade Advance 4.0; VITA Zahnfabrik). After a short introduction on how to use the device, the students made 1-point measurements on the same patient on the maxillary central incisor. In the first measurement, the patient's mouth was open, and the palatal surface uncovered. In the second measurement, the patient's mouth was closed slightly, and the tongue pressed on the lingual surface of the maxillary central incisor. The mean ±SD and the 95% confidence interval (95 % CI) were calculated using the Student t test for each test series (α=.05).ResultsStatistical evaluation of the 2 measurements revealed changes in the L*a*b* values with a mean L*=0.204, a*=-0.351, and b*=0.02; a median of 0.4, -0.3, and -0.1, respectively; a ±SD of 2.37, 0.64, and 0.89, respectively; and 95% CIs of L*=-0.476 to 0.884, a*=-0.531 to -0.702, and b*=-0.23 to 0.52, respectively. These differences were not statistically significant (P>.05). The measurements of L*, a*, and b* with and without tongue coverage of the lingual surfaces of the maxillary teeth did not show any statistically significant differences (P=.663).ConclusionsThe results demonstrate that the position of the tongue does not influence measurement accuracy during the application of the Easyshade Advance device.



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A method for using solid modeling CAD software to create an implant library for the fabrication of a custom abutment

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Jing Zhang, Rimei Zhang, Guanghui Ren, Xiaojie Zhang
This article describes a method that incorporates the solid modeling CAD software Solidworks with a dental milling machine to fabricate individual abutments in house. This process involves creating an implant library with 3-dimensional (3D) models and manufacturing a base, scan element, abutment, and crown anatomy. The 3D models can be imported into any dental computer-aided design and computer-aided (CAD-CAM) manufacturing system. This platform increases abutment design flexibility, as the base and scan elements can be designed to fit several shapes as needed to meet clinical requirements.



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Cast erosion from the cleaning of debris after the use of a cast trimmer

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Paul A. Hansen, Mark W. Beatty
Statement of problemWhether using tap water to rinse off debris will make a clinical difference to the surface detail of a gypsum cast is unknown. In addition, how best to remove debris from the cast is unknown.PurposeThe purpose of this in vitro study was to evaluate the efficiency of different methods of cleaning a gypsum cast after trimming and the effect of short-term exposure to tap water on the surface quality of the cast.Material and methodsA die fitting American National Standards Institute/American Dental Association specification 25 (International Standards Organization specification 6873) for dental gypsum products was embedded in a Dentoform with the machined lines positioned at the same level as the occlusal surface of the posterior teeth. A flat plate was used to ensure that the plane of occlusion for the die was at the same position as the posterior teeth. Forty polyvinyl siloxane impressions of the Dentoform were made and poured with vacuum-mixed improved Type IV dental stone. Each cast was inspected for the accurate reproduction of the lines. The base of the 2-stage pour was trimmed with a cast trimmer with water, and surface debris was removed by rinsing by hand under tap water for 10 seconds, by brushing the cast with a soft toothbrush for 10 seconds, or by resoaking the cast and using a soft camel's brush in slurry water for 10 seconds. The amount of debris was evaluated on a scale of 1 to 4, and the quality of the 20-μm line was evaluated on a scale of 1 to 4 under ×15 magnification. The nonparametric Kruskal-Wallis ranks test was used to identify significant differences among the different cleaning methods (α=.05).ResultsResults of the Kruskal-Wallis and Kruskal-Wallis Z-value tests demonstrated that all cleaning methods produced cleaner casts than were observed for uncleansed controls (P<.001), but no differences in debris removal were found among the different cleaning methods (.065≤P≤.901). The ability to see the quality of a 20-μm line (P=.974) was not statistically different among the groups.ConclusionsRinsing the cast under flowing tap water and brushing, or hand washing under flowing tap water, or using a soft camel's hair brush in slurry water for 10 seconds had no noticeable effects on the quality of a 20-μm line, and all 3 methods resulted in a clean cast.



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Light-transmitting fiber optic posts: An in vitro evaluation

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Antigoni Stylianou, John O. Burgess, Perng-Ru Liu, Daniel A. Givan, Nathaniel C. Lawson
Statement of problemThe clinical challenge of adhering cement to intracanal dentin is transmitting light to the most apical parts of root canals to allow more efficient polymerization of the cement.PurposeThe purpose of this in vitro study was to compare the cement-polymerizing ability, microstructure, and radiopacity of a new fiber optic post (iLumi fiber optic Post) with a clinically successful fiber post (DT Light Post).Material and methodsPolymerizing ability was compared using a modified depth-of-cure protocol. A split aluminum mold with a 12-mm cylindrical hole (diameter=4.7 mm) was filled with light-polymerized resin cement (Variolink Esthetic LC). Each fiber post (n=12) was positioned and light-polymerized on the coronal end for 60 seconds with a light-emitting diode polymerization light. Unpolymerized resin was dissolved with an organic solvent, and the weight and length of the polymerized resin cement were measured. Scanning electron microscopy was used to examine vertical and horizontal cross-sections. The radiopacity values of both the posts and 5 additional reference posts were evaluated using an aluminum step wedge.ResultsThe weight and length of the polymerized resin cement were significantly greater (P<.05) with the fiber optic post, which scanning electron microscopy showed to have a higher density of parallel fibers. The iLumi post demonstrated greater radiopacity among the tested fiber posts and a titanium alloy post.ConclusionsThe iLumi fiber optic posts have a unique structural fiber composition and excellent radiopacity and light-transmitting ability that produce more complete polymerization of the resin cement than the DT Light posts.



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Reproducibility of different arrangement of resin copings by dental microstereolithography: Evaluating the marginal discrepancy of resin copings

Publication date: Available online 16 September 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Dong-Yeon Kim, Jin-Hun Jeon, Ji-Hwan Kim, Hae-Young Kim, Woong-Chul Kim
Statement of problemMicrostereolithography (μ-SLA), a form of additive manufacturing, can produce one or more platforms of resin copings. However, no evaluation has been made of the variation in marginal discrepancy using this method, even though this is an important factor for a successful restoration.PurposeThe purpose of this in vitro study was to evaluate the reproducibility and marginal discrepancy of resin copings fabricated using dental μ-SLA.Material and methodsA master die of a mandibular right first molar tooth was made from Type IV stone and scanned to produce a stereolithography file. Resin copings were then fabricated using μ-SLA additive manufacturing by repeating 1, 3, or 6 arrays to give a total number of 18. The marginal discrepancies of these resin copings were measured using digital microscopy (at ×160 magnification), and the data obtained were analyzed using a nonparametric Kruskal-Wallis H test, post hoc Mann-Whitney U-test, and Bonferroni correction.ResultsThe mean ±SD total marginal discrepancies of 1, 3, and 6 arrays were found to be 72.2 ±39.1 μm, 61.2 ±37.3 μm, and 92.5 ±54.1 μm. Statistically significant differences were found among the compared groups (P<.05).ConclusionsBased on the marginal discrepancy, μ-SLA of additive manufacturing is more precise when 3 arrays are used than when 1 or 6 arrays are used on a single build platform. Because the fit is affected by the number of copings fabricated, further research of multiple resin copings is required.



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Hepatitis D virus infections among injecting drug users with and without human immunodeficiency virus infection in Taiwan

Publication date: Available online 18 September 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Meng-Hsuan Hsieh, Shu-Chi Wang, Ming-Yen Hsieh, Chung-Feng Huang, Ming-Lun Yeh, Jeng-Fu Yang, Ko Chang, Wei-Ru Lin, Chun-Yu Lin, Tun-Chieh Chen, Jee-Fu Huang, Chia-Yen Dai, Jih-Jin Tsai, Wan-Long Chuang, Ming-Lung Yu
In Taiwan, injecting drug use has been the main route of human immunodeficiency virus (HIV) transmission since 2005, with hepatitis B virus (HBV) and hepatitis D virus (HDV) also having similar transmission routes. This has now become an important public health issue. The aim of this study is to explore the conditions of HDV infections between injecting drug users (IDUs) with and without HIV infection in Southern Taiwan. In this study, 87 IDUs were enrolled, including 27 anti-HDV seronegative IDUs and 60 anti-HDV seropositive IDUs, and the results of their liver function tests, CD4 cell counts, and anti-HIV and HIV RNA levels were analyzed. The prevalence of anti-HDV seropositivity among hepatitis B surface antigen (HBsAg) seropositive IDUs in this study was 68.9% (60/87). The prevalence rate of anti-HDV seropositive IDUs among anti-HIV seronegative and anti-HIV seropositive cases was 40.0% (12/30) and 84.2% (48/57), respectively. Anti-HIV seropositivity was related to anti-HDV seropositivity (odds ratio = 9.34, 95% confidence interval = 2.67–31.59, p < 0.001). Among IDUs with HIV infection, there was no significant difference in CD4 cell counts and HIV RNA viral load between HBsAg-positive patients with anti-HDV seronegativity and those with anti-HDV seropositivity. In conclusion, the prevalence of HDV infection among IDUs is higher among IDUs with HIV infection. Because anti-HIV seropositivity is significantly related to anti-HDV seropositivity, HDV infection among IDUs is still important. We suggest that for IDUs, HBsAg and anti-HDV should be monitored closely.



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Histological changes of the adult albino rats entorhinal cortex under the effect of tramadol administration: Histological and morphometric study

Publication date: Available online 3 June 2016
Source:Alexandria Journal of Medicine
Author(s): Ibrahim K. Ragab, Hala Z.E. Mohamed
BackgroundTramadol is a centrally acting synthetic analgesic agent with opioid activity. Tramadol is used to treat moderate to severe pain. The entorhinal cortex has initially attracted attention because of its strong reciprocal connections with the hippocampal formation and its involvement in certain brain disorders.Aim of workThe present study was designed to assess the deleterious effects of tramadol on the entorhinal cortex of the adult male albino rats.Materials and methodsThe study was carried out on 40 adult male rats. The rats were divided equally into two groups: control group, received 1ml normal saline 0.9% intraperitoneally for 4weeks. Treated group received 50mg/kg/day of tramadol intraperitoneally for 4weeks. All animals were anaesthetized by ether inhalation and perfused by normal saline. The brains were extracted from the skulls. For light microscopy, the brains of 10 animals in each group were processed for paraffin sections and stained by Gallocyanine stain. For electron microscopy, the entorhinal cortex was dissected in 10 brains of each group and processed. Semithin sections were prepared and stained with toluidine blue. Morphometric and statistical studies were performed.ResultsBy light microscopy, the treated groups showed neuronal cells disorganization. Apoptotic cells were detected. In addition, diffuse chromatolysis of nuclear chromatin, absence of nucleoli, multinuclear cells, intercellular edema and a congested blood capillary were noticed. By electron microscopy, the treated groups of both lateral and medial entorhinal areas showed granular and pyramidal apoptotic cells. The morphometric and statistical studies showed significant increase of apoptotic index % in treated group as compared with control group.ConclusionTramadol had degenerative effects on both lateral and medial entorhinal areas. Light as well as electron microscopic examination of entorhinal areas came to prove these effects. Tramadol abuse should be avoided without medical description due to its toxic effects.



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Self-reported medical care seeking behaviour of doctors in Nigeria

Publication date: Available online 14 May 2016
Source:Alexandria Journal of Medicine
Author(s): A.E. Fawibe, L.O. Odeigah, T.M. Akande, A.G. Salaudeen, I. Olanrewaju
BackgroundThere is need for information on the medical care seeking behaviour of Nigerian doctors.PurposeThis work was therefore designed to study the medical care seeking behaviour of Nigerian doctors in Nigeria.MethodsIt was a cross-sectional survey among doctors in Nigeria.ResultsData from 522 doctors were included in the analysis. Majority of them (80.5%) had one form of illness or the other in the year preceding the survey. Only 35% of them reportedly consulted another doctor during their illness. Most of the consultations (61.2%) were informal in the form of over the phone (45.6%), Corridor (33.3%) and home visit (21.1%) and just 18.4% of the consultations occurred within 24h of onset of illness. A low 19.5% of them had a regular source of medical care. Screening for illnesses was generally below expectation. Just 6 out of the 436 (1.4%) male doctors had screened for prostate cancer while 39 out of 86 (45.3%) females had screened for cervical cancer. A significantly higher proportion of general practitioners (p=0.01) and doctors above 45 years of age (P=0.004) consulted informally. Higher proportion of general practitioners and resident doctors based their consultations on their familiarity with the doctors consulted (p=0.001) and privacy during consultation (p=0.001). Delay in consultation for more than 24h after onset of illness was more likely in those above below the age of 45 years (p=0.001).ConclusionThis study has shown that Nigerian doctors are often reluctant patients who frequently tend to delay medical care. The teaching of appropriate medical care seeking behaviour should be incorporated into medical curriculum in Nigeria.



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The death of an emperor – Mohammad Reza Shah Pahlavi and his political cancer

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3
Author(s): Ardavan Khoshnood, Arvin Khoshnood
Mohammad Reza Pahlavi, the Shah of Iran, was toppled in the Islamic Revolution of 1979. A year later he passed away from lymphoma, a disease he had secretly battled for several years, but still it remains unknown exactly when he was diagnosed with cancer, if he was aware of his condition and who close to him knew about his illness. Following his 1979 exile from Iran, physicians from numerous countries became involved in his treatment, which was typified by political and medical intrigues, contributing to a suboptimal and dangerous medical care which may ultimately have contributed to his death. After acute surgery of his spleen in June 1980, the Shah's condition worsened and he eventually passed away on July 27. This study shows that the international intelligence organizations were probably aware of the Shah's disease, and that the Shah was not cared for in accordance with good medical practice.



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The plasma level of soluble receptor for advanced glycation end products in systemic lupus erythematosus patients and its relation to disease activity

Publication date: June 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 2
Author(s): Anna Nashaat Abou-Raya, Maher Abdel Nabi Kamel, Eman Abdel Ghani Sayed, Ahmed Abdel Hamid El-Sharkawy
IntroductionIn recent years, the role of high mobility group box-(HMGB-1) protein and its receptors has received increasing attention. It has been documented that HMGB-1 is associated with disease activity in systemic lupus erythematosus (SLE). HMGB-1 supports the inflammatory clearance of apoptotic cells and remnants. It binds to molecules released from apoptotic cells such as nucleosomes and DNA thereby, increasing the immunogenicity of macrophages through receptors for advanced glycation end products (sRAGE).Aim of the workWas to measure the plasma level of sRAGE in SLE patients and to correlate it with the clinical and laboratory parameters of disease activity.Patients and methodsThe study was composed of 35 SLE patients; 31 females and 4 males (Group I) and 20 age and gender matched healthy subjects as a control (Group II). All patients fulfilling the American College of Rheumatology (ACR) classification criteria for the diagnosis of SLE. Active disease was identified using SLE disease activity index (SLE-DAI).Demographic data, cutaneous manifestations, arthritis, vasculitis, myositis, renal, and hematological disorders were recorded. In addition; complete blood picture, blood urea, serum creatinine, 24h urine proteins, creatinine clearance, protein/creatinine ratio, C3, C4, Anti-nuclear antibody, Anti-double stranded DNA were conducted for all patients and controls.ResultsThe mean value of plasma level of (sRAGE) in SLE patients was significantly higher in SLE patients than in the normal healthy controls (P<0.001). There was a statistically significant positive correlation between sRAGE and SLE-DAI (P<0.001).ConclusionThe plasma level of sRAGE is considered as a potential biomarker for disease activity in SLE, severity and prognosis.



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Value of non-contrast CT examination of the urinary tract (stone protocol) in the detection of incidental findings and its impact upon the management

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3
Author(s): Mohamed Samir Shaaban, Ahmed Fouad Kotb
BackgroundUrolithiasis is one of the most common urinary tract diseases worldwide, with a wide range of affected age groups. Non-contrast CT examination of the urinary tract is the gold-standard examination for detection and characterization of urinary tract stones, with great impact upon the choice of method of management. Aside from detection of stones, non-contrast CT examination of the abdomen and pelvis also offers a valuable overlook upon the other abdominal organs, pathologies of which may simulate a stone disease, or accompany stone disease and can be detected incidentally, which may shift management plan dramatically.Aim of workTo demonstrate the use of non-contrast CT examinations (stone protocol) in the detection of abdominal pathologies other than stones, whether or not simulating the clinical picture of urolithiasis, and its impact upon patient management.Patients and methodsAssessment of the non-contrast examinations of the urinary tract of patients referred for suspected stone urolithiasis recording any incidental finding and follow-up of the impact of these incidental findings upon the management delivered to the patient.ResultsA total of 719 examinations were performed, of which 334 had urinary tract stones only, 211 had incidental finding beside urinary tract stones, 170 had an incidental finding with no urinary tract stones, and four patients had neither stones nor incidental findings. A total number of 381 patients had incidental findings, 198 (47%) of which had an impact upon the management.ConclusionNon-contrast CT examination of the urinary tract (stone protocol) is a valuable tool in the detection of incidental findings which may simulate, or coincide with urolithiasis and it has a significant impact upon the management of the patients.



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A study on adverse drug reactions in a tertiary care hospital of Northeast India

Publication date: Available online 27 June 2016
Source:Alexandria Journal of Medicine
Author(s): Ratan J. Lihite, Mangala Lahkar, Sukirti Das, Debeeka Hazarika, Murali Kotni, Mudasir Maqbool, Swapna Phukan
ObjectivePurpose of this study was to monitor adverse drug reactions reported from various departments of a tertiary care hospital in Northeast India. Reported adverse drug reactions were analysed for causality and severity assessment.MethodsThis cross sectional study was conducted in a tertiary care hospital at Guwahati, Northeast India, for 7months. Patients of all age and either sex were included. Adverse drug reactions were reported by the physicians of this hospital and their causality and severity assessments were performed as per Naranjo's and Hartwig's assessment criteria respectively. Descriptive statistics were used for data analysis.ResultsTotal 255 adverse drug reactions were reported from various departments of this tertiary care hospital. Most of the adverse drug reactions were observed in the age group of 21–30year. Acne (46) was commonly reported reaction. Topical steroids, betamethasone sodium phosphate and clobetasol were reported to induce maximum number of reactions (59). Skin (227, 66.9%) was commonly affected organ system. Most of the adverse drug reactions were possible (240, 94.1%) and mild (222, 87%) in nature.ConclusionsThe topical steroid (betamethasone sodium phosphate) was reported to induce adverse drug reactions in majority of the patients. The commonly reported reaction was acne.



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Rifaximin: A reasonable alternative for norfloxacin in the prevention of spontaneous bacterial peritonitis in patients with HCV-related liver cirrhosis

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3
Author(s): Mohammed M. Shamseya, Marwa A. Madkour
BackgroundNorfloxacin is the most commonly used agent for the prophylaxis against spontaneous bacterial peritonitis (SBP) in patients with liver cirrhosis. Rifaximin, another broad spectrum antibiotic, is used for the treatment of traveler's diarrhea and hepatic encephalopathy.ObjectiveWe aimed to test the efficacy of rifaximin versus norfloxacin for prevention of SBP in patients with hepatitis C virus (HCV)-related liver cirrhosis.Patients and methods86 patients with HCV-related liver cirrhosis and ascites were enrolled and divided into two groups of matching age, sex and Child–Pugh class. Group I was given norfloxacin 400mg/day as single dose, and group II rifaximin 1200mg/day in three divided doses. They were followed for up to one year. Study endpoints were SBP, hepatocellular carcinoma, compliance failure, death, or liver transplantation.ResultsMore than 70% of patients received the antimicrobial as primary prophylaxis and the rest were given secondary prophylaxis against SBP. The mean follow-up period was 10.16±2.64months for norfloxacin and 10.26±2.32months for rifaximin (p=0.863). Although statistically insignificant (p=0.265), patients on rifaximin developed fewer episodes of SBP than those on norfloxacin (4.7% vs. 14%). Also, the infection-free duration before SBP was longer (p=0.129) with rifaximin than norfloxacin (9.5 vs. 5.0months). Rifaximin significantly reduced the rate of new compared to past episodes of SBP by 20.9% (p=0.007) vs. 13.9% for norfloxacin (p=0.112). Overall survival was equal in both groups. Patients adhered to therapy regimen of norfloxacin for significantly longer time than rifaximin (p=0.010).ConclusionRifaximin is – at least – as good as norfloxacin. It seems to be an appropriate alternative for long-term primary and secondary prophylaxis of SBP in cirrhotic patients with ascites. Modification of dose regimen should be considered to improve patient's compliance to rifaximin.



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Detection of occult hepatitis B virus among chronic hepatitis C patients

Publication date: June 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 2
Author(s): Ola Abd El Kader Mahmoud, Abeer Abd El Rahim Ghazal, Dalia El Sayed Metwally, Mohamed Mohamed Shamseya, Hamdallah Mohamed Hamdallah
BackgroundConcurrent infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are increasingly recognized in patients with chronic hepatitis. In Egypt, the last decade showed a remarkable decline in HBV infection associated with remarkable rise in HCV infection. The probable impact of occult HBV in patients with chronic HCV infection has been previously investigated and the evidence suggests a possible correlation with lower response to anti-viral treatment, higher grades of liver histological changes, and development of hepatocellular carcinoma. The aim of this study was to analyze the possible influence of occult HBV infection on the clinical outcomes in chronic HCV patients and to compare conventional and real-time PCR in detecting HBV DNA among Hepatitis B surface antigen (HBsAg) negative chronic HCV.MethodsSera collected from 100 chronic HCV patients (negative for HBsAg and positive for anti-HCV and HCV RNA) were tested for anti-HBc, anti-HBe and anti-HBs by ELISA, HCV-RNA viral load was determined by real-time PCR (TaqMan probe technique) and HBV DNA was detected with primers encoding the surface (S), core (C), polymerase (pol) and X genes. In addition, determination of liver enzymes including aspartate and alanine aminotransferases (AST, ALT) activities was performed.ResultsFifty-eight percent of the study group were positive for anti-HBc. Meanwhile, only 18 cases (18%) were positive for the polymerase gene by nested PCR and were considered as occult HBV. Among these 18 polymerase gene positive patients (occult HBV) anti-HBc was detected among 9 (50%) of cases. Different gene profiles were noticed among the 18 polymerase gene positive patients.



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Value of serum tenascin-C in patients with acute myocardial infarction

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3
Author(s): Rania Gaber, Wesam Salah Ibrahim, Hanaa El-sayed Nofal, Dina Shafik Mahran
BackgroundMyocardial infarction (MI) is defined as myocardial cell necrosis due to significant and sustained ischemia. TN-C is an extracellular matrix glycoprotein that is expressed in several important steps during the very early stage of cardiogenesis. TN-C is not normally expressed in the adult heart, but transiently appears during pathological conditions and plays important roles in tissue remodeling.AimTo study the role of TN-C in myocardial infarction patients and to evaluate its role as a predictor of HF in these patients.MethodsThis study was conducted on 45 cases uniformly divided into 3 closely matched (in age and sex) groups as follows: Group (I) includes 15 patients who were suffering from AMI; Group (II) includes 15 patients who were suffering from HF on top of MI; and Group (III) includes 15 healthy volunteers coming for regular annual checkup. 3–6ml venous blood was collected on the day of admission under complete aseptic conditions and stored at −70°C until assayed by ELISA.ResultsTN-C levels in the sera of patients with AMI Group (I) were significantly higher than those of healthy volunteers. Moreover, in Group I of AMI, a positive correlation between TN-C level on one side and CK, CK-MB and troponin T level on the other side was found. TN-C levels in the sera of patients with congestive heart failure on top of acute MI Group (II) were significantly higher than those of healthy volunteers. Pro-BNP levels in patients with heart failure Group (II) were significantly higher than those with AMI not complicated with heart failure Group (I). Levels of pro-BNP were also positively correlated with those of TN-C in patients with heart failure on top of AMI Group (II).ConclusionsSerum TN-C might be a novel marker reflecting active structural remodeling in the myocardium following infarction, with high TN-C levels at acute stages possibly predicting progression of LV remodeling. Also, the incorporation of a combination of serum TN-C and plasma BNP levels may improve risk stratification for congestive heart failure after AMI. Further studies on large scale are needed for more evaluation of TN-C role in HF.



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Biliary duct obstruction treatment with aid of percutaneous transhepatic biliary drainage

Publication date: June 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 2
Author(s): Daniel Knap, Natalia Orlecka, Renata Judka, Aleksandra Juza, Michał Drabek, Maciej Honkowicz, Tomasz Kirmes, Bartosz Kadłubicki, Dominik Sieroń, Jan Baron
IntroductionPercutaneous Transhepatic Biliary Drainage (PTBD) is a procedure indicated in patients with non-operative lesions, when endoscopic application of prosthesis is impossible due to anatomic reasons, complications or severe general condition of patient. Most often it is a palliative procedure, aiming for live-quality improvement, although not altering prognosis of basic disease.AimThis study presents own experience in biliary drainage with the aid of percutaneous transhepatic method and simultaneous assessment of method effectiveness and safety. The aim was to assess outcomes and complications of PTBD in a large group of patients.Materials and methodIn time period 2007–2014, 167 patients hospitalized in Radiodiagnostics and Radiology Department of Clinical Hospital, were investigated retrospectively. PTBD procedure was applied to patients with biliary tract obstruction. In total 186 procedures of percutaneous drainage were applied. Average age of patients was 63.6years. Bilirubin, alkaline phosphatase and gamma-glutamyl transferase were measured before and after procedure. All data were analyzed statistically.ResultsIn examined group percutaneous drainage was successful in 90.7% interventions. In 8.1% procedures drainage application was ineffective. The most common complication during procedure was hemobilia (3.2%) and the long term complication was drain dislocation (2.7%). The mean bilirubin levels declined from 397.06μmol/l before drainage to 297.88μmol/l after drainage (p<0.05).ConclusionsPTBD is an effective method of biliary tract decompression and it is an important alternative to endoscopic drainage. This method is indicated in patients with neoplastic obstruction of biliary tract with low expected survival rate and thus is a palliative procedure.



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Time bound changes (in 24h) in human sperm motility and level of calcium and magnesium in seminal plasma

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3
Author(s): J. Valsa, K.P. Skandhan, B. Sumangala, V. Jaya
A detailed sperm motility study for 24h after collection was done. The level of calcium and magnesium in seminal plasma during this period was also seen to understand the role of these electrolytes on sperm motility.Good care was taken in selection of subjects (young and healthy), collection and pre-physical analysis of sample. Subjects (healthy, 18–25years) were to maintain abstinence (2–5days). Collection of sample into wide mouthed container provided was done next to laboratory by masturbation at 8am±30m. The total study was done in one month period. Samples were studied at ½, 1, 2, 4, 8, 12 and 24h time for percentage of (1) total sperm motility, (2) active and progressive and (3) non-progressive motility and seminal plasma calcium and magnesium. Total sperm motility deteriorated to 50% in 8h whereas active and progressive type reduced to 50% in 4h. At 24h total sperm motility was 9.8% and active and progressive motility 3.0%.Level of calcium (27.2mg/dl) and magnesium (13.54mg/dl) in seminal plasma did not show any significant changes during study period from that of at ½h. The study concluded that electrolytes under study were not responsible for the decrease in motility during study period.



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Editorial Board

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3





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Impact of osteitis and biofilm formation and correlation between both in diffuse sinonasal polyposis in Egyptian adults; a prospective clinical and histopathologic study

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3
Author(s): Ayman Moustafa Al-Madani, Suzan Mohamed Helal, Hoda Mahmoud Khalifa, Moustafa Mohamed Abdelnaby
BackgroundThe pathogenesis of diffuse sinonasal polyposis is still not completely established, possible explanations are osteitis, aeroallergens, fungal sinusitis and biofilms. There are no reports in Egypt about osteitis and biofilms in those patients.PurposeTo study the incidence and impact of osteitis and biofilms in Egyptian patients on diffuse sinonasal polyposis patients.Patients and methodsFifty patients (22 males, mean age of 30.68±7.24years) submitted to surgery for diffuse sinonasal polyposis. Computerized scan on sinuses ordered and scored by Lund–Mackay staging protocol, severity of Osteitis using the Global Osteitis Scoring Scale. Tissue samples were taken from diseased sinuses to be analyzed histopathologically for osteitis, and with scanning electron microscopy to detect bacterial biofilms. Another ten patients as a control scheduled for septoplasty or turbinectomy with no evidence of sinusitis, and tissue specimens were obtained 1cm behind the anterior end of inferior turbinate and processed in the same manner for biofilm comparison.Study designContemporary prospective cross-sectional cohort study.ResultsIn 70% (35/50) of the polyposis patients, histopathology was positive for osteitis. Biofilms were detected by electron microscope in 39 (78%). Two of controls (20%) were biofilm positive with a significant difference (p=0.035). The mean Lund–Mackay was 19.08±3.67 and mean osteitis score was 18.68±11.99. There was a significant correlation between Lund–Mackay and osteitis score (p<0.001) and between both and histopathologically proven osteitis (p=0.049), biofilms (p=0.005) and postoperative endoscopic healing (p=0.046) where increased soft tissue disease and osteitis and biofilm were associated with bad healing and vice versa.ConclusionOsteitis and bacterial biofilms underlie the majority of Polypoidal chronic rhinosinusitis and both correlated significantly. Scanning electron microscope is a good tool for detecting bacterial biofilms. Sinus surgery with surgical ventilation, mechanical disruption of biofilms and osteitis is a mandatory therapeutic choice with prolonged treatment with antibiotics and nasal wash.



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Swyer syndrome: The gender swayer?

Publication date: Available online 11 June 2016
Source:Alexandria Journal of Medicine
Author(s): Jaideep Khare, Prasun Deb, Prachi Srivastava, Babul H. Reddy
46XY complete gonadal dysgenesis (SWYER SYNDROME) is a rare type of Disorder of Sex Development. Herein we report a 15years-old child, reared as female, presented with complaints of primary amenorrhoea, without short stature or Turner's stigmata. Secondary sexual development was normal. Biochemically, luteinizing hormone (LH) was 23.29mIU/ml and follicle stimulating hormone (FSH) was 54.94mIU/ml. Serum estradiol level was 15.33pg/ml (21–51), and Testosterone was 14.04ng/dl. USG abdomen revealed a small uterus with thinned endometrium. MRI Abdomen showed hypoplastic uterus with non-visualized B/L ovaries (? Complete/pure gonadal dysgenesis). Patient had withdrawal bleeding with estrogen progesterone challenge test. Karyotype analysis revealed 46XY with no evidence of mosaicism. Based on these results a diagnosis of Swyer Syndrome (complete gonadal dysgenesis: Disorder of Sexual Development) was suspected. Patient was managed with a multidisciplinary approach and various issues were discussed.



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Agmatine inhibits nuclear factor-κB nuclear translocation in acute spinal cord compression injury rat model

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3
Author(s): Doaa M. Samy, Passainte S. Hassan, Cherine A. Ismail, Mona A. Hady, Mohamed A. Eshra
Secondary damage after acute spinal cord compression injury (SCCI) exacerbates initial insult. Nuclear factor kappa-B (NF-κB)-p65 activation is involved in SCCI deleterious effects. Agmatine (Agm) showed neuroprotection against various CNS injuries. However, Agm impact on NF-κB signaling in acute SCCI remains to be investigated. The present study compared the effectiveness of Agm therapy and decompression laminectomy (DL) in functional recovery, oxidative stress, inflammatory and apoptotic responses, and modulation of NF-κB activation in acute SCCI rat model. Rats were either sham-operated or subjected to SCCI at T8–9, using 2-Fr. catheter. SCCI rats were randomly treated with DL at T8–9, intraperitoneal Agm (100mg/kg/day), combined (DL/Agm) treatment or saline (n=16/group). After 28-days of neurological follow-up, spinal cords were either subjected to biochemical measurement of oxidative stress and inflammatory markers or histopathology and immuno-histochemistry for NF-κB-p65 and caspase-3 expression (n=8/group). Agm was comparable to DL in facilitating neurological functions recovery, reducing inflammation (TNF-α/interleukin-6), and apoptosis. Agm was distinctive in combating oxidative stress. Agm neuroprotective effects were paralleled with inhibition of NF-κB-p65 nuclear translocation. Combined pharmacological and surgical interventions were proved superior in functional recovery. In conclusion, present research suggested a new mechanism for Agm neuroprotection in rats SCCI through inhibition of NF-κB activation.



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Bacteriophage-antibiotic synergism to control planktonic and biofilm producing clinical isolates of Pseudomonas aeruginosa

Publication date: June 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 2
Author(s): Amina Amal Mahmoud Nouraldin, Manal Mohammad Baddour, Reem Abdel Hameed Harfoush, Sara AbdelAziz Mohamed Essa
IntroductionPseudomonas aeruginosa (P. aeruginosa) is a highly resistant opportunistic pathogen and is capable of forming biofilms on medical devices. Bacterial biofilms, which are micro-colonies encased in extracellular polysaccharide material are so difficult to be treated by conventional antibiotics. During the last decade, P. aeruginosa phages have been extensively examined as an alternative to antimicrobial agents. The aim of the study was to assess bacteriophage-antibiotic combination on planktonic and biofilm states of P. aeruginosa isolates.MaterialsIn this study, we isolated 6 lytic phages, from hospital effluents, they were tested against 50 P. aeruginosa strains, isolated from different clinical specimens delivered to the Diagnostic Microbiology Laboratories, Faculty of Medicine, Alexandria University.ResultsOut of the 50 isolates, 15 were susceptible to these phages. So the biofilm forming capacity of these 15 isolates was investigated. The results showed that 14 isolates (93.33%) produced detectable biofilm. The minimum inhibitory concentration (MIC) and minimum biofilm eradication concentration (MBEC) assays were used to evaluate the antibiotic sensitivity patterns of these P. aeruginosa isolates in their planktonic and biofilm phases to amikacin and meropenem. Also, the effects of phage on the planktonic and biofilm states of isolates at different multiplicities of infections (MOI) were tested. On the planktonic state, the amikacin-phage combination showed synergistic effect (P=0.001), and the meropenem-phage combination showed synergistic effect (P=0.003). On the biofilm state, the amikacin-phage combination showed biofilm eradication in 50% of the isolates (P=0.003). On the other hand, the meropenem-phage combination showed biofilm eradication in 14.3% of the strains.ConclusionThe combination of phage and antibiotics could have potentially more benefits on P. aeruginosa planktonic and biofilm states than just using phages or antibiotics alone.



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Finite element model to study two dimensional unsteady state calcium distribution in cardiac myocytes

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3
Author(s): Kunal Pathak, Neeru Adlakha
The calcium signaling plays a crucial role in expansion and contraction of cardiac myocytes. This calcium signaling is achieved by calcium diffusion, buffering mechanisms and influx in cardiac myocytes. The various calcium distribution patterns required for achieving calcium signaling in myocytes are still not well understood. In this paper an attempt has been made to develop a model of calcium distribution in myocytes incorporating diffusion of calcium, point source and excess buffer approximation. The model has been developed for a two dimensional unsteady state case. Appropriate boundary conditions and initial condition have been framed. The finite element method has been employed to obtain the solution. The numerical results have been used to study the effect of buffers and source amplitude on calcium distribution in myocytes.



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Androgen receptor expression as a prognostic and predictive marker in triple-negative breast cancer patients

Publication date: June 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 2
Author(s): Fatma Zakaria, Nehal El-Mashad, Dareen Mohamed
PurposeIt is clear that triple-negative breast cancer (TNBC) tumors are heterogeneous group, but clinically important sub-sets have begun to emerge. We investigate the immunohistochemical expression of androgen receptor (AR) among those hormonal insensitive groups which have only the option of chemotherapy. Exploiting this knowledge for therapy has been challenging.Patients & methodsSeventy seven patients with TNBC subtype, treated from January 2009 until February 2011 were evaluated for AR expression where AR-positive expression group (⩾10% nuclear stained cells) was conducted to receive anti-androgen therapy post adjuvant chemotherapy (Bicalutamide "Casodex®") 50mg, once daily with or without meals at the same time each day, to date. AR expression was correlated with other prognostic factors and survival (disease free survival (DFS) and overall survival (OS)). Cox proportional hazard model was used to assess variables in the multivariate analysis.ResultsThe median age in the present study was 35.6year (19–63years). The median follow-up period was 24months (3–60months). AR-positive expression in the present study was (21⧹77) 27.27% correlated with clinical outcomes, for recurrent event (n=4, 19.05%), (P=0.000, HR 12.750, Cl 95% 3.668–44.318) and for death event, no body died in AR positive expression group (P=0.000, HR 0.644, Cl 95% 0.533–0.779). Improved survival with AR-positive expression group for 2-year and 3-year DFS was 85% and 78% respectively with (P=<0.001, Cl 95% 39.17–51.39) and for OS at 2-year and 3-year was 100% (P=0.0005). In univariate and multivariate analysis, AR positive expression with anti-androgen therapy in TNBC patients in our present study had retained their independent prognostic value for DFS (P=0.0006, HR 4.659, Cl 95% 1.553–13.977). Bicalutamide was well-tolerated therapy with no grade 3/4 treatment-related adverse events.ConclusionsBicalumide is well tolerated in AR positive TNBC subtype patients and could offer an alternative to cytotoxic chemotherapy in those patients with better OS and DFS.



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Species identification and antifungal susceptibility pattern of Candida isolates in cases of vulvovaginal candidiasis

Publication date: September 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 3
Author(s): Dalia Saad ElFeky, Noha Mahmoud Gohar, Eman Ahmad El-Seidi, Mona Mahmoud Ezzat, Somaia Hassan AboElew
Vulvovaginal candidiasis (VVC) remains one of the most common infections of the female genital tract. Correct identification of the isolated Candida species is essential to direct the empirical antifungal therapy. Objectives: This local study was conducted to identify the spectrum of Candida species associated with VVC using different phenotypic and genotypic methods and assess their antifungal susceptibility pattern. Materials and methods: High vaginal swabs were collected from 125 patients presenting with a clinical picture suggestive of VVC. Swabs were subjected to Gram-stain and culture on Sabouraud dextrose agar. Species identification of Candida isolates was done using phenotypic methods including germ tube test, Rice Tween-80 agar, Chrom ID (CAN2) agar and API 20C AUX, while PCR-RFLP was used as the gold standard method. Antifungal susceptibility testing was done using the disk diffusion method. Results: Vaginal swab cultures yielded Candida growth in 63 cases (50.4%). Candida albicans was the predominant isolated species (60.3%) while the most common non-albicans species was Candida glabrata (12.7%). Forty-five (71.4%) and fifty-five (87.3%) Candida isolates were correctly speciated by Rice Tween-80 Agar and API 20C AUX, respectively, while fifty-seven isolates (90.5%) were correctly assigned into the 3 groups of yeasts identified by CAN2 agar. Amphotericin B was more effective than azoles against vaginal Candida isolates. Conclusion: C. albicans is the most common species associated with VVC. API 20C AUX was the most accurate phenotypic method for the proper identification of most Candida species whereas PCR-RFLP could properly confirm Candida species identification genotypically.



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Post-tonsillectomy hemorrhage after bipolar diathermy vs. cold dissection surgical techniques in Alahsa region, Saudi Arabia

Publication date: June 2016
Source:Alexandria Journal of Medicine, Volume 52, Issue 2
Author(s): Ibrahim K. Aljabr, Fathelrahman M. Hassan, Khalid A. Alyahya
IntroductionTonsillectomy is a common surgical procedure done by otolaryngologists. Tonsillectomy is a relatively simple procedure. The concept of implementing it as a day case operation has become increasingly popular.Material and MethodsThis is a cross sectional study done in Alahsa city, eastern province, Saudi Arabia during the period from January 2014 to March 2015,This study reported the postoperative hemorrhage after Bipolar diathermy and Cold dissection surgical techniques to evaluate the incidence of the hemorrhage and to identify the possible risk factors associated with its occurrence.ResultsPostoperative bleeding occurred in 45 (3.6%) out of 1232 patients. Post-tonsillectomy hemorrhage according to operation technique was significantly higher among patients who underwent bipolar diathermy than cold dissection technique (p<0.05).ConclusionBleeding after operation by bipolar diathermy technique was occurring more frequently within the first five days. Hemoglobin level was significantly decreased in post-tonsillectomy hemorrhage.



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Modeling of GP(I) zone formation during quench in an industrial AA7449 75mm thick plate

Publication date: 15 December 2016
Source:Materials & Design, Volume 112
Author(s): P. Schloth, A. Deschamps, Ch.-A. Gandin, J.-M. Drezet
The GP(I) zone formation during quench is simulated in an industrial Aluminum alloy AA7449 75mm thick plate by using a multi-class precipitation model. For this purpose, results of in situ SAXS experiments are reported. A methodology is presented that takes advantage of the collected data to derive i - a thermodynamic description for GP(I) zones from reversion heat treatments by using a solubility product and ii - the influence of excess vacancies on diffusion coefficients. This approach allows reproducing reasonably well the GP(I) zone formation measured during rapid cooling. Further, the simulated as-quenched surface yield strength compares well with experimental results reported in the literature.

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Isolation and in vitro permeation of phenylpropylamino alkaloids from Khat (Catha edulis) across oral and intestinal mucosal tissues

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Minaleshewa Atlabachew, Sandra Combrinck, Alvaro M. Viljoen, Josias H. Hamman, Chrisna Gouws
Ethnopharmacological relevanceKhat, the leaves of Catha edulis, is used as a "natural amphetamine-like" stimulant in eastern and southern Africa, as well as in the Arabian Peninsula. Leaves are masticated to elicit a state of euphoria. Although the psychostimulatory effects of the leaves are attributed to the presence of phenylpropylamino alkaloids (i.e. cathinone, cathine and norephedrine), the extent of permeation of these alkaloids across the oral and intestinal mucosa has not been established.Materials and methodsCathinone was isolated in the form of the oxalate salt from young buds, following acid-base extraction. High performance countercurrent chromatography (HPCCC) was used to isolate cathine and norephedrine, following borohydride reduction of a mixture of the three alkaloids. The in vitro permeability of these three alkaloids in their pure form, as well as in a crude extract, was evaluated across Caco-2 cell monolayers and across excised porcine intestinal, sublingual and buccal tissues.ResultsThe purities of the isolated cathine and norephedrine were in excess of 90%, thereby proving that HPCCC can be applied for efficient separation of these alkaloids from extracts of Khat. The apparent permeability (Papp) coefficients for the Khat alkaloids in their pure form were all above 1.0×10⁻⁶cm/s, indicating that the transport of the three alkaloids across the selected biological membranes is comparable to that of the highly permeable reference compound, caffeine. Although readily transported across the various membranes, the alkaloids were transported to a lesser extent when present in a leaf extract, suggesting that other phytochemicals present in the extract influence their permeation.ConclusionsThese results provide evidence that chewing of Khat contributes to the buccal and sublingual absorption of the psychoactive alkaloids in the bloodstream directly across the oral mucosal membranes. In addition, it confirms that these metabolites will be readily absorbed from the gastrointestinal tract when swallowed.

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Efficacy and safety of Derris scandens (Roxb.) Benth. for musculoskeletal pain treatment: A systematic review and meta-analysis of randomized controlled trials

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Panupong Puttarak, Ratree Sawangjit, Nathorn Chaiyakunapruk
Ethnopharmacological relevanceDerris scandens (Roxb.) Benth. has been used as active ingredient in Thai traditional medicine recipes for pain treatment. Dry stem powder and ethanolic extract also recommended in Thailand National List of Essential Medicines (NLEMs) for musculoskeletal pain treatment as herbal medicine. However, no summarization of clinical effect and safety has been evaluated.ObjectiveOur study aimed to determine the clinical effects and safety of D. scandens for musculoskeletal pain treatment compared with standard regimen, nonsteroidal anti-inflammatory drugs (NSAIDs).MethodsInternational and Thai databases were searched from inception through August 2015. Comparative randomized controlled trials investigating oral D. scandens for musculoskeletal pain were included. Outcomes of interest included level of pain and adverse event. Mean changes of the outcomes from baseline were compared between D. scandens and NSAIDs by calculating mean difference.ResultsFrom 42 articles identified, 4 studies involving a total of 414 patients were included for efficacy analysis. The effects of oral D. scandens on reducing pain score were no different from those of non-steroidal anti-inflammatory drugs at any time points (3, 7, 14 days and overall). The overall pain reduction in the D. scandens group was not inferior to treatment with NSAIDs (weighted mean difference 0.06; 95% CI: −0.20, 0.31) without evident of heterogeneity (I²=0.00%, p=0.768). When compared, the adverse events (AEs) of D. scandens showed no different relative risk with NSAIDs. The major adverse events were gastrointestinal symptoms.ConclusionD. scandens may be considered as an alternative for musculoskeletal pain reduction.

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Endoplasmic reticulum-derived reactive oxygen species (ROS) is involved in toxicity of cell wall stress to Candida albicans

Publication date: Available online 17 September 2016
Source:Free Radical Biology and Medicine
Author(s): Qilin Yu, Bing Zhang, Jianrong Li, Biao Zhang, Honggang Wang, Mingchun Li
The cell wall is an important cell structure in both fungi and bacteria, and hence becomes a common antimicrobial target. The cell wall-perturbing agents disrupt synthesis and function of cell wall components, leading to cell wall stress and consequent cell death. However, little is known about the detailed mechanisms by which cell wall stress renders fungal cell death. In this study, we found that ROS scavengers drastically attenuated the antifungal effect of cell wall-perturbing agents to the model fungal pathogen C. albicans, and these agents caused remarkable ROS accumulation and activation of oxidative stress response (OSR) in this fungus. Interestingly, cell wall stress did not cause mitochondrial dysfunction and elevation of mitochondrial superoxide levels. Furthermore, the iron chelator 2,2'-bipyridyl (BIP) and the hydroxyl radical scavengers could not attenuate cell wall stress-caused growth inhibition and ROS accumulation. However, cell wall stress up-regulated expression of unfold protein response (UPR) genes, enhanced protein secretion and promoted protein folding-related oxidation of Ero1, an important source of ROS production. These results indicated that oxidation of Ero1 in the endoplasmic reticulum (ER), rather than mitochondrial electron transport and Fenton reaction, contributed to cell wall stress-related ROS accumulation and consequent growth inhibition. Our findings uncover a novel link between cell wall integrity (CWI), ER function and ROS production in fungal cells, and shed novel light on development of strategies promoting the antifungal efficacy of cell wall-perturbing agents against fungal infections.

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