The importance of dermoscopy for the diagnosis of acquired bilateral telangiectatic macules: the angioid streak pattern reveals underlying chronic liver disease

Abstract

Background

Acquired bilateral telangiectatic macules (ABTM) are a newly recognized disease entity, which manifest as multiple telangiectatic pigmented macules confined mostly to the upper arms.

Objectives

To evaluate clinical and dermoscopic features in a group of 50 patients with ABTM and to determine the diagnostic usefulness of dermoscopy in ABTM

Methods

Patients were selected from two tertiary teaching hospitals in Korea (Pusan National University Hospitals [Busan and Yangsan]). Fifty patients (41 males and 9 females; mean age 48.1 years; range 26-78 years) with ABTM were included in the study. The dermoscopic findings were graded using a 4-point scale: none (0), mild (1), moderate (2), and severe (3). In addition, the results of 23 patients with and 27 patients without chronic liver disease (CLD) were compared to determine whether the presence of CLD affect dermoscopic findings.

Results

Three distinct dermoscopic patterns were observed; brown pigmentations, telangiectasia (linear-irregular vessels) and an angioid streak pattern. Brown pigmentation in the group without CLD had higher severity score than those in CLD group (mean score: 2.00 vs 1.48, P =0.033). However, mean telangiectasia severity score was higher in the CLD group (2.14 vs 1.39, P < 0.001). The angioid streak pattern was more severe and more common in patients with CLD than in those without (1.37 vs 0.35 (P < 0.001) and 63.0% vs. 26.1%, respectively).

Conclusion

Detailed observations with dermoscopy can provide first clues of the presence of ABTM and underlying chronic liver disease.

This article is protected by copyright. All rights reserved.

Disfiguring facial mycoses- a diagnostic and therapeutic challenge

Some fungal infections may lead to devastating destruction of face, sometimes followed by fatal consequences. Conidiobolus coronatus is a rare, but serious emerging fungal pathogen of humans, causing Conidiobolomycosis, commonly infecting nasal mucosa and with potential to extend to involve vital structures such as brain and eyes. Treatment of this infection is extremely difficult and can cause significant disfiguring sequale, unless aggressively treated. We illustrate an interesting case, encountered within a short space of time affected by such infections and emphasize the need for thorough evaluation, investigation and aggressive initial treatment to achieve a good clinical response.

This article is protected by copyright. All rights reserved.

‘It’s Just a Story’: Pornography, Desire, and the Ethics of Fictive Imagining

Evaluation of three chemical immobilization protocols in golden-headed lion tamarins (Leontopithecus chrysomelas) undergoing vasectomy surgery

Abstract

Background

The golden-headed lion tamarin (Leontopithecus chrysomelas), originally endemic to Bahia, was introduced in Rio de Janeiro. The species is currently found in remaining forests within the region of original occupation of the golden lion tamarin (Leontopithecus rosalia), which may compromise the survival of the golden lion tamarin. Groups of golden-headed lion tamarins were captured and translocated to Bahia. However, the area chosen reached its limit and males underwent to vasectomy procedures.

Methods

Animals were separated into 3 groups: S-ketamine and midazolam, S-ketamine and dexmedetomidine, and racemic ketamine and dexmedetomidine.

Results and Conclusions

Heart rate, sedation and muscle relaxation degrees, antinociception, and lidocaine consumption presented significant difference between midazolam and dexmedetomidine groups. Bradycardia was present on dexmedetomidine groups, with values remaining within the normal range. Dexmedetomidine groups present the best outcomes for muscle relaxation, sedation, and antinociception and were safe for vasectomy surgery in golden-headed lion tamarins.

Morphometric Analysis of the Umbilicus According to Age

Abstract

Background

Morphometric and anatomical analyses of the shape and position of the umbilicus have been conducted in adults, but umbilicoplasty in children remains challenging because growth is still occurring.

Objectives

The main objective of this study was to evaluate the difference in the position and shape of the umbilicus between childhood and adulthood. The secondary objective was to improve the surgical management of umbilicoplasty in children.

Methods

This prospective single-center study focused on the morphometric analysis of the umbilicus in 200 adults and children. All data, including standardized measures and pictures, were determined by one single operator.

Results

Despite a variation of approximately 2% in the xiphoid-pubis distance, the location of the umbilicus remains stable during the entire growth period. In a supine individual, the location is at one half to two thirds of the xiphoid-pubis distance (slightly lower in children), with a mean ratio of 0.57 for the xiphoid-umbilicus distance to the xiphoid-pubis distance. In the general population, the most common shapes are round and vertical oval. T-shaped umbilici were only observed in adults. Round and protruding shapes were twice as frequent in children under 18 as in adults. The horizontal oval shape was twice as frequent in adults.

Conclusions

Abdominal growth and changes in the repartition of subcutaneous adipose tissues with age are responsible for the vertical orientation and deepening of the umbilicus as well as its horizontal orientation. To promote final cosmetic outcomes, secondary umbilicoplasty must place the umbilicus between one half and two thirds of the xiphoid-pubis distance.

Level of Evidence: 4

Facial Plastic Surgery Clinics of North America: Functional Rhinoplasty

MarcusBenjamin C., ed. Facial Plastic Surgery Clinics of North America: Functional Rhinoplasty. New York, NY: Elsevier, 2017. ISBN-13: 978-0323528382. $98.99.

Eyelid Make-Up to Manage Transient Blepharoptosis After Botulinum Toxin Injection

Transient blepharoptosis is a feared complication after botulinum toxin-A (BTX-A) cosmetic injections into the upper third of the face. Alpha-adrenergic agonist eyedrops are usually employed to address this adverse effect.^1-3 However, response may vary among patients and their use may be associated with ocular adverse effects.^2-4 The use of eyelid make-up might be an alternative approach to manage temporary upper eyelid ptosis. The authors had previous experience using a similar approach to conservatively manage severe myopathic blepharoptosis cases when surgical correction was contraindicated.⁵

3-O-Glyceryl-2-O-hexyl ascorbate suppresses melanogenesis by interfering with intracellular melanosome transport and suppressing tyrosinase protein synthesis

Summary

Background

Ascorbic acid (AsA) has multifunctional benefits on skin beauty, such as the reduction in oxidative stress and the induction of collagen production. Among them, the prevention and improvement of skin pigmentation by AsA is a most important benefit for people. However, it is well known that AsA not only is quite unstable in formulations but it also has a low capability of skin penetration due to its hydrophilic property. In addition, existing water-soluble AsA derivatives that were developed to improve its stability also have low skin penetration.

Aim

To investigate the potential of a newly synthesized amphiphilic derivative of AsA, 3-O-Glyceryl-2-O-hexyl ascorbate (VC-HG), which has an added glyceryl group and a hexyl group, on skin beauty focusing on its skin lightening/whitening effects.

Methods

DNA microarray analysis and real-time PCR were used to clarify the effects of VC-HG on melanogenesis using B16 mouse melanoma cells. The effects of VC-HG on melanin synthesis, tyrosinase protein levels, and the inhibition of tyrosinase activity were evaluated.

Results

DNA microarray analysis revealed that treatment with VC-HG downregulated the expression of genes encoding tyrosinase and MyosinVa. Further, real-time PCR analysis showed the downregulation of tyrosinase, MyosinVa, Rab27a, and Kinesin mRNAs following VC-HG treatment. In addition, VC-HG caused decreases in tyrosinase protein levels and melanin synthesis.

Conclusion

We conclude that VC-HG has an impact on skin lightening/whitening by inhibiting tyrosinase protein synthesis and interfering with intracellular melanosome transport.

Clinical significance of interferon-γ neutralizing autoantibodies against disseminated nontuberculous mycobacterial disease

Abstract

Background

Interferon-γ neutralizing autoantibodies (nIFNγ-autoAb) are reported in patients with disseminated nontuberculous mycobacteria (NTM) infection and may function by increasing the infection risk. Notwithstanding, the prevalence of nIFNγ-autoAb as well as the clinical presentation, diagnosis, and natural history, of disseminated NTM infection in these patients is poorly understood.

Methods

In this retrospective observational study, data and sera for 331 Japanese subjects with mycobacterial infection were collected and analyzed. IFNγ-autoAb titers in sera were quantified using an enzyme-linked immunosorbent assay; neutralizing capacity was evaluated via flow cytometry.

Results

Disseminated NTM was identified in 50 HIV-negative patients. Of these, 30 of 37 (81%) immunocompetent patients had an increased nIFNγ-autoAb titer while only 1 of 13 (7.7%) immunodeficient patients had an increased nIFNγ-autoAb titer (p<0.0001, chi squared). Presenting symptoms were non-specific and NTM infection was not included in the differential diagnosis in most cases. All patients with disseminated NTM and increased a serum nIFNγ-autoAb level received prolonged antimicrobial therapy. In 6 cases when antibiotic treatment was discontinued, NTM infection recurred and required resumption of antibiotic therapy for infection control. The mortality rate was 3.2% in disseminated NTM patients with nIFNγ-autoAb and 21% in those without.

Conclusions

nIFNγ-autoAb were present in most patients with disseminated NTM infection without a diagnosis of clinical immunodeficiency. Diagnosis of disseminated NTM requires a high degree of suspicion and can be improved by measuring serum nIFNγ-autoAb titer. Long-term antibiotic therapy helps prevent recrudescent NTM infection.

Management of an outbreak of Exophiala dermatitidis bloodstream infections at an outpatient oncology clinic

Abstract

Exophiala (Wangiella) dermatitidis is a dematiaceous fungus that can grow in yeast or mold forms and is typically found in decaying organic matter. It can cause central nervous system disease, particularly in immunocompromised patients, and has been implicated as a respiratory pathogen in cystic fibrosis patients [1,2]. It has also been identified as a colonizer in the gastrointestinal tract [3]. However, bloodstream infections with this organism are exceedingly rare.

Dynamics of bacterial colonization with Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis during symptomatic and asymptomatic viral upper respiratory infection.

Abstract

Background

Virus is detected in about 80% of upper respiratory tract infections (URIs) in children and is also detectable in the nasopharynx of 30% of asymptomatic children. The effect of asymptomatic viral infection on the dynamics of bacterial density and colonization of the nasopharynx has not been reported.

Objective

To assess the presence and density of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in the nasopharynx of 4 to 7 year old children during URI and when well.

Methods

Nasal samples were obtained during 4 surveillance periods when children were asymptomatic and whenever they developed symptoms of URI. Respiratory viruses and bacterial pathogens were identified and quantified using PCR.

Results

The proportion of children colonized with all three bacteria was higher during acute URI visits compared with asymptomatic surveillance visits. Mean bacterial densities were significantly higher at all visits for all three pathogens when a virus was detected. The difference between the means was 1.0, 0.4 and 0.7 log₁₀ CFUe/ml for S. pneumoniae, H. influenzae and M. catarrhalis, respectively, compared with visits in which virus was not detected. The percent of children colonized and density were also higher at asymptomatic visits in which virus was detected compared with visits in which virus was not detected.

Conclusion

The density and frequency of colonization with S. pneumoniae, H. influenzae and M. catarrhalis in nasal washes increase during periods of both symptomatic and asymptomatic viral infection. Increases in bacterial colonization observed during asymptomatic viral infection were nearly the same magnitude as when children were symptomatic.

A leg ulcer with pulsating varicose veins – from the legs to the heart

ABSTRACT

We present the case of a 58-year-old man who presented to our wound care centre with a 7 -month history of a progressive unilateral leg ulcer. He reported intermittent, heavy bleeding at the ulcer. The duplex sonography showed a bilateral incompetence of the saphenofemoral junctions and the entire course of the great saphenous veins and, surprisingly, also a bilateral reversed arterial-like pulsating flow in the great and small saphenous veins as well as in the deep veins of the lower extremities. During cardiac examination by auscultation and echocardiography, we detected a previously undescribed severe tricuspid insufficiency with strongly reduced systolic ejection of both the left and the right ventricle and repercussions on the peripheral venous system as a cause for the pulsating veins. This case report highlights that, although infrequent, the presence of pulsating varicose veins points to the presence of cardiac abnormalities, especially severe tricuspid insufficiency, and should direct clinicians to initiate a thorough cardiological examination. Our case highlights that consequent compression therapy can be sufficient for wound healing in such cases and should be initially considered. These patients are at risk of severe bleeding, and therefore, interventions should be carefully planned.

Comparison of human umbilical cord blood-derived mesenchymal stem cells with healthy fibroblasts on wound-healing activity of diabetic fibroblasts

Abstract

Various types of skin substitutes composed of fibroblasts and/or keratinocytes have been used for the treatment of diabetic ulcers. However, the effects have generally not been very dramatic. Recently, human umbilical cord blood-derived mesenchymal stromal cells (hUCB-MSCs) have been commercialised for cartilage repair as a first cell therapy product using allogeneic stem cells. In a previous pilot study, we reported that hUCB-MSCs have a superior wound-healing capability compared with fibroblasts. The present study was designed to compare the treatment effect of hUCB-MSCs with that of fibroblasts on the diabetic wound healing in vitro. Diabetic fibroblasts were cocultured with healthy fibroblasts or hUCB-MSCs. Five groups were evaluated: group I, diabetic fibroblasts without coculture; groups II and III, diabetic fibroblasts cocultured with healthy fibroblasts or hUCB-MSCs; and groups IV and V, no cell cocultured with healthy fibroblasts or hUCB-MSCs. After a 3-day incubation, cell proliferation, collagen synthesis levels and glycosaminoglycan levels, which are the major contributing factors in wound healing, were measured. As a result, a hUCB-MSC-treated group showed higher cell proliferation, collagen synthesis and glycosaminoglycan level than a fibroblast-treated group. In particular, there were significant statistical differences in collagen synthesis and glycosaminoglycan levels (P = 0·029 and P = 0·019, respectively). In conclusion, these results demonstrate that hUCB-MSCs may have a superior effect to fibroblasts in stimulating diabetic wound healing.

Evaluation of a multifactorial approach to reduce the prevalence of pressure injuries in regional Australian acute inpatient care settings

Abstract

The aim of the study was to compare the changes in the prevalence of pressure injuries from 2008 to 2014 in relation to staff behaviour in acute/subacute inpatient care settings. In 2008, the large regional health district Hunter New England Local Health District implemented an initiative called the Crystal Model which resulted in changes in their policy and an e-learning education program for all nursing staff. A retrospective cross sectional study compared data from the 2008, 2010 and 2014 point prevalence surveys of PI in acute services. These were collected as part of an annual pressure injury prevention and management quality audit for adult inpatients. The total number of participants included 1407 participants in 2008, 1331 participants in 2010 and 1199 participants in 2014. From 2008 to 2014 there was a 15.7% decrease in percentage of patients with hospital-acquired pressure injuries and the percentages of each stage of pressure of injury 1–4 decreased. From 2008 to 2014 the completion and documentation of risk assessment, the documentation of repositioning and the implementation of pressure-relieving equipment increased. A multifactorial model can reduce the prevalence of pressure injuries in acute inpatient settings. The theories of knowledge translation and the modified Theory of Planned Behaviour can be utilised to analyse changes in health professionals habituated pressure injury prevention practice

RF-Scalp Cooling

Publication date: Available online 7 November 2017
Source:Actas Dermo-Sifiliográficas (English Edition)
Author(s): O.M. Moreno-Arrones, D. Saceda-Corralo, S. Vañó-Galván

PRACTICAL MANAGEMENT OF ACNE FOR CLINICIANS An International Consensus from the Global Alliance to Improve Outcomes in Acne

Rosacea and alcohol intake

To the Editor: The paper by Li1 on alcohol intake and risk for rosacea prompted us to make some considerations and report our experience. We previously showed that rosacea patients have a significantly higher prevalence of small intestinal bacterial overgrowth (SIBO) than controls and that SIBO eradication significantly improved their lesions.2,3 Later, we investigated the role of various microorganisms in rosacea, with a 3-year follow-up of patients that had been treated.4 Demodex folliculorum, Helicobacter pylori, and SIBO were examined and all played a pathogenic role; SIBO prevailed in papulopustular rosacea, H.

A New Editor for Jaad

The anterolateral thigh flap with kiss technique for microsurgical reconstruction of oncological scalp defects

Defects after radical resection of scalp tumor feature extensive size, complexity of composite defect and poor elasticity of surrounding original tissue1. The anterolateral thigh (ALT) flap is one of the most frequently used workhorses for scalp reconstruction. However, most scalp defects are rounded instead of oval shaped and prone to be significantly wider than the maximal transverse diameter of classical ALT flap when direct closure of donor site is scheduled. Recently, Zhang et al.2 developed the concept of "economy in autologous flap transfer" and reported on the kiss technique in order to both reduce donor site morbidity and enable optimal soft tissue coverage.

Journals Received

JTLA, Journal of the Faculty of Letters, The University of Tokyo: Aesthetics.

Table_of_Contents

British_Society_of_Aesthetics

Back_Cover

Front_Cover

Books Received

BERLINER, TODD. Hollywood Aesthetic: Pleasure in American Cinema. (Oxford: OUP). 2017. pp. 298. £25.99 (pbk).

Subscriptions

Notes on Contributors

ANTHONY CROSS is Lecturer in the Department of Philosophy at Texas State University. His research focuses on the ethical dimensions of our engagement with artworks and other cultural objects, on aesthetic normativity, and on the ethics of partiality.

The Missing Person Found. Part I: Expressing Emotions in Pictures

Abstract

In Sight and Sensibility Dominic Lopes argues that expressiveness in pictures should be analyzed on the model of the "contour" theory of musical expressiveness, according to which an "expression" need not express anything about the inner psychological states of a person. According to his "contour theory of pictorial expression," expression by scenes and designs requires "no being to whom the expressed emotion is attributable" (the "missing person problem"). However, on this account expression has lost its fundamental raison d'être, that of manifesting somebody's actual emotional states. By contrast, I argue that successful works of pictorial expression depict the way the world appears to someone (the artist or his/her persona) when in some emotional state. Moreover, the emotional attitude thus expressed by the work is an important unifying principle for pictures, and hence an important artistic value.

Aesthetic Choice

Abstract

Our lives are filled with aesthetic choices, that is, choices of objects for aesthetic experience. Choice is crucial to having a fulfilling aesthetic life. Our immediate satisfaction and long term flourishing require the ability to generate rewarding aesthetic opportunities. A good aesthetic life is one of good aesthetic choices. Given the centrality of choice to a good aesthetic life, aesthetic theory is in need of an account of choice. However, aesthetic choice has gone unexamined. This paper considers how choice helps to make us who we are as aesthetic persons. I situate aesthetic choice within debates in contemporary choice theory. The paper also examines whether the recommenders on websites like Amazon or Netflix pose a risk to our aesthetic flourishing. Aesthetic choice is mostly constructive and conditional, in other words, ad hoc and easily influenced. Aesthetic choices tend to be small choices, with low stakes and relaxed deliberation. The effect of our choices is cumulative, and the import of individual choices is best judged by seeing them in the context of other choices, especially the plans to which they belong.

Art Criticism as Practical Reasoning

Abstract

Most recent discussions of reasons in art criticism focus on reasons that justify beliefs about the value of artworks. Reviving a long-neglected suggestion from Paul Ziff, I argue that we should focus instead on art-critical reasons that justify actions—namely, particular ways of engaging with artworks. I argue that a focus on practical rather than theoretical reasons yields an understanding of criticism that better fits with our intuitions about the value of reading art criticism, and which makes room for a nuanced distinction between criticism that aims at universality and criticism that is resolutely personal.

Art and identity: A reply to Stopford

Abstract

Richard Stopford, in criticizing my defense of purist restoration, attributes to me and refutes a metaphysical view I do not have concerning the identity and persistence conditions of an art work. I took for granted the ordinary idea of identity as continuity-in-space-and-time-under-a-sortal-concept, such as statue. I argued that Michelangelo's Pietà remained the same statue after it was disfigured but that the damage was irreparable. By fixing molded prosthetics to the ruined work of art, the Vatican introduced a macaronic element into one's aesthetic attitude toward the Pietà by making one attend simultaneously, without any visual guidance as to which is which, to (1) parts of the statue that were completed by Michelangelo's hand and intended to be a work of art and (2) pieces added in the twentieth century for an different purpose, e.g., to make viewing the statue less disconcerting than a recognition of the damage would demand. An integral restoration, in contrast, allows one both to envision the art work as created and to grieve for what has been lost.

Peter Kivy and the Philosophy of Music (1980–2002)

Abstract

In the beginning—or more exactly, the seventies, when I was in graduate school at the University of Michigan—was the void, and darkness was upon the face of the waters. Philosophical reflection on the experience, meaning, and powers of music by analytic philosophers was almost non-existent. And then, as the 1980s dawned, came Peter Kivy. Suddenly there was light, and analytic philosophy of music was born. In this piece I summarize the substance of the successive instalments in the astounding series of books on the philosophy of music that Peter published between 1980 and 2002, allowing myself some critical reflections in a few cases.

Fictional Characters, Real Problems: The Search for Ethical Content in Literature

Fictional Characters, Real Problems: The Search for Ethical Content in LiteratureHagbergGarry L. (ED.) oup. 2016. pp. 416. £55.00 (hbk)

Aesthetics as Philosophy of Perception

Aesthetics as Philosophy of PerceptionNanayBenceoup. 2016. pp. 240. £35.00 (hbk).

Art Rethought: The Social Practices of Art

Art Rethought: The Social Practices of ArtNICHOLAS WOLTERSTORFF oup. 2015. pp. 331. £30.00 (hbk).

The Possibility of Culture: Pleasure and Moral Development in Kant’s Aesthetics

The Possibility of Culture: Pleasure and Moral Development in Kant's Aesthetics BRADLEY MURRAY wiley-blackwell. 2015. pp. 145. £80.50 (hbk).

Factors Associated With Remission of Skin Disease in Dermatomyositis

This cohort study examines factors associated with clinical remission of skin disease in dermatomyositis.

Impact of Donor and Recipient Human Cytomegalovirus Status on Kidney Transplantation

Abstract

Human cytomegalovirus (HCMV) is considered to be a major pathogen that affects the outcome of solid organ transplantation. Both recipient and donor may be HCMV positive, therefore HCMV reinfection is possible after transplantation. However, little is known how cytomegalovirus transmitted from an infected donor to an infected recipient modulates the recipient's already suppressed immunity, and what the clinical consequences are. To investigate these issues, 52 kidney recipients were followed up for two years after transplantation. T, B, and natural killer lymphocytes, naïve and memory T subsets, CD28 expression, relative telomere length, cytomegalovirus-specific lymphocytes, and serum cytokines were measured several times posttransplant. Patients were monitored for signs of cytomegalovirus viremia and other infections. The most importantly observation was that cytomegalovirus-specific lymphocytes expand vastly in HCMV infected recipients who received kidneys from infected donors, in comparison to uninfected donors. Despite this, higher rate of HCMV viremia was found. Immune deterioration was found as an increased number of CD28 negative T lymphocytes, inverted CD4/CD8 index and shortened telomeres. This was superior in HCMV infected recipients transplanted from infected donor, when compared to uninfected. In conclusions, cytomegalovirus alters the immune system in kidney transplant recipients and promotes immune exhaustion.

Autophagy as a Therapeutic Target: The Double-edged Sword

By Christina Towers, PhD

Autophagy is an important cellular process that facilitates the degradation of damaged cytoplasmic material and toxic protein aggregates. Its role in neuronal function is apparent by the neurodegenerative phenotypes observed in autophagy deficient genetic mouse models. Mice with neuron-specific knock out of the core autophagy protein, ATG7, are viable but most go on to develop behavioral defects and eventually massive neuronal loss in the cerebral corticies¹.

But perhaps the most causative links between autophagy and neurological functioning have been observed in animal models of progressive neurodegenerative diseases including Alzheimer's, Parkinson's, and Huntington's disease. Each of these devastating diseases is characterized by a build-up of toxic protein aggregates: β-amyloid peptides and Tau proteins in the case of Alzheimer's, α-synuclein or lewy bodies in Parkinson's, or polyQ-containing proteins transcribed from a mutant HTT gene in Huntington's disease². The inherent function of autophagy in all cells is to degrade toxic proteins, and neurons in particular rely on this process to maintain homeostasis and prevent toxic accumulations of the above mentioned pathological proteins. Specifically, in Huntington's disease, substandard autophagosomes are formed that are devoid of contents resulting in a build-up of mutant HTT proteins³. Additionally, mutant HTT can interfere with autophagosome-lysosome fusion, a critical step in maintaining autophagosome degradation⁴.

In Alzheimer's disease, the hippocampus is the first brain region affected, leading to loss of short-term memory. Huntington's disease affects first the basal ganglia leading to defective motor control. Finally, Parkinson's disease primarily affects substantia nigra dopaminergic neurons and resulting in uncontrolled-body movements.

There has been a large effort to discover autophagy inducing compounds that could be used to combat these deadly diseases. These compounds include mTOR inhibitors like Rapamycin analogs, resveratrol, and metformin as well as natural products like trehalose and curcumin. A number of these compounds are moving into pre-clinical rodent models and even phase I clinical trials for nuerodegenerative diseases². An unfortunate caveat to these experiments, however, is that all of these drugs can have autophagy independent targets, making any successful results difficult to interpret as strictly a result of autophagy inhibition.

Perhaps the most interesting question these studies beg is what on-target neurological side effects can be anticipated from targeted autophagy inhibition in cancer, a disease where autophagy plays a pro-tumorigenic role. There are currently over 50 clinical trials attempting to inhibit autophagy with the lysosomal inhibitor, chloroquine, across multiple tumor types. Thus far neurological side effects have not have been observed, but all of these studies are either still in progress or just recently concluded, without the ability to track any long-term side effects in these patients. Pre-clinical mouse studies with induced systemic loss of autophagy in a developed tumor showed a complete regression of the lesions, however, the mice developed a number of adverse side effects including neurodegeneration⁵. Importantly, these studies do suggest that a therapeutic window may exist where incomplete autophagy inhibition (it is unlikely that any pharmacological compound will be 100% efficient) for a short period of time may be sufficient to reduce tumor growth without neurological side effects. Nonetheless, these potential issues need to be addressed over the course of ongoing clinical trials, as do the reverse – the effects of autophagy induction to treat neurodegeneration and on-target side effects on cancer incidence and progression.

New Alzheimer's Poster

References

1. Komatsu, M. et al. Loss of autophagy in the central nervous system causes neurodegeneration in mice. Nature 441, 880-884, doi:10.1038/nature04723 (2006).
   
2. Towers, C. G. & Thorburn, A. Therapeutic Targeting of Autophagy. EBioMedicine, doi:10.1016/j.ebiom.2016.10.034 (2016).
3. Martinez-Vicente, M. et al. Cargo recognition failure is responsible for inefficient autophagy in Huntington's disease. Nat Neurosci 13, 567-576, doi:10.1038/nn.2528 (2010).
4. Wong, Y. C. & Holzbaur, E. L. The regulation of autophagosome dynamics by huntingtin and HAP1 is disrupted by expression of mutant huntingtin, leading to defective cargo degradation. J Neurosci 34, 1293-1305, doi:10.1523/JNEUROSCI.1870-13.2014 (2014).
5. Karsli-Uzunbas, G. et al. Autophagy is required for glucose homeostasis and lung tumor maintenance. Cancer Discov 4, 914-927, doi:10.1158/2159-8290.CD-14-0363 (2014).

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The BPD trio? Interaction of dysregulated PDGF, VEGF, and TGF signaling in neonatal chronic lung disease

The development of neonatal chronic lung disease (nCLD), i.e., bronchopulmonary dysplasia (BPD) in preterm infants, significantly determines long-term outcome in this patient population. Risk factors include m...

Amelogenesis imperfecta in the dentition of a wild chimpanzee

Abstract

This report describes a case of amelogenesis imperfecta in the dentition of a female chimpanzee. Amelogenesis imperfecta is a group of rare genetic conditions that create severe enamel defects, which, although well researched in humans, has not yet been investigated in wild non-human primates.

Buccal Plate Preservation with Immediate Implant Placement and Provisionalization: 5-Year Follow-Up Outcomes

Abstract

Purpose

Despite socket preservation and/or immediate implant placement, resorption of the buccal plate after dental extraction continues to pose esthetic challenges to clinicians. Buccal plate preservation (BPP) is a technique that has been recently proposed with an aim to reduce the incidence of such resorption. This study was conducted to assess the long-term efficacy of BPP in maintaining the thickness of the buccal cortical plate after immediate implant insertion and provisionalization.

Materials and Methods

Ten consecutive patients were included in this study. Each patient underwent extraction of a non-restorable tooth, BPPPBPP, single immediate implant placement and immediate provisionalization. Cone beam CT scans were taken 3 months after surgery (T1) and 5 years after surgery (T2) to evaluate the effectiveness and longevity of the BPPPBPP technique in maintaining the augmented bone width. Two distinct measurements were taken for bone evaluation: (a) R1: 1 mm apical to the implant platform and (b) R2: 5 mm apical to the implant platform. The long axis of the implant was used as a fixed reference. Statistical test analysis was conducted using the SPSS software. Student's t test was used to assess statistical significance, and a p value of < 0.05 was considered significant.

Results

There were six females and four males in the study. The mean age of the sample was 37.6 years (range 23–64 years). At T1, the mean bone thickness of the buccal plate was found to be 2.36 mm at R1 (range: 1.9–3.1), and 2.23 at R2 (range: 1.9–3). At the T2 interval, the mean thickness of the plate was 2.28 mm at R1 (range: 1.7–3) and 2.18 at R2 (range: 1.9–3). The differences in these mean values were not statistically significant.

Conclusions

BPPPBPP is an effective means for augmentation and maintenance of the buccal cortical plate around an immediately placed and provisionalized dental implant. It is a viable alternative to socket preservation with the added benefit that it allows for immediate implant placement.

Pleiotropic Effects of White Willow Bark and 1,2-Decanediol on Human Adult Keratinocytes

Background: Acne vulgaris is a common skin defect, usually occurring during adolescence, but often it can persist in adults leaving permanent face scarring. Acne is usually treated with topical drugs, oral antibiotics, retinoids, and hormonal therapies, but medicinal plants are increasingly employed. Objective: To investigate the protective role of white willow bark (WWB) and 1,2-decanediol (DD) on the damage caused by lipopolysaccharides (LPS) on human adult keratinocytes (HaCaT). Methods: HaCaT were exposed to LPS alone or in association with WWB and DD. Epidermal viability, metabolic modulation, inflammatory activity, and cell migration were assessed with both common standardized protocols or high-throughput screening systems. Results: The preincubation of HaCaT with WWB and DD (used separately or in combination) differently prevented the alterations induced by LPS on HaCaT in terms of growth factor release (IGF, EGF, VEGF), cytokine production (IL-1α, IL-6, IL-8), or expression of the transcription factor FOXO-I. Moreover, they partially restore wound repair lowered by LPS. Conclusions: These results suggest that both natural compounds were able to differently affect several functions of LPS-stressed keratinocytes suggesting their potential role for the prevention of acne vulgaris, without adverse effects.
Skin Pharmacol Physiol 2018;31:10-18

Capsaicin Used on Skin Influences Ion Transport Pathways: An in vitro Study

Acute, adverse skin effects to capsaicin can be activated by inhibition of sodium transport not only in nociceptive neurons, but also in keratinocytes. The aim of the current study was to describe and compare immediate (15 s) and prolonged (30 min) effects of capsaicin on epidermal (not neural) sodium transport using a rabbit skin model. Skin fragments (n = 169) were incubated in 4 conditions: undisturbed ion transport (U; n = 48); inhibited sodium transport (I_Na; n = 34) with amiloride used as sodium transport blocker; long-term irritation by capsaicin with undisturbed ion transport (CAPSA-U; n = 43) and with inhibited sodium transport (CAPSA-I_Na; n = 35). After 30 min of incubation, a solution of capsaicin was applied directly to the skin fragments. The study demonstrated that sodium transport inhibition eliminated the effects of both immediate and prolonged capsaicin application. The results could be the basis for future research considering selective sodium transport inhibitors for human skin to reduce the side effects of capsaicin, related to activation of sodium channels in keratinocytes.
Skin Pharmacol Physiol 2018;31:19-27

Real world challenges and unmet needs in the diagnosis and treatment of suspected invasive pulmonary aspergillosis in patients with hematological diseases: an illustrative case study

Abstract

Recent years have seen important advances in the diagnosis of invasive pulmonary aspergillosis (IPA), complemented by the introduction of new therapies. Despite this, IPA remains a major cause of infection-related mortality in patients with hematological diseases. There are two main reasons for this. First, diagnosis of IPA remains a challenge, since risk factors and the clinical, radiological and mycological presentations vary not only by fungal disease stage, but also by patient group (e.g. neutropenic versus non-neutropenic patients). Diagnosis is particularly challenging in patients receiving mold-active prophylactic or empirical treatment, which reduces the sensitivity of all diagnostic tests for IPA. Second, treatment of IPA is complex due to unpredictable pharmacokinetic profiles of antifungal agents, small therapeutic window in terms of exposure and adverse events, and multiple drug-drug interactions through the CYP450 system. Here we report a case of a 23-year-old male with severe aplastic anaemia and subpleural nodules. Diagnostic tests for IPA obtained during ongoing mold-active empirical treatment were negative. Intravenous voriconazole was stopped after visual disturbances and hallucinations. The patient then had an anaphylactic reaction to liposomal amphotericin B and was switched to intravenous posaconazole, which had to be discontinued due to a significant increase in transaminase levels. He was treated with oral isavuconazole with reduced dosage, triggered by increasing transaminases under the standard dosage. Even under reduced dosage, blood concentrations of isavuconazole were high and treatment was successful. The case illustrates real-world challenges and unmet needs in the diagnosis and treatment of IPA in patients with hematological diseases.

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Deactivation and Regeneration of NaTaO3 Photocatalyst in Co-operating Dehydrogenation Coupling of Isopropanol and Hydrogenation Coupling of Acetone Reaction System

Abstract

Photocatalyst activity is influenced by many factors, such as adsorption of by-products, runoff of surface hydroxyl groups, and carriers. In this study, a simple and efficient photocatalyst regeneration method was developed. Results indicated that NaTaO₃ photocatalyst lost its photo-activity after three cycles of reaction that involves coupling of isopropanol and hydrogenation coupling of acetone reaction system. Runoff of Na on the surface was the main reason for the deactivation of NaTaO₃ photocatalyst. After hydrothermal treatment of the deactivated NaTaO₃ with 10 M NaOH at 180 °C for 12 h, its photocatalytic activity was restored to the original level. The photocatalytic activity remained stable even after 10 cycles

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Potential usefulness of methyl gallate in the treatment of experimental colitis

Abstract

Methyl gallate is a gallotannin widely distributed in nature. Previous studies have demonstrated its antioxidant, anti-inflammatory, antimicrobial and anti-tumor activities. In the present study, the activity of methyl gallate on experimental models of inflammatory bowel disease has been investigated. Experimental colitis was induced in Sprague–Dawley rats through the intracolonic instillation of an acetic acid solution (2 mL, 4% v/v). Methyl gallate (100 and 300 mg/kg, p.o.) and the reference drug mesalazine (100 mg/kg, p.o.) were tested. Methyl gallate induced a significant reduction in the colon weight/length ratio and macroscopic lesion score. Besides, the malondialdehyde content and the GSSG/GSH ratio were remarkably decreased. Furthermore, the administration of methyl gallate reduced the expression of COX₂, IL-6, TNFα and the severity of microscopic tissue damage induced by acetic acid, while the mean goblet cell density was significantly higher in both the group treated with methyl gallate and the one treated with mesalazine, in comparison with untreated animals. The Na⁺K⁺ATPase pump activity was recovered in treated groups (control: 827.2 ± 59.6, colitis: 311.6 ± 54.8, methyl gallate 100 mg/kg: 642.2 ± 175.0, methyl gallate 300 mg/kg: 809.7 ± 100.6, mesalazine: 525.3 ± 81.7). Methyl gallate was also found to induce a significant reduction in the castor oil-induced intestinal motility in Swiss mice, decreasing the peristalsis by 74.5 and 58.82% at 100 and 300 mg/kg p.o., respectively. This compound also antagonized the jejunum contractions induced by Ach and CaCl₂. This study demonstrates that methyl gallate exerts beneficial effects in a preclinical model of intestinal disorders.

Yeast polyubiquitin gene UBI4 deficiency leads to early induction of apoptosis and shortened replicative lifespan

Abstract

Ubiquitin is a 76-amino acid protein that is highly conserved among higher and lower eukaryotes. The polyubiquitin gene UBI4 encodes a unique precursor protein that contains five ubiquitin repeats organized in a head-to-tail arrangement. Although the involvement of the yeast polyubiquitin gene UBI4 in the stress response was reported long ago, there are no reports regarding the underlying mechanism of this involvement. In this study, we used UBI4-deletion and UBI4-overexpressing yeast strains as models to explore the potential mechanism by which UBI4 protects yeast cells against paraquat-induced oxidative stress. Here, we show that ubi4Δ cells exhibit oxidative stress, an apoptotic phenotype, and a decreased replicative lifespan. Additionally, the reduced resistance of ubi4Δ cells to paraquat that was observed in this study was rescued by overexpression of either the catalase or the mitochondrial superoxide dismutase SOD2. We also demonstrated that only SOD2 overexpression restored the replicative lifespan of ubi4Δ cells. In contrast to the case of ubi4Δ cells, UBI4 overexpression in wild-type yeast increases the yeast's resistance to paraquat, and this overexpression is associated with large pools of expressed ubiquitin and increased levels of ubiquitinated proteins. Collectively, these findings highlight the role of the polyubiquitin gene UBI4 in apoptosis and implicate UBI4 as a modulator of the replicative lifespan.

Identification of surfactants and its correlation with physicochemical parameters at the confluence region of Vembanad Lake in India

Abstract

The present study describes the monitoring of some of the major classes of surfactants in water. The separation, identification, and the quantitative estimation of the compounds were achieved using LC-Q-ToF-MS. The analyses revealed the presence of variety of surfactants including linear alkylbenzene sulfonate (LAS), alcohol ethoxysulfates (AES), and alcohol ethoxylates (AE). Further, emphasis was given to AES as they are one of the most produced and consumed surfactants in the world. And as far as India is concerned, the present study is one of the most significant attempt regarding the identification and quantification of AES. The data obtained during the analysis revealed that the average concentration of AES C12Ex varied from 0.7 to 13.6 μg L⁻¹ while that of C14Ex ranged between 1.3 and 10.4 μg L⁻¹. The risk assessment revealed that higher chain AES are capable of posing medium level risk to the aquatic compartment. In addition, the study also included the physicochemical analysis of water from the selected area. Water was found to be acidic in nature and the salinity, TDS, and EC values were found to be high during the pre-monsoon season. The order of the levels of anionic constituents was of Cl⁻>SO₄²⁻SO₄²⁻>F⁻>NO₃²⁻ ≅ PO₄²⁻ while that of cations were Na⁺ > Mg²⁺ > K⁺ > Ca²⁺. Results of correlation analysis showed that statistically negative correlation exists between AES homologs and pH while slight positive correlations were found between AES and other parameters including TDS and EC. The suitability of this water for domestic and agricultural purposes has been examined on the ground of basic quality indices such as the water quality index (WQI) and sodium adsorption ratio (SAR). The WQI measurements also revealed that the water quality of the region falls under the "very poor" category especially during the pre-monsoon season. The study could explore the cumulative share of these canals in the quality impairment of the receiving Vembanad Lake.

Plant assays and avoidance tests with collembola and earthworms demonstrate rehabilitation success in bauxite residue

Abstract

Bauxite residues are a by-product of alumina manufacture from bauxite ore and are commonly disposed of in purpose-built bauxite residue disposal areas (BRDAs). Revegetation is viewed as the most effective way to landscape and rehabilitate closed BRDAS and physicochemical assessment remains the primary indicator of rehabilitation success. Little is known about the ability of keystone mesofaunal species to colonise and establish in these environments yet the long-term success of rehabilitation is dependent on residues becoming suitable habitats for such groups. Using six different residue treatments (untreated, leached, organic application, organic amended, and two revegetated field treatments) together with OECD test soil, this study assessed the characteristics of residues with plant germination and seedling development using the Rhizotest™ approach with Lepidium sativum, Sinapis alba, and Sorghum bicolor. Avoidance tests with soil mesofauna Eisenia foetida together with growth and reproduction tests for Folsomia candida were conducted to determine possibility of inhibition in residue soils. Unamended residue is inhibitory to plant growth and mesofaunal establishment. Amendment improves the physicochemical properties of the residue, and data revealed that both gypsum and organic addition is required to promote conditions favourable to plant growth and mesofauna establishment. Earthworms avoid residues with elevated Na content but will choose substrate with high soluble Ca content. F. candida preferentially moves to residues from field treatments, and both mortality and reproduction rates are comparable or superior to OECD soil. On the basis of these assays, we propose that bauxite residue can be transformed to a soil-like medium capable of supporting keystone species.

Laser und Narben

Zusammenfassung

Narben entstehen nach tiefdermalen Verletzungen der Haut und können sich in Abhängigkeit von Alter, Lokalisation, Ursache, Heilungsverlauf und individueller Disposition als unreife, reife, atrophe, hypertrophe oder keloidale Narben präsentieren. Vor allem Keloide und hypertrophe Narben sind häufig mit Juckreiz, Spannungsgefühl, Schmerzen und sogar Funktionseinschränkungen assoziiert und können die Lebensqualität von Patienten signifikant reduzieren. Auch vermeintlich physiologische Narbentypen, wie beispielsweise Ritznarben nach Selbstverletzungen, führen in vielen Fällen zu einem ausgeprägten Leidensdruck bei Betroffenen. Trotz intensiver Forschungsaktivität sind insbesondere die Pathomechanismen der überschießenden Narbenbildung bisher nur unzureichend verstanden und sicher wirksame Behandlungsmöglichkeiten bisher nicht verfügbar. Aufgrund zunehmend soliderer Studienlage werden heutzutage neben etablierten, konventionellen Verfahren vermehrt verschiedene Lasertechnologien und -wellenlängen zur Behandlung von verschiedenen Narbentypen eingesetzt.

Evaluation of antioxidant, DNA targeting, antimicrobial and cytotoxic studies of imine capped copper and nickel nanoparticles

Publication date: Available online 6 November 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): P. Adwin Jose, J. Dhaveethu Raja, M. Sankarganesh, J. Rajesh
In this work, we have synthesized pyrimidine derivatives of Schiff base ligand 2-(4,6-dimethoxypyrimidin-2-ylimino)methyl)-6-methoxyphenol (DPMM) stabilized copper nanoparticles (DPMM-CuNPs) and nickel nanoparticles (DPMM-NiNPs) by modified Brust-Schiffrin technique as two step phase transfer assisted method and confirmed by UV–Visible, SEM and TEM analysis. The free radical scavenging activity of DPMM, DPMM-CuNPs & DPMM-NiNPs with 2, 2′-diphenylpicryl hydrazyl (DPPH), hydrogen peroxide (H2O2) super oxide dismutase (SOD) and nitric oxide (NO) shows that the antioxidant activity of DPMM-CuNPs is higher than DPMM & DPMM-NiNPs. Interaction study of DPMM-CuNPs & DPMM-NiNPs with CT-DNA has been investigated by absorption spectral titration, fluorescence studies, cyclic voltammetry and viscometric measurements. Dose dependent antibacterial and antifungal studies of DPMM-CuNPs & DPMM-NiNPs against five different bacteria Shigella sonnei, Staphylococcus aureus, Escherichia coli, Klepsiella pneumoniae, Pseudomonas fluoroscens and five different fungi Aspergillus niger, Candida albicans, Candida tropicalis, Mucor indicus and Rhizopus show that the compounds have significant antibacterial and antifungal activity. Cytotoxicity studies of DPMM-CuNPs & DPMM-NiNPs on human breast cancer cell line (MCF-7) were studied by 3-(4, 5-dimethylthiazol-2-yl-)-2, 5-diphenyltetrazolium bromide (MTT) assay. 50% cell viability was found at 25μg/mL for DPMM-CuNPs and 300μg/mL for DPMM-NiNPs. Collective biological results reveal that the synthesized DPMM-CuNPs is more biologically active than DPMM-NiNPs.

Graphical abstract

Consumption of ellagic acid and dihydromyricetin synergistically protects against UV-B induced photoaging, possibly by activating both TGF-β1 and wnt signaling pathways

Publication date: Available online 7 November 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Na Rang Moon, Suna Kang, Sunmin Park
Ellagic acid (EGA) and dihydromyricetin (DHM) are both found in fruits and vegetables are used for anti-aging treatment for the skin. The anti-photoaging efficacy of EGA and DHM was investigated in UV-B irradiated skin in vivo and the involvement of transforming growth factor (TGF)-β1 and wnt signaling pathways were examined in vitro. HaCaT cells were treated with either 50μM EGA, 50μM DHM or 25μM EGA+25μM DHM before 100mJ/cm² UV-B exposure, and then oxidative stress and inflammation was measured. The involvement of TGF-β1 and wnt signaling was measured using their inhibitors, respectively, in HaCaT cells. Mice were fed a high fat diet with either 0.7% cellulose, 0.7% EGA, 0.7% DHM or 0.35% EGA+0.35% DHM for 3weeks and the dorsal skin of the mice had UV-B irradiation. 3% cellulose, 3% EGA, 3% DHM or 1.5% EGA+1.5% DHM in 1,3-buthylene glycol was applied onto the dorsal skin at 30min before 1 MED UV-B exposure. In 100mJ/cm² UVB irradiation, EGA and DHM mainly decreased oxidative stress and inflammation, respectively in HaCaT cells. Their activities were blocked by the TGF-β1 inhibitor, indicating their actions were mediated by TGF-β1 signaling (TGF-β1➔pSmad3➔Smad7). DHM enhanced wnt signaling by increasing β-catenin and decreasing Dickkopf-related protein-1. In mice, 1 MED UV-B exposure induced sunburn, redness, and blistering. EGA, DHM and especially EGA+DHM lessened their severity. UV-B increased epidermal thickness and damaged epidermal nucleus and cell structures. DHM and especially EGA+DHM prevented damage to the nucleus and cell structures. Expressions of circulating and dorsal skin IL-1β and TNF-α mRNA were lower in descending order of: control, EGA, DHM, EGA+DHM and normal-control. In conclusion, the consumption of EGA+DHM had a synergistically protective action against UV-B damage in the skin tissues of mice and HaCaT cells, and it may be associated with activating of both TGF-β1 and wnt signaling.

Graphical abstract

Ternary composite of TiO2 nanotubes/Ti plates modified by g-C3N4 and SnO2 with enhanced photocatalytic activity for enhancing antibacterial and photocatalytic activity

Publication date: Available online 6 November 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Masoud Faraji, Neda Mohaghegh, Amir Abedini
A series of g-C3N4-SnO2/TiO2 nanotubes/Ti plates were fabricated via simple dipping of TiO2 nanotubes/Ti in a solution containing SnCl2 and g-C3N4 nanosheets and finally annealing of the plates. Synthesized plates were characterized by various techniques. The SEM analysis revealed that the g-C3N4-SnO2 nanosheets with high physical stability have been successfully deposited onto the surface of TiO2 nanotubes/Ti plate. Photocatalytic activity was investigated using two probe chemical reactions: oxidative decomposition of acetic acid and oxidation of 2-propanol under irradiation. Antibacterial activities for Escherichia coli (E. coli) bacteria were also investigated in dark and under UV/Vis illuminations. Detailed characterization and results of photocatalytic and antibacterial activity tests revealed that semiconductor coupling significantly affected the photocatalyst properties synthesized and hence their photocatalytic and antibacterial activities. Modification of TiO2 nanotubes/Ti plates with g-C3N4-SnO2 deposits resulted in enhanced photocatalytic activities in both chemical and microbial systems. The g-C3N4-SnO2/TiO2 nanotubes/Ti plate exhibited the highest photocatalytic and antibacterial activity, probably due to the heterojunction between g-C3N4-SnO2 and TiO2 nanotubes/Ti in the ternary composite plate and thus lower electron/hole recombination rate. Based on the obtained results, a photocatalytic and an antibacterial mechanism for the degradation of E. coli bacteria and chemical pollutants over g-C3N4-SnO2/TiO2 nanotubes/Ti plate were proposed and discussed.

Graphical abstract

Biofabrication of morphology improved cadmium sulfide nanoparticles using Shewanella oneidensis bacterial cells and ionic liquid: For toxicity against brain cancer cell lines

Publication date: Available online 7 November 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Shuqing Yu, Siyuan Chen, Yiming Ding, Qiang Zhu, Nijia Zhang
The present work determines the anticancer activity of bio-mediated synthesized cadmium sulfide nanoparticles using the ionic liquid and bacterial cells (Shewanella oneidensis). Bacterial cells have been exposed to be important resources that hold huge potential as ecofriendly, cost-effective, evading toxic of dangerous chemicals and the alternative of conventional physiochemical synthesis. The Shewanella oneidensis is an important kind of metal reducing bacterium, known as its special anaerobic respiratory and sulfate reducing capacity. The crystalline nature, phase purity and surface morphology of biosynthesized cadmium sulfide nanoparticles were analyzed by Fourier transform infrared spectroscopy, X-ray diffraction, Field emission scanning electron microscopy, Energy dispersive spectroscopy and Transmission electron microscopy. The use of imidazolium based ionic liquids as soft templating agent for controlling self-assembly and crystal growth direction of metal sulfide nanoparticles has also advanced as an important method. The microscopic techniques showed that the nanoparticles are designed on the nano form and have an excellent spherical morphology, due to the self-assembled mechanism of ionic liquid assistance. The antitumor efficiency of the cadmium sulfide nanoparticles was investigated against brain cancer cell lines using rat glioma cell lines. The effectively improved nano-crystalline and morphological structure of CdS nanoparticles in the presence of IL exhibit excellent cytotoxicity and dispersion ability on the cell shape is completely spread out showing a nice toxic environment against cancer cells. The cytotoxicity effect of cadmium sulfide nanoparticles was discussed with a diagrammatic representation.

Graphical abstract

Facile green synthesis of zinc oxide nanoparticles using Ulva lactuca seaweed extract and its evaluation of photocatalytic, antibiofilm and larvicidal activity: impact on mosquito morphology and biofilm architecture

Publication date: Available online 7 November 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Ramachandran Ishwarya, Baskaralingam Vaseeharan, Subramanian Kalyani, Balan Banumathi, Marimuthu Govindarajan, Naiyf S. Alharbi, Shine Kadaikunnan, Mohammed N. Al-anbr, Jamal M. Khaled, Giovanni Benelli
The bioactivity of semiconductor nanocomplexes has been poorly studied in the field of pesticide science. In this research, the synthesis of zinc nanoparticles was accomplished through new effortless green chemistry process using the Ulva lactuca seaweed extract as a reducing and capping agent. The production of U. lactuca-fabricated ZnO nanoparticles (Ul-ZnO Nps) was characterized by powder X-ray diffraction (XRD), UV–visible and Fourier transform infrared (FTIR) spectroscopy, as well as transmission electron microscopy (TEM). The U. lactuca-fabricated ZnO NPs were tested for their photodegradative action against organic dyes, antibiofilm and larvicidal activities. The UV visible absorbance spectrum of Ul-ZnO Nps exhibits the absorbance band at 325nm and TEM image shows average crystallite sizes of nanoparticles at 10–50nm. Methylene blue (MB) dye was efficiently corrupted under sunlight in the presence of Ul-ZnO Nps. Excellent bactericidal activity was shown by the Ul-ZnO Nps on Gram positive (Bacillus licheniformis and Bacillus pumilis) and Gram negative (Escherichia coli, Proteus vulgaris) bacteria. High antibiofilm activity was noted under both dark and sunlight condition. The impact of a single treatment with Ul-ZnO Nps on biofilm architecture was also analyzed by confocal laser scanning microscopy (CLSM) on both Gram positive and Gram negative bacteria. Moreover, Ul-ZnO NPs led to 100% mortality of Aedes aegypti fourth instar larvae at the concentration of 50μg/ml within 24h. The effects of ZnO nanoparticle-based treatment on mosquito larval morphology and histology were also monitored. Overall, based on our results, we believe that the synthesis of multifunctional Ul-ZnO Nps using widely obtaining seaweed products can be promoted as a potential eco-friendly option to chemical methods currently used for nanosynthesis of antimicrobials and mosquito larvicides.

Graphical abstract

Telepresence and Trust: a Speech-Act Theory of Mediated Communication

Abstract

Trust is central to our social lives in both epistemic and practical ways. Often, it is rational only given evidence for trustworthiness, and with that evidence is made available by communication. New technologies are changing our practices of communication, enabling increasing rich and diverse ways of 'being there', but at a distance. This paper asks: how does telepresent communication support evidence-constrained trust? In answering it, I reply to the leading pessimists about the possibility of the digital mediation of trust, Philip Pettit and Hubert Dreyfus. I also rebut Media Richness Theory, which proposes a linear relationship between the volume of mediated information and the quality of communication. Positively, I develop a speech-act theory of digitally mediated communication, drawing on Austen's identification of the illocutionary act. The choice of a particular technology of communication constitutes part of what is communicated, including a setting of the social 'frame', and thus the possibilities for trust to be sustained or eroded. How something is said is part of what it is that is said.

De-extinction as Artificial Species Selection

Abstract

This paper offers a paleobiological perspective on the debate concerning the possible use of biotechnology to bring back extinct species. One lesson from paleobiology is that extinction selectivity matters in addition to extinction rates and extinction magnitude. Combining some of Darwin's insights about artificial selection with the theory of species selection that paleobiologists developed in the 1970s and 1980s provides a useful context for thinking about de-extinction. Using recent work on the prioritization of candidate species for de-extinction as a test case, the paper argues that de-extinction would be a form of artificial species selection in which humans influence which species persist vs. go extinct. This points to a serious gap in our ethical theory: Much work has been done to clarify the value(s) of biological diversity, but we also need theoretical guidance for decisions that amount to species sorting, and that will shape the macroevolutionary future.

Promoting Biodiversity

Abstract

Advances in biotechnology mean that it may soon be possible to recreate previously extinct species. This has led to an emerging debate within bioethics about whether we ought to reintroduce extinct species into our ecosystems. In this paper, we discuss the role that biodiversity could play in this debate. Many believe that biodiversity is a good that should be protected. We argue that if biodiversity is a good, then this suggests it should also be promoted, including by reintroducing previously extinct species. We begin by outlining different ways in which biodiversity could be conceptualized, and then analyze various accounts of its value. We suggest no approach justifies an asymmetry between "protecting" biodiversity by conserving species alive today, and "creating" biodiversity by introducing previously extinct species. This suggests that if we have reasons stemming from biodiversity to protect species from extinction, we will have similar reasons to reintroduce previously extinct species. We close by asking whether arguments from biodiversity speak in favor of introducing some novel species into the ecosystem.

Mechanisms of angiogenesis in microbe-regulated inflammatory and neoplastic conditions

Abstract

Commensal microbiota inhabit all the mucosal surfaces of the human body. It plays significant roles during homeostatic conditions, and perturbations in numbers and/or products are associated with several pathological disorders. Angiogenesis, the process of new vessel formation, promotes embryonic development and critically modulates several biological processes during adulthood. Indeed, deregulated angiogenesis can induce or augment several pathological conditions. Accumulating evidence has implicated the angiogenic process in various microbiota-associated human diseases. Herein, we critically review diseases that are regulated by microbiota and are affected by angiogenesis, aiming to provide a broad understanding of how angiogenesis is involved and how microbiota regulate angiogenesis in microbiota-associated human conditions.

Overproduction of S. meliloti ArgC ( N -acetyl-gamma-glutamyl phosphate reductase) promotes growth delay and inefficient nodules

Abstract

argC encodes N-acetyl-gamma-glutamyl phosphate reductase, the enzyme that catalyzes the high-energy consuming third step in the arginine synthesis pathway. A comparative analysis revealed two translation start sites in argC from Sinorhizobium meliloti. To determine whether both protein versions are synthesized in the organism and their functional role, we obtained genetic constructs with one (1S) or two (2S) start sites, with promoters of low (pspeB) or high (plac) transcriptional rate. The constructs were transferred to the S. meliloti 1021 derivative argC mutant strain. Both protein versions were found in the free-living proteomes, but only ArgC 1S showed post-translational modification. Expression levels from argC 1S were five times higher than those of 2S, when transcribed by plac, and in concordance, its protein activity was 3-fold greater. The overexpression of both versions under plac delayed cellular growth. Inoculation of Medicago sativa plants with the S. meliloti strain harboring the argC 1S under plac induced nodulation but not nitrogen fixation. However, the strain with the argC 2S under the same promoter had a positive phenotype. Overproduction of ArgC protein for the synthesis of arginine induced physiological and symbiotic effects.

An Arf-GAP promotes endocytosis and hyphal growth of Ashbya gossypii

Abstract

The ADP-ribosylation factor (ARF) family of GTPases are highly conserved from yeast to human and regulate vesicle budding. Sec7 domain containing proteins stimulate the guanine nucleotide exchange on Arf proteins while ARF-GTPase activating proteins stimulate the hydrolysis of GTP. Since vesicle trafficking is important for hyphal growth we studied the A. gossypii homolog of S. cerevisiae ARF3 along with its putative GEF and GAP encoded by YEL1 and GTS1, respectively. Deletion of YEL1 had no discernible phenotype and deletion of ARF3 had only a minor defect in vacuolar fusion. In contrast, deletion of GTS1 severely impaired hyphal growth, and mutants showed defects in the maintenance of polarity and the localization of cortical actin patches. The uptake of the lipophilic dye FM4–64 was delayed in gts1 hyphae indicating a defect in endocytosis. Gts1 has several protein domains of which the Arf-GAP domain is required for complementation of the gts1 mutant phenotype. GFP-tagged GTS1 under control of its endogenous promoter localized to the plasma membrane but was enriched at hyphal tips and septal sites corresponding to a role in polarized vesicle trafficking. Our results indicate that this ARF-GTPase module plays an important role for filamentous hyphal growth.

Adaptive Designs for Clinical Trials: Application to Healthcare Epidemiology Research

Abstract

Clinical trials with adaptive designs use data that accumulates during the course of the study to modify study elements in a pre-specified manner. The goal is to provide flexibility such that a trial can serve as a definitive test of its primary hypothesis, preferably in a shorter time period, involving fewer human subjects, and at lower cost. Elements that may be modified include the sample size, endpoints, eligible population, randomization ratio, and interventions. Accumulating data used to drive these modifications include the outcomes, subject enrollment (including factors associated with the outcomes), and information about the application of the interventions. This review discusses the types of adaptive designs for clinical trials, emphasizing their advantages and limitations in comparison to conventional designs, and opportunities for applying these designs to healthcare epidemiology research, including studies of interventions to prevent healthcare associated infections, combat antimicrobial resistance, and improve antimicrobial stewardship.

Duration of Antibiotic Use among Adults with Uncomplicated Community-Acquired Pneumonia Requiring Hospitalization in the United States

Abstract

Background

Previous studies suggest duration of antibiotic therapy for community-acquired pneumonia (CAP) often exceeds national recommendations and might represent an important opportunity to improve antibiotic stewardship nationally. The objective of this study was to determine average length of antibiotic therapy (LOT) for patients treated for uncomplicated CAP in US hospitals and proportion of patients with excessive durations.

Methods

Records of retrospective cohorts of patients 18-64 years with private insurance and ≥65 years with Medicare hospitalized for CAP in 2012-13 were utilized. Inpatient LOT was estimated as a function of LOS using MarketScan® Hospital Drug Database data. Outpatient LOT was based on prescriptions filled at discharge. Data were obtained from MarketScan® Commercial Claims and Encounters and 100% Medicare claims and Part D event files. Excessive duration was defined as outpatient LOT >3 days.

Results

Inclusion criteria were met for 22,128 patients 18-64 years across 2,100 hospitals and 130,746 patients ≥65 years across 3,227 hospitals. Median total LOT was 9.5 days. LOT exceeded recommended duration for 74% of patients 18-64 years and 71% of patients ≥65 years. Patients 18-64 years received a median (quartile 1 -quartile 3) 6 (3-7) days outpatient LOT and those ≥65 years 5 (3-7) days.

Conclusions

In this nationwide sample of patients hospitalized for uncomplicated CAP, median total LOT was just under 10 days, with over 70% of patients having likely excessive treatment duration. Better adherence to recommended duration of therapy for CAP by improving prescribing at hospital discharge may be an important target for antibiotic stewardship programs.

Erratum

An error appeared in the 1 September 2016 issue of the journal [Kalil AC, Metersky ML, Klompas M, et al. Management of Adults with Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis 2016; 63(5):e61–e111]. The online supplementary data file was not uploaded with the published articles. The supplementary data files are now available at http://ift.tt/2h95bN3.

Optimizing Tuberculosis Diagnosis in HIV-Infected Inpatients Meeting the Criteria of Seriously Ill in the WHO Algorithm

Abstract

BACKGROUND

The WHO algorithm for the diagnosis of tuberculosis in seriously ill HIV-infected patients lacks a firm evidence base. We aimed to develop a clinical prediction rule for the diagnosis of tuberculosis and to determine the diagnostic utility of the Xpert MTB/RIF assay in seriously ill HIV-infected patients.

METHODS

We conducted a prospective study among HIV-infected inpatients with any cough duration and WHO-defined danger signs. Culture-positive tuberculosis from any site was the reference standard. A priori selected variables were assessed for univariate associations with tuberculosis. The most predictive variables were assessed in a multivariate logistic regression model and used to establish a clinical prediction rule for diagnosing tuberculosis.

RESULTS

We enrolled 484 participants: median age 36 years, 65·5% female, median CD4 count 89 cells/µL, and 35·3% on antiretroviral therapy. Tuberculosis was diagnosed in 52·7% of participants. The c-statistic of our clinical prediction rule (variables: cough ≥14 days, unable to walk unaided, temperature >39 ^oC, chest radiograph assessment, haemoglobin, and white cell count) was 0·811 (95%CI 0·802, 0·819). The classic tuberculosis symptoms (fever, night sweats, weight loss) added no discriminatory value in diagnosing tuberculosis. Xpert MTB/RIF assay sensitivity was 86·3% and specificity was 96·1%.

CONCLUSION

Our clinical prediction rule had good diagnostic utility for tuberculosis among seriously ill HIV-infected inpatients. Xpert MTB/RIF assay, incorporated into the updated 2016 WHO algorithm, had high sensitivity and specificity in this population. Our findings could facilitate improved diagnosis of tuberculosis among seriously ill HIV-infected inpatients in resource-constrained settings.

Miriam Solomon, Jeremy R. Simon, and Harold Kincaid (eds): The Routledge companion to philosophy of medicine

Correction to: Acquisition of Tn6018-3′ CS regions increases colistin MICs against Acinetobacter baumannii isolates harboring new variants of AbaRs

Abstract

The published online version of this article contained a mistake. The correct affiliation of Alireza Ekrami should have been "Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran" . The authors regret this error.

A New Editor for Jaad

Publication date: Available online 7 November 2017
Source:Journal of the American Academy of Dermatology
Author(s): Bruce H. Thiers

Positioning error of custom 3D-printed surgical guides for the radius: influence of fitting location and guide design

Abstract

Purpose

Utilization of 3D-printed patient-specific surgical guides is a promising navigation approach for orthopedic surgery. However, navigation errors can arise if the guide is not correctly positioned at the planned bone location, compromising the surgical outcome. Quantitative measurements of guide positioning errors are rarely reported and have never been related to guide design and underlying bone anatomy. In this study, the positioning accuracy of a standard and an extended guide design with lateral extension is evaluated at different fitting locations (distal, mid-shaft and proximal) on the volar side of the radius.

Methods

Four operators placed the surgical guides on 3D-printed radius models obtained from the CT scans of six patients. For each radius model, every operator positioned two guide designs on the three fitting locations. The residual positioning error was quantified with a CT-based image analysis method in terms of the mean target registration error (mTRE), total translation error ( \(\Delta T\) ) and total rotation error ( \(\Delta R\) ) by comparing the actual guide position with the preoperatively planned position. Three generalized linear regression models were constructed to evaluate if the fitting location and the guide design affected mTRE, \(\Delta T\) and \(\Delta R\) .

Results

mTRE, \(\Delta T\) and \(\Delta R\) were significantly higher for mid-shaft guides ( \(p=0.0001,\,p= 0.0001\,\hbox {and} p=0.001\) ) compared to distal guides. The guide extension significantly improved the target registration and translational accuracy in all the volar radius locations ( \(p=0.001\) ). However, in the mid-shaft region, the guide extension yielded an increased total rotational error ( \(p= 0.0001\) ).

Conclusion

Our study demonstrates that positioning accuracy depends on the fitting location and on the guide design. In distal and proximal radial regions, the accuracy of guides with lateral extension is higher than standard guides and is therefore recommended for future use.

MicroRNA in gastrointestinal cell signalling

Abstract

Our gut forms an important organ and its formation, functioning and homeostasis are maintained by several factors including cell signalling pathways and commensal microflora. These factors affect pathological, physiological and immunological parameters to maintain gut health and prevent its inflammation. Among these, different intracellular signalling pathways play an important role in regulating gut homeostasis. These pathways are in turn regulated by various microRNAs that play a key role in maintaining the balance between tolerance and inflammation. This review highlights the importance of various cell signalling pathways in modulating gut homeostasis and the role specific miRNAs play in their regulation.

Evaluation of Mayer-Rokitansky-Küster-Hauser syndrome with magnetic resonance imaging: Three patterns of uterine remnants and related anatomical features and clinical settings

Abstract

Objective

To characterize the anatomical features and clinical settings of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and correlate them with patterns of uterine involvement.

Methods

Pelvic magnetic resonance images and medical records of 92 MRKH patients were retrospectively reviewed. Patients were subgrouped by uterine morphology: uterine agenesis, unilateral rudimentary uterus and bilateral rudimentary uteri. Uterine volume, presence of endometrium, location of ovary, endometriosis and pelvic pain were compared among groups.

Results

The mean uterine volume was 33.5 ml (17.5–90.0 ml) for unilateral uterine remnants, and 16.1 ml (3.5–21.5 ml) for bilateral uterine rudiments (p<0.01). The incidence of presence of endometrium (100% vs. 22%, p<0.001), haematometra (56% vs. 3%, p<0.001) and ovarian endometriosis (22% vs. 3%, p<0.01) was significantly increased in the group of unilateral rudimentary uteri as compared with the group of bilateral uterine remnants. Thirty-one patients (38%) showed ectopic ovaries. Pelvic pain was more common in individuals with unilateral rudimentary uterus than those who had no (56% vs. 5%, p<0.01) or bilateral uterine remnants (56% vs. 14%, p<0.05).

Conclusion

MRKH patients with different patterns of uterine involvement may have differentiated anatomical features and clinical settings.

Key Points

• Rudimentary uteri, especially bilateral rudimentary uteri, were quite common in MRKH syndrome.

• Uterine remnants can be relatively large, especially the unilateral rudimentary uterus.

• Presence of endometrium and related complications are not rare in MRKH syndrome.

• Existence of endometrium and complications are more frequent in unilateral rudimentary uterus.

Apparent diffusion coefficient maps obtained from high b value diffusion-weighted imaging in the preoperative evaluation of gliomas at 3T: comparison with standard b value diffusion-weighted imaging

Abstract

Objective

To assess whether ADC maps obtained from high b value DWI were more valuable in preoperatively evaluating the grade, Ki-67 index and outcome of gliomas.

Methods

Sixty-three patients with gliomas, who underwent preoperative multi b value DWI at 3 T, were enrolled. The ADC₁₀₀₀, ADC₂₀₀₀ and ADC₃₀₀₀ maps were generated. Receiver operating characteristic analyses were conducted to determine the area under the curve (AUC) in differentiating high-grade gliomas (HGG) from low-grade gliomas (LGG). Pearson correlation coefficients (R value) were calculated to investigate the correlation between parameters with the Ki-67 proliferation index. Survival analysis was conducted by using Cox regression.

Results

The AUC of the mean ADC₁₀₀₀ value (0.820) was lower than that of the mean ADC₂₀₀₀ value (0.847) and mean ADC₃₀₀₀ value (0.875) in differentiating HGG from LGG. The R value of the mean ADC₁₀₀₀ value (−0.499) was less negative than that of the mean ADC₂₀₀₀ value (−0.530) and mean ADC₃₀₀₀ value (−0.567). The mean ADC₃₀₀₀ value was an independent prognosis factor for gliomas (p = 0.008), while the mean ADC₁₀₀₀ and ADC₂₀₀₀ values were not.

Conclusion

ADC maps obtained from high b value DWI might be a better imaging biomarker in the preoperative evaluation of gliomas.

Key Points

• ADC ₃₀₀₀maps could improve the differentiation between HGG and LGG.

• The mean ADC ₃₀₀₀value had a closer correlation with the Ki-67 index.

• The mean ADC ₃₀₀₀value was an independent prognosis factor for gliomas.

Erratum to: Tubulin-related cerebellar dysplasia: definition of a distinct pattern of cerebellar malformation

Evaluating anorexia-related brain atrophy using MP2RAGE-based morphometry

Abstract

Aim

To evaluate brain atrophy in anorexic patients by automated cerebral segmentation with the magnetization-prepared 2 rapid acquisition gradient echo (MP2RAGE) MRI sequence.

Material and methods

Twenty patients (female; mean age, 27.9 years), presenting consecutively for brain MRI between August 2014–December 2016 with clinical suspicion of anorexia nervosa and BMI<18.5 kg/m² were included. Controls were ten healthy females (mean age, 26.5 years). Automated brain morphometry was performed based on MP2RAGE. Means of morphometric results in the two groups were compared and correlation with BMI was analysed.

Results

Significantly lower volumes of total brain, grey matter (GM), white matter (WM), cerebellum and insula were found in anorexic patients. Anorexics had higher volumes of CSF, ventricles, lateral ventricles and third ventricle. When adjusted means for weight and height were compared, the volume of WM and cerebellum were not significantly different. However, volume of WM was significantly affected by weight and positively correlated with BMI. Significant positive correlations were found between BMI and volumes of total brain, GM, cortical GM and WM. BMI was negatively correlated with volumes of CSF and third ventricle.

Conclusion

Brain atrophy was demonstrated in anorexic patients with MP2RAGE-based automated segmentation, which seems to reliably estimate brain volume.

Key points

• Automated brain segmentation based on 3-D MRI seems to reliably estimate brain volume.

• This technique detected brain atrophy in patients suffering from anorexia nervosa.

• Brain changes in anorexia nervosa can be quantitatively and qualitatively followed-up by MRI.

The relationship of cancer characteristics and patient outcome with time to lung cancer diagnosis after an abnormal screening CT

Abstract

Purpose

The National Lung Screening Trial (NLST) demonstrated a reduction in lung cancer and all-cause mortality with low-dose CT (LDCT) screening. The aim of our study was to examine the time to diagnosis (TTD) of lung cancer in the LDCT arm of the NLST and assess its relationship with cancer characteristics and survival.

Methods

The subjects (N = 462) with a positive baseline screen and subsequent lung cancer diagnosis within 3 years were evaluated by data and image review to confirm the baseline abnormality. The cases were analysed for the relationship between TTD and imaging features, cancer type, stage and survival for 7 years from baseline screen.

Results

Cancer was judged to be present at baseline in 397/462 cases. The factors that showed significant association (p value trend less than 0.05) with longer TTD included smaller nodule size, pure ground glass nodules (GGNs), smooth/lobulated margins, stages I/II, adenocarcinoma, and decreasing lung cancer mortality. The logistic regression model for lung cancer death showed significant inverse relationships with size less than 20 mm (OR = 0.32), pure GGNs (OR = 0.24), adenocarcinoma (OR = 0.57) and direct relationship with age (OR = 1.4).

Conclusion

TTD after a positive LDCT screen in the NLST showed a strong association with imaging features, stage and mortality.

Key Points

• NLST observed variable time to lung cancer diagnosis from positive baseline screen.

• Time to diagnosis was associated with imaging features, cancer type and stage.

• In univariate but not multivariate analysis, longer TTD correlated with decreased mortality.

A meta-analysis of use of Prostate Imaging Reporting and Data System Version 2 (PI-RADS V2) with multiparametric MR imaging for the detection of prostate cancer

Abstract

Objectives

This meta-analysis was undertaken to review the diagnostic accuracy of PI-RADS V2 for prostate cancer (PCa) detection with multiparametric MR (mp-MR).

Methods

A comprehensive literature search of electronic databases was performed by two observers independently. Inclusion criteria were original research using the PI-RADS V2 system in reporting prostate MRI. The methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data necessary to complete 2 × 2 contingency tables were obtained from the included studies.

Results

Thirteen studies (2,049 patients) were analysed. This is an initial meta-analysis of PI-RADs V2 and the overall diagnostic accuracy in diagnosing PCa was as follows: pooled sensitivity, 0.85 (0.78–0.91); pooled specificity, 0.71 (0.60–0.80); pooled positive likelihood ratio (LR+), 2.92 (2.09–4.09); pooled negative likelihood ratio (LR–), 0.21 (0.14–0.31); pooled diagnostic odds ratio (DOR), 14.08 (7.93–25.01), respectively. Positive predictive values ranged from 0.54 to 0.97 and negative predictive values ranged from 0.26 to 0.92.

Conclusion

Currently available evidence indicates that PI-RADS V2 appears to have good diagnostic accuracy in patients with PCa lesions with high sensitivity and moderate specificity. However, no recommendation regarding the best threshold can be provided because of heterogeneity.

Key Points

• PI-RADS V2 shows good diagnostic accuracy for PCa detection.

• Initially pooled specificity of PI-RADS v2 remains moderate.

• PCa detection is increased by experienced radiologists.

• There is currently a high heterogeneity in prostate diagnostics with MRI.

Assessment of patency capsule retention using MR diffusion-weighted imaging

Abstract

Objectives

Evaluate the ability of MR diffusion-weighted imaging (DWI) to predict patency capsule retention in Crohn's disease (CD).

Methods

Clinical and imaging data were prospectively reviewed for 80 CD patients following patency capsule administration and MR-DWI under institutional review board (IRB) approval with informed consent. Two radiologists separately assessed the presence/absence of restricted diffusion in the distal ileum. Apparent diffusion coefficients (ADC) from three regions of interest on the ileal wall were averaged. The association between restricted diffusion and retention, and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Ability of ADC to predict retention was assessed with receiver operating characteristic (ROC) curve analysis.

Results

Restricted diffusion in the distal ileum was associated with capsule retention (p = 0.001, p < 0.0001). Sensitivity, specificity, PPV and NPV of restricted diffusion for capsule retention were 100.0%, 46.2%, 30.0%, 100% and 100.0%, 56.9%, 34.9%, 100%, respectively, for two radiologists. Accuracy of ADC to predict retention was high (area under the curve = 0.851, p < 0.0001). An ADC of 1.47 mm²/s showed 90.0% sensitivity and 50.0% specificity for retention.

Conclusions

Sensitivity and NPV of restricted diffusion for patency capsule retention were 100%, suggesting that DWI may predict gastrointestinal tract capability to pass video camera endoscopy.

Key Points

• Capsule endoscopy enables assessment of the gastrointestinal mucosa in Crohn's disease

• Prior patency capsule administration is recommended to evaluate gastrointestinal tract patency

• MR diffusion-weighted imaging may detect pathological constriction of the ileum

• Restricted diffusion in the distal ileum was associated with capsule retention

• MR-DWI may predict gastrointestinal tract capability to pass capsule endoscopy

PETRA, MSVAT-SPACE and SEMAC sequences for metal artefact reduction in dental MR imaging

Abstract

Objectives

Dental MRI is often impaired by artefacts due to metallic dental materials. Several sequences were developed to reduce susceptibility artefacts. Here, we evaluated a set of sequences for artefact reduction for dental MRI for the first time.

Methods

Artefact volume, signal-to-noise ratio (SNR) and image quality were assessed on a 3-T MRI for pointwise encoding time reduction with radial acquisition (PETRA), multiple-slab acquisition with view angle tilting gradient, based on a sampling perfection with application-optimised contrasts using different flip angle evolution (SPACE) sequence (MSVAT-SPACE), slice-encoding for metal-artefact correction (SEMAC) and compared to a standard SPACE and a standard turbo-spin-echo (TSE) sequence. Field-of-view and acquisition times were chosen to enable in vivo application. Two implant-supported prostheses were tested (porcelain fused to metal non-precious alloy and monolithic zirconia).

Results

Smallest artefact was measured for TSE sequences with no difference between the standard TSE and the SEMAC. MSVAT-SPACE reduced artefacts about 56% compared to the standard SPACE. Effect of the PETRA was dependent on sample used. Image quality and SNR were comparable for all sequences except PETRA, which yielded poor results.

Conclusion

There is no benefit in terms of artefact reduction for SEMAC compared to standard TSE. Usage of MSVAT-SPACE is advantageous since artefacts are reduced and higher resolution is achieved.

Key Points

• SEMAC is not superior to TSE in terms of artefact reduction.

• MSVAT-SPACE reduces susceptibility artefacts while maintaining comparable image quality.

• PETRA reduces susceptibility artefacts depending on material but offers poor image quality

The role of T1 perfusion-based classification in magnetic resonance-guided high-intensity focused ultrasound ablation of uterine fibroids

Abstract

Objective

To comparatively evaluate the role of magnetic resonance (MR) T1 perfusion-based time–signal intensity (SI) curves of fibroid tissue and the myometrium in classification of fibroids for predicting treatment outcomes of high-intensity focused ultrasound (HIFU) treatment.

Methods

The fibroids of 74 women who underwent MR-HIFU treatment were classified into group A (time–SI curve of fibroid lower than that of the myometrium) and group B (time–SI curve of fibroid equal to or higher than that of the myometrium). Non-perfused volume (NPV) ratios immediately after treatment and fibroid volume reduction ratios and symptom severity scores (SSS) at the 6-month follow-up were retrospectively assessed.

Results

The immediate NPV ratios in groups A and B were 95.3 ± 6.3% (n = 62) and 63.8 ± 11% (n = 12), respectively. At the 6-month follow-up, the fibroid volume reduction ratios in groups A and B were 0.52 ± 0.14 (n = 50) and 0.07 ± 0.14 (n = 11), with the corresponding improvement in mean transformed SSS being 0.86 ± 0.14 and 0.19 ± 0.3, respectively. No serious adverse effects were reported.

Conclusions

Our novel classification method could play an important role in classifying fibroids for predicting the immediate outcomes of HIFU treatment.

Key Points

• MRI is an important modality for outcome prediction in HIFU treatment

• Patient selection is a significant factor for achieving high NPV ratio

• NPV ratio is very strongly correlated with T1 perfusion-based classification

• T1 perfusion-based classification is a strong predictor of treatment outcome

Erratum to: Impact of model-based iterative reconstruction on low-contrast lesion detection and image quality in abdominal CT: a 12-reader-based comparative phantom study with filtered back projection at different tube voltages

Diffusion-weighted imaging versus contrast-enhanced MR imaging for the differentiation of renal oncocytomas and chromophobe renal cell carcinomas

Abstract

Objectives

To compare the performance of diffusion-weighted imaging (DWI) with that of contrast-enhanced MRI in differentiating renal oncocytomas from chromophobe renal cell carcinomas (RCCs).

Methods

We recruited 48 patients with histopathologically confirmed renal oncocytomas (n=16) and chromophobe RCCs (n=32). All patients underwent preoperative DWI and contrast-enhanced MRI. Apparent diffusion coefficient (ADC) and signal intensity were measured in each patient. ADC ratio and percentage of signal intensity change were calculated.

Results

Mean ADC values for renal oncoctytomas were significantly higher than those for chromophobe RCCs (1.59±0.21 vs. 1.09±0.29× 10⁻³ mm²/s, p < 0.001). Area under the ROC curve, sensitivity and specificity were 0.931, 87.5% and 84.4%, respectively, for ADC measurement of DW imaging; 0.825, 87.5% and 75%, respectively, for enhancement ratio (p > 0.05). Adding ADC values to the enhancement ratios in the ROC, analysis to differentiate renal oncocytoma from chromophobe RCCs increased specificity from 75 to 87.5% at 87.5% sensitivity without significantly increasing the AUC (0.930).

Conclusions

Both DWI and contrast-enhanced MRI may assist in differentiating renal oncocytomas from chromophobe RCCs, with DWI showing higher diagnostic value. The combination of the two parameters could potentially provide better performance in distinguishing these two tumours.

Key Points

• ADC values can assist in differentiating renal oncocytomas from chromophobe RCCs.

• DW imaging possesses better specificity than does contrast-enhanced MR imaging.

• Combining the two parameters provides higher specificity regarding the differential diagnosis.

Comparison of medical-grade and calibrated consumer-grade displays for diagnosis of subtle bone fissures

Abstract

Objective

To compare the diagnostic accuracy of medical-grade and calibrated consumer-grade digital displays for the detection of subtle bone fissures.

Methods

Three experienced radiologists assessed 96 digital radiographs, 40 without and 56 with subtle bone fissures, for the presence or absence of fissures in various bones using one consumer-grade and two medical-grade displays calibrated according to the DICOM-Grayscale Standard Display Function. The reference standard was consensus reading. Subjective image quality was also assessed by the three readers. Statistical analysis was performed using receiver operating characteristic analysis and by calculating the sensitivity, specificity, and Youden's J for each combination of reader and display. Cohen's unweighted kappa was calculated to assess inter-rater agreement. Subjective image quality was compared using the Wilcoxon signed-rank test.

Results

No significant differences were found for the assessment of subjective image quality. Diagnostic performance was similar across all readers and displays, with Youden's J ranging from 0.443 to 0.661. The differences were influenced more by the reader than by the display used for the assessment.

Conclusion

No significant differences were found between medical-grade and calibrated consumer-grade displays with regard to their diagnostic performance in assessing subtle bone fissures. Calibrated consumer-grade displays may be sufficient for most radiological examinations.

Key points

• Diagnostic performance of calibrated consumer-grade displays is comparable to medical-grade displays.

• There is no significant difference with regard to subjective image quality.

• Use of calibrated consumer-grade displays could cut display costs by 60-80%.

The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI

Abstract

Objective

To prospectively investigate the longitudinal effect of ejaculatory abstinence on MRI-measured seminal vesicle (SV) volume and whole-prostate ADC over consecutive days.

Methods

15 healthy male volunteers (mean 35.9 years, range 27–53) underwent 3-T MRI at baseline and 1, 2 and 3 days post-ejaculation. Prostate and SV volumes were derived by volume segmentation and whole-gland apparent diffusion coefficient (ADC) values calculated. A mixed-effects linear regression compared ADC values and prostate/seminal vesicle volumes in each volunteer between studies in a pairwise manner.

Results

All subjects completed the four MRIs. Mean prostate volume was 22.45 cm³ (range 13.04–31.21 cm³), with no change between the four studies (p = 0.89–0.99). 13/15 subjects showed SV volume reduction from baseline to day 1, with group-mean decreasing from 6.45 to 4.80 cm³ (−25.6%, p < 0.001), and a significant reduction from baseline to day 2 (−18.1%, p = 0.002). There was a significant volume increase from both day 1 (+21.3%, p = 0.006) and day 2 (+10.2%, p = 0.022) to day 3 post-ejaculation. There was a significant reduction in ADC from 1.105 at baseline to 1.056 × 10⁻³ mm²/s at day 1 (mean −4.3%, p = 0.009).

Conclusion

The longitudinal effect of ejaculation on SV volume was demonstrated. Significant reductions in SV volume and whole-gland ADC were observed post-ejaculation, supporting a 3-day period of abstinence before prostate MRI.

Key Points

• Seminal vesicle volume significantly reduced 24 h post-ejaculation remaining reduced at day 2

• Seminal vesicle fluid volume significantly increased from day 1 to day 3 post-ejaculation

• There was a significant reduction in whole-gland prostate ADC values day 1 post-ejaculation

• 3-day abstinence from ejaculation is required to ensure maximal seminal vesicle distension

The diagnostic value of high-frequency power-based diffusion-weighted imaging in prediction of neuroepithelial tumour grading

Abstract

Objectives

To retrospectively evaluate the diagnostic value of high-frequency power (HFP) compared with the minimum apparent diffusion coefficient (MinADC) in the prediction of neuroepithelial tumour grading.

Methods

Diffusion-weighted imaging (DWI) data were acquired on 115 patients by a 3.0-T MRI system, which included b0 images and b1000 images over the whole brain in each patient. The HFP values and MinADC values were calculated by an in-house script written on the MATLAB platform.

Results

There was a significant difference among each group excluding grade I (G1) vs. grade II (G2) (P = 0.309) for HFP and among each group for MinADC. ROC analysis showed a higher discriminative accuracy between low-grade glioma (LGG) and high-grade glioma (HGG) for HFP with area under the curve (AUC) value 1 compared with that for MinADC with AUC 0.83 ± 0.04 and also demonstrated a higher discriminative ability among the G1-grade IV (G4) group for HFP compared with that for MinADC except G1 vs. G2.

Conclusions

HFP could provide a simple and effective optimal tool for the prediction of neuroepithelial tumour grading based on diffusion-weighted images in routine clinical practice.

Key Points

• HFP shows positive correlation with neuroepithelial tumour grading.

• HFP presents a good diagnostic efficacy for LGG and HGG.

• HFP is helpful in the selection of brain tumour boundary.