Controllable synthesis of NiCo2O4/Al core-shell nanowires thermite film with excellent heat release and short ignition time

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): Yajie Chen, Wenchao Zhang, Chunpei Yu, Debin Ni, Kefeng Ma, Jiahai Ye
NiCo2O4 has been selected as an oxidizer to realize the nanothermite film for the first time in this study. The NiCo2O4/Al core-shell nanowires (NWs) thermite film has been fabricated using a facile hydrothermal-annealing synthesis method and a controllable magnetron sputtering process. The as-obtained NiCo2O4/Al NWs thermite film shows a uniform structure and distribution on the substrate, with a favorable interfacial contact between the bimetallic oxide and the fuel at the nanoscale. It is found that the quantity of Al plays a key role in the total heat release magnitude. The maximal heat release of the NiCo2O4/Al nanothermite film has reached 2076.0 J/g at the optimal Al deposited thickness of 450 nm with the obtained optimum Al/NiCo2O4 molar ratio of 4.9. Moreover, this design strategy is highly compatible with microelectromechanical systems (MEMs) and it can be applied to realize other nanothermites composed by bimetallic oxide and fuel.

Graphical abstract

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Liquid metal embrittlement in laser beam welding of Zn-coated 22MnB5 steel

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): M.H. Razmpoosh, A. Macwan, E. Biro, D.L. Chen, Y. Peng, F. Goodwin, Y. Zhou
Despite frequent reports of liquid metal embrittlement (LME) during resistance spot welding, no work has been done to investigate the LME sensitivity in laser beam welding (LBW) of advanced high strength steels. The present study was therefore undertaken to reflect the LME sensitivity of Zn-coated 22MnB5 press-hardening steel as a function of stress intensity and heat input during LBW. The results proved a direct relation between the external load and LME susceptibility, where the threshold tensile stress of about 80%YS is necessary to trigger the embrittlement. Electron backscatter diffraction (EBSD) in conjunction with electron probe micro-analyzer (EPMA) results confirmed the intergranular penetration of Zn along the prior austenite high-angle grain boundaries in upper-critical heat affected zone (UCHAZ). The presence of Zn over the maximum Zn-solubility of austenite promotes α-Fe(Zn) transformation along the LME-crack which assists the loss of ductility. The present findings provide an understanding of the mechanism of embrittlement in UCHAZ and suggest solutions to mitigate the LME in LBW of boron steels.

Graphical abstract

https://ift.tt/2tpi9fm

Deposition behavior, microstructure and mechanical properties of an in-situ micro-forging assisted cold spray enabled additively manufactured Inconel 718 alloy

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): Xiao-Tao Luo, Meng-Lin Yao, Ninshu Ma, Makoto Takahashi, Chang-Jiu Li
Cold spray is capable to additively manufacture oxide-free metallic parts in open air due to its low processing temperature. However, for metals with relatively high hardness such as Inconel 718 superalloy (IN718), it is still a big challenge to get dense deposits by using low-priced nitrogen gas. In this work, In-situ micro-forging (MF) was introduced to cold spray by mechanically mixing big-sized 410 stainless steel (410SS) particles into the IN718 powder so that the deposited IN718 layer can be hammered and plastically deformed by the MF particles during spraying and results in fully dense deposits. As 50 vol% MF particles were mixed into the IN718 powder, the porosity was decreased from 5.6% to 0.26%. Due to the low impact velocity, 410SS particles were not embedded into the IN718 deposits and the possible contamination was avoided. An oxide scale removal induced increment in deposition efficiency was detected for the first time. Due to the lower porosity and enhanced inter-particle bonding, a great improvement in ultimate strength from 96 to 464 MPa was achieved by the in-situ MF effect. After heat treated at 1200 °C for 6 h, the sample fractured at a high strength of 1089 MPa and revealed a ductile fracture manner.

Graphical abstract

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Flexural fatigue properties of polycarbonate fused-deposition modelling specimens

Publication date: 5 October 2018
Source:Materials & Design, Volume 155
Author(s): Josep M. Puigoriol-Forcada, Alex Alsina, Antonio G. Salazar-Martín, Giovanni Gomez-Gras, Marco A. Pérez
This report presents an experimental investigation on the influence of part build orientation on the flexural fatigue behaviours of fused-deposition modelling (FDM) processed polycarbonate (PC) parts. Quantification of fatigue behaviour is required to show the feasibility of manufacturing industrial parts with the FDM technique. Therefore, stress-cyclic strain (S-N) curves were experimentally obtained for alternating stress (R − 1) and mean stress (R − 0.5). Test performances show that the part build orientation significantly affects the dynamic behaviour of FDM parts because of the inner anisotropy. Furthermore, to prove the validity of simulation methods such as finite element analysis (FEA), a case study was conducted. A designed part was simulated with FEA and the obtained von Mises stresses were corrected using the Goodman correction and the S-N curve for R − 1. This part was also manufactured and tested to compare the simulated and experimental results. The results show good accuracy between the virtual and physical models.

Graphical abstract

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SUNCT and SUNA: an Update and Review

Abstract

Purpose of Review

The purpose of this review is to provide an update on the clinical features, diagnosis, pathogenesis, epidemiology, and treatment of the rare primary headache disorders short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with autonomic symptoms (SUNA). Together these entities are known as short-lasting unilateral neuralgiform headache attacks (SUNHA).

Recent Findings

Recent case reports of secondary SUNCT and SUNA due to medullary infarcts support the theory that the trigeminohypothalamic pathway is involved in the pathophysiology of SUNHA. While medical therapy for SUNHA has not significantly changed, surgical therapy for refractory SUNCT and SUNA has made advancements with a recent case series demonstrating the efficacy of deep brain stimulation.

Summary

We will discuss the pathophysiology of both the pain and the autonomic symptoms experienced in SUNCT and SUNA attacks as well the medical, procedural, and surgical options for treatment with emphasis on recent advances. Specific secondary causes reported in the recent literature will be discussed in brief.

https://ift.tt/2lqm0VY

CO 2 Laser for De-epithelialization in Tympanoplasty

Abstract

Tympanoplasty repairs tympanic membrane perforations but also covers an umbrella of procedures characterized by surgery of the mastoid bone. Tympanoplasty is widely regarded as a beneficial procedure with an over 90% graft closure success rate and an over 80% return to normal hearing range. Though surgical technique and graft type are important in determining surgical outcomes of the procedure, results are most greatly correlated with location of the perforation. Marginal perforations are associated with the most complications in reconstruction of the tympanic membrane, lack of vascularization and limited membrane area delaying the healing process (4). Lasers have been used in medical procedures dating back to the 1960s. The advantage of infrared lasers such as CO₂ are the precision of cutting and the smooth interaction with tissues (5). The CO₂ laser is absorbed by the tympanic membrane and does not damage the middle ear while visible lasers penetrate and can damage the ear drum (6). This retrospective study of 150 patients from 2013–2016 assesses and demonstrates the viability of using carbon dioxide laser as an alternative to the traditional method for de-epithelialization of tympanic perforation margins during tympanoplasty. By comparing closure rates and audiogram data, this study reveals parameters of use, benefits and adverse outcomes on healing and hearing restoration with the CO₂ laser-assisted method. Perforation closure rate of 91% and hearing improvement in 66% of patients was observed. Fourteen patients did not undergo closure of the tympanic membrane with an overwhelming majority of the 14 having large and marginal perforations.

https://ift.tt/2K5TQgN

Cochlear Implant in Prelingually Deaf Children: Our Experience

Abstract

Retrospective study of the prelingual cochlear implantation programme under government scheme done at medical college hospital in central India. Forty-two prelingually deaf children screened and sent for cochlear implantation at our centre From March 2015 to Feb 2018 were reviewed with respect to their age, sex, preimplantation hearing aid use, surgical technique for cochlear implantation, type of FDA (USA) approved cochlear implant, post operative speech therapy and its outcome with respect to categories of auditory perception and speech intelligibility scoring were compared for children younger than 4 years and older than 4 years. For outcome measurement non parametric statistical method was used for any significance between the two groups. There was a wide range of children implanted ranging from 2 to 7 years. Both varia and mastoidectomy and posterior tympanotomy method of cochlear implantations were done with good rate complete insertion and electrode activation. There was no significant difference between the two group with regard to CAP and SIR outcomes after 1 year. In order to get better outcomes with respect to the speech language development, there is need to strengthen the early identification and cochlear implantation before 4 years of age in government approved schemes.

https://ift.tt/2K37Ft7

Role of Preincisional Peritonsillar Infiltration of Bupivacaine in Postoperative Pain Relief in Tonsillectomy Patients

Abstract

Tonsillectomy is one of the most common surgical procedures carried out in ENT since ancient time, is associated with several morbidities in which the pain and bleeding being the commonest and can cause considerable delay in starting oral intake and discharge from the hospital. Different methods have been used to reduce posttonsillectomy pain including use of opioids, sucralfate and local anaesthetics. Local anaesthetics in the form of pre-incisional or post-incisional peritonsillar infiltration and also topical post-incisional spray or packing are some of the most effective methods for post-tonsillectomy pain management. In our hospital, a study was carried out for preincisional peritonsillar infiltration of 0.5% bupivacaine in tonsillectomy patients for post operative pain relief. Written informed valid consent was taken, all routine investigations were done. Pre anaesthetic check up was done and bupivacaine test dose was given, none of the patients showed allergic reactions. Our study showed that this is effective method of controlling post operative pain. Patients receiving bupivacaine showed lower pain scores 6 h post operatively. The mean pain scores for Bupivacaine group were 2.85, 5.52 and 7.04 versus 5.04, 7.04 and 7.61 in saline group at 2, 4, and 6 h post operatively (t value significant). Pre incisional peritonsillar infiltration of 0.5% bupivacaine significantly reduces postoperative pain till 6 h, thereby reducing the need of analgesics intraoperatively and post operatively. Oral intake was also earlier without any adverse effects in our study.

https://ift.tt/2Ke08ei

Psychiatric and functional neuroimaging abnormalities in chronic hepatitis C virus patients: Is vasculitis a contributing factor?

Publication date: Available online 20 June 2018
Source:Arab Journal of Gastroenterology
Author(s): Hania S. Zayed, Amr Amin, Samy Alsirafy, Nahla D. Elsayed, Soheir Abo Elfadl, Mohamed Nasreldin, Dalia Enaba, Zeinab Nawito
Background and study aimsCentral nervous system (CNS) involvement in hepatitis C virus (HCV) infection has different facets such as anxiety, depression, cognitive impairment and vasculitis. We were interested in detecting subclinical CNS involvement in chronic HCV infected subjects with and without systemic vasculitis.Patients and methodsNineteen patients (15 females and 4 males) with chronic HCV infection (mean age 46.5 ± 7 and mean duration since diagnosis of HCV infection 4.7 ± 4 years, including 6 (32%) Child-Pugh class A cirrhotic patients) and 30 age, sex and education matched healthy control subjects were studied. Thirteen patients had associated vasculitis. Patients and control subjects were assessed using the block design and comprehension subtests of Wechsler Bellevue Adult Intelligence Scale, Wechsler Memory scale (WMS), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). Brain HMPAO Single Photon Emission Computed Tomography (SPECT) was performed for HCV patients.ResultsPatients with HCV had lower scores on the block design test compared to control subjects (8.37 ± 1.89 versus 10.37 ± 1.47, p < 0.001), lower total WMS scores (43.15 ± 10.49 versus 60.27 ± 8.08, p < 0.001) and higher anxiety and depression scores (16.94 ± 10.46 and 37.17 ± 10.38 versus 10.3 ± 4.67 and 28.9 ± 5.99, p = 0.004 and 0.001, respectively). Total WMS were lower in HCV patients with vasculitis compared to those without vasculitis (39.14 ± 9.3 versus 51.17 ± 8.3, p = 0.019) while the block design and comprehension tests, BAI and BDI were not significantly different between both groups. The block design and comprehension tests, WMS, BAI and BDI were not significantly different between cirrhotic and non-cirrhotic patients. Seven patients had different patterns of cerebral hypoperfusion on SPECT, and all of them had associated vasculitis. Abnormal SPECT was associated with lower total WMS scores (35.87 ± 10.8 versus 46.79 ± 8.6 in those with normal SPECT, p = 0.049).ConclusionsVasculitis may contribute to the development of neuropsychiatric involvement in HCV patients.



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The gut microbiome and irritable bowel syndrome: State of art review

Publication date: Available online 20 June 2018
Source:Arab Journal of Gastroenterology
Author(s): Ahmed E. Salem, Rajdeep Singh, Younan K. Ayoub, Ahmed M. Khairy, Gerard E. Mullin
Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract, the physiology of which is not very well understood. There are multiple factors and pathways involved in pathogenesis of this entity. Among all, dysmotility, dysregulation of the brain-gut axis, altered intestinal microbiota and visceral hypersensitivity play a major role. Over the last years, research has shown that the type of gut microbiome present in an individual plays a significant role in the pathophysiology of IBS. Multiple studies have consistently shown that subjects diagnosed with IBS have disruption in gut microbiota balance. It has been established that host immune system and its interaction with metabolic products of gut microbiota play an important role in the gastrointestinal tract. Therefore, probiotics, prebiotics and antibiotics have shown some promising results in managing IBS symptoms via modulating the interaction between the above. This paper discusses the various factors involved in pathophysiology of IBS, especially gut microbiota.



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Rifaximin versus metronidazole in management of acute episode of hepatic encephalopathy: An open labeled randomized clinical trial

Publication date: Available online 20 June 2018
Source:Arab Journal of Gastroenterology
Author(s): Mohamed A. Mekky, Ahmad R. Riad, Marwa A. Gaber, Mohamed O. Abdel-Malek, Yosef M. Swifee
Background and study aimsMany regimens are tried in managing overt hepatic encephalopathy (HE). We investigated the efficacy of rifaximin versus metronidazole in management of an acute episode of HE on top of cirrhosis.Patients and methodsAn open label prospective controlled trial was conducted on patients with an acute episode of HE on top of cirrhosis who were randomly divided into metronidazole-group (M-group) and rifaximin-group (R-group) with 60 patients in each.The main outcome measure was the clinical improvement of HE, duration of hospital stay and the changes in the level of serum ammonia after 3 days of starting therapy.ResultsBoth M-group and R-group were comparable as regards age and sex (mean age 51 ± 11 years and 49 ± 12; male/female ratio 45:15 and 50:10, respectively). Forty-six patients (76.7%) in M-group compared with forty-five (75%) in R-group showed clinical improvement (p = 0.412). Hospital stays were comparable between both group; 4.2 ± 2.1 and 3.9 ± 1.7 for M-group and R-group; respectively (p = 0.435). There was no significant difference of venous ammonia levels (Mean of delta 160.77 ± 185.34 µg/dL and 207.95 ± 218.43 µg/dL with p 0.664 and 0.974 in M-group and R-group, respectively). No adverse events were reported throughout the whole study.ConclusionRifaximin and metronidazole are equally effective in management of acute episode of overt HE, therefore, re-auditing of treatment protocols of HE are warranted especially in limited resource settings.



https://ift.tt/2K8seaP

Treatment of PPI-resistant gastro-oesophageal reflux: A systematic review

Publication date: Available online 20 June 2018
Source:Arab Journal of Gastroenterology
Author(s): Giulia Gallusi, Stefano Pontone
Background and study aimsSeveral studies have demonstrated the superiority of proton-pump inhibitors (PPIs) in resolving erosive gastro-oesophageal reflux disease (GORD). However, this first line of treatment can fail to control symptoms in around 30% of cases, especially in the presence of non-erosive GORD. In situations where the first line of treatment fails, there is a lack of concordance regarding the best strategy to apply. This study presents a systematic review of the trials which have tested second-line treatments after PPI failure.MethodsThe study was conducted according to the PRISMA statement. The systematic review included medical trials written in English which were published between 2000 and 2016 and were retrieved from PubMed and Scopus using the keywords 'PPI-resistant gastro-oesophageal reflux', 'alginate AND gastro-oesophageal reflux', 'hyaluronic acid AND gastro-oesophageal reflux', 'prokinetics AND gastro-oesophageal reflux', 'sucralfate AND gastro-oesophageal reflux' and 'baclofen AND gastro-oesophageal reflux'.ResultsTen randomised and non-randomised studies were included, which included 1515 patients of both sexes (mean age = 49.19 years, age range = 18–85, males = 700; 46.2%).ConclusionsA personalised choice of the best treatment for PPI-resistant GORD should be based on the results of an upper endoscopy and pH/MII monitoring. For patients in situations where the first line of treatment fails, we encourage the execution of trials for testing double doses of PPIs against alternative medicaments.



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Prognostic factors of patients with gastroenteropancreatic neuroendocrine neoplasms

Publication date: Available online 20 June 2018
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Pao-Yuan Huang, Kai-Lung Tsai, Chih-Ming Liang, Wei-Chen Tai, Kun-Ming Rau, Keng-Liang Wu, Chao-Cheng Huang, Seng-Kee Chuah
There is an increasing trend in the incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) worldwide. The aim of the present study was to identify the prognostic factors of patients with GEP-NENs. A cross-sectional, retrospective chart review study was conducted among patients with pathologically proven GEP-NENs between January 2003 and December 2016 at Kaohsiung Chung-Gung Memorial Hospital. A total of 97 patients who met the inclusion criteria were included (male/female = 56/41, age: 57.7 ± 15.4 years). The presentation, clinical characteristics, and disease outcomes were reviewed and analyzed. The most common primary site of the GEP-NENs was the rectum (49.5%), followed by the pancreas (17.5%), duodenum (11.3%), stomach (10.3%), colon (6.2%), and appendix (5.2%), and most GEP-NENs were hormonally nonfunctional (94.8%). There were 56 tumors classified as G1 neuroendocrine tumors (NETs), 9 as G2 NETs, and 14 as G3 neuroendocrine carcinoma (NEC). Metastasis was found in 15 patients (15%). Curative treatments, such as surgery or endoscopic resection, were performed in 83.5% of patients (n = 81). The mean overall survival duration was 107.2 ± 7.8 months. The estimated 3- and 5-year overall survival rates for all patients were 84% and 82%, respectively. Logistic regression analysis showed that large tumor size, non-rectal NENs, high histopathological grading, lymphatic metastases and distant metastases were associated with poor survival. This study suggested that the presence of lymphatic or distant metastases at diagnosis is an independent risk factor for poor prognosis in patients with GEP-NENs.



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Superior vena cava syndrome presenting as position-dependent periorbital oedema

Description 

A 54-year-old woman presented to our dermatology clinic with a 2 months history of periorbital oedema, more prominent after lying down in horizontal position. Her face and throat felt swollen. She experienced dyspnoea on exertion, fatigue and had lost 6 kg of weight. Treatment with antihistamines and oral prednisone were ineffective. She smoked one pack of tobacco per week. Medical history and family history were unremarkable. She did not use any medications. Physical examination revealed prominent periorbital oedema and facial swelling (figure 1). Chest radiograph revealed a pathologically enlarged right hilum, broadened mediastinum and modest pleural effusion (figure 2). Diagnosis of superior vena cava syndrome (SVCS) was made and the patient was referred to the pulmonologist.

Figure 1

Prominent periorbital oedema and facial swelling after lying down the night before as a presenting symptom of superior vena cava syndrome.

...

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Acute locked superior shoulder dislocation in a patient with cuff tear arthropathy

In the field of traumatic shoulder dislocations, this report of a 61-year-old female patient discusses the case of an acute locked superior shoulder dislocation in conjunction with a chronic rotator cuff arthropathy resulting from a low-energy fall on the outstretched and abducted arm. Radiological assessment revealed a complex combination of associated bony injuries including a fracture of the upper part of the glenoid and an impaction fracture of the inferior articular surface of the humeral head. Closed reduction and immobilisation were not successful in obtaining joint stability. This unique report highlights the clinical importance of accurate management of bony injuries in traumatic shoulder dislocation.

https://ift.tt/2yu8IRJ

Renal pelvicalyceal rupture secondary to extraperitoneal pelvic packing (EPP) in the unstable trauma patient

Presented here is the case of an 86-year-old man who was found to have right-sided pelvicalyceal rupture and anuric renal failure, secondary to obstructive uropathy caused by life-saving extraperitoneal pelvic packing (EPP) in the settling of severe trauma. In efforts to control haemorrhage in this haemodynamically unstable patient, EPP placement deviated from the recognised method of three extraperitoneal packs bilaterally with seven surgical packs placed. Progress postoperative imaging revealed right-sided hydroureteronephrosis with obstruction evident at the level of the extraperitoneal pelvic packs, identified by delayed contrast excretion from the preceding CT angiography imaging. Urology performed bilateral retrograde pyelograms at his relook laparotomy, timed after removal of his extraperitoneal packs and haemostasis, which showed impression of the surgical pack on the distal ureter but no persisting obstruction or short-term complications. Anuric renal failure improved, and renal function returned to near premorbid levels on day 4 postoperatively.

https://ift.tt/2lrkx1P

Massive faecal impaction leading to abdominal compartment syndrome and acute lower limb ischaemia

Abdominal compartment syndrome (ACS) is associated with significant morbidity and mortality requiring prompt treatment. We report a rare case of a 57-year-old man who developed acute lower limb ischaemia, severe metabolic acidosis and renal impairment from massive faecal impaction of unknown aetiology resulting in ACS causing occlusion of the right common iliac artery. This was treated with faecal disimpaction, which eventually resulted in slow but full recovery.

https://ift.tt/2tq1oR7

Laparoscopic revisional surgery for an unusual complication of Roux-en-Y gastric bypass

With the worldwide epidemic of obesity, there has been an increase in the numbers of primary and revisional procedures of bariatric surgery such as the Roux-en-Y gastric bypass (RYGBP). Nevertheless, this type of surgery is not exempt from complications. An excessive length of non-functional Roux limb proximal to the jejunojejunostomy can cause abnormal upper gastrointestinal symptoms after laparoscopic RYGBP. We present the case of a female patient who presented these unspecific abdominal symptoms after laparoscopic RYGBP who underwent laparoscopic resection in order to reduce the length of the dilated blind loop responsible for the symptoms.

https://ift.tt/2lnjuzR

Gorlin-Goltz syndrome: first reported case of bullae in the lungs complicated with tension pneumothorax

A 13-year-old girl was referred by her general practitioner with acute worsening exertional dyspnoea and sudden onset of left-sided chest pain. There was no associated trauma, palpitations or syncope. Clinical examination revealed that the left lung was hyper-resonant on percussion with reduced air entry on auscultation. Chest X-ray showed a left tension pneumothorax. She was treated conservatively with chest drain. Follow-up X-ray revealed multiple bullae within her left lung. Unfortunately, she redeveloped a pneumothorax and was sent to a tertiary centre. She was under the care of the paediatric cardiothoracic surgeons who organised a CT thorax and performed a lobectomy to remove the bullae. She was discharged from the tertiary centre and currently being followed up under the care of the paediatrician in the district general hospital. She have not developed any further pneumothoraxes.

https://ift.tt/2yE3dA7

Posterior root medial meniscus reconstruction: an option in chronic posterior root meniscal injury management

Posterior root medial meniscus (PRMM) tears have shown to be biomechanically equivalent to complete meniscectomy. Drawbacks from PRMM tears repair are unsatisfactory healing rates. In this case report, we outlined a PRMM reconstruction with gracilis graft healing outcome in chronic PRMM tear case, based on clinical and MRI evaluation. A 60-year-old man reported a chief complaint of increasing pain on the right knee joint in the last 1 year after a deep-flexion injury. On MRI investigation, we confirmed the chronic PRMM tear as Osteoarthritis Kellgren-Lawrence grade II. Then, we planned to perform a PRMM reconstruction with gracilis graft per arthroscopy. At the 6-month MRI evaluation, we found healing of the attached PRMM on its footprints, with intact graft transition from the meniscus to the tibial bone tunnel.

https://ift.tt/2ll2KZX

Symptomatic dyspnoea addressed by excision of ossified anterior longitudinal ligament

Ossification of the anterior longitudinal ligament (OALL) in cervical spine is known to cause dysphagia. However, dyspnoea and obstructive sleep apnoea (OSA) due to OALL is a rare entity. A 50-year-old man presented to our clinic 2 years after anterior cervical discectomy and fusion (ACDF) with complaints of dysphagia, dyspnoea and difficulty in sleeping supine. The clinico-neurological examination of patient was normal without any long tract signs. The diagnosis of OALL was made on plain lateral radiographs. Ultrasonic bone cutter was used to convert sessile osteophyte mass into a pedunculated mass. It was then disconnected from the anterior aspect of vertebral bodies with a chisel. The patient showed immediate relief from dysphagia and OSA. Dyspnoea improved over a week and the postoperative change in voice responded well to speech therapy. To the best of our knowledge, this is the first report of dyspnoea due to OALL after ACDF.

https://ift.tt/2ytbeHF

Long-term control of laryngeal plasma cell mucositis with systemic immunosuppression

Plasma cell mucositis (PCM) is a rare non-neoplastic plasma cell proliferative disorder of the mucous membranes, which typically presents as soft tissue lesions involving oral, upper airway or genital mucosa. Laryngeal involvement resulting in stridor has been reported in four other cases previously, with three requiring tracheostomy. We present a case of supraglottic stenosis in a 53-year-old woman presenting with dysphonia and stridor, requiring surgical resection on three occasions accompanied by tracheostomy on two occasions; biopsy was consistent with PCM. Due to relapsing disease activity, high-dose prednisolone and mycophenolate mofetil were commenced with prednisolone eventually being ceased. After 2 years of mycophenolate mofetil therapy, the patient's disease has been controlled without need for further surgical intervention. This is the first reported case of prolonged symptomatic improvement with the use of systemic immunosuppressive therapy with mycophenolate mofetil in PCM.

https://ift.tt/2lnjrEb

The environmental characteristics and applications of biochar

Abstract

The environmental deterioration is in a grave situation, and it is urgent to restore the environment. Biochar is a carbon-rich pyrolysis product of feedstock, which has aroused extensive concern due to its broad application potential for getting rid of pollutants and rehabilitating environment. This review generalizes three aspects on biochar, including production and properties, applications and mechanisms, and its modifications. Firstly, the production and characteristics have been summarized, because the practical applications of biochar are highly related to the special characteristics of biochar. Secondly, this paper outlines the latest applications of biochar for environmental remediation, and further provides a critical review on the application mechanisms in environmental restoration. Thirdly, the modification methods and applications of modified biochar are summarized, and all of the ways can be classified into two types: pretreatment of feedstock and modification of primitive biochar. Furthermore, the possible improvements and outlooks of applying biochar in environmental remediation are proposed. This review provides useful information for the application of biochar in environmental restoration.

https://ift.tt/2I7a5oY

Environmental genotoxicity and risk assessment in the Gulf of Riga (Baltic Sea) using fish, bivalves, and crustaceans

Abstract

Environmental genotoxicity in the Gulf of Riga was assessed using different bioindicators (fish, clams, and isopods) collected from 14 study stations. Comparison of genotoxicity responses (micronuclei (MN) and nuclear buds (NB)) in blood erythrocytes of herring (Clupea harengus), eelpout (Zoarces viviparous), and flounder (Platichthys flesus) revealed the species- and site-specific differences. For the first time, the analysis of genotoxicity was carried out in gill cells of isopods Saduria entomon. The highest inductions of MN and NB in gill cells of investigated S. entomon and clams (Macoma balthica) were evaluated in specimens from station 111A (offshore zone). In fish, the highest incidences of MN were measured in eelpout and in herring collected in the southern part of Gulf of Riga (station GOR3/41S). Moreover, in the southern coastal area, the assessment of genotoxicity risk (according to micronuclei levels) indicated exceptionally high risk for flounder, eelpout, and clams.

https://ift.tt/2K8htW4

Antialgal effects of α-linolenic acid on harmful bloom-forming Prorocentrum donghaiense and the antialgal mechanisms

Abstract

Harmful algal blooms (HABs) induced by Prorocentrum donghaiense occur frequently and cause a serious threat to the marine ecosystem. In this study, antialgal effects of α-linolenic acid (ALA) that is generally extracted from diverse macroalga on P. donghaiense were investigated. Specifically, the growth, cellular morphology and ultrastructure, reactive oxygen species (ROS) content, mitochondrial membrane potential (MMP), cytochrome C (Cyt-C), and caspase-9,3 activity of untreated and treated P. donghaiense were investigated. The results showed that ALA significantly inhibited the growth of P. donghaiense. Under ALA exposure, the cellular morphology and ultrastructure were damaged. ALA also induced ROS overproduction in the algal cells, decreased MMP, induced Cyt-C release, and activated caspase-9,3, which strongly relates to algal apoptosis. In summary, this study revealed the responses of morphology and physiology of P. donghaiense when exposed under ALA, and shows the potential of biotechnology on controlling P. donghaiense.

https://ift.tt/2I7TWzH

A Normalized Trace Geometry Modeling Method with Bulge-Free Analysis for Direct Ink Writing Process Planning

3D Printing and Additive Manufacturing, Ahead of Print.


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Imaging predictors of treatment outcomes in rectal cancer: an overview

Publication date: Available online 20 June 2018
Source:Critical Reviews in Oncology/Hematology
Author(s): Lakshmi Shree Mahadevan, James Zhong, BhanuPrasad Venkatesulu, Harmeet Kaur, Shreerang Bhide, Bruce Minsky, William Chu, Martijn Intven, Uulke A. van der Heide, Baukelien van Triest, Sunil Krishnan, William Hall
The treatment protocols for rectal cancer continue to evolve, with increasing acceptance of a watch-and-wait policy for clinical complete responders to neoadjuvant chemoradiation therapy. It still, however, remains unclear who is likely to achieve a pathological complete response, which unequivocally portends a very favorable overall prognosis. Evolution of modern imaging techniques has paved the way for potential prediction of treatment response based on baseline, on-treatment, early post-treatment and subsequent follow-up imaging alone. Independent of tumor grade and stage, tumor marker levels, tumor size, radiation dose and fractionation, chemotherapy regimen, and extent/type of surgery, imaging biomarkers like circumferential resection margin (CRM), extramural venous space invasion (EMVI), imaging-based tumor regression grade, perfusion/diffusion-based functional imaging parameters, and imaging-based metabolic response have the ability to predict the likelihood of local recurrence and/or distant metastases. Textural features of images can add a further dimension to the predictive power of imaging. Finally, integration of genomic data with imaging biomarkers can potentially discern molecular mechanisms associated with distinct radiographic attributes of tumors. In this review, we evaluate and summarize the evidence to date of each imaging modality as a biomarker and its contribution to personalized decision making in rectal cancer.



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Tuning B cell responses to antigens by cell polarity and membrane trafficking

Publication date: September 2018
Source:Molecular Immunology, Volume 101
Author(s): Felipe del Valle Batalla, Ana-María Lennon-Dumenil, María-Isabel Yuseff
The capacity of B lymphocytes to produce specific antibodies, particularly broadly neutralizing antibodies that provide immunity to viral pathogens has positioned them as valuable therapeutic targets for immunomodulation. To become competent as antibody secreting cells, B cells undergo a series of activation steps, which are triggered by the recognition of antigens frequently displayed on the surface of other presenting cells. Such antigens elicit the formation of an immune synapse (IS), where local cytoskeleton rearrangements coupled to mechanical forces and membrane trafficking orchestrate the extraction and processing of antigens in B cells. In this review, we discuss the molecular mechanisms that regulate polarized membrane trafficking and mechanical properties of the immune synapse, as well as the potential extracellular cues from the environment, which may impact the ability of B cells to sense and acquire antigens at the immune synapse. An integrated view of the diverse cellular mechanisms that shape the immune synapse will provide a better understanding on how B cells are efficiently activated.



https://ift.tt/2MIPKtu

Hsp90/Sec22b promotes unconventional secretion of mature-IL-1β through an autophagosomal carrier in porcine alveolar macrophages during Mycoplasma hyopneumoniae infection

Publication date: September 2018
Source:Molecular Immunology, Volume 101
Author(s): Zhenzhen Zhang, Yanna Wei, Beibei Liu, Yuzi Wu, Haiyan Wang, Xing Xie, Zhixin Feng, Guoqing Shao, Qiyan Xiong
Interleukin-1β (IL-1β) is a critical inflammatory regulator in response to Mycoplasma hyopneumoniae infection. However, the mechanism involved in the secretion of IL-1β during Mycoplasma hyopneumoniae infection is unclear. In this study, we demonstrated that Mycoplasma hyopneumoniae infection increased the secretion of mature-IL-1β (m-IL-1β), but not pro-IL-1β, in porcine alveolar macrophages. Moreover, Mycoplasma hyopneumoniae infection promoted the generation of autophagosomes, which attributed to the unconventional secretion of m-IL-1β. Further results revealed that Hsp90 was required for the entry of m-IL-1β into autophagosomes during Mycoplasma hyopneumoniae infection. The fusion of m-IL-1β-containing autophagosome and plasma membranes was regulated by Sec22b and independent of lysosomal dysfunction. In conclusion, we provide evidence that Hsp90/Sec22b promotes the unconventional secretion of IL-1β through an autophagosomal carrier during Mycoplasma hyopneumoniae infection. The elucidation of the molecular and cellular machinery in Mycoplasma hyopneumoniae infected mammalian cells in this study suggests avenues for further study and applications and paves the way for novel therapeutic strategies to prevent tissue damage in mycoplasma-associated diseases.



https://ift.tt/2tdzYi3

Complement analysis in the era of targeted therapeutics

Publication date: Available online 20 June 2018
Source:Molecular Immunology
Author(s): Zoltán Prohászka, Michael Kirschfink, Ashley Frazer-Abel
Complement immunobiology, and with it complement analysis, has undergone a renaissance in the past decade. Classically, complement analysis was limited number of testing C3, C4 in a routine laboratory with the possible addition of CH50 with all other analysis being performed at only few highly esoteric laboratories. This diagnostics expanding beyond specialized laboratories is the result of the growing recognition of the role played by complement dysfunction in many more diseases and disorders and the concomitant increase in interest in complement targeting therapeutics. In response, laboratories specializing in complement analysis have joined with the International Complement Society and the IUIS to coordinate efforts to standardize and improve complement testing, ongoing efforts that have already borne fruit. A recognition of the power of complement analysis has brought forward new testing but also realization of the importance of post-draw specimen handling to limit ex vivo activation, as well as the sometimes large difference between testing laboratory results. The increased usefulness of complement analysis and efforts to standardize and expand it means the future is strong for complement analysis.



https://ift.tt/2tqIk5t

Tuning B cell responses to antigens by cell polarity and membrane trafficking

Publication date: September 2018
Source:Molecular Immunology, Volume 101
Author(s): Felipe del Valle Batalla, Ana-María Lennon-Dumenil, María-Isabel Yuseff
The capacity of B lymphocytes to produce specific antibodies, particularly broadly neutralizing antibodies that provide immunity to viral pathogens has positioned them as valuable therapeutic targets for immunomodulation. To become competent as antibody secreting cells, B cells undergo a series of activation steps, which are triggered by the recognition of antigens frequently displayed on the surface of other presenting cells. Such antigens elicit the formation of an immune synapse (IS), where local cytoskeleton rearrangements coupled to mechanical forces and membrane trafficking orchestrate the extraction and processing of antigens in B cells. In this review, we discuss the molecular mechanisms that regulate polarized membrane trafficking and mechanical properties of the immune synapse, as well as the potential extracellular cues from the environment, which may impact the ability of B cells to sense and acquire antigens at the immune synapse. An integrated view of the diverse cellular mechanisms that shape the immune synapse will provide a better understanding on how B cells are efficiently activated.



https://ift.tt/2MIPKtu

Amyotrophic lateral sclerosis: The complement and inflammatory hypothesis

Publication date: Available online 20 June 2018
Source:Molecular Immunology
Author(s): Anne-Lene Kjældgaard, Katrine Pilely, Karsten Skovgaard Olsen, Stephen Wørlich Pedersen, Anne Øberg Lauritsen, Kirsten Møller, Peter Garred
Amyotrophic lateral sclerosis (ALS) is a devastating, neurodegenerative motor neuron disease. The aetiology of ALS remains an enigma which hinders the design of an effective treatment to prevent, postpone, or reverse the pathophysiological changes occurring during the aggressive progression of this disease.During the last decade, basic research within the innate immune system, and in particular the complement system, has revealed new, important roles of the innate immune system during development, homeostasis, and ageing within as well as outside the central nervous system. Several lines of evidence indicate that aberrant activation of the complement system locally in the central nervous system as well as systemically may be involved in the pathophysiology of ALS. This exciting new knowledge could point towards the innate immune system as a potential target of medical intervention in ALS. Recently, the historic perception of ALS as a central neurodegenerative disease has been challenged due to the significant amount of evidence of a dying-back mechanism causing the selective destruction of the motor neurons, indicating that disease onset occurs outside the borders of the blood-brain-barrier. This review addresses the function of the innate immune system during ALS. We emphasize the role of the complement system and specifically suggest the involvement of ficolin-3 from the lectin pathway in the pathophysiology of ALS.



https://ift.tt/2yvPgE0

Hsp90/Sec22b promotes unconventional secretion of mature-IL-1β through an autophagosomal carrier in porcine alveolar macrophages during Mycoplasma hyopneumoniae infection

Publication date: September 2018
Source:Molecular Immunology, Volume 101
Author(s): Zhenzhen Zhang, Yanna Wei, Beibei Liu, Yuzi Wu, Haiyan Wang, Xing Xie, Zhixin Feng, Guoqing Shao, Qiyan Xiong
Interleukin-1β (IL-1β) is a critical inflammatory regulator in response to Mycoplasma hyopneumoniae infection. However, the mechanism involved in the secretion of IL-1β during Mycoplasma hyopneumoniae infection is unclear. In this study, we demonstrated that Mycoplasma hyopneumoniae infection increased the secretion of mature-IL-1β (m-IL-1β), but not pro-IL-1β, in porcine alveolar macrophages. Moreover, Mycoplasma hyopneumoniae infection promoted the generation of autophagosomes, which attributed to the unconventional secretion of m-IL-1β. Further results revealed that Hsp90 was required for the entry of m-IL-1β into autophagosomes during Mycoplasma hyopneumoniae infection. The fusion of m-IL-1β-containing autophagosome and plasma membranes was regulated by Sec22b and independent of lysosomal dysfunction. In conclusion, we provide evidence that Hsp90/Sec22b promotes the unconventional secretion of IL-1β through an autophagosomal carrier during Mycoplasma hyopneumoniae infection. The elucidation of the molecular and cellular machinery in Mycoplasma hyopneumoniae infected mammalian cells in this study suggests avenues for further study and applications and paves the way for novel therapeutic strategies to prevent tissue damage in mycoplasma-associated diseases.



https://ift.tt/2tdzYi3

Complement analysis in the era of targeted therapeutics

Publication date: Available online 20 June 2018
Source:Molecular Immunology
Author(s): Zoltán Prohászka, Michael Kirschfink, Ashley Frazer-Abel
Complement immunobiology, and with it complement analysis, has undergone a renaissance in the past decade. Classically, complement analysis was limited number of testing C3, C4 in a routine laboratory with the possible addition of CH50 with all other analysis being performed at only few highly esoteric laboratories. This diagnostics expanding beyond specialized laboratories is the result of the growing recognition of the role played by complement dysfunction in many more diseases and disorders and the concomitant increase in interest in complement targeting therapeutics. In response, laboratories specializing in complement analysis have joined with the International Complement Society and the IUIS to coordinate efforts to standardize and improve complement testing, ongoing efforts that have already borne fruit. A recognition of the power of complement analysis has brought forward new testing but also realization of the importance of post-draw specimen handling to limit ex vivo activation, as well as the sometimes large difference between testing laboratory results. The increased usefulness of complement analysis and efforts to standardize and expand it means the future is strong for complement analysis.



https://ift.tt/2tqIk5t

Treatment strategies and outcomes in diffuse large B-cell lymphoma among 1011 patients aged 75 years or older: A Danish population-based cohort study

Publication date: August 2018
Source:European Journal of Cancer, Volume 99
Author(s): Maja Bech Juul, Pernille Hammershoej Jensen, Henriette Engberg, Sonja Wehberg, Andriette Dessau-Arp, Donika Haziri, Helene Bjoerg Kristensen, Joachim Baech, Lene Schurmann, Michael Roost Clausen, Rebecca Valentin, Lene Meldgaard Knudsen, Lars Munksgaard, Tarec Christoffer El-Galaly, Henrik Frederiksen, Thomas Stauffer Larsen
BackgroundOptimal treatment strategy for the oldest patients with diffuse large B-cell lymphoma (DLBCL) remains controversial, as this group often is precluded from clinical trials, and population-based studies are limited.MethodsAll Danish DLBCL-patients ≥75 years diagnosed from 2003 to 2012 were identified, using the Danish National Lymphoma Registry (LYFO). Information regarding baseline characteristics, treatment, comorbidities and outcomes was retrieved from LYFO, the Danish National health registries and medical records. Patients were stratified by age (75–79; 80–84 and 85 + years), comorbidity score and treatment modality (standard treatment [R-CHOP/CHOP-like], less intensive regimens or palliative treatment).FindingsA total of 1011 patients were included. Standard treatment was initiated in 64%, ranging from 83% among patients aged 75–79 years to 32% among patient aged 85 + years. With standard treatment, median overall survival (OS) estimates were 4·6, 2·6, and 1·9 years for the age groups 75–79, 80–84 and 85+ years. Among patient aged 75–79 and 80–84 years, OS was superior with standard treatment, although high comorbidity scores attenuated this association. Among patients aged 85+ years, survival was not influenced by treatment intensity. Patients ≥80 years had similar OS regardless of intended (R-)CHOP dosing, whereas patients of 75–79 years scheduled for full dose had higher OS. Standard treatment was not associated with increased hospitalisation.InterpretationStandard treatment is feasible with good outcomes in a large proportion of elderly DLBCL-patients. Planned dose reduction in patients aged ≥80 years had no negative impact on OS.



https://ift.tt/2tdAz3l

Watershed microinfarct pathology and cognition in older persons

Publication date: October 2018
Source:Neurobiology of Aging, Volume 70
Author(s): Alifiya Kapasi, Sue E. Leurgans, Bryan D. James, Patricia A. Boyle, Zoe Arvanitakis, Sukriti Nag, David A. Bennett, Aron S. Buchman, Julie A. Schneider
Brain microinfarcts are common in aging and are associated with cognitive impairment. Anterior and posterior watershed border zones lie at the territories of the anterior, middle, and posterior cerebral arteries, and are more vulnerable to hypoperfusion than brain regions outside the watershed areas. However, little is known about microinfarcts in these regions and how they relate to cognition in aging. Participants from the Rush Memory and Aging Project, a community-based clinical-pathologic study of aging, underwent detailed annual cognitive evaluations. We examined 356 consecutive autopsy cases (mean age-at-death, 91 years [SD = 6.16]; 28% men) for microinfarcts from 3 watershed brain regions (2 anterior and 1 posterior) and 8 brain regions outside the watershed regions. Linear regression models were used to examine the association of cortical watershed microinfarcts with cognition, including global cognition and 5 cognitive domains. Microinfarcts in any region were present in 133 (37%) participants, of which 50 had microinfarcts in watershed regions. Persons with multiple microinfarcts in cortical watershed regions had lower global cognition (estimate = −0.56, standard error (SE) = 0.26, p = 0.03) and lower cognitive function in the specific domains of working memory (estimate = −0.58, SE = 0.27, p = 0.03) and visuospatial abilities (estimate = −0.57, SE = 0.27, p = 0.03), even after controlling for microinfarcts in other brain regions, demographics, and age-related pathologies. Neither the presence nor multiplicity of microinfarcts in brain regions outside the cortical watershed regions were related to global cognition or any of the 5 cognitive domains. These findings suggest that multiple microinfarcts in watershed regions contribute to age-related cognitive impairment.



https://ift.tt/2trqUW6

The contribution of small vessel disease to subtypes of Alzheimer's disease: a study on cerebrospinal fluid and imaging biomarkers

Publication date: October 2018
Source:Neurobiology of Aging, Volume 70
Author(s): Daniel Ferreira, Sara Shams, Lena Cavallin, Matti Viitanen, Juha Martola, Tobias Granberg, Mana Shams, Peter Aspelin, Maria Kristoffersen-Wiberg, Agneta Nordberg, Lars-Olof Wahlund, Eric Westman
We investigated whether subtypes of Alzheimer's disease (AD), that is, typical, limbic-predominant, hippocampal-sparing, and minimal atrophy AD, had a specific signature of small vessel disease and neurodegeneration. Four hundred twenty-three clinically diagnosed AD patients were included (161 typical, 121 limbic-predominant, 70 hippocampal-sparing, 71 minimal atrophy). One hundred fifty-six fulfilled a biomarkers-based AD diagnosis. White matter hyperintensities and cerebral microbleeds (CMB) had the highest prevalence in limbic-predominant AD, and the lowest prevalence in minimal atrophy AD. CMB existed evenly in lobar and deep brain areas in limbic-predominant, typical, and hippocampal-sparing AD. In minimal atrophy AD, CMB were mainly located in brain lobar areas. Perivascular spaces in the centrum semiovale were more prevalent in typical AD. Small vessel disease contributed to the prediction of Mini-Mental State Examination. Minimal atrophy AD showed highly pathological levels of cerebrospinal fluid Aß1-42, total tau, and phosphorylated tau, in the absence of overt brain atrophy. Cerebral amyloid angiopathy seems to have a stronger contribution to hippocampal-sparing and minimal atrophy AD, whereas hypertensive arteriopathy may have a stronger contribution to typical and limbic-predominant AD.



https://ift.tt/2MJQi2w

The hippocampal longitudinal axis—relevance for underlying tau and TDP-43 pathology

Publication date: October 2018
Source:Neurobiology of Aging, Volume 70
Author(s): Albert Lladó, Adrià Tort-Merino, Raquel Sánchez-Valle, Neus Falgàs, Mircea Balasa, Beatriz Bosch, Magda Castellví, Jaume Olives, Anna Antonell, Michael Hornberger
Recent studies suggest that hippocampus has different cortical connectivity and functionality along its longitudinal axis. We sought to elucidate the possible different pattern of atrophy in longitudinal axis of hippocampus between Amyloid/Tau pathology and TDP-43-pathies. Seventy-three presenile subjects were included: Amyloid/Tau group (33 Alzheimer's disease with confirmed cerebrospinal fluid [CSF] biomarkers), probable TDP-43 group (7 semantic variant progressive primary aphasia, 5 GRN and 2 C9orf72 mutation carriers) and 26 healthy controls. We conducted a region-of-interest voxel-based morphometry analysis on the hippocampal longitudinal axis, by contrasting the groups, covarying with CSF biomarkers (Aβ42, total tau, p-tau) and covarying with episodic memory scores. Amyloid/Tau pathology affected mainly posterior hippocampus while anterior left hippocampus was more atrophied in probable TDP-43-pathies. We also observed a significant correlation of posterior hippocampal atrophy with Alzheimer's disease CSF biomarkers and visual memory scores. Taken together, these data suggest that there is a potential differentiation along the hippocampal longitudinal axis based on the underlying pathology, which could be used as a potential biomarker to identify the underlying pathology in different neurodegenerative diseases.



https://ift.tt/2ytYEYP

MicroRNA alterations in iPSC-derived dopaminergic neurons from Parkinson disease patients

Publication date: September 2018
Source:Neurobiology of Aging, Volume 69
Author(s): Eduard Tolosa, Teresa Botta-Orfila, Xavier Morató, Carles Calatayud, Raquel Ferrer-Lorente, María-José Martí, Manel Fernández, Carles Gaig, Ángel Raya, Antonella Consiglio, Mario Ezquerra, Rubén Fernández-Santiago
MicroRNA (miRNA) misregulation in peripheral blood has been linked to Parkinson disease (PD) but its role in the disease progression remains elusive. We performed an explorative genome-wide study of miRNA expression levels in dopaminergic neurons (DAn) from PD patients generated by somatic cell reprogramming and induced pluripotent stem cells differentiation. We quantified expression levels of 377 miRNAs in DAn from 3 sporadic PD patients (sPD), 3 leucine-rich repeat kinase 2–associated PD patients (L2PD) (total 6 PD), and 4 healthy controls. We identified differential expression of 10 miRNA of which 5 were upregulated in PD (miR-9-5p, miR-135a-5p, miR-135b-5p, miR-449a, and miR-449b-5p) and 5 downregulated (miR-141–3p, miR-199a-5p, miR-299–5p, miR-518e-3p, and miR-519a-3p). Changes were similar in sPD and L2PD. Integrative analysis revealed significant correlations between miRNA/mRNA expression. Moreover, upregulation of miR-9-5p and miR-135b-5p was associated with downregulation of transcription factors related to the DNA hypermethylation of enhancer elements in PD DAn (FOXA1 and NR3C1). In summary, miRNA changes are associated with monogenic L2PD and sPD and co-occur with epigenetic changes in DAn from PD patients.



https://ift.tt/2MHDnhm

Chilaiditi Syndrome: A Case Report Highlighting the Intermittent Nature of the Disease

Background. Chilaiditi syndrome is a phenomenon where there is an interposition of the colon between the liver and the abdominal wall leading to clinical symptoms. This is distinct from Chilaiditi sign for which there is radiographic evidence of the interposition, but is asymptomatic. Case Presentation. Here, we present the case of a patient who, despite having clinical symptoms for a decade, had a delayed diagnosis presumably due to the interposition being intermittent and episodic. Conclusions. This case highlights the fact that Chilaiditi syndrome may be intermittent and episodic in nature. This raises an interesting question of whether previous case reports, which describe complete resolution of the syndrome after nonsurgical intervention, are perhaps just capturing periods of resolution that may have occurred spontaneously. Because the syndrome may be intermittent with spontaneous resolution and then recurrence, patients should have episodic follow-up after nonsurgical intervention.

https://ift.tt/2I9CTNn

Hematopoietic stem cell therapy for autoimmune diseases – Clinical experience and mechanisms

Publication date: Available online 20 June 2018
Source:Journal of Autoimmunity
Author(s): Tobias Alexander, Dominique Farge, Manuela Badoglio, James O. Lindsay, Paolo A. Muraro, John A. Snowden
With accumulating evidence and improved outcomes along with recognition that modern biological therapies are not universally effective, require chronic administration and have high acquisition costs, hematopoietic stem cell transplantation (HSCT) has become an emerging direction for cell therapy in autoimmune diseases (ADs). The goal of this therapy is to induce medication-free remissions by resetting the immune system into a naïve and self-tolerant state through eradication of the autoreactive immunologic memory and profound re-configuration of the immune system induced by the transplant procedure. Safety of HSCT has generally improved by implementing internal quality management and external accreditation. Inter-disciplinary guidelines for patient selection, transplant technique and supportive care along with greater center experience should optimize safe and appropriate delivery of HSCT in specific ADs. In this review, we discuss the current role and future perspectives of HSCT in AD, focusing on recent published clinical and scientific studies and recommendations in the field.

Graphical abstract

https://ift.tt/2KdzXEy

Protective role of commensal bacteria in Sjögren Syndrome

Publication date: Available online 20 June 2018
Source:Journal of Autoimmunity
Author(s): Mahira Zaheer, Changjun Wang, Fang Bian, Zhiyuan Yu, Humberto Hernandez, Rodrigo G. de Souza, Ken T. Simmons, Deborah Schady, Alton G. Swennes, Stephen C. Pflugfelder, Robert A. Britton, Cintia S. de Paiva
CD25 knock-out (CD25KO) mice spontaneously develop Sjögren Syndrome (SS)-like inflammation. We investigated the role of commensal bacteria by comparing CD25KO mice housed in conventional or germ-free conditions. Germ-free CD25KO mice have greater corneal barrier dysfunction, lower goblet cell density, increased total lymphocytic infiltration score, increased expression of IFN-γ, IL-12 and higher a frequency of CD4⁺IFN-γ⁺ cells than conventional mice. CD4⁺ T cells isolated from female germ-free CD25KO mice adoptively transferred to naive immunodeficient RAG1KO recipients caused more severe Sjögren-like disease than CD4⁺ T cells transferred from conventional CD25KO mice. Fecal transplant in germ-free CD25KO mice reversed the spontaneous dry eye phenotype and decreased the generation of pathogenic CD4⁺IFN-γ⁺ cells. Our studies indicate that lack of commensal bacteria accelerates the onset and severity of dacryoadenitis and generates autoreactive CD4⁺T cells with greater pathogenicity in the CD25KO model, suggesting that the commensal bacteria or their metabolites products have immunoregulatory properties that protect exocrine glands in the CD25KO SS model.



https://ift.tt/2K1Ama4

A Midterm Assessment of Implementation of the Decadal Survey on Life and Physical Sciences Research at NASA.

The 2011 National Research Council decadal survey on biological and physical sciences in space, Recapturing a Future for Space Exploration: Life and Physical Sciences Research for a New Era, was written during a critical period in the evolution of science in support of space exploration. The research agenda in space life and physical sciences had been significantly descoped during the programmatic adjustments of the Vision for Space Exploration in 2005, and this occurred in the same era as the International Space Station (ISS) assembly was nearing completion in 2011. Out of that period of change, Recapturing a Future for Space Exploration presented a cogent argument for the critical need for space life and physical sciences, both for enabling and expanding the exploration capabilities of NASA as well as for contributing unique science in many fields that can be enabled by access to the spaceflight environment.

https://ift.tt/2K8m2MI

Magnesium in the Central Nervous System [Internet].

Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level.

https://ift.tt/2MLWvdY

Ulcerated necrobiosis lipoidica: A cutaneous granulomatous reaction associated with systemic B-cell lymphoma

Hamidreza Mahmoudi, Maryam Daneshpazhooh, Kambiz Kamyab, Negar Bahrololoumi Bafruee, Amin Kiani, Ifa Etesami

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):481-484



https://ift.tt/2MKMUnJ

Linear IgA bullous dermatosis induced by diclofenac sodium

Sarita Sanke, Abhinav Kumar, Ram Chander

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):496-497



https://ift.tt/2MG3QMe

Paradigm shift in antinuclear antibody negative lupus: Current evidence

Anup Kumar Tiwary, Piyush Kumar

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):384-387



https://ift.tt/2tw8zrl

Generalized multinucleate cell angiohistiocytoma with involvement of palms and soles: An unusual manifestation

Kulsupa Nimmannitya, Suthep Jerasutus, Suthinee Rutnin

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):468-470



https://ift.tt/2MFMr6i

Giant eccrine porocarcinoma in an unusual location

Aylin Türel Ermertcan, M Kürşat Evrenos, Ferdi Öztürk, Peyker Temiz

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):521-521



https://ift.tt/2MFMzCO

Incidence of leprosy in Firozabad district (Uttar Pradesh)

Anil Kumar, Anita Girdhar, Joy Kumar Chakma

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):403-407

Objective: To assess incidence of leprosy in Firozabad District (U.P.). Materials and Methods: A random sample of 148,061 population was covered by this second survey, spread over 259 units (230 rural/29 urban). The survey was conducted between March 2011 and November 2012. Clinically confirmed cases detected in known disease-free population were labeled as incident cases and treated. Results: The overall incidence rate of leprosy was found to be 3.4 per 10,000 person years; In healthy contacts it was 3.1, in paucibacillary contacts 29.7 while it was 89.3 in multibacillary contacts. The differences in incidence rate of these three groups were significant (P < 0.001). Incidence rate was significantly higher by age; 1.1 in persons <15 years to 8.0 in those >44 years of age, and in high endemicity areas with three or more cases. In terms of incidence rate ratio (95% confidence interval), the incidence for ages 15–24 years was 3.2 times significantly higher than for those under 15 years, 5.3 times (4.3–6.5) in ages 30–44 years and 7.0 times (5.6–8.7) for age ≥45 years. Incidence rate ratio was also significantly higher in paucibacillary contacts, by 9.5 times (7.0–13.0) and 27.7 times (18.8–40.6) in multibacillary contacts, as compared to healthy controls. Incidence rate ratio (95% confidence interval) was significantly higher by 2.9 times (2.4–3.5) in areas with endemicity status of 3 to 5 cases and by 2.0 times (1.6–2.5) in areas with >5 cases as compared to areas with no endemicity. It was 2.4 times more (1.6–3.5) in Narkhi, 2.4 times higher (1.7–3.5) in Tundla and 3.0 times higher (2.1–4.5) in Aravon blocks than in Aeka block of the district. Incidence rate was also found to be significantly higher (3.7) among females, 1.3 times higher (1.1–1.5) than in males (2.9). Incidence rate ratio (95% confidence interval) was also 2.5 times higher (1.2–5.1) among persons having reported disease of greater than 4 years in comparison to 1.5 in persons having disease for 2 to 3 years. Limitations of Study: None to the best of our knowledge. Conclusion: The present study suggests that incidence rate of leprosy is significantly higher among persons of above 15 years, in females, among contacts of paucibacillary/multibacillary disease, in areas where >3 leprosy cases were found and in Tundla, Narkhi and Aravon blocks in Firozabad district.

https://ift.tt/2tmkxUc

Clinical, immunological profile and follow up of patients with pemphigus: A study from India

Sivaranjini Ramassamy, Poonam Agrawal, Dharshini Sathishkumar, Lydia Mathew, John Victor Peter, Thenmozhi Mani, Renu George

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):408-413

Background: Pemphigus has a protracted course and multiple factors influence its prognosis. The objective of this study was to describe the epidemiology and clinical profile of pemphigus patients and to study its influence on treatment end points. Methods: This was a retrospective chart review done in an Indian tertiary care hospital from December 1991 to December 2013. Patients with less than 3 months' follow up and those who had paraneoplastic pemphigus were excluded. Results: There were 132 patients with pemphigus, of which 118 (89.4%) had pemphigus vulgaris and 14 (10.6%) had pemphigus foliaceous. The time to disease control (TDC) was available for 100 patients (n = 100, 75.7%); patients with a minimum follow up of 3 months (n = 80) were included for studying the end points like time to first disease remission (TDR) and time to first disease relapse (TDRe). The median period of follow up was 23 months (range 3–245). Out of the 100 patients, 61.9% were on oral steroids with adjuvant therapy. The steroid dose required for disease control for n = 100, ranged from 0.2 to 1.5 mg/kg body weight. Of these, 60% were treated with steroid dose of 1 mg/kg, 22% with >1 mg/kg, and 18% with <1 mg/kg. The mean time to disease control (in months) in the group which received <1 mg/kg steroid was 1.02 ± 0.68, 1 mg/kg was 0.72 ± 0.51, and >1 mg/kg was 1.02 ± 0.62 (P = 0.017); with a significant difference between the groups 2 and 3 (P = 0.007), implying a faster disease control in those who received 1 mg/kg dose. This difference was significant after adjusting for the steroid sparing drugs taken at baseline (P = 0.009, C.I. - 1.44-13.59). The mean time to first disease remission (TDR) was 11.46 ± 2.06 months. Out of the 80 patients with a minimum follow up of 3 months, 75% had achieved either partial or complete remission. None of the other epidemiological, clinical or immunological parameters had an impact on the TDC or TDR. Conclusions: The epidemiological, clinical or immunological parameters had no impact on the treatment end points like time to disease control and time to first disease remission. The dose of steroids required for disease control higher than 1 mg/kg offered no advantage in the time to disease control as compared to 1 mg/kg. Limitations: The study was retrospective and disease severity scores were not applied. In view of the shorter follow up period, long term prognostic end points and mortality could not be well represented. The median period of follow up was 23 months. The serum anti- desmoglein antibody titres were not available at various treatment end points for correlation at different time intervals.

https://ift.tt/2yskmfP

Plica polonica: from national plague to death of the disease in the nineteenth-century Vilnius

Eglė Sakalauskaitė-Juodeikienė, Dalius Jatužis, Saulius Kaubrys

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):510-514



https://ift.tt/2tf6CA8

Is there a correlation of serum and tissue T helper-1 and -2 cytokine profiles with psoriasis activity and severity? A cross-sectional study

Sujay Khandpur, Vishal Gupta, Dayasagar Das, Alpana Sharma

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):414-418

Background: Previous studies correlating Th1 and Th2 cytokine profiles with psoriasis activity provided inconsistent results. Correlation of tissue cytokine levels with psoriasis severity has not been studied till now. Objective: To compare serum and tissue Th1 and Th2 cytokine profiles of patients with active and stable psoriasis as well as healthy controls, and to correlate them with psoriasis severity. Methodology: This was a cross-sectional study involving adult patients with 'active' psoriasis (untreated progressive chronic plaque psoriasis, guttate psoriasis, and erythrodermic psoriasis), 'stable' psoriasis (stable plaque psoriasis or those with completely resolved lesions) and healthy subjects with non-inflammatory skin lesions as controls. Mean levels of Th1 and Th2 cytokines in serum [interleukin 2 (IL-2), interferon-gamma (IFN-γ), IL-4, IL-10] and tissue mRNA expression (IFN-γ, IL-4) were compared among these three groups. Results: There were 30 patients each in active and stable psoriasis groups, and 15 in the control group. Mean serum IL-2, IFN-γ, and IL-10 levels of patients with psoriasis patients were significantly higher than the controls (P < 0.001 for both active and stable psoriasis), whereas mean serum IL-4 level of patients was significantly lower than the controls (P < 0.001). However, there was no statistically significant difference of serum cytokine levels between active and stable psoriasis groups. Mean quantitative tissue mRNA expression of IFN-γ and IL-4 of patients with active and stable psoriasis were significantly lower than the controls (P < 0.001 and <0.01, respectively), but were not significantly different between active and stable psoriasis groups. Serum and tissue cytokines showed weak correlation with psoriasis area and severity index. Limitations: Small sample size and heterogenous nature of patients with psoriasis in terms of disease activity, morphology and treatment are limitations of this study. Conclusions: There is no significant change in the serum or tissue levels of Th1 and Th2 cytokines with activity or severity of psoriasis.

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Rational use of laboratory tests in dermatology

Saumya Panda

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):377-383



https://ift.tt/2MHFfqp

Intramatricial injections for nail psoriasis: An open-label comparative study of triamcinolone, methotrexate, and cyclosporine

Jyotisterna Mittal, Bharat Bhushan Mahajan

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):419-423

Background: One of the most effective options available for treating psoriatic fingernails is intramatricial injection of triamcinolone acetonide. Efficacies of intramatricial methotrexate and cyclosporine have not been comparatively evaluated to date. Methods: Ninety fingernails in 17 patients were assigned to three groups of thirty nails each, and treated with intramatricial injections of triamcinolone acetonide (10 mg/ml), methotrexate (25 mg/ml) and cyclosporine (50 mg/ml) respectively. Each nail was given two injections with a 6-week interval, and graded at 24 weeks using the Nail Psoriasis Severity Index. Results: In both triamcinolone acetonide and methotrexate groups, 15 (50%) nails out of 30 showed >75% improvement. In the cyclosporine group, only ten (33%) nails showed >75% improvement. Side effects were most in the nails treated with cyclosporine. Limitations: The limited follow-up period of 24 weeks may have been insufficient for detecting delayed remissions. The number of patients was small and there was no randomization or blinding. The lack of a placebo/ no- treatment arm can be considered a limitation. Conclusions: Amongst the three drugs studied, intramatricial methotrexate injection yielded the most improvement with minimum side effects, results being comparable to intramatricial triamcinolone acetonide injection. Cyclosporine was the least effective drug, with the most side effects. Intramatricial injection therapy is a safe, economical, simple and effective therapeutic modality in the management of nail psoriasis.

https://ift.tt/2yvx9Ow

Mongolian spots combined with halo-like disappearance surrounding café au lait spots

Aslı Bilgiç Temel, Cumhur Ibrahim Bassorgun, Banu Nur, Erkan Alpsoy

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):474-477



https://ift.tt/2MFLV8m

Eruptive pseudoangiomatosis - cherry angiomas with perilesional halo

Dimple Chopra, Aastha Sharma, Satwinder Kaur, Ravinder Singh

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):424-430

Eruptive pseudoangiomatosis is a rare viral exanthem characterized by acute onset of hemangiomata-like lesions, however, histological findings are distinct from that of true angiomas. This entity has been reported from Europe, North America, Japan, and Korea till date. Here, we report 12 cases of eruptive pseudoangiomatosis from a tertiary care hospital in Punjab.

https://ift.tt/2ytj44i

Topical timolol in PHACES syndrome: Is it safe?

Deepika Pandhi, Deepak Jakhar, Anupama Tandon, Archana Singal

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):488-491



https://ift.tt/2MLU7US

Chinese version of the treatment of autoimmune bullous disease quality of life questionnaire: Reliability and validity

Guo Chen, Baoqi Yang, Zhaoxia Zhang, Qing Yang, Xiaoxiao Yan, Dédée F Murrell, Furen Zhang

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):431-436

Background: Treatments for autoimmune blistering disease carry significant risks of medical complications and can affect the patient's quality of life. Recently, the Treatment of Autoimmune Bullous Disease Quality of Life questionnaire was developed in Australia. Objective: The objective of this study was to evaluate the reliability and validity of the Chinese version of the Treatment of Autoimmune Bullous Disease Quality of Life questionnaire in Chinese patients with autoimmune blistering diseases. Methods: The Chinese version of the Treatment of Autoimmune Bullous Disease Quality of Life questionnaire was produced by forward-backward translation and cross-cultural adaptation of the original English version. Autoimmune blistering disease patients recruited in the study self-administered the Chinese Treatment of Autoimmune Bullous Disease Quality of Life questionnaire, the Dermatology Life Quality Index and the 36-item Short-Form Health Survey. Reliability of the Chinese Treatment of Autoimmune Bullous Disease Quality of Life was evaluated using internal consistency and test-retest (days 0 and 7) methods. Validity was analyzed by face, content, construct, convergent and discriminant validity measures. Results: A total of 86 autoimmune blistering disease patients were recruited for the study. Cronbach's alpha coefficient was 0.883 and the intraclass correlation coefficient was 0.871. Face and content validities were satisfactory. Convergent validity testing revealed correlation coefficients of 0.664 for the Treatment of Autoimmune Bullous Disease Quality of Life and Dermatology Life Quality Index and –0.577 for the Treatment of Autoimmune Bullous Disease Quality of Life and 36-item Short-Form Health Survey. With respect to discriminant validity, no significant differences were observed in the Treatment of Autoimmune Bullous Disease Quality of Life scores of men and women (t = 0.251, P = 0.802), inpatients and outpatients (t = 0.447, P = 0.656), patients on steroids and steroid-sparing medications (t = 0.672, P = 0.503) and patients with different autoimmune blistering disease subtypes (F = 0.030, P = 0.971). Limitations: Illiterate patients were excluded from the study. The patients were from a single hospital and most of their conditions were in a relatively stable status. Conclusion: The Chinese version of the Treatment of Autoimmune Bullous Disease Quality of Life questionnaire is a reliable and valid instrument to measure treatment burden and to serve as an end point in clinical trials in Chinese autoimmune blistering disease patients.

https://ift.tt/2toyTDu

The strawberry tongue: What, how and where?

Keshavmurthy A Adya, Arun C Inamadar, Aparna Palit

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):500-505



https://ift.tt/2MKKbLp

Solitary dome-shaped erythematous lump of long duration on the palm

Deepashree Daulatabad, Deepika Pandhi, Nadeem Tanveer, Sonal Sharma, Ishmeet Kaur

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):437-439



https://ift.tt/2tqyDUu

Multiple inflamed cutaneous nodules in an elderly female

Kiran Preet Malhotra, Azfar Neyaz, Arsh Gupta, Monjyoti Das, Nuzhat Husain

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):518-520



https://ift.tt/2MJZzYg

A creeping eruption of the buttocks

Roger Haber, Julien Bachour

Indian Journal of Dermatology, Venereology, and Leprology 2018 84(4):440-440



https://ift.tt/2ttUv1w

German dative case marking in monolingual and simultaneous bilingual children with and without SLI

Publication date: Available online 20 June 2018
Source:Journal of Communication Disorders
Author(s): Scherger Anna-Lena
This study explores the role of German dative case marking in disentangling effects of specific language impairment (SLI) and bilingualism. Longitudinal data of German-Italian bilingual children with SLI (N = 3) is compared to cross-sectional data (N = 42) of monolingual and bilingual typically developing (TD) children and monolingual children with SLI (ages four and seven). Spontaneous and elicited speech data is analysed in terms of target-like dative case marking in German. Results show differences between the acquisition of case marking of pronouns and of full Determiner Phrases (DPs). Regarding the target-like dative case marking in total, there were no differences found between bilingual TD, monolingual and bilingual children with SLI by the age of four. They demonstrated a similar delay when compared to monolingual TD children. By the age of seven, however, bilingual TD children 'catch up' with their monolingual peers. Children with SLI do not master the acquisition of dative case marking by this age. Cumulative effects of bilingualism and SLI were not found neither in younger nor in older bilingual children. These findings underline the importance of further research on linguistic markers and of distinguishing between effects of SLI and bilingualism.



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Psychopathological consequences of maltreatment among children and adolescents: A systematic review of the GxE literature

Publication date: Available online 20 June 2018
Source:Research in Developmental Disabilities
Author(s): Dario Maglione, Marcella Caputi, Benedetta Moretti, Simona Scaini
BackgroundIn the last years, several studies focused on the role of Gene-Environment interactions (GxE) in influencing psychopathological outcomes among maltreated children and adolescents. These studies analysed the effect of different genetic variations.AimsThe aim of the present review is to provide an overview of studies investigating GxE effects among maltreated children and adolescents.Methods and ProceduresA systematic literature review was performed by using the following keywords: "Child maltreatment" and "GxE", "Child maltreatment" and "Psychopathology", "Gene-Environment interaction", "Gene-environment correlation", "GxE and psychopathology", "Childhood trauma" and "Psychiatric symptoms", "Early adverse life events", "Early life stress", "Antisocial behaviour", "Depression", "Internalizing symptoms", through the following electronic databases: PubMed, Scopus and PsycINFO, from 2006 to 2017, finding a total of 31 papers.Outcomes and ResultsThe present review confirm that maltreatment produces worse psychopathological outcomes (antisocial behaviour, depression, and other psychiatric traits) in subjects with a specific genetic vulnerability.Conclusions and ImplicationsComprehending the pathways from child maltreatment to psychopathology in their full complexity will be essential to build efficacious preventive and therapeutic protocols.



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Zufallsbefund eines Dens invaginatus in der digitalen Volumentomographie

Laryngo-Rhino-Otol
DOI: 10.1055/a-0640-9305

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

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Nasal Obstruction Considerations in Sleep Apnea

Obstructive sleep apnea (OSA) is a highly prevalent condition in the context of the global obesity epidemic with significant medical comorbidities and psychosocial implications. The first-line treatment of OSA is continuous positive airway pressure (CPAP). There is evidence to demonstrate an association between nasal obstruction and OSA. Therefore, medications and surgical interventions to address nasal obstruction may play a role in the treatment of OSA. In addition, surgical correction of nasal obstruction has been shown to improve CPAP tolerance and compliance.

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Corrigendum

Journal of Cutaneous Pathology, Volume 45, Issue 7, Page 555-555, July 2018.


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A case of adult onset folliculocentric Langerhans cell histiocytosis

Journal of Cutaneous Pathology, Volume 45, Issue 7, Page 469-472, July 2018.


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Issue Information

Journal of Cutaneous Pathology, Volume 45, Issue 7, July 2018.


https://ift.tt/2K7jv8Z

Diagnostic yield of MRI of the brain and IAC in patients with neurotologic complaints

Quantify number of MRI scans obtained in a tertiary neurotology practice and identify likelihood of pathologic findings.

https://ift.tt/2K7R6iX

Secretome analysis of alkaliphilic bacterium Bacillus lehensis G1 in response to pH changes

Publication date: October 2018
Source:Microbiological Research, Volume 215
Author(s): How Lie Ling, Zaidah Rahmat, Farah Diba Abu Bakar, Abdul Munir Abdul Murad, Rosli Md. Illias
Bacillus lehensis G1 is an alkaliphilic bacterium that is capable of surviving in environments up to pH 11. Secretome related to bacterial acclimation in alkaline environment has been less studied compared to cytoplasmic and membrane proteome. The aim of this study was to gain better understanding of bacterial acclimation to alkaline media through analyzing extracellular proteins of B. lehensis. The pH range for B. lehensis growth was conducted, and two-dimensional electrophoresis and MALDI-TOF/TOF MS analysis were conducted to characterize changes in protein profiling in B. lehensis cultured at pH 8 and pH 11 when compared with those cultured at pH 10 (optimal growth pH). B. lehensis could grow well at pH ranging from 8 to 11 in which the bacteria showed to posses thinner flagella at pH 11. Proteomic analyses demonstrated that five proteins were up-regulated and 13 proteins were down-regulated at pH 8, whereas at pH 11, 14 proteins were up-regulated and 8 were down-regulated. Majority of the differentially expressed proteins were involved in the cell wall, main glycolytic pathways, the metabolism of amino acids and related molecules and some proteins of unknown function. A total of 40 differentially expressed protein spots corresponding to 33 proteins were identified; including GlcNAc-binding protein A, chitinase, endopeptidase lytE, flagellar hook-associated proteins and enolase. These proteins may play important roles in acclimation to alkaline media via reallocation of cell wall structure and changes to cell surface glycolytic enzymes, amino acid metabolism, flagellar hook-associated proteins and chaperones to sustain life under pH-stressed conditions.



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Brevibacterium linens RS16 confers salt tolerance to Oryza sativa genotypes by regulating antioxidant defense and H+ ATPase activity

Publication date: Available online 19 June 2018
Source:Microbiological Research
Author(s): Poulami Chatterjee, Sandipan Samaddar, Ülo Niinemets, Tong-Min Sa
Soil salinity is one of the major limitations that affects both plant and its soil environment, leading to reduced agricultural production. Evaluation of stress severity by plant physical and biochemical characteristics is an established way to study plant-salt stress interaction, but the halotolerant properties of plant growth promoting bacteria (PGPB) along with plant growth promotion is less studied till date. The aim of the present study was to elucidate the strategy, used by ACC deaminase-containing halotolerant Brevibacterium linens RS16 to confer salt stress tolerance in moderately salt-tolerant (FL478) and salt-sensitive (IR29) rice (Oryza sativa L.) cultivars. The plants were exposed to salt stress using 0, 50, and 100 mM of NaCl with and without bacteria. Plant physiological and biochemical characteristics were estimated after 1, 5, 10 days of stress application. H⁺ ATPase activity and the presence of hydroxyectoine gene (ectD) that is responsible for compatible solute accumulation were also analyzed in bacteria. The height and dry mass of bacteria inoculated plants significantly increased compared to salt-stressed plants, and the differences increased in time dependent manner. Bacteria priming reduced the plant antioxidant enzyme activity, lipid peroxidation and it also regulated the salt accumulation by modulating vacuolar H⁺ ATPase activity. ATPase activity and presence of hydroxyectoine gene in RS16 might have played a vital role in providing salt tolerance in bacteria inoculated rice cultivars. We conclude that dual benefits provided by the halotolerant plant growth promoting bacteria (PGPB) can provide a major way to improve rice yields in saline soil.



https://ift.tt/2M8VoEp

Olfactory cleft dilatation

Publication date: Available online 20 June 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): R. Jankowski, D.T. Nguyen, P. Gallet, C. Rumeau
The surgical technique of olfactory cleft dilatation consists in transmucosal lateral fracture-dislocation of the lateral wall of each olfactory cleft (i.e., of the turbinate wall of the ethmoid, composed, from anterior to posterior, of the middle, superior and supreme turbinates), in order to get access to the recess hosting the human olfactory mucosa and to the roof of the olfactory cleft (i.e., cribriform plate), with minimal trauma to the mucosa. Olfactory cleft dilatation is indicated for dysosmia secondary to constitutional stenosis of the olfactory clefts due to abnormal development of the ethmoid. Constitutional stenosis of the olfactory clefts should be differentiated from inflammatory obstruction and other diseases of the olfactory clefts, and especially from respiratory epithelial adenomatoid hamartoma, which enlarges the olfactory clefts and must be treated by resection. The technique of olfactory cleft dilatation is illustrated by three surgical cases. There was clear improvement in dysosmia in all three cases, without any complications. The place of constitutional olfactory cleft stenosis needs still to be defined in both diagnosis and treatment of dysosmia.



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French Society of ENT (SFORL) guidelines (short version): Audiometry in adults and children

Publication date: Available online 19 June 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): V. Favier, C. Vincent, É. Bizaguet, D. Bouccara, R. Dauman, B. Frachet, F. Le Her, C. Meyer-Bisch, S. Tronche, F. Sterkers-Artières, F. Venail
IntroductionFrench Society of ENT (SFORL) good practice guidelines for audiometric examination in adults and children.MethodsA multidisciplinary working group performed a review of the scientific literature. Guidelines were drawn up, reviewed by an independent reading group, and finalized in a consensus meeting.ResultsAudiometry should be performed in an acoustically controlled environment (<30dBA); audiometer calibration should be regularly checked; and patient-specific masking rules should be systematically applied. It should be ensured that masking is not overmasking. Adult pure-tone audiometry data should be interpreted taking account of clinical data, speech audiometry and impedancemetry. In case of discrepancies between clinical and pure-tone and speech audiometry data, objective auditory tests should be perform. In children aged 2 years or younger, subjective audiometry should be associated to behavioral audiometry adapted to the child's age. In suspected hearing impairment, behavioral audiometry should be systematically supplemented by objective hearing tests to determine and confirm the level and type of hearing impairment.



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How to perform microscopic/endoscopic resection of large petrous apex lesions

Publication date: Available online 20 June 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): V. Patron, M. Humbert, E. Micault, E. Emery, M. Hitier
The endoscope and microscope can be used conjointly in certain sites, such as middle ear cholesteatoma or for resection of cerebellopontine angle tumours. Petrous apex tumours are classically accessed via a lateral otological approach, or, for the most anterior tumours, via an endonasal endoscopic approach. Surgical access via a lateral incision is limited inferiorly by the superior bulb of the internal jugular vein, medially by the labyrinth, facial nerve and internal auditory canal, superiorly by the dura mater, and laterally by the internal carotid artery. Via an anterior endonasal approach, the corridor formed by the internal carotid artery and the paraclival dura limits access to the posterior part of the petrous apex, restricting this approach to certain cholesterol granulomas or small cholesteatomas. None of these approaches, on its own, is sufficient in the case of an extensive petrous apex lesion. The objective of this technical note is to describe the combined microscopic/endoscopic approach comprising sequential use of the microscope and the endoscope via a lateral approach for the management of large petrous apex lesions.



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The effect of cochlear implants on vestibular-evoked myogenic potential responses and postural stability

Current spread by electrical stimulation via inserted cochlear implant (CI) electrodes and the consequential increase in sound input can affect the equilibrium of patients. The aim of the present study was to clarify the effect of CIs on the equilibrium of patients through cervical vestibular-evoked myogenic potential (cVEMP) testing and static stabilometry performed with the CIs turned on (CI-on) and off (CI-off).

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Restoring NAD(+) Levels with NAD(+) Intermediates, the Second Law of Thermodynamics, and Aging Delay

Rejuvenation Research, Ahead of Print.


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Direct Immunofluorescence as a Helpful Tool for the Differential Diagnosis of Oral Lichen Planus and Oral Lichenoid Lesions

Abstract: A great number of lichenoid lesions have overlapping clinicopathological features, so the use of adjunct tests to establish definitive diagnosis is recommended for correct management and prognosis of the lesions. In this context, direct immunofluorescence (DIF) can be a useful tool. Thus, this study aimed to characterize the clinical, histopathological, and DIF pattern in patients with oral lichen planus (OLP) and patients with oral lichenoid lesions (OLLs). Patients with OLP and patients with OLL were characterized and compared with patients with mucous membrane pemphigoid, pemphigus vulgaris, and fibrous hyperplasia through a cross-sectional study. Patients with OLP (n = 30) and patients with OLL (n = 26) were mostly white women in the fifth decade of age, with reticular lesions mainly on the buccal mucosa. All patients with OLP and half of the patients with OLL showed liquefaction degeneration at the basal cell layer and a band-like lymphocytic infiltrate in the subepithelial tissue. Twenty-two patients with OLP (73.3%), 10 with OLL (38.4%), 25 with mucous membrane pemphigoid (96.1%), and all with pemphigus vulgaris (100%) had positive DIF. There was no positive DIF in patients with fibrous hyperplasia. The most frequent DIF pattern in patients with OLP and patients with OLL was linear fibrinogen at the basement membrane zone, and a logistic regression model for positive DIF found statistically significant difference in OLP versus OLL (odds ratio, 3.73; confidence interval, 1.23–11.38). Although clinical and histopathological features are sufficient for diagnosing most of the patients with OLP and OLL, DIF is a key tool in differentiating some lichenoid lesions and could improve the diagnosis of OLP and OLL, especially in lesions showing typical clinical and histological features of OLP.

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Immunophenotype Expression Change From CD52+ to CD52− on Erythrodermic Peripheral T-cell Lymphoma, Not Otherwise Specified After Treatment With Alemtuzumab

No abstract available

https://ift.tt/2JXnfuF

Nonhealing Ulcerations of the Breast: Answer

No abstract available

https://ift.tt/2JZYg5E

Cutaneous Metaplastic Carcinoma: Report of a Case With Sebaceous Differentiation

Abstract: In this study, a case of a 56-year-old woman with cutaneous metaplastic carcinoma in the neck is reported. It harbored basal cell carcinoma, squamous cell carcinoma, and sebaceous carcinoma, as well as osteosarcoma (with fibroblastic, osteoblastic, aneurysmal bone cyst-like, and chondroblastic patterns). To our knowledge, the literature does not mention sebaceous carcinoma in cutaneous metaplastic carcinoma. Epidemiology and intact mismatch repair proteins of this case support sporadic pathogenesis for this neoplasm. The patient has been followed up for 3 years after surgery with free margins, and no local recurrence or distant metastases have been observed.

https://ift.tt/2MHjeIo

Sebaceous Neoplasms With Rippled, Labyrinthine/Sinusoidal, Petaloid, and Carcinoid-Like Patterns: A Study of 57 Cases Validating Their Occurrence as a Morphological Spectrum and Showing No Significant Association With Muir–Torre Syndrome or DNA Mismatch Repair Protein Deficiency

Abstract: Sebaceous neoplasms with an organoid pattern (rippled, labyrinthine/sinusoidal, carcinoid-like, and petaloid) are rare. Previous studies suggested that the above patterns likely represent variations along a morphological continuum. The objectives of this study were to (1) validate this proposition by studying a large number of cases, (2) determine whether there are specific associations with clinical features, (3) establish their frequency, and (4) determine whether they have any association with Muir–Torre syndrome. Fifty-seven sebaceous neoplasms (54 sebaceomas and 3 sebaceous carcinomas) with organoid growth patterns were studied. These occurred in 36 men and 18 women (sex unknown in 3), with ages at diagnosis ranging from 22 to 89 years (mean, 63 years). All patients presented with a solitary nodule (mean size, 11 mm) on the head and neck area. Of the 57 tumors, 24 manifested a single growth pattern, 23 had a combination of 2 patterns, and 10 a combination of 3 patterns, indicating that these patterns are part of a morphological continuum of changes. The carcinoid-like pattern was the most frequent in the "monopatterned" neoplasms (13 cases), whereas the labyrinthine/sinusoidal pattern comprised most of the "polypatterned" lesions, in which various combinations occurred. Immunohistochemically, mismatch repair protein deficiency was detected in 3 of the 22 cases studied, whereas 5 of the 33 patients with available follow-up had an internal malignancy/premalignancy. In conclusion, sebaceous neoplasms with organoid growth patterns are predominantly sebaceomas having a predilection for the scalp, occurring as solitary lesions in elderly patients (male to female ratio of 2:1). Such patterns are expected to be found in a quarter of sebaceomas. In most cases, more than one of the organoid patterns is present. These lesions do not appear to be associated with internal malignancy or mismatch repair deficiency in most cases. However, confirmation of the absence of any significant association with Muir–Torre syndrome syndrome will require genetic studies.

https://ift.tt/2K6e4Uq

Human Papillomavirus–Driven Squamous Lesions: High-Risk Genotype Found in Conjunctival Papillomas, Dysplasia, and Carcinoma

Background: Human papillomavirus (HPV) is a causative agent for intraepithelial squamous neoplasms, particularly on mucosal surfaces. HPV has a well-established association with squamous cell carcinoma (SCC) of the oropharynx and genital tract, and recent studies suggest a potential role in ocular and periocular squamous neoplasms. Multiple high-risk HPV genotypes are associated with histologically similar squamous neoplasms, and some HPV genotypes have been differentially associated with high- or low-grade lesions. Methods: Squamous lesions were screened with immunohistochemical markers p16 and Ki-67 to compare expression in conjunctival papillomas (n = 21) to papillomas with high-grade dysplasia, SCC in situ, and invasive SCC (n = 40). Polymerase chain reaction was performed using the Roche COBAS HPV assay to identify the 14 most common high-risk HPV genotypes. Results: Compared with squamous papillomas, the lesions showing high-grade dysplasia or worse expressed p16 with greater intensity and in a greater percentage of the lesion. A trend toward mild Ki-67 expression in papillomas versus marked Ki-67 expression in high-grade squamous lesions was also observed. HPV-16 was present in 7 of the SCC in situ and invasive SCC lesions but none of the papillomas. Conclusions: HPV may have an important role in squamous lesions of the conjunctiva. In addition to positive polymerase chain reaction results, strong and diffuse p16 expression with marked Ki-67 is strongly suggestive of an HPV-driven lesion.

https://ift.tt/2M5Hra2