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AIM: This study assessed and compared the oral health status, dental trauma experience and oral health habits of children with and without epilepsy.METHODS: Thirty-five children with epilepsy aged 3-18years old were recruited from the pediatric neurology clinics of 2 university-affiliated district hospitals. A sample of 35 age- and gender-matched healthy children was recruited as controls. Clinical data on caries, gingival health, oral hygiene level and dental trauma were collected and compared between the groups. Information about children's oral health habits and reported dental trauma experience were obtained by structured questionnaire.RESULTS: Children with epilepsy had significantly poorer gingival health than healthy controls. No significant differences in dental caries experience, oral hygiene level, dental trauma experience, oral health habits and dental care service utilization were observed between the children with and without epilepsy. Among the children with epilepsy, those taking more than 1 antiepileptic drug had a greater prevalence of dental caries when compared with those receiving mono-antiepileptic drug therapy. The presence of gingival hyperplasia indicated poorer gingival health in epileptic children.CONCLUSION: The study shows that children with epilepsy had poorer oral health status in terms of gingival health than those without epilepsy. | [
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The stress of veterinary school and the high prevalence of psychological distress among veterinary students have been well documented. Pet ownership is known to improve overall health and reduce stress among the public. Yet, for veterinary students, owning a pet (especially a dog) can offer both rewards and challenges. The academic schedule for veterinary students often comprises long hours that can make caring for a dog challenging. This study explores the area of veterinary students' dog care options and perspectives by examining two aspects of this issue: (a) currently available options, as reported by academic administrators, and (b) perceived need for these options, as reported by veterinary students. A survey of associate deans for academic affairs (n = 30) found that routine on-site kenneling options for student-owned dogs are available at eight (26.6%) veterinary schools. Simultaneously, results of a student survey (n = 768) revealed a great desire for on-campus services. Among students who did not have access to on-campus kenneling facilities, 71.5% (453 of 634) felt that creating these options would be important or very important. Across all students surveyed, 76% (581 of 764) felt it would be important to have on-site dog housing/care available. Students experience considerable stress over having to find accommodations or care for their dogs while engaged in academic activities. Thus, providing on-site boarding and care options for student-owned dogs can play an important role in both recruiting prospective veterinary students and enhancing the well-being of those currently in the program. | [
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Despite the critical influence of motivation on education and work outcomes, little is known about the motivations driving people to become and remain veterinarians. This qualitative study explored the career motivations stated by Australian veterinary graduates (n = 43) using a free-response Ten Statements Test (TST) at graduation, with follow-up interviews 6-8 months later (n = 10). TST responses were coded using an alternate inductive-deductive approach that tested their fit against existing theories of motivation. Results showed that the stated motivations were predominantly oriented to perceived value, rather than self-beliefs such as expectancy of success. About a quarter of the statements were animal-related, principally themed around intrinsic animal orientation (e.g., I like animals) or extrinsic animal-related purpose (e.g., I want to help animals). However, many non-animal themes also emerged, including both intrinsic (e.g., love of learning, challenge/problem solving, variety, social relatedness) and extrinsic (e.g., helping people, social contribution, career opportunity) motivations. Interview data revealed a motivational narrative of early formative influences, with some interviewees describing a later transition toward more people- or goal-oriented motivations. This exploratory study, outlining a broad taxonomy of veterinary career motivations and their alignment to self-determination theory in particular, may provide a useful framework for exploring career motivations in veterinary education. | [
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Disruptions in psychiatric care delivery during the transition from adolescence to adulthood frequently lead - particularly in the case of severe mental illness - to a considerable treatment delay and an especially high rate of treatment dropout with a high risk of early chronification. The joint Task Force Transition, of the German Society of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP) and the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN), therefore analyzed general, sector-specific and disorder-specific gaps in the German psychiatric care system which obstruct a successful transition to the adult psychiatric care system. The article summarizes the results of the Task Force, outlines the aims and challenges of transition-psychiatric treatment models, and addresses their structural and professional prerequisites. The requirements and recommendations derived from this are transferred to psychiatric planning, health and research policy as well as education, training and professional development in order to optimally shape the transition from adolescent-centered to adult-oriented psychiatric care in the future. | [
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The structure of psychiatric outpatient clinics with multi-professional treatment teams provides a suitable frame for a successful transition from child to adult treatment settings. At present, however, the management of transition, especially for severely mentally ill adolescents, is unsatisfactory. In order to optimize conditions of transition, the following measures are proposed:? use of structured transfer sheets? round table conferences? shared trainings of child and adult psychiatrists? development of specific consultation hours for adolescents in transition; financial funding has to be established by health insurances. | [
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INTRODUCTION: The aim of the study was to examine adolescence-specific treatment models throughout Germany, to describe the implementation process of transition psychiatric care and to identify relevant health care problem areas for adolescents with mental disorders.METHODOLOGY: A questionnaire-based cross-sectional survey (N = 26) of hospital-based adolescent psychiatric treatment models was conducted. Service structures, treatment groups and interventions were investigated by the 28-item questionnaire.RESULTS: There is an increase in adolescence-specific hospital-based services in Germany. These are characterized by multi-professional team work in diagnosis and adolescence-specific therapy approaches. Most of the treatment available is for young adults only (>18years). Some of the services are organized in interdisciplinary cooperation models. Structural deficits in acute and crisis treatment, cross-sectoral cooperation and systematic transition are reported. Conclusions There is growing interest throughout Germany in the development of adolescent psychiatric treatment. Close interdisciplinary cooperation between child and adolescent psychiatry and adult psychiatry is necessary to overcome interface problems with the aim of a successful transition, but has not yet been implemented. Structural problems should be reduced in order to facilitate further development in transition psychiatry. | [
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The transition from private practice child and adolescent psychiatric care in to the following psychiatric care of adults bears many changes and problems for young people with psychiatric disorders. This article informs about structural difficulties and demands improvements regarding the handover. | [
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PURPOSE OF THE STUDY Arthrodesis of interphalangeal joints of the hand is a method used to treat conditions associated with joint destruction, instability and pain. Our study aims to evaluate the outcomes of the treatment of sequelae of septic arthritis of interphalangeal joints by arthrodesis with external fixation. This topic is hardly covered in literature. Moreover, it compares the outcomes of application of this method in diabetic patients and non-diabetic population. MATERIAL AND METHODS Arthrodesis by means of Stellbrink external fixator was performed in 17 patients who had suffered septic arthritis of interphalangeal joints of the hand. The following parameters were followed in patients in our group: age, sex, etiology of disease, smoking, diabetes, affected fingers and joints of the hand, side, microbial culture finding, wound healing, postoperative ATB therapy and its duration, radiographic signs of the union of arthrodesis and potential complications. RESULTS The group included 8 men and 9 women. The mean age was 66.2 years. 5 patients in the group were diabetic. In 16 patients the wound healed per primam, in 1 case per secundam. The average duration of postoperative ATB therapy was 4.3 weeks. The X-ray showed the union of fused articular surfaces at 6.9 weeks on average. Complications occurred in 3 patients, namely 1 case of secondary wound healing, 1 case of nail bed damage and 1 case of flexor tenosynovitis of the operated finger. The arthrodesis was successfully healed in all the patients and a no difference was detected between diabetic and nondiabetic patients. DISCUSSION When arthrodesis of interphalangeal joints of the hand is performed using an external fixator, the metal material is introduced outside the area of inflammation, or the field potentially at risk of infection, therefore this method is predetermined for surgeries in the terrain changed by inflammation or potentially at risk of inflammation. Compared to the other methods such as arthrodesis by inserting K-wires intramedullary, there is no risk of migration of the metal material and the associated soft tissue irritation. CONCLUSIONS Our study confirms the safety and efficiency of arthrodesis of interphalangeal joints of the hand by means of an external fixator in treating the sequelae of septic arthritis. The union of arthrodesis with no complications was observed even in all the diabetic patients. Ranking among the main advantages of this method are the easy care for the surgical wound, achievement of easy and firm fixation with the possibility to apply an external fixator outside the area of the original infection. Key words:arthrodesis, external fixator, septic arthritis, interphalangeal joint. | [
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PURPOSE OF THE STUDY A single treatment procedure for multi-fragmented non-reconstructible radial head fractures has not been established as of yet. One of the available treatment methods can be the implantation of an endoprosthesis, but there is no consensus in available publications. We therefore decided to trial their use and to obtain our own experience. This study includes the evaluation of the outcomes of treatment at one year postoperatively. MATERIAL AND METHODS Our group included eight patients (six men and two women with the mean age of 46.1 years, ranging from 24 to 80 years) with an implanted ExploR (Biomet, U.S.A.) radial head endoprosthesis. The radial head fractures were of three to six fragment type, in six cases there was an associated dislocation. In one case, there was a concomitant diaphyseal fracture of the ulna which was stabilised using the W?rzburger intramedullary nail (TRUE-Instrumente GmbH, Germany). The surgical approach through Kocher's interval was used in all cases. Fixation using a plaster splint from metacarpophalangeal joints up to the shoulder was applied postoperatively for a period of two to three weeks in all patients. RESULTS The assessment was carried out on average at 13 months (range 12-15 months) after the surgery. The mean elbow flexion was 7.5 to 136.9, forearm supination was 0 to 86.3 and forearm pronation was 0 to 80.0. The elbow joint maintained its stability in all cases. Neurological deficit did not develop in any of the patients. The DASH score reached the mean value of 11.2. The mean value of the Mayo Elbow Performance Score (MEPS) was 92.5. Radiological signs of implant loosening were observed in three cases. In two of these cases, bone resorption occurred surrounding the stem of endoprosthesis. In two patients, heterotopic ossification were found and in one case, an oversized endoprosthesis head was implanted. No recurrent elbow dislocation was seen in any of the patients. DISCUSSION The application of radial head endoprosthesis is indicated for comminuted radial head fractures and concurrent ligamentous injuries (fracture-dislocations, terrible triad, Essex-Lopresti injuries). Equally good functional outcomes may be achieved with the use of an endoprosthesis as by osteosynthesis. The complications of arthroplasty tend to be late, at ten or more years postoperatively. Further follow-up of our patients will be necessary, along with a further expansion of our group of patients. Complications may be prevented with the use of longer-stem implants and more up-to-date cemented bipolar endoprostheses which, according to recent studies, achieve equally good functional outcomes and reduce the number of necessary revision surgeries - implant removal in particular. CONCLUSIONS In treating the comminuted radial head fractures, the implantation of endoprosthesis helps to achieve a quick restoration of the elbow joint function along with good functional outcomes and prevents instabilities in case of associated ligamentous injuries. A basic precondition for successful treatment is the choice of an adequate size head. The radiological signs of stem loosening do not necessarily have to affect the functional outcomes. Key words: fracture, radial head, endoprosthesis, Kocher approach. | [
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] |
The authors describe a case report of a 5-year-old foreign girl with a rare bilateral hip dislocation after a car accident. Young surgeons at the emergency department performed an unsuccessful closed reduction. Since the clinical and ultrasound screening of DDH of all newborns in the Slovak Republic is carried out until the age of 4-6 weeks, the treatment of dislocated hips starts early and the late diagnosed dislocations occur rarely. The aim of the study is to point at differences in DDH screening all over Europe resulting in an increased risk of misdiagnosed patients. Key words:hip dislocation, childhood, trauma, DDH, screening. | [
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OBJECTIVE: To determine whether an injection of platelet rich plasma improves outcomes after acute Achilles tendon rupture.DESIGN: Randomised, placebo controlled, two arm, parallel group, participant and assessor masked, superiority trial.SETTING: Secondary care trauma units across 19 hospitals in the United Kingdom's health service.PARTICIPANTS: Recruitment commenced in July 2015 and follow-up was completed in March 2018. 230 adults aged 18 years and over were included, with acute Achilles tendon rupture presenting within 12 days of injury and managed with non-surgical treatment. Exclusions were injury at the insertion or musculotendinous junction, major leg injury or deformity, diabetes mellitus, platelet or haematological disorder, systemic corticosteroids, anticoagulation treatment, and other contraindicating conditions.INTERVENTIONS: Participants were randomised 1:1 to platelet rich plasma (n=114) or placebo (dry needle; n=116) injection. All participants received standard rehabilitation care (ankle immobilisation followed by physiotherapy).MAIN OUTCOMES AND MEASURES: Primary outcome was muscle tendon function at 24 weeks, measured objectively with the limb symmetry index (injured/uninjured?100) in maximal work done during the heel rise endurance test (an instrumented measure of repeated single leg heel rises until fatigue). Secondary outcomes included patient reported function (Achilles tendon rupture score), quality of life (short form 12 version 2), pain (visual analogue scale), goal attainment (patient specific functional scale), and adverse events. A central laboratory analysed the quality and content of platelet rich plasma. Analyses were by modified intention to treat.RESULTS: Participants were 46 years old on average, and 57 (25%) of 230 were female. At 24 weeks, 202 (88%) participants completed the heel rise endurance test and 216 (94%) the patient reported outcomes. The platelet rich plasma was of good quality, with expected growth factor content. No difference was detected in muscle tendon function between participants receiving platelet rich plasma injections and those receiving placebo injections (limb symmetry index, mean 34.7% (standard deviation 17.7%) v 38.5% (22.8%); adjusted mean difference -3.9% (95% confidence interval -10.5% to 2.7%)) or in any secondary outcomes or adverse event rates. Complier average causal effect analyses gave similar findings.CONCLUSIONS: There is no evidence to indicate that injections of platelet rich plasma can improve objective muscle tendon function, patient reported function, or quality of life after acute Achilles tendon rupture compared with placebo, or that they offer any patient benefit.TRIAL REGISTRATION: ISRCTN54992179. | [
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] |
OBJECTIVE: To evaluate if induction of labour at 41 weeks improves perinatal and maternal outcomes in women with a low risk pregnancy compared with expectant management and induction of labour at 42 weeks.DESIGN: Multicentre, open label, randomised controlled superiority trial.SETTING: 14 hospitals in Sweden, 2016-18.PARTICIPANTS: 2760 women with a low risk uncomplicated singleton pregnancy randomised (1:1) by the Swedish Pregnancy Register. 1381 women were assigned to the induction group and 1379 were assigned to the expectant management group.INTERVENTIONS: Induction of labour at 41 weeks and expectant management and induction of labour at 42 weeks.MAIN OUTCOME MEASURES: The primary outcome was a composite perinatal outcome including one or more of stillbirth, neonatal mortality, Apgar score less than 7 at five minutes, pH less than 7.00 or metabolic acidosis (pH <7.05 and base deficit >12 mmol/L) in the umbilical artery, hypoxic ischaemic encephalopathy, intracranial haemorrhage, convulsions, meconium aspiration syndrome, mechanical ventilation within 72 hours, or obstetric brachial plexus injury. Primary analysis was by intention to treat.RESULTS: The study was stopped early owing to a significantly higher rate of perinatal mortality in the expectant management group. The composite primary perinatal outcome did not differ between the groups: 2.4% (33/1381) in the induction group and 2.2% (31/1379) in the expectant management group (relative risk 1.06, 95% confidence interval 0.65 to 1.73; P=0.90). No perinatal deaths occurred in the induction group but six (five stillbirths and one early neonatal death) occurred in the expectant management group (P=0.03). The proportion of caesarean delivery, instrumental vaginal delivery, or any major maternal morbidity did not differ between the groups.CONCLUSIONS: This study comparing induction of labour at 41 weeks with expectant management and induction at 42 weeks does not show any significant difference in the primary composite adverse perinatal outcome. However, a reduction of the secondary outcome perinatal mortality is observed without increasing adverse maternal outcomes. Although these results should be interpreted cautiously, induction of labour ought to be offered to women no later than at 41 weeks and could be one (of few) interventions that reduces the rate of stillbirths.TRIAL REGISTRATION: Current Controlled Trials ISRCTN26113652. | [
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OBJECTIVE: To determine the relation between age and troponin level and its prognostic implication.DESIGN: Retrospective cohort study.SETTING: Five cardiovascular centres in the UK National Institute for Health Research Health Informatics Collaborative (UK-NIHR HIC).PARTICIPANTS: 257 948 consecutive patients undergoing troponin testing for any clinical reason between 2010 and 2017.MAIN OUTCOME MEASURE: All cause mortality.RESULTS: 257 948 patients had troponin measured during the study period. Analyses on troponin were performed using the peak troponin level, which was the highest troponin level measured during the patient's hospital stay. Troponin levels were standardised as a multiple of each laboratory's 99th centile of the upper limit of normal (ULN). During a median follow-up of 1198 days (interquartile range 514-1866 days), 55 850 (21.7%) deaths occurred. A positive troponin result (that is, higher than the upper limit of normal) signified a 3.2 higher mortality hazard (95% confidence interval 3.1 to 3.2) over three years. Mortality varied noticeably with age, with a hazard ratio of 10.6 (8.5 to 13.3) in 18-29 year olds and 1.5 (1.4 to 1.6) in those older than 90. A positive troponin result was associated with an approximately 15 percentage points higher absolute three year mortality across all age groups. The excess mortality with a positive troponin result was heavily concentrated in the first few weeks. Results were analysed using multivariable adjusted restricted cubic spline Cox regression. A direct relation was seen between troponin level and mortality in patients without acute coronary syndrome (ACS, n=120 049), whereas an inverted U shaped relation was found in patients with ACS (n=14 468), with a paradoxical decline in mortality at peak troponin levels >70?ULN. In the group with ACS, the inverted U shaped relation persisted after multivariable adjustment in those who were managed invasively; however, a direct positive relation was found between troponin level and mortality in patients managed non-invasively.CONCLUSIONS: A positive troponin result was associated with a clinically important increased mortality, regardless of age, even if the level was only slightly above normal. The excess mortality with a raised troponin was heavily concentrated in the first few weeks.STUDY REGISTRATION: ClinicalTrials.gov NCT03507309. | [
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] |
In the tumor immunotherapy field, the adoptive immunotherapies, in which patient-derived T cells are strengthened ex vivo by activation or genetic modification, have been shown to be effective. However, some issues still remain to be solved. For example, it is not easy to efficiently expand tumor antigen-specific T cells, since they easily get exhausted during ex vivo culture. Moreover, these strategies are costly and time-consuming, because they are mainly conducted in autologous settings. To address these issues, we have been utilizing the induced pluripotent stem(iPS)cell technology. When iPS cells are established from tumor antigen-specific T cells, T cells regenerated from these iPS cells are expected to express the same T cell receptor(TCR)as the original T cells. In line with this concept, we succeeded in regenerating tumor antigen-specific cytotoxic T cells in 2013. We subsequently succeeded in developing a method by which very potent cytotoxic T lymphocytes are regenerated. We are now developing a strategy where non-T derived iPSCs are transduced with exogenous TCR gene efficacy and safety of which have been clinically tested. We plan to apply this approach to HLA haplotype-homozygous iPS cell stock lines, expecting that it will become possible to establish "off-the-shelf T cell" bank against various types of tumors. | [
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] |
For anti-emetic therapy, the first guideline was published 2010, following second version was open for public in 2015. The latest guideline for anti-emetic therapy in Japan, version 2.2 was disclosed on web site of Japan Society of Clinical Oncology. The point of new version were included 3 points which were a new categorization of moderately emetic chemotherapy, improvement of olanzapine for anti-emetic drug, and steroid spearing for MEC. | [
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Chemotherapy induced nausea and vomiting(CINV)have been improved by several clinical trials. However, it is necessary to select antiemetic therapy for each patient, as there are cases where nausea and vomiting have not improved or are experiencing unpleasant adverse events. In this report, we would like to introduce the latest findings in antiemetic therapy for highly emetic chemotherapy by categorized NK1 receptor antagonist, steroids, and olanzapine. Especially for olanzapine, we are going to introduce the J-FORCE as one of the latest findings. This study was confirmed the usefulness of 5 mg olanzapine to improve side effects such as sleepiness caused by olanzapine 10 mg used in the United States. We hope that these findings will be fully utilized to help provide the best antiemetic therapy for many patients. | [
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Chemotherapy-induced nausea and vomiting(CINV)has been one of the most significant side effect, which needs symptom management.Nurses should enough knowledgeable to take roles of antiemetic administration, assessment, patient education, self-care.Therefore nursing contribute to improve patients' quality of life to minimize occurrence of CINV.The time of patients receiving anti-cancer drug therapy become longer, and more patients take medical care at home care setting or community based hospitals.These change CINV management with new aspects which include continuity, economy community. Nurses need to expand their roles to improve their knowledge, assessment, quality of nursing intervention. | [
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] |
The palliative care, methodologies, and evaluation methods of clinical study for chemotherapy-induced nausea and vomiting( CINV)are not defined well. In addition, it is important to consider that individualized antiemetic therapy should be treated according to each patient's risk factors as well as the emetogenicity of chemotherapy regimens. While the CTCAE is being widely used by medical staff in clinical practice for the evaluation of CINV, the patient-reported outcome(PRO)is also considered as an important method of assessment. In this article, we describe matters to consider during the process of designing, evaluating, and applying in a clinical setting for CINV study. Based on "Supportive care and policy of palliative care CINV" which is going to be published, we expect that clinical study designs would be optimized to accelerate the establishment of evidence by utilizing not only randomized controlled trial(RCT), but also real world data(RWD). | [
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] |
BACKGROUND: FoundationOne CDx is a cancer genome profiling test that has already been approved by the FDA, but its clinical utility in Japanese patients is unknown. In this study, we examined the clinical utility of FoundationOne CDx.METHODS: 46 samples from 43 Japanese pretreated patients with advanced solid tumors were tested with FoundationOne CDx between September 2018-January 2019.RESULTS: The median age of 43 patients was 63 years(ranged 18 to 82 years), and among them 24 were males and 19 females. Major cancer types were hepato-biliary and pancreatic(8 cases)and other digestive organs(8 cases). All 27 cases in which genome cancer board had been completed by January 17, 2019 were analyzable, and the number of detected gene mutations(except VUS)was an average of 4.3(ranged 0 to 14)per case. Of the 27 cases, one or more mutations were found in 26 cases(96%), and in all such 26 cases actionable mutations with candidates for therapeutic agents were found. In 4(15%)of them, the treatment corresponding to the gene mutation was performed. Among the cases in which target disease matched and clinical trials of the drug were being conducted in Japan, only one case participated in the trial. The most common reason for not participating in the trial was disease deterioration and PS reduction (33%).CONCLUSIONS: The FoundationOne CDx test showed that it can detect gene mutations in various cancer types in Japanese patients. | [
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] |
Febrile neutropenia(FN)occurs in 3-25% of patients with castration-resistant prostate cancer(CRPC)receiving docetaxel( DTX). Therefore, the need for granulocyte colony-stimulating factor with DTX as prophylaxis has not been established. Herein, we report the efficacy of primary prophylaxis with pegfilgrastim after DTX in patients with CRPC. The subjects were 30 CRPC patients who received DTX at our hospital between January 2013 and October 2017. Twelve patients underwent primary prophylaxis with pegfilgrastim(Peg-G group), whereas the other 18 did not(control group). FN developed in 1(8.3%) and 8(44.4%)patients in the Peg-G and control groups, respectively(p=0.049). No significant differences were observed in RDI between the 2 groups. The average medical cost per course of DTX was lower in the Peg-G group than in the control group. These results demonstrate that primary prophylaxis with pegfilgrastim is useful because DTX induces FN at a high frequency in patients with CRPC, and pegfilgrastim significantly reduces its incidence without increasing the medical cost. | [
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] |
We retrospectively examined 106 cases of tapentadol use in Japan in August 2014 for cancer pain at our hospital.The advantage of the opioid medication tapentadol is that its introduction is suitable in patients undergoing anti-cancer treatment because of the low incidence of gastrointestinal symptoms, with glucuronidation involved in the metabolism, and lack of interactions with other drugs.However, depending on the dosage form and presence of swallowing disorders, the administration should be considered carefully. | [
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Several studies have reported increased anticoagulation effect of warfarin(WF)when combined with tyrosine kinase inhibitors(TKIs), such as gefitinib and erlotinib. However, effects of TKIs other than gefitinib and erlotinib on the anticoagulation effect of WF have not been clarified. To assess the degree and onset of prothrombin time-international normalized ratio (PT-INR)elevation and changes in WF daily doses in patients additionally receiving TKIs, this retrospective, single-center observational study compared PT-INR values and WF daily doses during WF treatment in the absence and presence of TKIs. Seven different TKIs(afatinib, alectinib, axitinib, crizotinib, pazopanib, regorafenib, and vandetanib)were prescribed during treatment with WF of venous thromboembolism in 10 cancer patients. Compared to baseline PT-INR, significant PT-INR elevations were observed in all patients during the combination therapy. The median PT-INR increased 1.6-fold from the baseline in the presence of TKIs(p<0.01), and the onset of PT-INR elevation was observed at a median of 18 days. As all patients receiving WF with the 7 TKIs showed PT-INR elevation, enhancement of the anticoagulation effect of WF in the presence of TKIs appears to be highly frequent. PT-INR should be carefully monitored, and adjusting the WF dosage may become necessary during the WF and TKI combination therapy. | [
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] |
BACKGROUND: Aside effect of anti-angiogenic agent treatment is proteinuria. Evaluation of the severity of adverse effects and the decision to discontinue treatment is based on the qualitative analysis of urinary proteins. However, a qualitative analysis result may not be indicative of the actual amounts of protein excreted. In this study, we evaluated the possibility of using the urine protein/creatinine ratio(UPCR), instead of a qualitative urine analysis, to monitor patients treated with antiangiogenic agents.METHODS: Urinalysis data of patients receiving anti-angiogenic agents-bevacizumab, ramucirumab, or aflibercept-were retrospectively analyzed from clinical records. Acorrelation between the urine protein content(qualitative and quantitative analyses)and continuity of anti-angiogenic agent treatment was evaluated.RESULTS: Atotal of 24 patients (age, 70.837.45 years)who received treatment for colorectal cancer(n=17), lung cancer(n=4), gastric cancer(n=2), and breast cancer(n=1)were included. One hundred and sixty-five urinalysis results were collected. Alinear correlation between the qualitative urinalysis results(1+to 3+)and UPCR(r=0.746, p<0.01)was obtained. In patients with a urine protein content of 2+(qualitative analysis), the UPCR was <2.0 for 25 patients and ?2.0 but <3.5 for 4 patients. Similarly, in patients with a urine protein content of 3+, the UPCR was <2.0 for 3 patients and ?2.0 but <3.5 for 1 patient. Seventeen patients with a urine protein content of 2+ and 3 patients with a urine protein content of 3+ discontinued treatment with anti-angiogenic agents before estimation of the UPCR could be performed. These figures were reduced to 4 patients and 2 patients, respectively, following UPCR assessment.CONCLUSIONS: Switching the estimation of proteinuria from a qualitative analysis to UPCR might lead to better safety monitoring and prevent unnecessary discontinuation of anti-angio- genic agent treatment. | [
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Sharing patient information between hospital and pharmacy is an important requirement to ensure safe and effective chemotherapy in outpatients. However, the usefulness of the information feedback from community pharmacies to the hospital has not been clarified. In this study, we analyzed feedback information with the aim of evaluating the usefulness of information feedback from pharmacies through a cooperation system based on information sharing in hospital and pharmacies. The type of information feedback was the most common side effect of supportive therapy, followed by confirmation/ inquiries of treatment contents, abnormality in clinical laboratory test values, etc. In total, 31.0% of the feedbacked information was information not described in the medical record. As a result of feedback of 38.0%, medication therapy was changed. Totally, 73.7% of the information not described in the medical record, but received through feedback, resulted in changes in medication therapy. The information feedback by sharing information on outpatient chemotherapy at pharmacies and hospitals was expected to contribute to patient safety and quality of life during outpatient chemotherapy. | [
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] |
A 79-year-old woman had recurrence in the mediastinal lymph node 6 months after curative resection of advanced esophageal cancer(pStage ?). After radiation therapy and 12 courses of chemotherapy with docetaxel, new recurrent tumors progressed in the mediastinum and apical region of the left lung, and her performance status(PS)deteriorated to grade 3. Alternate-day, low-dose S-1 chemotherapy was started at a dose of 60mg/day. Tumors decreased in size within 6 months, and her PS improved from grade 3 to 0. She had been treated for 33 months without severe adverse events until disease progression. So far, we have experienced in clinical practices that the alternate-day S-1 administration was tolerable for patients who were unfit for the standard daily administration. Alternate-day, low-dose S-1 administration may be a sustainable and effective option in S-1 chemotherapy in patients with recurrent esophageal cancer with impaired PS. | [
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Esophageal bypass surgery is a treatment for oral ingestion in cases of unresectable esophageal cancer with esophageal stricture. Esophageal bypass surgery may be necessary especially in cases of advanced esophageal stricture after CRT because of the high risk of bleeding and perforation due to esophageal stent placement. In recent years, as a safe technique with fewer complications, esophageal bypass surgery using a Y-shaped gastric tube has been increasingly performed. Therefore, we will introduce cases that have undergone esophageal bypass surgery after undergoing stent placement for unresectable advanced esophageal cancer stenosed after CRT. | [
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Herein, we report the manifestation of type 1A Charcot-Marie-Tooth disease(CMT)in a 54-year-old female gastric cancer patient caused by oxaliplatin(L-OHP)of neoadjuvant chemotherapy containing S-1 plus L-OHP(G-SOX). In this case, peripheral sensory neuropathy(PSN)appeared in both upper limbs immediately after the administration of L-OHP. Subsequently, we observed sensory neuropathy of gloves-socks type in both the upper and lower limbs and motor neuropathy in both lower limbs, which caused the patient to be unable to sit up. Physical examination revealed upside-down champagnebottle- like mild atrophy in both lower limbs and hollow feet in both legs, as well as the disappearance of deep tendon reflexes in both lower limbs. In her family history, her eldest daughter had undergone Achilles tendon elongation surgery for suspected CMT at the age of 3 years. Considering these, she was suspected to have CMT and was finally diagnosed with type 1A CMT based on genetic testing. In anti-cancer treatments that cause PSN(not just by L-OHP), possible involvement of occult peripheral nerve disease like CMT should be considered when more rapid and untypical PSN appears after the administration of anti-cancer drugs. | [
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] |
A 65-year-old woman who had diabetes mellitus was referred to the Department of Diabetes Internal Medicine of our hospital in June 201X due to disease progression. Chest radiography revealed an abnormal shadow, and computed tomography( CT)showed a 2 cm nodular shadow in the right S10. Lung cancer was suspected because of increased serum progastrin- releasing peptide(ProGRP)level and smoking history. She was referred to our department and was diagnosed with carcinoid on transbronchial biopsy. After 1 month, CT demonstrated regression of the carcinoid and improved serum ProGRP level. After more than 1 month, the carcinoid size did not change, and serum ProGRP level slightly increased. We expected that it would be difficult for the carcinoid to regress. After glycemic control was improved, the patient underwent right lower lobectomy via video-assisted thoracoscopy. In the resected specimen, the border of carcinoid was clear. She was diagnosed with a typical carcinoid. The carcinoid was not accompanied by inflammation or necrotic tissue. A carcinoid is a low-grade malignant tumor and does not usually regress spontaneously. However, in this case, it regressed spontaneously. | [
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A woman in her early 60s noticed bilateral breast masses and visited a different hospital. Core needle biopsy showed diffuse large B-cell lymphoma of the right breast and invasive ductal carcinoma of the left breast. After referral to our department, PET-CT was performed. Compared with mild fluorodeoxyglucose accumulation in left breast cancer(BC), highly accumulated lesions were found on the right breast, left anterior chest wall, nasopharynx, and tonsil. The right breast lesion was the largest with a diameter of 30mm and was considered the primary lesion of malignant lymphoma(ML). The ML was classified as stage ?, pathologically proven with erythema of the left breast and nasopharynx. Three courses of R-CHOP were performed. However, due to suspicion of heart failure, chemotherapy was changed to R-CEOP(non-anthracycline-containing regimen)and 3 courses were additionally performed. The therapeutic effect of R-Chemo for ML was CR. Left BC showed a tendency of shrinkage. After intrathecal administration of anticancer drugs to prevent infiltration of ML into the central nervous system and preoperative endocrine therapy with aromatase inhibitor, left lumpectomy and sentinel lymph node biopsy were performed. BC was classified as clinical stage ?A and had an estrogen receptor score of 3b. Postoperative whole breast radiotherapy was completed, and the planned internal use of exemestane was more than 5 years. With multidisciplinary therapy, 3.5 years had passed since the initial treatment without recurrence. | [
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An 83-year-old woman visited our hospital with a mass on her right breast mass. Breast ultrasonography revealed a tumorous lesion approximately 30mm in diameter in the right E region. Fibrous tumor was suspected from core needle biopsy. Since surgery for definite diagnosis was not desired, she was followed. Seven months after the first visit, skin redness, pain, and rapid increase in tumor size was consciously recognized, which prompted a reconsultation. The tumor diameter rapidly increased to 74 mm, and a total right mastectomy was performed as a semi-emergency procedure. Necrotic and hemorrhagic lesions were mixed in a mottled state in the cleaved surface of the excised specimen, and the pathological diagnosis was stromal sarcoma mainly comprising of fibrosarcoma components. Stromal sarcoma of the breast lacks the epithelial component of a malignant phyllodes tumor, and effective systemic therapy has not been established; therefore, cases with local recurrence or distant metastasis result in poor prognosis. Since we encountered a case of stromal sarcoma of the breast that showed a rapid increase after several months, we will provide a report with some literature consideration. | [
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A 67-year-old woman was diagnosed with Stage ?A breast cancer(T2N0M0)in 2003. She underwent mastectomy and lymph node dissection. Oral fluoropyrimidine was administered for 3 years as adjuvant chemotherapy. In 2008, the patient was diagnosed with multiple bone metastases and left supraclavicular lymph node metastasis. Radiotherapy was performed on the left first rib and left supraclavicular lymph node. She was treated with chemotherapy and endocrine therapy and bone metastasis therapeutic agent. In 2013, multiple liver metastases were noted and treated with chemotherapy. Liver metastases were well-controlled. Endocrine therapy was continued for bone metastases without visceral metastasis. In 2016, the patient was diagnosed with bone marrow carcinomatosis and died 2 weeks later due to bone marrow carcinomatosis. | [
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] |
In Japan, the number of the patients with colorectal carcinomas is increasing. Micropapillary carcinoma(MPC)is a rare adenocarcinoma that shows a characteristic histological feature. The first case of MPC was reported in 1993, which originated in the breast. It has been reported that MPC also rarely arises in the colon. In this report, we showed a case of MPC arising in the sigmoid colon in a 73-year-old man with adenosquamous carcinoma in the lung. The patient consulted a home physician due to cough, and a tumor on the right lung of the patient was detected by chest radiography and CT. The lung tumor was histologically diagnosed as adenosquamous carcinoma. FDG-PET/CT revealed hot spots in not only the right lung but also the sigmoid colon. Carcinoma was detected in the sigmoid colon through a colorectal endoscopic examination, and the carcinoma with regional lymph node metastasis was resected. The histological examination of the colon carcinoma revealed that it was MPC without any other histological types and with marked metastasis to the lymph nodes. For the treatment of lung cancer, additional treatment for colon cancer was not performed. Since pure MPC arising in the colon is extremely rare, the patient is followed carefully. | [
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A 65-year-old woman was diagnosed with simultaneous hepatic metastasis of rectal cancer with portal venous tumor thrombi(Vp3)that developed in the bifurcation of the portal vein. Four days from the first visit, abdominal dynamic contrastenhanced CT image on the portal venous phase shows that the tumor thrombi progressed in the main trunk of the portal vein (Vp4). We decided that it was a condition of oncologic emergency and initiated FOLFOXIRI plus BV therapy. After 12 courses, tumor shrinkage and regression of the portal venous tumor thrombi were achieved, but conversion surgery was impossible because the collateral circulation of the hepatic portal region remained. The treatment target was changed to the extension of the survival period. The initiation and reinitiation of FOLFOXIRI plus BV therapy and maintenance of 5-FU/l-LV plus BV therapy contributed to disease control in 24 months and survival period of 36months. | [
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A man in his late 50s had lumbago and thrombocytopenia. He was diagnosed with Philadelphia chromosome-positive acute lymphoblastic leukemia(Ph plus ALL). Remission induction chemotherapy was initiated with JALSG Ph plus ALL 208 protocol, but cerebral infarction in the right occipital lobe developed on day 2 and, to make matters worse, was accompanied by hemorrhagic cerebral infarction in the left occipital lobe on day 9. We decided that chemotherapy with multiple drugs was difficult to continue, and it was stopped. After improvement of the general condition, dasatinib therapy was started on day 52. After about 5 months, Ph plus ALL relapsed. Although mild disorientation and visual field defects remained due to old cerebral infarction, organ function was maintained, and patient performance status(PS)was classified as 1. Introduction of ponatinib was considered feasible, and ponatinib was started from a dose of 15mg/day to prevent the occurrence of vaso- occlusive adverse events. It was gradually increased to 30mg /day and continued about 4 months without recurrence of cerebral infarction. Complete molecular response was achieved with ponatinib therapy. It was suggested that, in patients with Ph plus ALL with a history of cerebral infarction, ponatinib could be a treatment option under careful risk management. | [
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A man in his late 40s was presented to a hospital with complaints of peripheral numbness and fatigue. Systemic edema, pleural effusion and ascites, pigmentation, splenomegaly, and CT findings of osteoplastic changes suggested POEMS syndrome. He was referred to our division, and a bone marrow examination indicated MGUS. However, his serum level of vascular endothelial growth factor(VEGF)was elevated to 1,520 pg/mL, and IgA-l type M protein was detected. He was diagnosed with POEMS syndrome and received four cycles of induction chemotherapy containing lenalidomide and dexamethasone( Ld). All symptoms improved gradually, and after auto peripheral blood stem cell harvest(aPBSCH), high-dose melphalan was administered, followed by auto peripheral blood stem cell transplantation(aPBSCT)being performed. Pleural effusion and ascites disappeared, while numbness remained slightly. His serum level of VEGF decreased to 68 pg/mL when the planned primary treatment was completed. Many cases of POEMS syndrome involve peripheral neuropathy; therefore, a lenalidomide-containing regimen may be a more adequate strategy than ones containing thalidomide and bortezomib. | [
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] |
The main aims of the CoLaus/PsyCoLaus cohort study are to better understand: 1) the personal, biologic, genetic end environmental determinants of cardiovascular risk factors and diseases, and 2) the existing association of mental disorders with cardiovascular diseases. The study was initiated in 2003 and over 6700 participants from the city of Lausanne were include and very rich phenotypic data were collected making the study unique worldwide. Numerous scientific articles were published in various fields such as epidemiology, public health, genetic, social and environmental determinants of cardiovascular diseases and their association with mental health. We briefly present here some key results obtained over the last 16 years. | [
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The field of valve intervention is rapidly changing. Clinical practice guidelines are based on evidence and practical clinical experience. The randomised trials considered for the guideline recommendations regarding indications for TAVI cover the high-risk and intermediate-risk subgroups of patients. With new evidence for low-risk patients, consideration has to be given to discussing TAVI as the default strategy in the majority of patients. This is a paradigm shift from the established practice. More than ever, the patient will be at the centre of the decision making. The Heart Team is essential for optimal patient pathways, as patient factors, longevity and durability considerations have to inform the discussion. Further developments discussed in this article revolve around evidence on secondary mitral regurgitation and mitral edge-to-edge repair. | [
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AIMS: The newly formed geometry between the native Valsalva and implanted transcatheter heart valve (THV) may induce local thrombogenicity. This study aimed to assess the incidence of and the clinical outcomes associated with Valsalva thrombus formation after transcatheter aortic valve implantation (TAVI).METHODS AND RESULTS: We retrospectively evaluated the multidetector computed tomography (MDCT) data of 338 patients following transcatheter aortic valve implantation (TAVI) using a balloon-expandable THV. The Valsalva and leaflet thrombi were assessed by MDCT at the left coronary cusp (LCC), right coronary cusp (RCC), and non-coronary cusp (NCC). Combined endpoints such as death, stroke, and readmission for heart failure rates in patients with and without Valsalva and/or leaflet thrombus were examined at two years. The overall incidence of Valsalva and leaflet thrombi was 8.9% and 8.3%, respectively. Significant differences in the location of the Valsalva thrombus in the LCC, RCC, and NCC were noted (5.0%, 4.2%, 8.9%, respectively, p<0.001). The independent predictor for increased risk of Valsalva thrombus was high Valsalva area to implanted THV size ratio (odds ratio 11.8, 95% confidence interval [CI]: 1.67-83.0, p=0.013). Combined endpoints were similar in patients with and without Valsalva thrombus, Valsalva/leaflet thrombus, and leaflet thrombus (p>0.05 for all).CONCLUSIONS: Valsalva thrombus was detected in 8.9% of patients following balloon-expandable THV implantation and was common in the LCC, but it did not increase the risk of adverse events after TAVI. | [
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] |
AIMS: Correction of mitral and/or tricuspid regurgitation (MR, TR) frequently leads to poor outcomes in the days following intervention. We sought to understand how abrupt correction of MR and TR affects ventricular load and to investigate if gradual correction is beneficial.METHODS AND RESULTS: MR and TR were simulated using the CircAdapt cardiovascular system model with effective regurgitant orifice (ERO) areas of 0.5 cm2 and 0.7 cm2. Ventricular and atrial contractility reductions to 40% of normal and pulmonary hypertension were simulated. Abrupt and gradual ERO closure were simulated with homeostatic regulation of blood pressure and volume. Abrupt correction of MR increased left and right ventricular fibre stress by 40% and 15%, respectively, whereas TR correction increased left and right ventricular fibre stress by 26% and 19%, respectively. This spike was followed by a rapid drop in fibre stress. Myocardial dysfunction prolonged the spike but reduced its amplitude. Right ventricular fibre stress increased more with pulmonary hypertension and TR. Gradual correction demonstrated no spike in tissue load.CONCLUSIONS: Simulations demonstrated that abrupt ERO closure creates a transient increase in ventricular load that is prolonged by worsened myocardial condition and exacerbated by pulmonary hypertension. Gradual closure of the ERO abolishes this spike and merits clinical investigation. | [
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AIMS: This study sought to analyse multislice computed tomography (MSCT) data of patients with tricuspid regurgitation and to report the variability of fluoroscopic viewing angles for several right-sided heart structures, as well as chamber views of the right heart in order to determine the optimal fluoroscopic viewing angles of six right-sided heart structures and right-heart chamber views.METHODS AND RESULTS: The MSCT data of 44 patients with mild to severe tricuspid regurgitation (TR) were retrospectively analysed. For each patient, we determined the optimal fluoroscopic viewing angles of the annulus/orifice en face view of the tricuspid valve, atrial septum, superior vena cava (SVC), inferior vena cava (IVC), coronary sinus (CS) and pulmonary valve. In this TR patient cohort, the average fluoroscopic viewing angle for the en face view of the tricuspid valve annulus was LAO 54-CAUD 15; RAO 10-CAUD 66 for the SVC orifice; LAO 27-CRA 59 for the IVC orifice; RAO 28-CRA 19 for the CS orifice; RAO 33-CAUD 33 for the atrial septum and LAO 13-CAUD 52 for the pulmonary valve annulus. The average viewing angle for right-heart chamber views was LAO 55-CAUD 15 for the one-chamber view; RAO 59-CAUD 54 for the two-chamber view; RAO 27-CRA 19 for the three-chamber view and LAO 5-CRA 60 for the four-chamber view.CONCLUSIONS: MSCT can provide patient-specific fluoroscopic viewing angles of right-sided heart structures. This information may facilitate transcatheter right-heart interventions. | [
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] |
Accurate evaluation of viable Ascaris ova in wastewater is the key to mitigating Ascaris reinfections in endemic regions. In this study, the viability of Ascaris ova in raw wastewater was determined using three different detection methods: culture-based, BacLight Live/Dead staining and propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR). Furthermore, comparative assessment of viability utilising the aforementioned detection methods was performed using seeded experiments in wastewater. The percentage of viability was: culture-based (82%), BacLight Live/Dead staining (87%) and PMA-qPCR (85%) respectively. Despite the fact that no statistical difference was shown in the viability determination among the three methods, PMA-qPCR-based viability determination would be preferable over the other two methods for evaluating potential public health risks with A. suum ova due to its accuracy, being least subjective and its rapid reaction time. | [
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] |
Chromium Cr(III) is considered as a toxic pollutant in industrial wastewater. Photocatalytic processes can be used as an efficient method for the treatment of heavy metal wastewaters. This study was conducted to synthesize copper (II) oxide (CuO) with dendrite, leaf and feather morphologies. Synthesized CuO with dendrite and leaf morphologies were characterized by XRD, SEM, and BET/BJH and CuO with feather morphology by XRD, SEM, BET/BJH, FTIR, TEM and DRS techniques. Parameters such as morphology CuO, the contact time (h), and adsorbent dosage (g) in adsorption of Cr(III) and morphology CuO, pH and initial concentration of Cr(III) in the photocatalytic oxidation were investigated. The results demonstrate that CuO feather at 24 h contact time with 0.1 g adsorbent with an adsorption efficiency of 57.24% has the highest efficiency compared to CuO of dendrite and leaf. Oxidation results demonstrate that CuO feather at 2 h with 0.1 g adsorbent dosage and pH = 7 had 89.14% removal efficiency. Also, oxidation results demonstrate that CuO feather at 2 h with 0.1 g adsorbent dosage and pH = 8 had 99.99% removal efficiency, which indicates the high efficiency of the feather. | [
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In this study, coal tar wastewater was treated by electrochemical oxidation technology using lead dioxide anodes. The influence of operating parameters, including applied current density, electrode gap and initial pH value, on the removal ratio of chemical oxygen demand (COD) was investigated. The results demonstrated that the COD removal ratio reached 90.5% after 3.5 h electrolysis with the current density at 3 A dm-2 and electrode gap at 1.0 cm. Correspondingly, the COD decreased from 5,125 mg L-1 to 487 mg L-1, which fitted the wastewater discharge standards of China, and the specific energy consumption (SECCOD) was 35.3 kWh kgCOD-1. Not only was the COD removal ratio only 77.1% after 2 h electrolysis but the BOD5/COD ratio of the wastewater reached 0.44, which could be biochemically treated, and the SECCOD decreased by 34.3%. Moreover, the main composition of pristine wastewater before and after 2 h electrolysis was analyzed by GC-MS, and the disappearance of macromolecules (such as ethyl-2-pyrenemethanol) and the production of small molecules (such as propane-1,3-diol) could improve the biodegradability of the wastewater. Therefore, electrochemical oxidation for 2 h is a promising alternative for pretreatment of coal tar wastewater prior to biological treatment. | [
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This study proposes a technology conceived based on an integrative approach that aims to promote phosphorus recovery and to recycle ferric water treatment sludge (FWTS), using it as a phosphorus adsorbent which may be applied as a soil ameliorant after reaching saturation. The assessed pilot plant operated with a daily influent flow of 360 litres and presented a removal efficiency of 94.4% 3.2% for chemical oxygen demand (COD) and of 91.2% 7.8% for suspended solids. It also presented promising results for phosphorus removal. The maximum efficiency of dissolved reactive phosphorus removal was 95% on the first day and it decreased until reaching adsorbent saturation. The estimated breakthrough time was one year in the condition in which the filling medium of a second constructed wetland was only FWTS. In this situation, the effluent phosphorus concentration was 0.2 mgL-1. The authors concluded that the application of FWTS in a constructed wetland bed is an interesting alternative. Batch adsorption experiments were run using phosphorus stock solution. Langmuir and Freundlich adsorption isotherm models were obtained for different initial pH values. The maximum adsorption capacity decreased as the initial pH was increased; values ranged from 4.76 mg Pg-1 (pH = 3.9) to 1.44 mg Pg-1 (pH = 9.0). | [
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This paper presents a method and mock-up design for evaluating the heat-island mitigation effect of porous/water-retentive blocks in a climatic environmental chamber using ambient temperature measurements. To create the proposed method, the heat circulation mechanism of blocks was considered. From this, we specified the climatic chamber design requirements, determined the required components and equipment for the mock-up, and developed the proposed method for evaluating heat-island mitigation performance based on ambient temperature. Using the proposed mock-up design and method, we confirmed that both surface and air temperatures were lower when porous/water-retentive blocks were installed compared to conventional blocks. This method can be used to analyze the difference between surface and ambient temperatures under various conditions to quantify the heat-island mitigation performance of different materials according to ambient temperature. | [
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This study focused on the synthesis of TiO2-Zeolite nanocomposite through a sol-gel approach. The decrease in the size of the nanocomposite is considered a primary parameter to improve photocatalytic activity. In this regard, fabricated samples were exposed to laser irradiation (532 nm) for four different time intervals in order to investigate the size variation of the nanocomposite. FTIR, UV-Vis, XRD, DLS, SEM and EDX analyses were applied to characterize and determine the size of the products. An optimized nanocomposite sample, in term of the particle size, was used for photodegradation of 2,4-D herbicide from aqueous solution. Photodegradation was carried out under UV irradiation (12 W) and Xe lamp irradiation (200 W). The obtained results showed that laser irradiation time has a substantial effect on controlling the size of the nanocomposite. Results from the photocatalyst study indicated that the elimination of 2,4-D under the Xe lamp irradiation was higher compared with the UV irradiation. Also, the final synthesized nanocomposite exhibited higher catalytic activity for photodegradation of 2,4-D compared with pure Zeolite and pure anatase TiO2 samples. The reusability of TiO2-Zeolite nanocomposite was studied in four successive cycles to evaluate the removal of 2,4-D under UV irradiation. | [
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Modified walnut shell (EAWNS) was prepared by reaction with epichlorohydrin and alkaline solution of aspartic acid and used to remove reactive dye (Reactive Brilliant Blue (KN-R)) from aqueous media. The isotherms, kinetics and thermodynamics of KN-R adsorption onto EAWNS were studied at 298-318 K. The isotherm data of KN-R adsorption onto EAWNS agreed closely with the Langmuir model. The theoretical monolayer adsorption capacity for KN-R was 224.42 mg/g at 318 K. The result from the Dubinin-Radushkevich model showed that the KN-R adsorption onto EAWNS is chemisorption. The adsorption rate of KN-R onto EAWNS conformed to the pseudo-second-order model. The diffusion mechanism was investigated by the intraparticle diffusion model. The mass-transfer coefficient calculated by the surface mass-transfer coefficient model was in range of 2.95 ? 10-5 to 2.93 ? 10-4cm/s. The thermodynamic results suggested that the adsorption of KN-R onto EAWNS is spontaneous and endothermic in nature. The design of a single-stage batch adsorption process based on EAWNS adsorbent was carried out. Furthermore, the recycled EAWNS maintains high adsorption capacity despite four cycles. | [
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] |
Mesoporous TiO2 has been prepared by a brief and simple sol-gel processing and applied for the removal of Cu(II) from aqueous solution. The adsorption behavior of mesoporous TiO2 for Cu(II) was investigated using batch experiments. Results showed that the pseudo-second-order model and Langmuir isotherm were more accurate to describe the kinetics process and adsorption isotherm. Mesoporous TiO2 adsorbent displayed excellent Cu(II) adsorption efficiency (195.52mg g-1). The thermodynamic parameters showed that the adsorption was spontaneous and endothermic. It was also found that mesoporous TiO2 could be used at least seven times without obvious loss of its original adsorption efficiency. Therefore, the obtained mesoporous TiO2 could be employed as an effective and low-cost adsorbent for removal of Cu(II) from contaminated effluents. | [
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] |
Characteristics of Chlorella sorokiniana treating wastewater with consideration of HRT (6 d, 16 h, 8 h), hydraulic conditions, light or dark culture were evaluated and compared with activated sludge. Results showed that optimal HRT was 8 h; if longer, effluent chemical oxygen demand (COD) and NH4+-N in the dark began to rebound. Mixing was beneficial to COD removal of algae, while aeration was suitable for nutrient removal. Growth of C. sorokiniana in the light was mixotrophic growth and 1.3-1.7 times more than that of dark heterotrophic growth. The maximum specific growth rate (max), productivity, and biomass yields on COD (YCOD), N (YNH4), P (YP) of algae were higher in the light than that in the dark. COD assimilation capacity of algae was similar to activated sludge but with different dynamics. N and P assimilation capacity of algae was 1.4, 1.2-2.5 times more than activated sludge; N and P removal efficiency of algae was 5%-10%, 10%-55% respectively higher than activated sludge. This study confirmed the advantage of algae over activated sludge and reveal why algae could assist the activated sludge process. | [
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In this study, a mesoporous TiO2/carbon catalyst (TiO2/C) was prepared by a facile impregnation-carbonization approach to catalyze ozonation of p-chloronitrobenzene (p-CNB). The catalyst was well characterized and the catalytic efficiency under various conditions was systematically evaluated. TiO2/C has a disordered mesostructure with a high specific surface area. 92.8% of p-CNB (2 mol/L) can be degraded within 20 min in the TiO2/C/O3 system in the presence of 1 mg/L O3, 100 mg/L catalyst, at pH = 5. Based on the evaluation of the effect of basic parameters, it could be deduced that the removal of p-CNB relied on the synthetic effect of catalysis by TiO2/C and the autocatalytic induction of p-CNB. The removal efficiency of p-CNB, the structure change and the leaching of Ti ions were also evaluated in five cycles, indicating TiO2/C is stable and recyclable for catalytic ozonation in water treatment. | [
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] |
In this work, we describe the morphological, electronic and catalytic properties of support TiO2-CeO2-ZrO2, prepared by sol-gel method, which was impregnated with copper at 5 and 10% by weight, in order to obtain efficient catalysts in the catalytic wet air oxidation (CWAO) of 2-cp. The catalysts were characterized by X-ray diffraction (XRD), scanning electron microscope (SEM-EDS), UV-Vis diffuse reflectance spectroscopy (DRS) and nitrogen physisorption by the Brunauer-Emmett-Teller (BET) method. The activity of the materials used in this study revealed that without the presence of Cu, the SCO2 is low and with a content of 10% this metal shows the best catalytic behaviour; conversely, a reaction mechanism is proposed that describes the complete oxidation of 2-cp in this case. | [
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A novel Fenton-SBR-microwave pyrolysis integrated process is developed to treat liquid crystal wastewater possessing complex components, high toxicity and strong stability. In this integrated process, Fenton-SBR and microwave pyrolysis are for the removal of chemical oxygen demand (COD) and disposal of iron mud generated in the Fenton process respectively. The effects of H2O2:Fe2+ molar ratio and Fenton dosage on COD removal were optimized. The experimental results revealed that the removal efficiencies for COD and total organic carbon (TOC) were 99.8% and 99.2%, and the values for MLSS and SVI were stable at 4,500 mg L-1 and 65%, respectively. Microscopic examination proved that there were rotifer, Epistylis galea, Opercularia coarctata, vorticella and mormon genus which are indicative microbes for good water quality. Iron mud waste produced in the Fenton reaction was handled with microwave pyrolysis, producing ?-Fe2O3 commercial byproduct. The estimated cost including chemical reagents and electricity for this integrated process is about $320 T-1, without consideration of the added value of the ?-Fe2O3 byproduct. TOC removals in the Fenton and SBR processes both fit well with pseudo-first-order kinetics and the corresponding half-life times are 0.15 and 7 h, respectively. | [
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] |
The understanding of the engineering behaviour of unsaturated soil is totally dependent on the water retention characteristic curve (WRCC). In this paper, a comprehensive study of the WRCCs of pond ash along with the ash's geotechnical behaviour has been made. The WRCC has been drawn experimentally using a Fredlund device based upon the pressure plate technique for both wetting and drying cycles. Further, an investigation was carried out to study WRCC hysteresis of pond ash. There exists a considerable hysteresis in drying and wetting curves of pond ash sample. The different WRCC models were used to fit the experimental WRCC data. The effect of compaction on WRCC was also studied. The air entry value in the case of a loose sample is low and the sample gets nearly desaturated at low soil suction as compared to a dense sample. Also, the wetting WRCC is predicted using the Feng and Fredlund model as it is difficult and time consuming to measure the whole hysteresis. The predicted results are compared with the measured wetting WRCC. Since the direct measurement of unsaturated hydraulic conductivity is difficult to obtain in engineering practices, the unsaturated hydraulic conductivity function is predicted using the measured WRCC as the input parameter using SEEP/W software. | [
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This study aims to investigate the performance and mechanism of raw (R-ND) and saponin-modified nano diatomite (M-ND) in the removal of azithromycin from aqueous solutions. Adsorbent characterization was performed using X-ray fluorescence, Brunauer-Emmett-Teller (BET), scanning electron spectroscopy, dynamic light scattering and energy-dispersive X-ray analyses. It was shown that the specific surface area of R-ND was 119.5 m2/g, 14-fold higher than that for raw diatomite, and for M-ND it was 90.1 m2/g. Various adsorption conditions, i.e. adsorbent dosage, pH, initial concentration and contact time were investigated. According to the results, despite reducing the specific surface area by 25%, modification of nano diatomite by saponin markedly enhanced its performance in the removal of azithromycin. The maximum adsorption capacity of R-ND and M-ND in the removal of azithromycin was 68 and 91.7 mg/g, respectively. Fourier transform infrared spectroscopy results revealed that azithromycin was adsorbed by O-H groups on the diatomite surface. Weber-Morris intra-particle diffusion (IPD) model suggested that while IPD is not the rate-controlling step in high concentrations of azithromycin, it is the only step that controls the rate of adsorption in low concentrations. In comparison to R-ND, M-ND showed a higher efficiency in the removal of azithromycin and, therefore, it can be used as a promising low-cost adsorbent to remove azithromycin from aqueous solutions. | [
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] |
In order to achieve efficient recovery of ions from the simultaneous desulfurization and denitrification wastewater, the effects of various factors (i.e. the saturation temperature, the cooling termination temperature, the stirring rate and the cooling rate) on crystallization yield, metastable zone width and crystal morphology were investigated to determine the optimal crystallization conditions of Mg2+//SO42-, NO3--H2O system. According to the results of experiments, the nucleation kinetics were also speculated by N?vlt self-consistent equation and classical 3D nucleation theory. Also, the crystallization products were characterized by X-ray diffraction and scanning electron microscopy. Under the determined optimal conditions, the yield of the crystal can reach 78%, and the crystal products were verified as pure MgSO4 7H2O, whose morphology is complete without defects. | [
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The efficiency of electrolysis (EC/Cl2) and photo-assisted electrolysis (EC/UV/Cl2) methods, in the presence of chloride, for the abatement of real dairy waste from a producer in the Triangulo Mineiro region of Brazil, was evaluated. A complete 23 factorial design was performed for the variables time, pH and current. After determining the ideal pH, a Central Compound Design (CCD) was performed, where the applied current (533.42 mA) and treatment time (60.45 minutes) were maximized. The effluent was subsequently submitted to prolonged EC/Cl2 and EC/UV/Cl2 treatment in order to evaluate the behaviour of specific environmental parameters over time. The EC/UV/Cl2 method was more efficient than simple EC/Cl2 treatment. The EC/UV/Cl2 method resulted in a reduction of all environmental parameters investigated to levels within legal standards for effluent discharge. A relatively low cost of treatment is obtained with Energy per Order (EEO) values of 0.89 and 1.22 kWh m-3 order-1 for the EC/UV/Cl2 and EC/Cl2 treatments, respectively. The electrochemical production of free chlorine species followed by subsequent photolysis and production of radical species can convert a simple electrochemical process into an advanced oxidation process (AOP). | [
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A monolithic-porous carbon (MPC) was fabricated by carbonizing a pine rod, and then the oxidized monolithic-porous carbon (O-MPC) was obtained via alkaline heat treatment of MPC. With well-ordered axial channels (diameters were 6-14 m and 40-50 m) and oxygen-containing functional groups, O-MPC as a flow-through cathode exhibited good capability in continuously generating H2O2 (422 mol/L) via oxygen reduction. O-MPC and additional Fe2+ composed an electro-Fenton system and the performance of the system in degradation of organic pollutants was evaluated. For phenol, bisphenol A or sulfamethoxazole at initial concentration of 10 mg/L the removal efficiency reached 74%-82% in a hydraulic retention time of 100 seconds, nearly close to that of the homogeneous Fenton process (90%). This efficiency may be maintained for at least 10 hours, indicating a good stability of O-MPC. The results demonstrate the potential of O-MPC as a flow-through electrode to realize homogeneous-like degradation of organic pollutants in wastewater. | [
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] |
The aim of this study was to assess the efficiency of mucilage extracted from the fruit of Dillenia indica for enhancing coagulation in the treatment of textile effluent. The mucilage extraction was carried out in water at room temperature. The pH, concentration of coagulant FeCl3.6H2O, and concentration of mucilage solution were optimized with star-type central composite design (CCD). We were able to analyze the synergistic effects between the FeCl3.6H2O and mucilage concentrations: the process of coagulation/flocculation (CF) for chemical oxygen demand (COD) removal was more efficient at a low chemical coagulant concentration (8.00 mg L-1) and a higher natural coagulant (NC) concentration (15.00 mg L-1). This demonstrated the potential of this mucilage to treat textile effluents, with 67.66%% COD removal, 96.86% turbidity removal and 91.12% apparent color reduction. The characterization of the mucilage of Dillenia indica was done using Fourier transform infrared spectroscopy (FTIR) and solid-state cross-polarization magic angle spinning carbon-13 nuclear magnetic resonance (CP/MAS 13C NMR), and the signals obtained indicated the presence of polysaccharides, which are responsible for enhancing the CF process. | [
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As a kind of earth-abundant and cheap natural clay mineral, palygorskite (Pal) was facilely modified by grafting with graphene oxide (GO) to fabricate GO/Pal composites for rapid removal of Pb(II) from aqueous solutions. The results of characterization confirmed that the GO/Pal composites were successfully grafted between GO sheets and Pal nanorods. The effects of pH, adsorbent dosage, adsorption time, initial Pb(II) concentration and temperature on the adsorption of Pb(II) onto the GO/Pal composites as adsorbents were systematically investigated. The maximum adsorption capacity over 106.6 mg/g was obtained within a short adsorption time of less than 1 h even at 298.15 K. The adsorption of Pb(II) was a fast process that more accurately followed the pseudo-second-order kinetic equation. This process also could be described better with the Langmuir equation model than the Freundlich model. The negative values of G and the positive values of H and S indicated that it was a spontaneous, endothermic and entropy-increasing adsorption process. Compared with pristine Pal and GO powders, such the GO/Pal composites as a cost-efficient and eco-friendly adsorbents could significantly improve the adsorption properties of Pb(II) and would have potential application in the industrial wastewater treatment for rapid removal of Pb(II). | [
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] |
In this work, inexpensive and easily available olive stone (OS) waste was used as the source material to prepare activated carbons (ACs) by chemical activation with phosphoric acid and zinc chloride. The mixture design of experiments (MDOE) method was applied to study the effect of the composition of the mixture of unmodified olive stones (UOS) and ACs prepared from olive stones activated with ZnCl2 (ACOS ZnCl2) and H3PO4 (ACOS H3PO4) on the absorption of pharmaceutical residues. The adsorbed tetracycline (TC) amounts at equilibrium predicted from the model equation developed using Microsoft Excel were found to be in good agreement with the experimental values (R2 = 0.999). Based on the results of the model, the amount of TC removed increased as the proportion of ACOS H3PO4 in the adsorbent mixture increased and the highest amount of TC adsorbed was obtained with an adsorbent made up entirely of ACOS H3PO4. Separate adsorption tests for sulfamethazine (SMT) and amoxicillin (AMX) on ACOS H3PO4 showed that SMT was adsorbed best (189.81 mg/g), followed by TC (183.11 mg/g) then AMX (155.69 mg/g). However, when these molecules were present together in the same solution, it was TC that adsorbed best, followed by SMT then AMX. In addition to this, the sorption process studied was best described by a pseudo-first-order model and it was the Langmuir model that satisfactorily described the equilibrium data. | [
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The aim of the study was to assess the information content of volatile fatty acid parameters for the differential diagnosis of infected and sterile pancreatic necrosis. The work is based on the results of examination and treatment of 34 patients with pancreatic necrosis. The analysis of concentrations of volatile fatty acids: acetic, propionic, butyric and isovaleric was carried out on an automated gas chromatograph Crystallux-4000 with a capillary column HP-FFAP and flame ionization detector. The indicators of acetic, propionic, butyric, isovaleric acid and the sum of volatile fatty acids are statistically significantly higher in patients with infected pancreatic necrosis compared with the indicators of volatile fatty acids in patients with sterile pancreatic necrosis. Volatile fatty acid values can be used for the differential diagnosis of infected and sterile pancreatic necrosis. | [
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] |
Cytological study is a highly specialized type of laboratory analysis of the cellular composition of biological material and is to assess the morphological characteristics of cellular elements. The modern development of digital technologies is increasingly forming the interest of specialists to such a section as telepathology (digital pathology), which is a process of virtual microscopy with the transformation of classical cytological preparations into digital. Most morphologists currently use some forms of digital imaging, such as static images obtained by optical cameras mounted under a microscope. The development of more high quality image and resolution in the digital pathology promotes the use of telepathology, including telecitology in their daily work for training specialists, counselling of medications, monitoring the quality of diagnosis. | [
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The developing and the testing results of an immunochromatographic test for the D-dimer qualitative determination were presents in the article. The test was approved blood plasma samples in comparison with a quantitative enzyme-linked immunosorbent assay (ELISA). The results of assay with developed test were the same with ELISA results for 87,1% and 100% for samples with increased (more than 400 ng/ml FEU) and normal concentration of D-dimer, respectively. The immunochromatographic test for determination of D-dimer can be included in the diagnostic strategy as a cut test after the assessment of venous thromboembolism risk. | [
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To develop predictive model of damage of nervous system on the basis of definition of concentration of interleukins-23, 12p40 and also a glial fibrillar acid protein (GFAP) in liquor of patients with various forms of syphilis. Comprehensive laboratory examination of patients with neurosyphilis and syphilis without specific damage of nervous system who were observed in venereologic office of BOUZAS of OO Clinical Dermatovenerologic Clinic of Omsk is conducted. To all patients were carried out: a serological blood analysis, serological and clinical trial of liquor, and also immunological research of liquor (interleukins - 23, 12p40, and also GFAP). On the basis of the research IL-23, SILT-12p40, GFAP, the level of protein and a pleocytosis in liquor the predictive model of development of neurosyphilis in patients with syphilis without specific damage of nervous system is offered. The analysis of immunological changes in liquor of patients showed that the research of a number of cytokines and markers of damage of nervous tissue to liquor as the most specific and reliable, especially in the absence of clinical symptomatology from central nervous system can be an integral part of diagnostics of neurosyphilis also. | [
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] |
To study the concentration of vasculoendothelial growth factor (VEGF) in mixed saliva and serum of patients in normal conditions and with generalized periodontitis. The main group (n = 42) was represented by patients with generalized periodontitis. The comparison group (n = 36) consisted of patients without periodontal tissue diseases. The concentration of VEFR was determined by the method of enzyme-linked immunosorbent assay (ELISA) using a commercial test-system "VEGF - IFA - BEST" (A-8784) ("Vector - Best", Russia). The median values VEFR in saliva were 5.49 times higher than the values for serum in the main group (p = 0.000000) and 7.01 times in the comparison group (p = 0.000000). The concentration of VEFR in the saliva of the examined main group exceeded the similar values of the comparison group (p = 0,014857); the median and interquartile range for the main group was 1098.45 (925.5; 1291) pg/ml, and for the comparison group 1360.5 (998.9; 2062) pg/ml. There were no differences in the serum VEFR concentration (p = 0.775124). No significant correlation was found between the serum VEFR content and the mixed saliva. The Spearman's rank correlation coefficient for the main group was R = 0,0184358, and for the comparison group, respectively, R = 0.188932. The source of VEFR in saliva are the glands and cells of the oral mucosa, and not the process of exudation from blood serum. The high content of VEFR in the saliva of healthy people and a decrease in its level during periodontitis indicates the important role of this protein in the processes of maintaining the normal state of periodontal tissues and reparation of tissues of the oral mucosa. | [
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] |
There was reported the results of the use of recombinant interleukin-1 in basic conservative measures in the surgical treatment of acute gastroduodenal ulcer bleeding. Gastric ulcer were in 20 patients, duodenal ulcer in 84 patients and combined ulcers in 16 patients. According to ?.?. ??????? hospitalized patients with mild blood loss were 27, moderate degree - 62 and severe degree - 31 patients. According to J. Forrest, 29 showed active bleeding (F Ia, F Ib), in 67 - unstable hemostasis (F IIa, F IIb, F IIc) and in 24 - F III. Within the framework of differentiated individual-active tactics, patients were operated in emergency (21), urgent (38), delayed (35), and 26 people underwent early planned operations. Patients in the main group (63) after the operation, was included recombinant interleukin-1 to the basic therapeutic measures additionally, taking into account the degree of blood loss and immune disorders. Patients of comparison group (57) before and after surgery received standard basic therapy without immunocorrection. In a comparative aspect, it has been proved that in postoperative period on the background of standard conservative measures, the use of recombinant interleukin-1 positively influences elimination of the secondary immunodeficiency and cytokine imbalance significantly improves the results of surgical treatment. | [
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] |
The aim was to study the level of some cytokines (?L-2, ?L-6, ?L-8 TNF) and calcium regulating hormones (calcitonin, parathyroid hormone, 25 (OH) D) in the blood of patients with rheumatoid arthritis (RA) depending on rheumatoid factor (RF) and the assessment of the role of the revealed violations in the pathogenesis of bone loss in this pathology. For this purpose, 74 patients with RA (59 women, 15 men) aged from 27 to 71 were examined. On the basis of RF in the blood serum, the patients were divided into 2 groups: seronegative and seropositive RA. The control group included 16 healthy individuals (13 women, 3 men). The results obtained that the serological variant of RA affects the serum levels of proinflammatory cytokines and calcium-regulating hormones: more pronounced changes were found in seropositive RA. The high production of IL-2, IL-6, IL-8, TNF- and parathyroid hormone detected in both groups of patients undoubtedly contributes to the mechanisms of bone loss in RA. In both groups we detected hypovitaminosis D. This results recommended to use this vitamin in the complex treatment of RA. | [
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Paecilomyces variotii is a commonly occurring species in air and food, and it is also associated with many types of human infections. Tissue forms of the fungus Paecilomyces variotii or their cytoskeletons were revealed in the cytoplasm of erythrocytes in patients with allergy and bronchial asthma in paecilomycosis. Our study was aimed at investigating the role of red blood cells in the mechanisms of the nonspecific protection of the host in conditions of chronic persistent infection of the blood with the fungus of the genus Paecilomyces. We examined a total of eighty-four 16-to-72-year-old patients (39 men and 45 women) presenting with activation of paecilomyces infection in blood. We used laboratory, biochemical, allergic-and-immunological and microbiological methods of study. Fungal cultures were identified phenotypically and by means of phylogenetic analysis.Our findings are suggestive of a new type of the oxygen-dependent mechanism of cytotoxicity of erythrocytes, which is caused by permanent formation of reactive oxygen species as a result of non-enzymatic oxidation of haemoglobin to methaemoglobin. The resulting superoxide anion radical (O2-), hydrogen peroxide (H2O2), and hydroxyl radical (OH-) exhibit a powerful bactericidal action which is, probably, activated when the fungal cells are captured and immersed in the erythrocyte cytoplasm or in a closed cavity formed by RBCs around large fungal cells. In conditions of chronic blood infection with tissue forms of fungi of the genus Paecilomyces oxygen-dependent cytotoxicity of erythrocytes is the main mechanism of readjustment of blood from the infectious agent of Paecilomycosis. | [
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When the nasopharynx is colonized with toxigenic strains of the diphtheria pathogen, toxin is released, which contributes to the death of epithelial cells. But in bacterial carriers, the development of the clinical picture of the disease does not occur. This is due to the peculiarities of the state of their immune system, as well as the peculiarities of the production of diphtheria exotoxin by corynebacteria in the biofilm. Goal. Determining the nature of the cytopathic effect of C. diphtheriae as part of a biofilm in CHO-K1 cell culture. The planktonic and biofilm (120- and 720-hour) cultures of the strains were studied: C. diphtheriae gravis tox+ ? 665, C. diphtheriae gravis tox+ ? 6765, C. diphtheriae mitis tox+ ? 269, C. diphtheriae gravis tox+ isolated from a patient with a diagnosis Localized oropharyngeal diphtheria C. diphtheriae gravis with a silent tox-gene. Biofilm (120- and 720-hour) cultures of diphtheria pathogen strains were obtained according to the Watnik method. The cytopathic effect of corynebacterial strains was studied on a CHO-K1 cell culture, taking into account in an inverted microscope. When studying the cytopathic effect of planktonic cultures of toxigenic strains of corynebacteria, it was found that the number of living CHO-K1 cells after 24 hours was insignificant (25.31.2%) and sharply decreased (2.50.5%) after 72 hours of cultivation. Under the influence of biofilm and, especially, 720-hour cultures, a different cytopathic effect dynamics was found: the number of living cells after 24 hours remained significant (82.52.2%), while at 72-hour it decreased to 25.03.0%. In the study of filtrates of planktonic and biofilm cultures of C. diphtheriae strain with a silent tox-gene, similar patterns were revealed. However, the number of live CHO-K1 cells when exposed to the filtrate of a 720-hour biofilm culture was significantly higher (p?0.05) than when studying toxigenic strains of corynebacteria. Considering the nature of the cytopathic action, it was found that planktonic cultures of toxigenic strains of corynebacteria are characterized by a change in the cell monolayer, manifested by their thinning and elongation. The study of 720-hour biofilm cultures at 72-hour exposure revealed the appearance of a large number of rounded cells (63-69%). The cytopathic effect, formed under the influence of filtrates of planktonic and biofilm cultures of C. diphtheriae with a silent tox-gene, as well as strains of non-diphtheria corynebacteria, is characterized by rounding of cells and the formation of symplasts. In the biofilm, the intensity of the cytopathic effect of toxigenic C. diphtheriae strains and C. diphtheriae strain with a silent tox-gene decreased. CPD, manifested by thinning and lengthening of CHO-K1 cells, is associated with the action of diphtheria exotoxin, and rounding is associated with corynebacterial enzymes and, apparently, fragments of surface structures - adhesins. Decreased release of toxin and enzymes beyond the C. bihfilm matrix is a significant cause of the asymptomatic carriage of diphtheria. | [
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Based on experimental studies with 10-fold dilutions of two the strains TBEV of the Far Eastern subtype, different in moleculargenetic characteristic complex data of simultaneously taking into account three indicators of their verification (virus titer, ELISA and PCR-RT) were obtained. The efficiency of detecting a genetic marker in PCR compared with ELISA for a weakly pathogenic strain with defects in the genetic structure was higher by a factor of 10, and for a highly pathogenic strain by a factor of 5,000. At the same time, positive results in both reactions with respect to two strains were detected with a virus titer of not less than 1-1.5 log TCID50, i.e. this level of virus in the sample is defined as epidemically significant. An algorithm for conducting research on the verification of TBEV is proposed: 1) Ticks collected from vegetation can be examined by ELISA or by PCR. All positive results can be summarized and considered viral ticks; 2) All samples with positive results only in PCR or ELISA must be investigated in two reactions in order to obtain confirmation of the possible infectivity of the pathogen; 3) To obtain a fast complex result of infection of the removed ticks from patients or blood after a tick bite, studies should be carried out simultaneously in two reactions simultaneously in ELISA and PCR; 4) Isolation virus should be carried out in biological samples (ticks collected from vegetation, ticks removed from patients, the blood of patients with suspected TBE, mammals) only with the same results in PCR and ELISA. Thus, such an approach to verifying TBEV in a tick or in the blood of patients will improve the reliability of laboratory diagnostics, identifying not only markers of TBEV, but also determining the infectivity of the pathogen, which may be the basis for the appointment of early intensive antiviral therapy. | [
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] |
When studying the effect of the metabolic products of clinical isolates of enterococci on the viability of Candida albicans, it was found that metabolites of all tested strains of Enterococcus faecium, E. faecalis had a fungistatic effect. At the same time a reliable fungicidal effect is a strain-specific feature. It is better to use the method of delayed antagonism on double-layer agar to assess the antifungal effect of enterococcal metabolism products. | [
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The reagent kit AmpligenBurk-mallei/pseudomallei-RT PCR is designed for detecting in vitro diagnostics and differentiate the DNA of glanders and melioidosis pathogens by real-time multiplex PCR in biological (clinical) material and cultures of microorganisms, as well as environmental objects and solid food products (rice). During clinical testing diagnostic value of reagent kit AmpligenBurk-mallei/pseudomallei-RT PCR has been studied. Based on the results obtained, a high analytical sensitivity (1?103 microbe cells/ml) and specificity (100%) of PCR-RT with the developed reagent kit were established, regardless of the type of material being studied. The diagnostic sensitivity of PCR-RT using a set of reagents was at least 98.0% and specificity at least 99%. The stages of state examination have been completed, a registration certificate has been obtained at Roszdravnadzor, production, sale and use of reagent kit in medical laboratory practice have been permitted. | [
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] |
OBJECTIVES: The gut microbiome is regarded as an essential dynamic organ that functions in nourishment, epithelial development and innate immunity. One important benefit of the dietary polysaccharides to human health is due to its fermentability in gut. It is been known quite well that dietary fiber is able of impacting colon microbiota. Fermented products from these polysaccharides, especially short-chain fatty acids (SCFAs) are bioactive molecules with health benefits. It is proposed that the dietary polysaccharide-deriving SCFAs could be converted into glucose and /or directly signal intestinal receptors and therefore contribute the benefits via gut-brain neural circuits. In addition, fermented polysaccharides can facilitate the beneficial bacteria to generate bioactive molecules important for the normal maturation of the host immune system. Manipulation of the microbiota and metabolites from intestinal microbiota might be a promising new approach for the prevention or treatment diseases (Fig. 2, Ref. 30). | [
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] |
OBJECTIVE: Spinal epidural fibrosis is commonly seen after laminectomy. There is not yet proven any agent preventing fibrosis in clinical usage. We used diclofenac sodium and diltiazem, which are fibrosis inhibitors.METHODS AND MATERIALS: 40 rats were divided into four groups of equal numbers: control, diclofenac sodium, diltiazem, and diclofenac sodium + diltiazem. Laminectomies were performed at L5 and L6. After a 4 week period, the rats were decapitated and the vertebral column blocks were removed for histopathologic examination. Fibrosis percentage, spread of fibrous regions, and fibroblast numbers were evaluated in each group and compared between the groups.RESULTS: The distribution of epidural fibrosis density, percentage of fibrosis, and distribution of fibroblasts in the diclofenac sodium + diltiazem group were significantly lower than in the other groups. The fibroblast numbers of the diltiazem, and diclofenac sodium + diltiazem groups were significantly lower than in the other groups.CONCLUSION: Diclofenac sodium + diltiazem used together provided better outcomes because each of them prevented fibrosis via different ways, probably through synergistic action (Tab. 5, Fig. 3, Ref. 43). | [
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] |
OBJECTIVES: We investigated the changes in the IL-6 and STAT3 expression levels in cachectic and non-cachectic patients with gastric, lung and breast cancer and evaluated the association between IL-6 and STAT3 levels and cancer types in terms of cachexia condition.BACKGROUND: Cancer-associated cachexia, observed in nearly 50‒80 % of cancer patients, has drawn attention in advanced patients. IL-6/JAK/STAT pathway plays an essential role in the progression of cancer cachexia through the regulation of the inflammatory response.METHODS: This study consisted of 48 gastric, breast and lung cancer patients (18 cachectic and 30 non-cachectic) and healthy individuals. Total RNA isolation and cDNA synthesis was performed after the collection of blood samples. IL-6 and STAT3 expression levels were analyzed by RT- PCR analysis.RESULTS: Our findings demonstrated that IL-6 mRNA levels considerably increased 19.898.25, 5.182.81 and 15.339.54-fold in gastric, lung and breast cancer patients with cachexia, respectively. Additionally, a 16.677.13, 14.2111.72 and 8.853.89-fold increase in the STAT3 expression level was detected in cachectic gastric, lung and breast cancer patients, respectively (p<0.01).CONCLUSION: STAT3 may be considered as a therapeutic target for cachectic patients with gastric, lung and breast cancer. Furthermore, IL-6 mediates STAT3 activation in cachectic gastric and breast cancer patients (Tab. 5, Fig. 2, Ref. 62). | [
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] |
BACKGROUND: This study was aimed to reveal whether there is a relationship between Raynaud Phenomenon (RP) and Helicobacter Pylori (HP).MATERIAL AND METHODS: Seventy-nine patients, who had been referred to outpatient clinic with Raynaud in the last 9 years were retrospectively screened. Of these, 29 patients with access to their data and who had HP screening tests were included in the study.RESULTS: HP direct antigen was found in feces in only one of 29 patients. When we compared the results of this study to the results of previous literature, it was observed that the patients admitted with RP symptoms by a gastroenterology outpatient clinic had a higher incidence for HP (+) scanning than the patients admitted with RP symptoms by a cardiovascular surgery policlinic (CVSOC).CONCLUSION: Although previous literature reports that HP leads to RP in the group of patients referred to other outpatient clinics, the same relation is very low in the Raynaud patient group in CVSOC. Patients admitted with RP in the CVSOC shouldn't be prescribed empirical antibiotic therapy for the eradication of HP. However, as the appropriate antibiotic regimen can resolve Raynaud symptoms in the presence of a HP(+) test, it makes this scanning rational for all symptomatic patients (Tab. 1, Fig. 1, Ref. 23). | [
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Head and neck squamous cell carcinomas (HNSCC) are a highly heterogenous disease which can be induced by two main carcinogens - tobacco and/or alcohol, or by HR HPV infection. This work examined 60 paraffin-embedded biopsies of head and neck carcinomas after histological verification. HPV infection, including its specific types in various HNSCC areas, was studied using multiplex qPCR. Expression levels of p16INK4A and p53 were detected by subsequent IHC analysis as being potential diagnostic markers. Based on the assumption that patients with HNSCC could benefit from anti-EGFR therapy (cetuximab), but the predictors are not yet defined, analyses of point mutations of ras genes (Kras, Nras) were carried out using multiplex qPCR and sequence analysis of the Braf gene. All statistical data were processed by Ch?-x2 test.HPV infection was detected in 23.34 % of cases with HNSCC, of which 100 % were HPV 16, which is the most frequently infection found in the oropharyngeal region. Using IHC analysis, a positive expression of P16INK4A was detected in 100 % of HPV-positive HNSCC while this expression was discovered to be highly correlated with HPV infection. Furthermore, a correlation between p53 and HPV-negative HNSCC was proved. The mutation incidence was the highest in the Kras gene (codon 12 and codon 146), Nras (codon 12) and Braf. A correlation between tumor location in the oropharyngeal region and Kras mutations was proved. The HPV infection correlated with Kras mutations in case of codon 146 but on the grounds of low amount of output data, these figures could be irrelevant. In one case, c.1808 G>A, protein 603 Arg>Gln mutation was found in the Braf gene but its correlation with head and neck carcinomas has not been described yet (Tab. 2, Fig. 2, Ref. 24). Keywords: head and neck carcinomas, biopsy, HPV types, PCR, p16INK4A, p53, molecular predictors, Kras, Nras, Braf. | [
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INTRODUCTION: Although the immunohistochemical staining with cytokeratin 7 (CK7) is an adjuvant method for identifying various components of the intrahepatic biliary system, the expression of CK7 does not occur in hepatocytes. In the literature, some studies suggest that a group of cells having dual morphologic and immunophenotypic characteristics of bile duct epithelium and hepatocytes, referred to as progenitor stem cells, was stained positive with CK7.MATERIALS AND METHODS: In this study, we examined a total of 219 cases diagnosed with autoimmune hepatitis, chronic hepatitis B, chronic hepatitis C, and primary biliary cholangitis between 2005 and 2017 in Uluda? University, Faculty of Medicine, Department of Medical Pathology.RESULTS: The comparisons of AIH cases with HepB, HepC and PBC cases demonstrated that the immunoreactivity to CK7 was significantly higher in the AIH group (p < 0.005) compared to the groups of HepB and HepC, whereas no significant differences were found between the AIH and PBC groups.CONCLUSIONS: In our study, it was concluded that the immunoreactivity to CK7 could be used as an adjuvant treatment to the clinicopathologic assessment in distinguishing between the AIH cases and chronic viral hepatitis. However, since CK7 immunoreactive hepatocytes were widely detected also in patients with chronic viral hepatitis, and there was no statistically significant difference between the PBC and AIH cases, it has been established that the inclusion of CK7 immunoreactivity into the diagnostic histopathological criteria for AIH would not be convenient (Tab. 1, Fig. 1, Ref. 22). | [
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INTRODUCTION: The aim of this study is to investigate the effects of obstructive jaundice on the liver and effectivity of alpha‑lipoic acid on liver damage and oxidative stress.MATERIALS AND METHODS: Thirty‑six male Sprague‑Dawley rats were divided into 3 groups per 12 animals, namely into Group I (control group): the bile duct was only mobilized by laparotomy, Group II (bile duct ligation group - BDL): the common bile duct was closed with clips and OJ was caused after laparotomy, and Group III (bile duct ligation and alpha‑lipoic acid group - BDL+LA): after closing the common bile duct, LA was administered in an intramuscular dose of 50 mg/kg for 10 days. On the 10th day, malondialdehyde, glutathione and superoxide dismutase levels were measured in liver and histopathological evaluation was performed.RESULTS: AST (U/L)/ALT(U/L) in groups I, II and III were 155.33/51.83, 445.28/165.89, 380.78/173.33, respectively (p < 0.005). Superoxide dismutase and glutathione levels were lower in patient groups than in the control group (0.31 l/g vs 0.36 l/g; p < 0.05). After the lipoic acid treatment, none of the biochemical markers of liver improved. Only the increase in superoxide dismutase (0.31 l/g and 0.34 l/g in groups II and III, respectively) and glutathione levels (0.16 l/g and 0.22 l/g in groups II and III, respectively) was statistically significant (p < 0.05).CONCLUSIONS: Histopathological damage was statistically significantly decreased and antioxidant levels were statistically significantly increased after LA treatment (Tab. 1, Fig. 6, Ref. 23). | [
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] |
BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with sleep disturbances that may result from abnormalities in melatonin production. The correlations of melatonin levels with the severity of sleep disorder and/or severity of ASD were reported.OBJECTIVES: To evaluate urinary levels of the melatonin metabolite, 6-sulphatoxymelatonin (aMT6s), in children with ASD, and their associations with sleep abnormalities and behavioural impairments.METHODS: Study involved 77 children with ASD and 84 controls aged 2.5‒15.5 years. Sleep disorders were assessed by Children's Sleep Habits Questionnaire. Morning and afternoon levels of aMT6s were determined by radioimmunoassay method. Urinary creatinine levels were assessed by an enzymatic method.RESULTS: The urinary aMT6s/creatinine values indicate that the night-time melatonin levels are significantly lower in ASD than in controls, but there are no significant differences in the daytime levels. In the ASD group, on average, a 6.8-fold difference between night-time and daytime values of urinary aMT6s/creatinine was found, whereas for the controls a 12.5-fold difference was observed, indicating a lower night-time increase in melatonin levels. In ASD group, the difference in night-time-daytime aMT6s/creatinine value correlated with some types of sleep problems, but not with the severity of ASD.CONCLUSION: The results indicate that in ASD there are differences in the patterns of melatonin secretion that may be associated with sleep impairment (Tab. 4, Fig. 2, Ref. 28). | [
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] |
AIM: To investigate the relationship between hemogram parameters and bacterial growth in cultures of blood, urine or sputum in intensive care unit patients.METHODS: This retrospective, observational, cross-sectional study was conducted in a tertiary referral hospital between March 2015 and December 2017. Baseline demographic and clinical characteristics, hemogram parameters and other laboratory test results of patients admitted to intensive care unit were recorded. Patients were divided into two groups as patients who were infected, and those who did not have any infectious agents grown in the culture dish, and then the groups were compared with each other.RESULTS: There were no significant differences between the groups in terms of baseline demographic and clinical characteristics. When the groups were compared in terms of hemogram parameters, the neutrophil‑to‑lymphocyte ratio (p < 0.001), platelet‑to‑lymphocyte ratio (p = 0.013), plateletcrit (p = 0.028) and mean platelet volume (p < 0.001) were significantly higher in infected patients than in non-infected patients.CONCLUSION: We suggest that neutrophil‑to‑lymphocyte ratio, platelet‑to‑lymphocyte ratio, plateletcrit, and mean platelet volume could be used as infection markers in the intensive care unit population (Tab. 1, Ref. 25). | [
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] |
AIM: We intended to investigate the association of bilirubin with total mortality in patients with chronic total coronary occlusion (CTO).METHODS: We included 172 patients who underwent coronary angiography due to stable angina pectoris and had CTO. We checked the viability of patients after 9 years of follow-up.RESULTS: Direct bilirubin levels were significantly lower in the non-viable group. We revealed age (OR = 1.045, 95% C.I: 1.009‒1.083; p = 0.015) and direct bilirubin concentrations (OR = 0.029, 95% C.I: 0.002‒0.435; p = 0.029) as independent predictors of mortality. Direct bilirubin value of > 0.2 mg/dL was associated with decreased mortality with a sensitivity of 85 %, and a specificity of 46 %.CONCLUSION: Serum direct bilirubin concentrations independently predict total mortality in patients with chronic total occlusion over 9 years of follow-up (Tab. 1, Fig. 2, Ref. 23). | [
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] |
AIM: The aim of the work was to evaluate the voice quality of 10 adult patients after thyroplasty type I using a silicone block. Preoperatively patients suffered from unilateral vocal fold paralysis.MATERIAL AND METHODS: We evaluated selected preoperative and postoperative patient findings (RBH according to Wendler classification, videolaryngostroboscopy and maximum phonation time MPT). The evaluation was performed by a phoniatrician and clinical speech therapist, using patient medical records and the Lingwaves and Glottis Analysis Tools (GAT) programs.RESULTS: Preoperatively we identified R1B1H1 - R3B3H3, postoperatively R0B0H0 - R3B3H2. In six cases the paralysed vocal cord was preoperatively in a paramedian position, twice in intermediate position and twice in a lateral position. In the case of 6 patients presbyphonic changes were present. Motility of the healthy vocal cord was within the norm. Postoperatively, the paretic vocal cord was medialised. We assessed the MPT value: preoperatively 3‒10 seconds, postoperatively 9‒17 seconds. Postoperatively we measured jitter (%), shimmer (%) and closing quotient values. In comparison with healthy subjects (Inwald et al. 2011), jitter and shimmer values were higher and closing quotient values after thyroplasty type I close to normal values (Tab.1).CONCLUSIONS: The postoperative voice quality was significantly better in comparison with the preoperative state; though, it never achieved the parameters of a normal voice. We confirmed the significant contribution of TPL I for the patients? quality of life through partial rehabilitation of their voices. | [
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BACKGROUND: Drug usage in pregnant women is associated with a problem of possible negative influence on prenatal development. It is always necessary to judge the need for drug administration during pregnancy.OBJECTIVE: The aim of presented study was to analyse data about pregnant women hospitalized in the postpartum period.METHODS: The study was designed as a retrospective observational study including 300 women hospitalized at the 2nd Department of Gynaecology and Obstetrics, University Hospital, Bratislava. Data were obtained through questionnaires in form of an interview.RESULTS: The average age of women was 30.79 4.40 years. Risk pregnancy occured in 20.59 % of women. Chronic disorders before pregnancy required regular pharmacotherapy in 29.24 %. Drug usage analysis: I. trimester, 31 % used at least one drug, 52 % nutritional supplements, 63.3 % drug and/or nutritional supplement; II. trimester, 23 % used at least one drug, 45 % nutritional supplements, 58.3 % drug and/or nutritional supplement; III. trimester, 32 % used at least one drug, 67 % nutritional supplements, 75.3 % drug and/or nutritional supplement.CONCLUSION: Drug usage during pregnancy requires great precaution at choosing pharmacotherapy. The benefit of pharmacotherapy should always outweight the potential risk of administered drug (Tab. 3, Fig. 3, Ref. 37). | [
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BACKGROUND: Adhesion is the initial process in the establishment of any infection and can contribute to bacterial pathogenesis. Without the ability to adhere to host cell surface, there is no invasion, dissemination, or persistence and host colonization by many bacterial pathogens, including B. burgdorferi. During the infection, B. burgdorferi cells interact with cells of various origins. We are having limited information and knowledge regarding the borrelial invasion, intracellular existence and the host cell damage and the pathological effects to the host. We have investigated by electron microscope the adherence of motile Borrelia burgdorferi s.l. to Vero cells derived from the kidney of an African green monkey by electronmicroscopy. These cells have been shown as an interesting model for study of the toxic potential of many bacterial pathogens.METHODS: Adherence of the long-term in vitro passaged Borrelia burgdorferi sensu lato strains to a 24-hour monolayer of primate kidney epithelial Vero cells was studied using transmission electronmicroscopy. The reaction was read after incubation at 1-hour intervals.RESULTS: A vertical contact between borreliae and Vero cells was confirmed already after one hour of in vitro incubation. A cytotoxic effect of borreliae could be observed when the time of incubation was extended to 4 hour. The extent of attachment varied between the two borrelia strains tested.CONCLUSION: The optimal time for spirochetal adhesion in our model was 1 h postinoculation. Our results suggest that borrelia attaches to the tested cells by length and by the tip. The data showed that the extent of attachment varied between the two borrelia strains tested (Tab. 1, Fig. 4, Ref. 21). | [
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The targeted delivery of nanomedicines into solid tumors remains challenging in cancer treatment. Stem cells with tumortropic migration ability are promising as biocarriers to transport nanomedicines. The transportation of nanomedicines into cancer cells is the key step for tumor targeted delivery via stem cells. In this study, we designed a magnetic nanocube (scMNP) loaded in mesenchymal stem cells for magnetic hyperthermia of prostate cancer, and the delivery and transportation pathways into the cancer cells were fully investigated. The MSCs acted as the carrier of the loaded scMNPs along with the upregulation of CXCR4 for the migration to cancer cells. The therapeutic effect was mainly due to scMNPs via magnetic hyperthermia. Stem cell-derived microvesicles containing scMNPs played an essential role in the crosstalk between stem cells and cancer cells for targeted delivery. Both in vitro and in vivo studies demonstrated that the system showed satisfactory therapeutic efficiency under magnetic hyperthermia therapy. Our investigation presents a comprehensive study of magnetic nanoparticles in combination with MSCs and their extracellular microvesicles and is promising as an effective strategy for magnetic hyperthermia therapy of prostate cancer. | [
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Verteporfin photodynamic therapy (PDT) has been approved for the treatment of exudative age-related macular degeneration (AMD) for over a decade. However, its extensive application has been impeded by inevitably collateral tissue damage and immediate induction of angiogenesis, in addition to the need of multiple treatments. In order to develop prospective photosensitizers for clinical use, a triphenyl phosphonium-modified cationic liposomal hypocrellin B (TPP cationic LHB) for angiogenic targeting and endothelial internalization was constructed. With optimal PDT parameters, TPP cationic LHB can lead to death of choroid-retinal vascular endothelial cells while cause negligible damage to collateral retinal pigment epithelium cells. This is likely due to the mitochondria targeting and effective intracellular singlet oxygen generation of TPP cationic LHB in vascular endothelial cells. Additionally, in vivo chick chorioallantoic membrane assay indicated the elevated neovessel-targeting ability and photo-induced anti-angiogenic activity of TPP cationic LHB. Furthermore, TPP cationic LHB PDT is able to maintain neovessel occlusion for an extended period of time compared with verteporfin PDT, without inducing significant increased expression of some angiogenic factors, such as vascular endothelial growth factor and integrin v₃. This study describes a facile strategy that may be useful for developing new-generation photosensitizers to circumvent the limitations of PDT treatment of exudative AMD. | [
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Herein, we report the functional decoration of single-walled carbon nanotubes (swCNTs) with Pt dendrimer-encapsulated nanoparticles (Pt DENs) (dia. (1.78 0.18) nm) for the amperometric sensing of glutamate. The functional decoration of swCNTs was carried out via electrochemical grafting of Pt DENs onto swCNTs, and subsequent cross-linking of glutamate oxidase (GluOx) enzymes to the grafted Pt DENs on swCNT surfaces. The critical role of Pt DENs as catalytic immobilization matrix allowed both the immobilization of GluOx enzymes while maintaining the enzymatic activity of GluOx, and the electrocatalytic oxidation of H₂O₂ generated enzymatically in the presence of glutamate. Taking advantage of Pt DENs as catalytic immobilization matrix, the resulting swCNTs films, denoted as GluOx/Pt DEN/swCNTs, were applied as amperometric sensing platforms that display superior analytical characteristics, including sensitivity, selectivity, stability, and reproducibility, to the non-catalytic counterpart (i.e., GluOx/swCNTs), which led to the promising application of GluOx/Pt DEN/swCNTs to the practical analysis of glutamate in real samples. | [
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Developing basement membranes (BMs) substitute remains major problem for constructing functional tissue engineered skin because of its complex structure and multifunction of regulating cellular behavior. Herein, a stable electrospinning method was employed to generate a biomimetic model of natural BMs based on novel scaffold electrospun from Poly(?-caprolactone) (PCL) and cellulose acetate (CA) incorporated with chitosan (CS). The morphology, structure, surface hydrophilicity, roughness and mechanical tensile strength of prepared monolayer and tri-layered scaffold were comprehensively compared. Besides, co-culture system via seeding keratinocytes (Kcs) and fibroblasts (Fbs) on opposite side of tri-layered scaffold revealed more effective segregation of both cell types within the central nanofibrous barrier together with enhanced cell attachment and proliferation than that on the monolayer scaffold. Moreover, the deposition of type VII collagen and laminin-5 was examined in comparison with normal skin BMs. Furthermore, the histological studies revealed characteristics of reconstructing BM zone at the junction of dermis-epidermis after in vivo implantation for 2 weeks, and wound healing while the seeded cells interacted with the endogenous cells. Additionally, the expression of active integrin 1 and phosphorylated focal adhesion kinase (FAK) was promoted with treatment of tri-layered scaffold. This study stressed that this tri-layer scaffold might provoke biomimetic responses of Kcs and Fbs and thus be applied for future development of BMs containing tissues. | [
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Hydrogels have been widely used to mimic the biochemical and mechanical environments of native extracellular matrices for cell culture and tissue engineering. Among them, self-assembling peptide hydrogels are of special interest thanks to their great biocompatibility, designability and convenient preparation procedures. In pioneering studies, self-assembling peptide hydrogels have been used for the culture of bone marrow cells. However, the low mechanical stability of peptide hydrogels seems to be a drawback for these applications, as bone marrow cells prefer hard substrates for osteogenic differentiation. In this work, we explored the use of hydroxyapatite (HAP)-peptide hybrid hydrogels for three-dimensional (3D) culture and differentiation of osteogenic MC3T3-E1 cells. We used HAP nanoparticles as crosslinkers to increase the mechanical stability of peptide hydrogels. Meanwhile, HAP provided unique chemical cues to promote the differentiation of osteoblasts. A phosphate group was introduced to the self-assembling peptide so that the peptide fibers could bind to HAP nanoparticles specifically and strongly. Rheological characterization indicated that the hybrid hydrogels were mechanically more stable than the hydrogels containing only peptides and can be used for long term cell culture. Moreover, the hydrogels were biocompatible and showed very low cytotoxicity. The favorable mechanical properties of the hybrid hydrogels and the chemical properties of HAP synergistically supported the differentiation of MC3T3-E1 cells. Based on these characterizations, we believe that these hybrid hydrogels can potentially be used as scaffolds for cartilage and bone regeneration in the future. | [
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Breast cancer tends to spread to other organs and bone metastasis has the highest frequency in breast cancer metastasis, while its mechanisms are not clear and the current treatments are not very effective. To better study the mechanisms and facilitate drug screening for breast cancer bone metastasis, an in vivo mouse model needs to be constructed. However, the construction of the humanized mouse model for cancer bone metastasis which will mimick real interactions between cancer tissue and bone tissue in the human microenvironment remains a challenge. In this study, we constructed a human engineering bone tissue composed with the human osteoblast-like cells (SaOS-2 cells) and the silica nanoparticlesincorporated human demineralized bone matrix (Si/DBM). The engineered bone was then transplanted into a nude mouse to build a humanized bone microenvironment. The human breast cancer cells were then injected into the fat pads of the nude mouse to form an orthotopic tumor. The results showed that the engineered bone tissue-constructed humanized bone microenvironment had significant advantages when inducing human cancer cells to metastasize into the engineered bone tissue. Further, the SaOS-2/Si/DBM had a stronger ability to entice cancer-bone metastasis through promoting osteogenesis compared to the SaOS-2/DBM. Accordingly, this study highlights a novel, facile and effective mouse model for human cancer-bone metastasis, which will provide a platform to explore the mechanisms and anti-tumor drug screening for cancer-bone metastasis. | [
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Busulfan and other chemotherapeutic drugs used in the treatment of cancer may result in temporary or even permanent damage to spermatogenesis. During spermatogenesis, the rapidly dividing spermatogonia are highly susceptible to chemotherapy. Consequently, there is significant interest in developing an approach that could provide stimulation and regenerate spermatogenesis after chemotherapy. In a previous study, we suggested the potential application for vascular endothelial growth factor C (VEGFC) because of its key role in stimulating the proliferation of spermatogonia. However, methods to facilitate the recovery of spermatogenesis in such patients using VEGFC, or other regulatory factors, are sorely lacking because of the rapid degradation of these proteins and restrictions created by the blood-testis-barrier. To this end, we loaded VEGFC into polyanion dextran sulfate incorporated in a polycation chitosan shell to produce VEGFC sustained-release ultrafine particles (UFPs, CS-DS-VEGFC). We tested such particles in an azoospermic mouse model, created using busulfan. For each mouse, CS-DS-VEGFC was injected into the seminiferous tubules of one testis, while unloaded UFPs (CS-DS), or the VEGFC protein alone, was injected into the opposite testis as a control. All mice were sacrificed and evaluated 5 weeks later. Spermatogenesis in the tubules that were injected with CS-DS-VEGFC was clearly better than those injected with controls, and contained more spermatogonia and spermatocytes, along with Ki67 and PCNA positive-cells per tubule. In addition, the phosphorylation levels of AKT and MAPK in these tubules were also higher than in controls, indicating that CS-DS-VEGFC could induce the sustained activation of these pathways. In conclusion, CS-DS-VEGFC, combined with the efferent tubule injection technique, is a feasible approach with which to improve the regeneration of spermatogenesis in busulfan-induced azoospermic mice. | [
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Hepatitis B virus (HBV) is closely related to occurrence and development of viral hepatitis. A mutation of 1896nt locus in its pre-C region can promote replication of HBV DNA and improve stability of pre-genome RNA structure, and can even help HBV evade immune clearance. In this study, magnetic beads-probe (MBs@probe) method, combined with single base extension (SBE) technology, was developed for in-situ mutation detection of HBV pre-C region 1896nt locus. Before successfully completing the genotyping of 165 HBV samples, the crucial reaction conditions were first optimized, such as SBE temperature, MBs size and amount, and probe concentration on the surface of MBs. Experimental results showed that these conditions had significant effects on MBs@probe in-situ mutation detection. Comprehensive considerations, such as 58 C of SBE temperature, high fluorescence intensity and signal-to-noise ratios (SNRs) were obtained when MBs@probe complex was made by 100 g of 300 nm-MBs and 3.0 M of probes in the system. Finally, 1896nt locus mutation in pre-C region of 165 HBV samples was successfully genotyped, among which 71 HBV samples were wild types and the remaining 94 samples were mutant types. Meanwhile, 14 randomly chosen samples were taken to further analyze fluorescence intensity and SNRs respectively, and sequencing results for the first two samples were consistent with results from the MBs@probe in-situ mutation detection method. Compared with two-color fluorescence hybridization (TCFH) genotyping technology, this method generally improves the SNRs to more than 10 (which is more than 2-fold), has higher reliability and is more suitable to detect SNPs for known sites. | [
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Ischemic strokes are caused by decreased blood flow into the brain, due to narrowed cerebral arteries. In the ischemic brain, high-mobility group box 1 (HMGB1) is released into extracellular spaces and induces inflammatory reactions. In this study, HMGB1 small interfering RNA (siRNA) was delivered into ischemic brains by intravenous administration using rabies virus glycoprotein (RVG) peptide-decorated exosomes. A fusion protein of RVG and Lamp2b was expressed in 293T cells. Since Lamp2b is an exosome membrane-integral protein, RVG-Lamp2b is integrated into the exosomes, producing RVG-decorated exosomes (RVG-Exo). HMGB1-siRNA was loaded into RVG-Exo and unmodified exosomes (Unmod-Exo) by electroporation. The exosomes were homogenous with a size of less than 50 nm and a negative surface charge. In vitro delivery assays showed that RVG-Exo showed higher efficiency to Neuro2A cells than Unmod-Exo. Also, HMGB1 levels were reduced more effectively by RVG-Exo/HMGB1-siRNA. In vivo delivery efficiency and therapeutic effects of RVG-Exo/HMGB1-siRNA were evaluated in a middle cerebral artery occlusion (MCAO) model. RVG-Exo/HMGB1-siRNA, Unmod-Exo/HMGB1-siRNA, and PEI25k/HMGB1-siRNA were administrated into the MCAO model intravenously through the tail vein. The results showed that HMGB1, tumor necrosis factor- (TNF-), and apoptosis levels in the brain were reduced in the RVG-Exo/HMGB1-siRNA group more efficiently than the other groups. In addition, the infarct size was decreased in the RVG-Exo/HMGB1 group more effectively than the other groups. These results suggest that RVG-Exo with HMGB1-siRNA may have potential as a therapeutic system for the treatment of ischemic strokes. | [
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With aging of population, changing of living habits, and intake of high-fat diet, more and more people have been suffering from cardio-cerebral apoplexy. The synchronous treatment of cardio-cerebral conditions based on an integral strategy may bring benefit to the better clinical efficacy. The simultaneously-targeting delivery of active molecules by nanoscale carriers to heart and brain remains unmet problem. The physiological difference of targets between heart and brain makes it a huge challenge which one targeting ligand modification acquires the delivery of two organs and treatment, simultaneously. Traditionally, dually targeting strategies are introduced to enhance the selectivity for one aimed tissue and delivery efficiency of these particles. However, the interference between two targeting ligands on the surface of nanoscale carriers may influence the affinity of these ligands with their receptors or transporters, resulting to the change distribution of carriers. Herein, we observed that how anti-cardiac troponin I (cTnI) antibody (Ab) conjugated with the linker, polyethylene glycol (PEG), on the surface of liposomes influenced the affinity of mannose derivatives with transporter and regulated distribution of these vesicles in the heart and brain. The dually targeting liposomes can target to the heart and brain tissue simultaneously by the regulation length of PEG chain linking with p -pentanoic acid phenyl--D-acetylmannosamine (Ac₄MAN). These results may bring benefit to design the multi-modification of nanocarriers and the treatment of cardio-cerebral diseases. | [
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Limited understanding of mitochondria disorders that induced by nanoparticles is a stumbling block for anti-cancer drug delivery targeting strategy. In present study, C6 glioma cells were exposed to aminated and alkylated SiO₂ nanoparticles for mitochondrion disordering and cell metabolism study. Collective results showed that aminated nanoparticles tend to trigger the cell-repair mechanism in cancer cells while alkylated nanoparticles could cause irreversible damages on cancer cells, although both types of the particles were proved to damage mitochondrion. The underlying mechanism show that aminated nanoparticles induced proton-stuck effect in mitochondrion and self-repairing in cancer cells by up-regulating p21. Otherwise, alkylated nanoparticles damaged mitochondrion and induced phosphorylated cyclin E accumulation lead to Fbw7 down-regulation caused further S phase arrest and severe late apoptosis. This work can help us elucidate the mechanism of the clinic application of nano-drug carriers. | [
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Rheumatosurgery is a discipline managing the symptoms of rheumatoid arthritis of the musculoskeletal system. In a vast number of patients this disease starts in the wrist and hand. The portfolio of surgical procedures performed on the skeleton and soft tissues in these regions can be divided into two groups that, however, often times overlap in practice. Commonly, a combination of these surgical interventions is used. The surgical management should commence with prophylactic interventions that aim to slow down the development of rheumatoid deformities. These are followed by reconstructive surgery which shall manage the already developed rheumatoid deformities and their complications. The prophylactic interventions include early and late synovectomy, peritenosynovectomy, tenodeses, tendon transpositions and limited arthrodeses. The reconstructive surgery procedures comprise osteotomy, resection procedures, alloplasties, total arthrodesis and tendon reconstructions. Key words: rheumatoid arthritis, rheumatosurgery, hand, wrist. | [
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PURPOSE OF THE STUDY Osteoporotic hip fractures commonly associated with comorbid diseases and use of multiple drugs. Polypharmacy status and the comorbidity-polypharmacy score (CPS) are the most common two grading system to predict mortality risk for the trauma patients older than 45 years. The purpose of the study was to determine whether the CPS or polypharmacy can predict the mortality risk in the older patients had a surgery due to an osteoporotic hip fracture. MATERIAL AND METHODS Consecutive patients aged > 65 years had an osteoporotic hip fracture due to a simple trauma were enrolled in the study. Detailed data were collected included comorbid conditions, medications, T-scores and additional fractures. Patients were divided into four groups according to CPS classification and polypharmacy status was indicated in case of using five or more drugs before admission. Overall mortality was assessed using Kaplan-Meier survival testing. Factors influencing 1-year, 2-year and 5-year mortality were evaluated using a multivariate logistic regression model with adjusted odds ratios (AORs) and a threshold significance at p < 0.05. RESULTS A total of 109 patients (65% women) with a mean age 80 8.06 were included in the study. The mean time to death from the surgery was 42.06 34.9 months. The Kaplan-Meier survival curves showed a significant difference in mortality among CPS groups. (Log-Rank test < 0.001). CPS presented a significant prediction in 1-year (AOR: 4.2; p < 0.05) and 2-year mortality (AOR: 2.9; p < 0.05) after adjustment for several covariates (including age, gender, surgical procedure) whereas 5-year mortality did not reveal a significant prediction (p = 0.46) Polypharmacy existence did not independently predict both overall or year-based mortality (p > 0.05) . CONCLUSIONS CPS is a better predictor for mortality risk than polypharmacy existence in the first two years in the patients underwent surgery for an osteoporotic hip fracture. Key words:osteoporotic hip fracture, mortality, polypharmacy, comorbidity. | [
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PURPOSE OF THE STUDY In the Czech Republic a systematic neonatal hip screening has been performed for many decades. Its aim is to prevent, by means of early treatment of hip dysplasia in the newborn period, the development of hip deformities leading to the onset of degenerative hip changes during the adulthood. The study aims to prove the effects of paediatric hip care based on the data analysis of the Czech National Register of Joint Replacement. MATERIAL AND METHODS The National Register of Joint Replacement comprises information on implantation of hip arthroplasties performed over the period of last 15 years, while the screening has been carried out for almost 60 years. An analysis of the patients' data from the register was conducted; the data was sorted by the diagnosis leading to surgery in individual age categories and individual years. The obtained data was correlated with the systems of newborn hip screening at the time when the treated generations of patients were born. RESULTS According to the National Register of Joint Replacement, in the period 2003-2017 a total of 174,515 primary hip joint replacements were performed, 345 total hip arthroplasties (0.19 %) were implanted for complete hip dislocation in dysplasia, 14,139 replacements (8.10%) were performed for postdysplastic hip degeneration. By comparing the periods 2005-2007 and 2015-2017 a decrease almost to a half of the number of implanted endoprostheses for hip dislocation was identified. Moreover, only 8 of 345 dislocated hips in the Register were managed by joint replacement in patients who were born during the systematic screening period. The percentage of endoprostheses implanted for postdysplastic degeneration decreased respectively; in 2005-2007 period 2,692 of 28,525 hip endoprotheses (9.44%) were implanted, whereas in 2015-2017 period 3,285 of 46,228 hips (7.11%) were operated on. This decline is statistically significant (p < 0.001, OR 1.34). DISCUSSION The efficiency and success rate of sonography resulted in Central Europe in such a rapid expansion of neonatal ultrasound hip screening that no comparative studies were carried out to confirm this concept (as is currently requested by evidencebased-medicine). This has later become the source of misunderstanding and subject to criticism primarily in the overseas literature. Those who focus on ultrasound screening feel that conducting prospective randomised studies on (non)treatment in ultrasound detected pathologies is ethically unacceptable today. When seeking another way of confirming the efficiency of universal screening, a detailed analysis of data from the hip joint replacement registry has proven successful. CONCLUSIONS A low number of arthroplasties implanted for hip dislocation in the Czech population is recorded in the National Register of Joint Replacement. This confirms the success of the existing system of neonatal hip screening; the results show that the treatment of hip dislocation in children is successful. The ongoing decline in the share of patients in the population treated by total hip replacement in postdysplastic degeneration has been confirmed. Data evolution will be subject to further research in the upcoming decades, with a positive effect of ultrasound monitoring of treatment to be foreseen. Key words: developmental dysplasia of the hip, screening, register of joint replacements. | [
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PURPOSE OF THE STUDY The pilot study deals with the current situation in proximal femoral fractures in culturally diverse regions, namely in Afghanistan (AFG) and in the Czech Republic (CZ). The study aimed to find out whether there are any differences in proximal femoral fractures in dependence on the selected criteria between the two culturally diverse areas. The study used the data of patients who underwent surgery for proximal femoral fracture at the Department of Orthopaedics of the 1 s t Medical Faculty of the Charles University and the Military University Hospital and at the Military Base Hospital Kabul. MATERIAL AND METHODS The study included patients aged 21 years or older who sustained a proximal femoral fracture in the period from October 2013 to February 2014. For the period concerned, the evaluation comprised 44 patients with a proximal femoral fracture from the Military Base Hospital Kabul, of whom 25 women and 19 men, and a total of 71 patients with a proximal femoral fracture from the Department of Orthopaedics of the 1st Medical Faculty of the Charles University and the Military University Hospital, of whom 43 women and 28 men. Based on the medical documentation, the following evaluation parameters were selected: age, sex, type of fracture. The data was processed using descriptive statistics, one-way and multifactorial analysis (ANOVA) and the POST-HOC test (Fisher LSD test, confidence interval = 95%) RESULTS The mean age of all the patients who suffered a fracture of proximal femur in AFG (58 years) was considerably lower (p < 0.001) than in patients in CZ (81 years). Similarly, a significant difference (p <0.001) was identified in the age of men and women treated for a proximal femoral fracture in both the countries. In AFG there was a statistically significant difference (p = 0.002) between the age of men and women, where women sustaining fractures were younger (54 years) compared to men (63 years). In CZ no significant age difference was reported (83 years vs 78 years). In AFG, the observed fractures occurred generally in their 6th and 7th decade, whereas in CZ only in their 9th decade. The incidence of proximal femoral fractures in Afghan women is the highest in their 5th and 6th decade. Pertrochanteric fractures and intracapsular fractures prevailed in both countries. The lowest age in both types of the fracture was reported in Afghan women (52 years in femoral neck fracture, p <0.001, 54 years in trochanteric fracture, p = 0.039). DISCUSSION Significant differences between the patients in AFG and CZ concern several factors. Afghanistan is a country with the lowest average life expectancy. In the Afghan population a major Vitamin D deficiency was confirmed. This is related to the conservative dress code, especially in women, when the Vitamin D synthesis is suppressed. That can cause the occurrence of osteoporosis in women at a considerably younger age than in the population in the Czech Republic, which is subsequently accompanied by an increased incidence of proximal femoral fractures. Similar results, however, were also obtained in men. One of the risk factors of osteoporosis development is also low physical activity throughout the lifetime. This risk factor is significant primarily in female population in the Muslim world. Afghanistan also faces serious malnutrition. All of that is reflected in low life expectancy in the given country, incidence of osteoporosis and injuries in this region. There is reasonable evidence that the mortality in a causal relationship with proximal femoral fracture is substantially higher in this region than in Western Europe. CONCLUSIONS The results of the pilot study showed that there are significant differences in age and frequency of fractures in dependence on sex and country. The obtained results can be considered valuable since there are virtually no scientific or professional studies on osteoporosis and fractures in the given area that would help physicians get ready for significant differences. These results may become a source of valuable information not only for medical practitioners coming to Afghanistan to help as volunteers in the framework of developmental assistance from all over the world, but also for physicians from Europe, with respect to the wave of migrants coming from this area. Key words: proximal femur, fracture, gender, age, Afghanistan, Czech Republic. | [
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