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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Preparation and properties of Zr2MoP2O12 ceramics with negative thermal expansion

Publication date: 15 December 2016
Source:Materials & Design, Volume 112
Author(s): Toshihiro Isobe, Naoto Houtsuki, Yuko Hayakawa, Katsumi Yoshida, Sachiko Matsushita, Akira Nakajima
This study presents a synthetic method for preparing Zr2MoP2O12 powder and its sintered body using a solid-state reaction and a pressureless sintering method, respectively. The optimum heating sequence required to synthesize Zr2MoP2O12 was 873K for 4h, 1173K for 2h and 1323K for 30min. The specific surface area of the obtained powder was 4.2m²/g. Several sintering additives were evaluated to obtain the Zr2MoP2O12 sintered body, and the most stable additive was 2mass% ZnO, which yielded a relative density of >90% following sintering at 1173K for 2h. Young's modulus, Poisson's ratio, Vickers micro-hardness and fracture toughness of Zr2MoP2O12 sintered with 2mass% ZnO were 81GPa, 0.26, 3.1GPa and 0.6MPa·m^1/2, respectively.

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Effects of mold temperature on the microstructure and tensile properties of SiCp/2024 Al-based composites fabricated via powder thixoforming

Publication date: 15 December 2016
Source:Materials & Design, Volume 112
Author(s): P.B. Li, T.J. Chen, H. Qin
In this study, the effects of mold temperature on the microstructure and tensile properties of 2024 Al-based composites reinforced with SiC particles (SiCp; 10vol.%) and fabricated via powder thixoforming were investigated. The tensile properties of the composite were dependent upon the mold temperature because it affected the secondary solidification behavior, compactness of the secondary solidified structures, dislocation density introduced by the plastic deformation that occurs during thixoforming, and recrystallization behavior. The tensile properties of the composite that was thixoformed at 350°C exhibited the largest improvements, with the ultimate tensile strength (UTS) increasing by 235.4% (UTS=379MPa) and elongation decreasing by 31.0% (elongation=4.0%) compared to those of the as-cast 2024 alloy. The increased UTS was ascribed to the thermal-mismatch and load-transfer strengthening mechanisms, enhanced compactness, increased dislocation density, decreased grain size, and lower concentration of the deleterious θ-phase. The fracturing of the composites was caused by the cracking and debonding of the SiCp as the mold temperature increased, which in turn led to the total matrix failure.

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Deformation behavior and microstructure evolution of a Ti/TiB metal-matrix composite during high-temperature compression tests

Publication date: 15 December 2016
Source:Materials & Design, Volume 112
Author(s): M. Ozerov, M. Klimova, A. Kolesnikov, N. Stepanov, S. Zherebtsov
A Ti/TiB metal-matrix composite (MMC) was produced by spark plasma sintering (SPS) using a Ti-10wt.%TiB2 powder mixture at temperatures of 850 or 1000°C, corresponding to the α or β phase fields of Ti, respectively. The structures of both conditions were similar; however, a higher fraction of unreacted TiB2 and finer TiB whiskers were observed after sintering at 850°C. The mechanical behavior and microstructural response of the MMC to uniaxial compression in the temperature range from 500 to 1050°С was studied. At low temperatures of 500–700°C, the MMC sintered at 1000°C had a greater strength and lower ductility. At higher temperatures of 850–1050°C, the MMC sintered at 1000°C was compressed to a 70% strain without cracking, whereas surface cracks were observed in the specimen sintered at 850°C. Microstructure evolution of the Ti matrix was associated with the i) formation of a cell microstructure at 500°C, ii) continuous dynamic recrystallization at 700°C, and iii) discontinuous dynamic recrystallization at temperatures ≥850°C. A considerable decreasing the length of the TiB whiskers, which occurred much slower in the β phase, was observed during deformation. The mechanisms governing the mechanical behavior in different temperature regions were established using activation energy analysis.

Graphical abstract

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Investigation of a new type of composite ceramics for thermal barrier coatings

Publication date: 15 December 2016
Source:Materials & Design, Volume 112
Author(s): Dongbo Zhang, Zhongyu Zhao, Binyi Wang, Shuangshuang Li, Jianjun Zhang
In order to explore a novel material for thermal barrier coatings (TBCs), the composite ceramic materials of lanthanum zirconate (La2Zr2O7) and lanthanum phosphate (LaPO4) were prepared by calcining. The phases and micro-structures of La2Zr2O7/LaPO4 composite ceramic materials were studied by X-ray diffraction (XRD) and scanning electron microscopy (SEM). The properties of La2Zr2O7/LaPO4 material, such as thermal conductivity, coefficient of thermal expansion (CTE) and mechanical properties of La2Zr2O7/LaPO4 were investigated using laser flash method, high-temperature dilatometer and micro-hardness test. Based on XRD patterns, the pyrochlore and monazite phases were obtained in La2Zr2O7/LaPO4 composite ceramic material without any chemical reaction. According to SEM morphology, the La2Zr2O7 was closely near to LaPO4 along with a lot of pores, it might cause the decrease of thermal conductivity. The thermal conductivities of composite ceramics were similar to that of La2Zr2O7. The CTE of them were about 10×10⁻⁶K⁻¹, which was close to the value of LaPO4. Because of doping LaPO4, hardness and Young's modulus of samples were lower than that of La2Zr2O7. The studies revealed that the La2Zr2O7/LaPO4 composite ceramics had good mechanical and thermal physical properties and could be applied as new candidate materials for TBCs in the future.

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Precipitation behavior of a novel cobalt-based superalloy subjected to prior plastic deformations

Publication date: 15 December 2016
Source:Materials & Design, Volume 112
Author(s): Huakang Bian, Yunping Li, Daixiu Wei, Yujie Cui, Fenglin Wang, Shihai Sun, Kenta Yamanaka, Yuichiro Koizumi, Akihiko Chiba
The precipitation behavior of a novel cobalt-based superalloy subjected to prior plastic deformations was investigated in details by using field emission scanning electron microscope (FE-SEM), transmission electron microscope (TEM), etc. The precipitation of a μ-phase, which appeared at temperatures of 1073–1373K, was confirmed, while MC-type carbide was observed at the temperatures >1173K. The prior plastic deformations promoted the precipitation of the μ-phase during subsequent aging. Further, the precipitation of the μ-phase at temperatures lower than 1173K was confirmed to occur predominantly along the {111} slip bands; this was the dominant deformation mechanism of this alloy during plastic deformation. In contrast, there was no evidence that the precipitation of the MC-type carbide was affected by the prior plastic deformations in the case of the specimens exposed at 1273 and 1373K.

Graphical abstract

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A step towards the white light

Publication date: Available online 17 September 2016
Source:Materials Today
Author(s): David Bradley




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Long-term in-vivo tests assess the degradation of bone implants

Publication date: Available online 17 September 2016
Source:Materials Today
Author(s): Laurie Winkless




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A better understanding of glass

Publication date: Available online 17 September 2016
Source:Materials Today
Author(s): Laurie Donaldson




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Events

Publication date: Available online 17 September 2016
Source:Materials Today





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Recognition of achievement – priorities and process

Publication date: Available online 17 September 2016
Source:Materials Today
Author(s): Lynnette D. Madsen, Rita R. Colwell




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Printing 3D porous carbon networks in a zeolite

Publication date: Available online 17 September 2016
Source:Materials Today
Author(s): David Bradley




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Solar boost

Publication date: Available online 17 September 2016
Source:Materials Today
Author(s): David Bradley




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Carbon nanotubes in space!

Publication date: Available online 17 September 2016
Source:Materials Today
Author(s): Laurie Winkless




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From the Medical Board of the National Psoriasis Foundation: Perioperative management of systemic immunomodulatory agents in patients with psoriasis and psoriatic arthritis

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Young M. Choi, Maya Debbaneh, Jeffrey M. Weinberg, Paul S. Yamauchi, Abby S. Van Voorhees, April W. Armstrong, Michael Siegel, Jashin J. Wu
Treatment with systemic immunomodulatory agents is indicated for patients with moderate to severe plaque psoriasis and psoriatic arthritis. In these patients, surgery may confer an increased risk of infectious or surgical complications. We conducted a literature review to examine studies addressing the use of methotrexate, cyclosporine, and targeted immunomodulatory agents (tumor necrosis factor-alfa inhibitors, interleukin [IL]-12/23 inhibitors, IL-17 inhibitors) in patients undergoing surgery. We examined 46 total studies; the majority were retrospective studies in patients with rheumatoid arthritis and inflammatory bowel disease. One study in patients with psoriasis and psoriatic arthritis reviewed 77 procedures and did not find an elevated risk of postoperative complications with tumor necrosis factor-alfa and IL-12/23 inhibitors even with major surgeries. Based on level III evidence, infliximab, adalimumab, etanercept, methotrexate, and cyclosporine can be safely continued through low-risk operations in patients with psoriasis and psoriatic arthritis. For moderate- and high-risk surgeries, a case-by-case approach should be taken based on the patient's individual risk factors and comorbidities.



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Self-pumped MFCs that need no external power source

Publication date: Available online 17 September 2016
Source:Materials Today
Author(s): Laurie Donaldson




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Dermatology Calendar

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4





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Table of Contents

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4





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Blue-gray blotch: A helpful dermoscopic finding in optimal biopsy site selection for true vasculitis

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Ji Yoon Choo, Jung Min Bae, Ji Hyun Lee, Jun Young Lee, Young Min Park




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Information for Readers

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4





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Association of insulin-like growth factor (IGF)-1 gene polymorphisms with plasma levels of IGF-1 and acne severity

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Shekh Mohammad Amanur Rahaman, Dipankar De, Sanjeev Handa, Arnab Pal, Naresh Sachdeva, Tulikalipi Ghosh, Parul Kamboj
BackgroundPolymorphisms of the insulin-like growth factor (IGF)-1 gene consisting of variable cytosine adenosine repeats in the promoter region may directly influence the expression of IGF-1.ObjectiveWe sought to assess the role of IGF-1 gene polymorphisms in determination of plasma IGF-1 levels, acne, and its severity.MethodsIn this case-control study, 80 patients with acne vulgaris of 4 severity grades as per Global Acne Grading System and 80 age- and gender-matched control subjects without acne were studied. All the study subjects were without any disorder or a history of drug intake likely to affect IGF-1 level within a year before the study inclusion date. IGF-1 polymorphism was determined by polymerase chain reaction and plasma levels of IGF-1 by enzyme-linked immunosorbent assay. Acne severity was assessed by Global Acne Grading System.ResultsMean plasma IGF-1 level in acne cases was significantly higher than in non-acne controls (P = .04). Plasma IGF-1 level positively correlated with severity of acne (P = .01). Individuals homozygous for the 192-base pair (bp) allele had 4.29 times odds risk (95% confidence interval 1.38-13.33) of having acne and a significantly higher mean level of IGF-1 compared with non-192/non-192 participants. Individuals homozygous for the 192-bp allele had 3.08 times odds risk (95% confidence interval 1.15- 8.31) of having higher severity grade of acne compared with non-192/non-192 participants.LimitationsA relatively small number of participants were studied.ConclusionsPlasma IGF-1 levels positively correlate with severity of acne. The 192/192 homozygotes had higher risk of acne and higher severity grade of acne. Functional studies showing the relationship between IGF-1 promoter level polymorphism and actual gene expression in skin are warranted.



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JAAD Case Reports Article List

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4





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Multiple Mohs micrographic surgery is the most common reason for divergence from the appropriate use criteria: A single institution retrospective cohort study

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Emily Stamell Ruiz, Pritesh S. Karia, Frederick C. Morgan, Christine A. Liang, Chrysalyne D. Schmults




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Journal Based CME Instructions and Information

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4





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See one, do one, teach one: The ethical dilemma of residents performing their first procedure on patients

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Caroline LaRosa, Jane M. Grant-Kels




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Nevi and pregnancy

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Amy Kalowitz Bieber, Kathryn J. Martires, Marcia S. Driscoll, Jane M. Grant-Kels, Miriam Keltz Pomeranz, Jennifer A. Stein
Changes in the moles of pregnant women are frequently attributed to pregnancy, but recent studies suggest that pregnancy does not induce significant physiologic changes in nevi. It is common for nevi on the breasts and abdomen to grow with normal skin expansion, but studies that have examined melanocytic nevi on the backs or lower extremities have found no significant changes in size during pregnancy. Several studies have also investigated the belief that moles darken during pregnancy and have found insufficient evidence to support this idea. Dermoscopically, transient changes have been identified, but none are suggestive of melanoma. Results vary in terms of histologic changes seen in samples taken from pregnant women, but all authors agree that any histopathologic features consistent with melanoma should be viewed as melanoma and not attributed to pregnancy. Biopsy specimens should be obtained promptly from any changing mole that would raise concern for malignancy in a nonpregnant patient. Such procedures can be performed safely during pregnancy.



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Editorial Board

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4





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CME examination

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4





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Pigmentation in African American skin decreases with skin aging

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Anna L. Chien, Jean Suh, Sabrina Sisto Alessi Cesar, Alexander H. Fischer, Nancy Cheng, Flora Poon, Barbara Rainer, Sherry Leung, Jo Martin, Ginette A. Okoye, Sewon Kang
BackgroundTristimulus colorimetry, which uses the Commission Internationale de l'Eclairage L*a*b* model to quantify color, has previously been used to analyze pigmentation and erythema in human skin; however, colorimetry of African American skin is not well characterized.ObjectiveWe sought to analyze skin color patterns in African Americans and compare them with those of Caucasians.MethodsColorimetry readings of the sun-protected buttock and sun-exposed back of forearm were taken from 40 Caucasian and 43 African American participants from March 2011 through August 2015. African American participants also completed a lifestyle questionnaire. Correlation coefficients, paired t tests, and multivariable linear regression analyses were used for statistical comparisons.ResultsForearm skin was lighter in African Americans ages 65 years and older versus 18 to 30 years (P = .02) but darker in Caucasians ages 65 years or older versus 18 to 30 years (P = .03). In African Americans ages 18 to 30 years, the buttock was darker than the forearm (P < .001), whereas in Caucasians the buttock was lighter than the forearm (P < .001). A lighter forearm than buttock was correlated with supplement use, smoking (ages 18-30 years), and less recreational sun exposure (ages ≥65 years) in African Americans.LimitationsOur study was limited by the sample size and focal geographic source.ConclusionsPigmentation patterns regarding sun-protected and sun-exposed areas in African Americans may differ from that of Caucasians, suggesting that other factors may contribute to skin pigmentation in African Americans.



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Answers to CME examination

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4





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The study of nevi in children: Principles learned and implications for melanoma diagnosis

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Alon Scope, Michael A. Marchetti, Ashfaq A. Marghoob, Stephen W. Dusza, Alan C. Geller, Jaya M. Satagopan, Martin A. Weinstock, Marianne Berwick, Allan C. Halpern
Melanocytic nevi are a strong phenotypic marker of cutaneous melanoma risk. Changes in nevi during childhood and adolescence make these prime periods for studying nevogenesis. Insights gained by the study of nevi in childhood have implications for melanoma detection in both adults and children. A more comprehensive understanding of the morphologic characteristics of nevi in different anatomic locations, in association with the patient's age and pigmentary phenotype may aid in the identification of melanomas. When monitoring melanocytic lesions over time, it is essential to differentiate normal from abnormal change. This review summarizes the rapidly expanding body of literature relevant to nevus phenotype, particularly in the context of our experience with the Study of Nevi in Children (SONIC) Project.



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The American Board of Dermatology, Inc Future Meeting & Exam Dates

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4





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Understanding patient experience in university-based dermatology clinics: Time motion analysis

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Sameer Gupta, Suephy Chen, Pinar Keskinocak, Lori Houghtalen, Aimen Ismail, Monique Kumar




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Pregnancy and melanoma

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Marcia S. Driscoll, Kathryn Martires, Amy Kalowitz Bieber, Miriam Keltz Pomeranz, Jane M. Grant-Kels, Jennifer A. Stein
Malignant melanoma is the most common malignancy during pregnancy, and is diagnosed during childbearing age in approximately one-third of women diagnosed with melanoma. The impact of hormonal changes during pregnancy and from iatrogenic hormones on melanoma is controversial. Women undergo immunologic changes during pregnancy that may decrease tumor surveillance. In addition, hormone receptors are found on some melanomas. In spite of these observations, the preponderance of evidence does not support a poorer prognosis for pregnancy-associated melanomas. There is also a lack of evidence that oral contraceptives or hormone replacement therapy worsens melanoma prognosis.



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The cutaneous expression of vitamin K-dependent and other osteogenic proteins in calciphylaxis stratified by clinical features and warfarin use: A case control study

Publication date: October 2016
Source:Journal of the American Academy of Dermatology, Volume 75, Issue 4
Author(s): Frances Tian, Andrew T. Patterson, Jonathan J. Davick, Steven W. Ing, Benjamin H. Kaffenberger, Alejandro A. Gru




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Modeling background radiation using geochemical data: A case study in and around Cameron, Arizona

Publication date: December 2016
Source:Journal of Environmental Radioactivity, Volume 165
Author(s): Kara E. Marsac, Pamela C. Burnley, Christopher T. Adcock, Daniel A. Haber, Russell L. Malchow, Elisabeth M. Hausrath
This study compares high resolution forward models of natural gamma-ray background with that measured by high resolution aerial gamma-ray surveys. The ability to predict variations in natural background radiation levels should prove useful for those engaged in measuring anthropogenic contributions to background radiation for the purpose of emergency response and homeland security operations. The forward models are based on geologic maps and remote sensing multi-spectral imagery combined with two different sources of data: 1) bedrock geochemical data (uranium, potassium and thorium concentrations) collected from national databases, the scientific literature and private companies, and 2) the low spatial resolution NURE (National Uranium Resource Evaluation) aerial gamma-ray survey. The study area near Cameron, Arizona, is located in an arid region with minimal vegetation and, due to the presence of abandoned uranium mines, was the subject of a previous high resolution gamma-ray survey. We found that, in general, geologic map units form a good basis for predicting the geographic distribution of the gamma-ray background. Predictions of background gamma-radiation levels based on bedrock geochemical analyses were not as successful as those based on the NURE aerial survey data sorted by geologic unit. The less successful result of the bedrock geochemical model is most likely due to a number of factors including the need to take into account the evolution of soil geochemistry during chemical weathering and the influence of aeolian addition. Refinements to the forward models were made using ASTER visualizations to create subunits of similar exposure rate within the Chinle Formation, which contains multiple lithologies and by grouping alluvial units by drainage basin rather than age.



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Editorial Board

Publication date: October 2016
Source:Dental Materials, Volume 32, Issue 10





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Botanical drugs in Ayurveda and Traditional Chinese Medicine

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Yogini Jaiswal, Zhitao Liang, Zhongzhen Zhao
Ethnopharmacological relevanceChina and India have a long history in the therapeutic application of botanical drugs in traditional medicine. Traditional Chinese Medicine (TCM) and Ayurveda are considered as two of the most ancient systems of medicine, with history of more than two millennia. Medicinal plants are the principal medicinal materials used in both these systems.Aim of the reviewThis review discusses about the histories of Ayurveda and TCM, the common medicinal plants species, the drug processing strategies used, and the current statuses of these traditional systems of medicine (TSM). Through the views presented in this article, we aim to provide a new perspective to herbal drug researchers for expanding and improving the utilization of botanical drugs and their therapeutic applications.MethodsA bibliographic investigation of Chinese and Indian pharmacopoeias, monographs and official websites was performed. Furthermore, information was obtained from scientific databases on ethnobotany and ethno medicines.ResultsThe review of Ayurveda and TCM ethno medicine indicates that both these systems have many medicinal materials in common. The studies carried out by the authors for comparison of plants from same genus from both these TSM's have been discussed to further bring focus to the utilization of "qualitatively" similar species which can be utilized and substituted for endangered or economically valued species. The overview of ancient literature and scientific findings for drugs in both these systems suggests that, the botanical drugs used in common and their processing methods can be explored further for extensive utilization in traditional medicine.ConclusionThis review describes the histories, common medicinal plant species, their processing methods and therapeutic applications in Ayurveda and TCM. The insights provided through this article may be used by herbal drug researchers and pharmacologists for further exploration of botanical drugs from these two traditional systems of medicine.

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Effect of fenugreek on hyperglycaemia and hyperlipidemia in diabetes and prediabetes: A meta-analysis

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Jing Gong, Ke Fang, Hui Dong, Dingkun Wang, Meilin Hu, Fuer Lu
Ethnopharmacological relevanceFenugreek is a widely used herb for the treatment of diabetes mellitus (DM) but the effects in randomized controlled trials (RCTs) were controversial. Therefore, a meta-analysis was conducted to estimate the overall effects of fenugreek on hyperglycaemia and hyperlipidemia in diabetes and prediabetes.Materials and methodsPubMed, EMBASE, web of science, Chinese Biomedical Literature database (CBM), the Cochrane library, China Doctor Dissertations Full-text Database (CDFD), Wan Fang medical database, China Proceedings of Conference Full-text Database (CPCD), China national knowledge internet (CNKI) and China Master's Theses Full-text Database (CMFD) were searched to find the available literatures. RCTs with regard to the efficacy and safety of fenugreek on prediabetes or DM were included. The data of fasting blood glucose (FBG), postprandial 2h blood glucose (2hBG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-c) and high density lipoprotein cholesterol (HDL-c) were extracted to appraise the net change with fixed or randomized effect model.ResultsA total of 10 articles (12 studies) were included in the analysis. Pooled results showed fenugreek significantly decreased the levels of FBG (MD −0.84mmol/L; 95% CI −1.38 to −0.31; p=0.002), 2hBG (MD −1.30mmol/L; 95% CI −1.78 to −0.83; p<0.0001), HbA1c (MD −1.16; 95% CI −1.23 to −1.09; p<0.00001) and TC (MD −0.30mmol/L; 95% CI-0.56 to −0.03; p=0.03). In spite of the reductive trends in the TG or LDL-c levels and incremental trends of HDL-c, these results were not statistically significant or need further verification for fenugreek in the treatment of DM and prediabetes. Some studies were of low quality. No liver and kidney toxicity were found in all included studies, and the main side effects were gastrointestinal discomfort.ConclusionsThe results suggest fenugreek has the hypoglycaemic and TC-lowering efficacy; however, the effects on TG, LDL-c and HDL-c need further confirmations.

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Screening study on the anti-angiogenic effects of Traditional Chinese Medicine – Part I: Heat-clearing and detoxicating TCM

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Xiang Tu, YuanPing Deng, Jing Chen, Quan Hu, ChengShi He, James B. Jordan, Sen zhong
Ethnopharmacological relevanceFew studies have explored the anti-angiogenic effects of TCM - even more so, as it applies to cancer treatment research. Heat-clearing and detoxicating TCM is the most frequently used category in the treatment of cancerous tumors, but lacks sufficient validation studies.Aim of the studyThe present research (in our series of studies) aims to explore the anti-angiogenic effects of TCM; so we begin with heat-clearing and detoxicating TCM.Materials and MethodsSix typical heat-clearing and detoxicating TCM (Philippine Violet Herb, Wild Chrysanthemum, Heartleaf Houttuynia Herb, Chinese Lobelia Herb, Spreading Hedyotis Herb and Uniflower Swisscentaury Root) were decocted, concentrated, sieved and desiccated to attain the water extract. This study utilized the vascular organism research model for Fli1a-EGFP zebrafish, which were raised and maintained under standard conditions. 22h post-fertilization (hpf) embryos were distributed into 12-well plates for a treatment period of 26h. The TCM water extracts which were diluted in 0.1% dimethyl sulfoxide (DMSO), were added to each well at a concentration of 200μg/ml. The positive control was 5μg/ml PTK787 (vatalanib) and the vehicle control was 0.1% DMSO. At 48hpf larvae were tricaine anesthetized and imaged. To demonstrate if TCM shows angiogenesis defects, ten larvae were randomly chosen to conduct a quantitative assay. Quantitative real-time PCR was conducted to dissect the mechanisms involved by analyzing the contributions of signaling pathways and molecules concerning angiogenesis, with a total of ten genes examined.ResultsAll 30 larvae treated with Wild Chrysanthemum, Uniflower Swisscentaury Root and PTK787 showed angiogenesis defects. Embryos treated with Wild Chrysanthemum and Uniflower Swisscentaury Root showed a lower number of complete intersegmental vessels (ISVs) and there was statistically significant differences between TCM and the vehicle control. Wild Chrysanthemum and Uniflower Swisscentaury Root have a higher inhibition rate and the statistical difference between TCM and the vehicle control was significant. Compared with vehicle controls, Wild Chrysanthemum could significantly modulate the relative mRNA expression of all ten genes. Whereas, Uniflower Swisscentaury Root could significantly regulate the relative mRNA expression of seven genes, it did not show a significant impact on the remaining three genes.ConclusionsThe present research demonstrates that Wild Chrysanthemum and Uniflower Swisscentaury Root have anti-angiogenic effects in zebrafish and that they could regulate both proangiogenic mechanisms and negative angiogenesis regulators. Their anti-angiogenic effects result from effects on negative regulators overriding their effects on proangiogenic mechanisms. The results provide new insights into their clinical application and therapeutic potential for the management of angiogenesis-dependent diseases such as cancer.

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Total flavonoid aglycones extract in Radix scutellariae inhibits lung carcinoma and lung metastasis by affecting cell cycle and DNA synthesis

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Yang Wang, Hui-juan Cao, Shu-jun Sun, Jian-ye Dai, Jun-wei Fang, Qian-hua Li, Chao Yan, Wen-wei Mao, Yong-yu Zhang
Ethnopharmacological relevanceRadix Scutellariae (Scutellaria baicalensis Georgi, RS), a traditional herbal medicine commonly used to treat inflammation, hypertension, cardiovascular disease, bacterial and viral infections, is reported to treat lung cancer by supplements of modern medicine. The total flavonoid aglycones extract (TFAE) from RS is the most important composition for the pharmacodynamic effects. The present study was designed to evaluate the anti-lung tumor effect of TFAE on A549 cells and A549 cell nude mice xenografts. The aim of the study is to investigate the effect and mechanism of TFAE treating non-small cell lung cancer both in vitro and in vivo.Materials and methodsThe anti-tumor activity of TFAE in vitro was investigated using the MTT assay. The changes of cell invasion and migration were detected by Transwell assay and tube formation experiments were used to detect the anti-angiogenic effect. The anti-tumor effects of TFAE in vivo were evaluated in A549 cell nude mice xenografts. The mechanism of TFAE was detected by flow cytometry technology, western blot assay and immuno-histochemistry assay.ResultsIn vitro, TFAE inhibited the proliferation, invasion and migration of A549 cells in a dose- and time-dependent manner. In vivo, TFAE by oral administration at 100mg/kg for 30 days decreased the tumor volume and tumor weight in A549 cell xenograft by 25.5% with no statistical significance (P<0.05) compared to the cis-platinum positive control group (30.0%). The cell cycle and DNA synthesis experiment illustrated that TFAE could induce A549 cell cycle to arreste in S phase and DNA synthesis in A549 cells be inhibited, while TFAE had no influence on apoptosis of A549 cells. Western Blot assay demonstrated that the treatment of TFAE could make Cyclin D1 decrease and p53 increase both in vitro and in vivo.ConclusionTFAE displayed the inhibition effects of non-small cell lung cancer both in vitro and in vivo and the underlying mechanism might be related to the increased p53 protein expression and decreased Cyclin D1 expression, leading to cell cycle arrested in S phase and the decrease of DNA synthesis.

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Jiangzhi Capsule improves fructose-induced insulin resistance in rats: Association with repair of the impaired sarcolemmal glucose transporter-4 recycling

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Lirong Jiang, Ling Yao, Yifan Yang, Dazhi Ke, Robert Batey, Jianwei Wang, Yuhao Li
Ethnopharmacological relevanceJiangzhi Capsule, originated from an experienced formula in traditional Chinese Medicine, has been listed and used for the management of metabolic abnormalities in Australia for a long time. To better understand Jiangzhi Capsule, this study investigated its effect on insulin resistance.Materials and methodsMale rats were treated with liquid fructose in their drinking water over 14 weeks. Jiangzhi Capsule was co-administered (once daily, by oral gavage) during the last 7 weeks. Indexes of lipid and glucose homeostasis were determined enzymatically, by ELISA and/or histologically. Gene expression was analyzed by real-time PCR, Western blot and/or immunohistochemistry.ResultsTreatment with Jiangzhi Capsule (100mg/kg) attenuated fructose overconsumption-induced increases in basal plasma insulin concentrations, the homeostasis model assessment of insulin resistance index and the adipose tissue insulin resistance index in rats. The increased plasma glucose concentrations during oral glucose tolerance test were also inhibited. Furthermore, Jiangzhi Capsule had a trend to attenuate the decreased ratios of glucose and non-esterified fatty acids to plasma insulin concentrations. Mechanistically, this insulin-sensitizing action was accompanied by normalization of the downregulated sarcolemmal glucose transporter (GLUT)-4 protein expression and the decreased phosphorylated Akt to total Akt protein ratio in gastrocnemius.ConclusionsThese results suggest that Jiangzhi Capsule ameliorates fructose-induced insulin resistance with a link to repair of the impaired sarcolemmal GLUT-4 recycling through modulation of the ratio of phosphorylated Akt to total Akt in gastrocnemius. Our findings provide an evidence-based and mechanistic understanding of Jiangzhi Capsule for the management of insulin resistance-associated disorders.

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Ethnobotanical investigations on plants used in folk medicine in the regions of Constantine and Mila (North-East of Algeria)

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Rayene Ouelbani, Souheir Bensari, Toma Nardjes Mouas, Douadi Khelifi
Ethno-pharmacological relevanceConstantine and Mila regions have been investigated in an ethnobotanical study for the first time. A total of 102 medicinal plants have been cited to treat human ailments. Twenty-eight new species of 31 common plants with 151 new therapeutic applications and 12 new cited species including one endemic specie Zygophyllum cornutum Coss were found as compared to other Algerian regions. In addition, to the best of our knowledge, 369 new medicinal uses of 75 known plants, were reported for the first time in the Mediterranean basin.Aim of the studyThis study is aimed at contributing to safeguard world cultural heritage and document ethnomedicinal uses of plants in Algeria and the Mediterranean basin; data on the national and global uses in the world were obtained to extract new potential species for further phytochemical and clinical investigations.Materials and methodsThe survey was carried out in two cities in the northeast of Algeria: Constantine and Mila. It was based on semi-structured interviews of 79 local informants. Data were analyzed using quantitative indices, namely, informant consensus factor, fidelity level (FL), use value (UV), and relative frequency citation (RFC), to evaluate the reliability and richness of herbal knowledge in the region.ResultsThe interviewed persons used 102 plant species belonging to 90 genera and distributed among 53 families, represented mainly by Lamiaceae, Apiaceae, and Asteraceae (30%, 13%, and 10%, respectively), which were used to treat 14 ailment categories. The category of most frequent ailments (16%) was digestive disorders (diarrhea, constipation, and stomach bloating). The highest RFC was found for Origanum glandulosum Desf. With regard to the fidelity level, a higher FL was found for Tilia cordata Mill. (100%), followed by Artemisia herba alba Asso. with an FL of 95.74% and Punica granatum L. with an FL of 93.09%) to treat gastrointestinal system diseases, and Aloe sp. L. with an FL of 96.67% for skin diseases. The highest UV was found for Origanum glandulosum Desf. (2.280). Moreover, new medicinal uses were recorded for the first time in Algeria and Mediterranean regions.ConclusionThe present study has highlighted the rich herbal knowledge about newfound medicinal plants and their new uses in the Mediterranean region, which could be useful not only in facilitating other studies such as phytochemical and pharmacological investigations and upgrading the sources of biomolecules beneficial to people but also in reopening discussion on pharmacovigilance in herbal medicine as an imperative requirement for local authorities.

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α-Cyperone of Cyperus rotundus is an effective candidate for reduction of inflammation by destabilization of microtubule fibers in brain

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Azam Azimi, Seyed Mahmood Ghaffari, Gholam Hossein Riazi, Seyed Shahriar Arab, Mohammad Mehdi Tavakol, Shahriar Pooyan
Ethnopharmacological relevanceCyperus rotundus L. (Cyperaceae), commonly known as purple nutsedge or nut grass is one of the most invasive and endemic weeds in tropical, subtropical and temperate regions. This plant has been extensively used in traditional medicine for anti-arthritic, antidiarrheal and antiplatelet properties as well as treatment for several CNS disorders such as epilepsy, depression and inflammatory disorders. Inflammation is evidently occurring in pathologically susceptible regions of the Alzheimer's disease (AD) brain as well as other disorders. Many cellular processes are responsible in chronic inflammation. Microtubule-based inflammatory cell chemotaxis is a well-recognized process that influences production of cytokines and phagocytosis. The effect of α-Cyperone, one of main ingredients of Cyperus rotundus on microtubule assembly and dynamics has not been examined and is the purpose of this investigation.Materials and methodsMicrotubules and tubulin were extracted in order to explore their interaction with α-Cyperone by utilization of turbidimetric examinations, intrinsic fluorescence and circular dichroism spectroscopy (CD) studies. The molecular docking analysis was executed in order to facilitate a more detail and stronger evidence of this interaction. The BINding ANAlyzer (BINANA) algorithm was used to evaluate and further substantiate the binding site of α-Cyperone.ResultsIt was demonstrated that α-Cyperone had a pronounced influence on the tubulin structure, decreased polymerization rate and reduced concentration of polymerized tubulin in vitro. The CD deconvolution analysis concluded that significant conformational changes occurred, demonstrated by a drastic increase in content of β-strands upon binding of α-Cyperone. The fluorescence spectroscopy revealed that a static type of quenching mechanism is responsible for binding of α-Cyperone to tubulin. Upon characterization of various biophysical parameters, it was further deduced that ligand binding was spontaneous and a single site of binding was confirmed. Transmission electron microscopy revealed that upon binding of α-Cyperone to microtubule the number and complexity of fibers were noticeably decreased. The computational analysis of docking suggested that α-Cyperone binds preferably to β-tubulin at a distinct location with close proximity to the GTP binding and hydrolysis site. The ligand interaction with β-tubulin is mostly hydrophobic and occurs at amino acid residues that are exclusively on random coil. The BINANA 1.2.0 algorithm which counts and tallies close molecular interaction by performing defined set of simulations revealed that amino acid residues Arg 48 and Val 62 have registered the highest scores and are possibly crucial in ligand-protein interaction.Conclusionα-Cyperone binds and interacts with tubulin and is capable of distinctly destabilizing microtubule polymerization. The effect of this interaction could result in reduction of inflammation which would be highly beneficial for treatment of inflammatory diseases such as AD.

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Inhibitory effects of Saussurea involucrata (Kar. et Kir.) Sch. -Bip. on adjuvant arthritis in rats

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Xiaoli Han, Dan Su, Xiaoyan Xian, Mingyang Zhou, Xianzhe Li, Jian Huang, Jinhui Wang, Huiyuan Gao
Ethnopharmacological relevanceSaussurea involucrate (Kar. et Kir.) Sch. -Bip is an endangered species of the Compositae family, and this species has long been used for the treatment of rheumatoid arthritis, dysmenorrhea, stomachache, and altitude sickness in Uighur folk and Chinese medicine.Aim of the studyThis study aimed to investigate the different therapeutic efficacy of alcohol infusion (SEI) and water decoction (SWD) of S. involucrata in treating rheumatoid arthritis using complete Freund's adjuvant (CFA)-induced arthritis (AA) in a rat model.Materials and methodsMale Wistar rats (160–180g) were immunized by intradermal injection of 0.1mL of CFA into the left hind metatarsal footpad. Aspirin was chosen as the positive drug. Alcohol infusion (SEI, 400 and 800mg/kg) and water decoction (SWD, 443 and 886mg/kg) of S. involucrata aerial parts were orally administered from day 1 and continued for 21 days. Arthritis severity was evaluated by arthritic score, body weight loss, and paw swelling. The levels of TNF-α, IL-β, and IL-6 in the serum of AA rats were detected by enzyme linked immunosorbent assay (ELISA). Histological changes in the ankle joint were also analyzed in the AA rats.ResultsBoth SEI and SWD significantly ameliorated AA severity, as suggested by the modulatory effects on body weight loss, paw swelling, and arthritic score. Histopathological improvement in the joint architecture was also observed in the SEI- and SWD-treated AA rats. The overproduction of TNF-α, IL-1β, and IL-6 was remarkably attenuated in the serum of all treated rats. Furthermore, the therapeutic effect of SWD was more potent than that of SEI in treating rheumatoid arthritis using AA in a rat model, which was reported for the first time.ConclusionsThese results suggested that the extract of S. involucrata significantly attenuated adjuvant arthritis in rats by decreasing the levels of TNF-α, IL-1β, and IL-6 in the serum. S. involucrata has the potential to be regarded as a candidate for the treatment of human arthritis. Moreover, the therapeutic effect of SWD was much better than alcohol infusion, indicting that active constituents are mainly in the water extract, which is helpful for the clinical treatments to choose the appropriate process.

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(3′R)-hydroxytabernaelegantine C: A bisindole alkaloid with potent apoptosis inducing activity in colon (HCT116, SW620) and liver (HepG2) cancer cells

Publication date: 24 December 2016
Source:Journal of Ethnopharmacology, Volume 194
Author(s): Angela Paterna, Sofia E. Gomes, Pedro M. Borralho, Silva Mulhovo, Cecília M.P. Rodrigues, Maria-José U. Ferreira
Ethnopharmacological relevanceTabernaemontana elegans Stapf. (Apocynaceae) is a medicinal plant traditionally used in African countries to treat cancer.Aims of the studyTo discover new apoptosis inducing lead compounds from T. elegans and provide scientific validation of the ethnopharmacological use of this plant.Materials and methodsThrough fractionation, (3′R)-hydroxytaberanelegantine C (1), a vobasinyl-iboga bisindole alkaloid, was isolated from a cytotoxic alkaloid fraction of the methanol extract of T. elegans roots. Its structure was identified by spectroscopic methods, mainly 1D and 2D NMR experiments. Compound 1 was evaluated for its ability to induce apoptosis in HCT116 and SW620 colon and HepG2 liver carcinoma cells. The cell viability of compound 1 was evaluated by the MTS and lactate dehydrogenase (LDH) assays. Induction of apoptosis was analyzed through Guava ViaCount assay, by flow cytometry, caspase-3/7 activity assays and evaluation of nuclear morphology by Hoechst staining. To determine the molecular pathways elicited by 1 exposure, immunoblot analysis was also performed.Results(3′R)-hydroxytaberanelegantine C (1) displayed strong apoptosis induction activity as compared to 5-fluorouracil (5-FU), the most used anticancer agent in colorectal cancer treatment. In the MTS assay, compound 1 exhibited IC50 values similar or lower than 5-FU in the three cell lines tested. The IC50 value of 1 was also calculated in CCD18co normal human colon fibroblasts. The lactate dehydrogenase assay showed increased LDH release by compound 1, and the Guava ViaCount assay revealed that 1 significantly increased the incidence of apoptosis to a further extent than 5-FU. Moreover, the induction of apoptosis was corroborated by evaluation of nuclear morphology by Hoechst staining and caspase-3/7 activity assays of 1 treated cells. As expected, in immunoblot analysis, compound 1 treatment led to poly(ADP-ribose) polymerase cleavage. This was accompanied by decreased anti-apoptotic proteins Bcl-2 and XIAP steady state levels in all three cancer cell lines tested.ConclusionsCompound 1 showed remarkable induction of apoptosis in HCT116, SW620 and HepG2 cells. Together, the results suggest that compound 1 is a promising lead structure for inducing apoptosis.

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Evidence that activation of nuclear peroxisome proliferator-activated receptor alpha (PPARα) modulates sleep homeostasis in rats

Publication date: Available online 16 September 2016
Source:Brain Research Bulletin
Author(s): Eric Murillo-Rodríguez, Khalil Guzmán, Gloria Arankowsky-Sandoval, Mireille Salas-Crisóstomo, Ramsés Jiménez-Moreno, Oscar Arias-Carrión
The peroxisome proliferator-activated receptor alpha (PPARα) is a member of the nuclear receptor superfamily that has been suggested as a modulator of several physiological functions. The PPARα recognizes as an endogenous ligand the anorexic lipid mediator oleoylethanolamide (OEA) which displays wake-inducing properties. Despite that recent evidence indicates that activation of PPARα by synthetic agonists such as Wy14643 enhances waking as well as the extracellular contents of wake-related neurotransmitters, the role of PPARα in sleep recovery after prolonged waking has not been fully described. Thus, the aim of this study was to characterize if PPARα regulates sleep rebound after total sleep deprivation (TSD). We report that after 6h of TSD activation of PPARα by pharmacological systemic administration of OEA (10, 20 or 30mg/Kg, i.p.) promoted alertness by blocking the sleep rebound after TSD. Besides, wake-linked compounds such as dopamine, norepinephrine, serotonin, or adenosine collected from nucleus accumbens were enhanced after TSD in OEA-treated animals. These sleep and neurochemical results were mimicked after injection of PPARα agonist Wy14643 (10, 20, 30mg/Kg, i.p.). However, similar findings from the sham of vehicle groups were observed if PPARα antagonist MK-886 was administered to rats (10, 20, 30mg/Kg, i.p.). Our results strengthened the hypothesis that PPARα might modulate sleep and neurochemical homeostasis after sleep deprivation.

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Cordycepin attenuates traumatic brain injury-induced impairments of blood-brain barrier integrity in rats

Publication date: Available online 16 September 2016
Source:Brain Research Bulletin
Author(s): Jing Yuan, Aihua Wang, Yan He, Zhihua Si, Shan Xu, Shanchao Zhang, Kun Wang, Dawei Wang, Yiming Liu
Loss of blood-brain barrier (BBB) integrity is a downstream event caused by traumatic brain injury (TBI). BBB integrity is affected by certain physiological conditions, including inflammation and oxidative stress. Cordycepin is a susbtance with anti-inflammatory and anti-oxidative effects. Therefore, it is necessary to investigate whether cordycepin affects TBI-induced impairments of BBB integrity. Using TBI rats as the in vivo model and applying multiple techniques, including stroke severity evaluation, Evans blue assessment, quantitative real-time PCR, Western blotting and ELISA, we investigated the dose-dependent protective effects of cordycepin on the TBI-induced impairments of BBB integrity. Cordycepin treatment attenuated the TBI-induced impairments in a dose-dependent manner, and played a role in protecting BBB integrity. Cordycepin was able to alleviate TBI-induced loss of tight junction proteins zonula occludens protein-1 (ZO-1) and occludin, which are important for BBB integrity. Moreover, cordycepin suppressed pro-inflammatory factors, including IL-1β, iNOS, MPO and MMP-9, and promoted anti-inflammation-associated factors arginase 1 and IL-10. Furthermore, cordycepin inhibited NADPH oxidase (NOX) expression and activity following TBI, probably through NOX1, but not NOX2 and NOX4. Cordycepin has protective effects against brain damages induced by TBI. The protection of cordycepin on BBB integrity was probably achieved through recovery of tight junction proteins, inhibition of local inflammation, and prevention of NOX activity.



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Suppressor of cytokine signaling 2 (SOCS2) contributes to encephalitis in a model of Herpes infection in mice

Publication date: Available online 16 September 2016
Source:Brain Research Bulletin
Author(s): Larissa Fonseca da Cunha Sousa, Milene Alvarenga Rachid, Graciela Kunrath Lima, Aline Silva de Miranda, Márcia de Carvalho Vilela, Norinne Lacerda Queiroz, David Henrique Rodrigues, Marco Antonio Campos, Erna Geessien Kroon, Fabiana Simão Machado, Antônio Lúcio Teixeira
The most severe manifestation of Herpes Simplex Type 1 virus (HSV-1) infection is encephalitis characterized by arousal impairment and seizures that can evolve to coma and death. Previous studies reported the involvement of suppressor of cytokine signaling (SOCS) proteins, specifically SOCS1 and SOCS3, in HSV-1 infection, suggesting that other members of this family could be involved in the immune response against HSV-1. No previous study has reported the role of SOCS2 in HSV-1 infection. In the current study, C57BL/6 wild-type mice (WT) and mice deficient in SOCS2 gene (SOCS2^−/−) were subjected to intracranial inoculation with 10² plaque forming units (PFU) of HSV-1. Survival curve, neuroinflammatory parameters and neuropathology were evaluated. Infected SOCS2^−/− mice had increased survival in comparison with infected WT animals. This better outcome was associated with reduced leukocyte infiltration, concentration of cytokines, and structural changes in the brain. SOCS2 seems to play a detrimental role in HSV-1 encephalitis. Moreover, the control of neuroinflammatory response in HSV-1 infection was of paramount importance to clinical outcome.



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