PASH syndrome a disease with genetic heterogeneity

PASH syndrome is a clinical entity associating pyoderma gangrenosum (PG), severe acne and hidradenitis suppurativa (HS)¹. Absence of pyogenic sterile arthritis (PA) distinguishes PASH syndrome from PAPASH and PAPA syndromes which associate PA in combination with PG, severe acne with or without HS, respectively^2,3. Mutations in PSTPIP1 (proline-serine-threonine-phosphatase interacting protein 1) gene were identified in patients with PAPA and PAPASH syndromes, although genetic heterogeneity was observed in PAPA syndrome^2,3. Loss-of-function mutations in the y-secretase genes, Nicastrin (NCSTN), Presenilin Enhancer-2 (PSENEN), and Presenilin-1 (PSEN1), have been reported in a small proportion of HS patients^4,5.

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‘Is nitrogen mustard contamination responsible for the reported MT-45 toxicity?’ Reply from the authors

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Superficial Papular Neuroma: Case Series of a New Entity R2

Abstract

Background

Dermal neural lesions arise in various circumstances and may be difficult to classify.

Methods

We describe the clinical, histopathologic and immunophenotypic features of a series of terminally-differentiated neural lesions not described previously, to our knowledge.

Results

Four cases from men aged 58–66 years were included. Some lesions reportedly bled, but no inciting trauma or prior biopsies were reported. None recurred after biopsy, with follow-up ranging from 19 to 113 months. All lesions were papular, with vertically-oriented S100-positive spindled cells and nerve fibers in the papillary dermis. Slight epidermal hyperplasia, dilated superficial thin-walled vessels and minimal to mild inflammation were seen in each. Fibers were uniformly fine in three cases, with slightly thicker central fibers in the fourth. Three had parakeratotic scale. None were associated with dermal fibrosis or adnexal proliferation. Neurofilament stained axons in each. EMA was negative in all cases. CD34, melan-A and HMB45 were negative when performed.

Conclusions

We report a small series of benign neural lesions and propose the name "superficial papular neuroma" for this distinct entity. Awareness is important to understand the clinical significance of these lesions and avoid misinterpretation that could lead to overtreatment, unnecessary work-up and increased cost.

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‘Is nitrogen mustard contamination responsible for the reported MT-45 toxicity?’ Reply from the authors

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PASH syndrome a disease with genetic heterogeneity

PASH syndrome is a clinical entity associating pyoderma gangrenosum (PG), severe acne and hidradenitis suppurativa (HS)¹. Absence of pyogenic sterile arthritis (PA) distinguishes PASH syndrome from PAPASH and PAPA syndromes which associate PA in combination with PG, severe acne with or without HS, respectively^2,3. Mutations in PSTPIP1 (proline-serine-threonine-phosphatase interacting protein 1) gene were identified in patients with PAPA and PAPASH syndromes, although genetic heterogeneity was observed in PAPA syndrome^2,3. Loss-of-function mutations in the y-secretase genes, Nicastrin (NCSTN), Presenilin Enhancer-2 (PSENEN), and Presenilin-1 (PSEN1), have been reported in a small proportion of HS patients^4,5.

This article is protected by copyright. All rights reserved.

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Random Skin Biopsy in the Diagnosis of Intravascular Lymphoma

Abstract

Intravascular lymphoma (IVL) is a relatively rare type of non-Hodgkin lymphoma (NHL). IVL is characterized by selective growth of large lymphoma cells within small blood vessels. IVL is most often B-cell type, and only rarely found to be T-cell type^1–3 or NK-cell type.

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Myxoid variant of primary cutaneous Anaplastic Large Cell Lymphoma: first two cases.

Abstract

Anaplastic large cell lymphoma (ALCL) is a CD30+ T-cell non-Hodgkin lymphoma with two main clinical presentations: primary cutaneous (pcALCL) and systemic (sALCL). While rare cases of myxoid sALCL have been reported, there are no previous cases of myxoid pcALCL reported. We present two unusual cases of pcALCL showing prominent collections of dermal mucin closely intermingling with the anaplastic lymphocytes. Patient 1 was a 30-year-old woman who presented with ulcerated nodules on her neck, abdomen, chest, and shoulders. A systemic lymphoma was excluded by physical examination, positron emission tomography and computed tomography (PET-CT) scan, as well as by bone marrow biopsy and flow cytometry studies. The patient was closely followed up for 10 months without evidence of systemic involvement. The biopsy showed diffuse infiltration of the dermis by a CD2+, CD30+, ALK-negative ALCL. Patient 2 was a 55-year-old woman who presented with a single nodule on her right arm. A systemic lymphoma was excluded by physical examination as well as by a PET-CT scan. The biopsy showed diffuse and dense lymphoid infiltration of the whole biopsy by a CD3+, CD4+, CD30+, ALK-negative ALCL. The atypical lymphocytes were intermingled with large amounts of dermal stromal mucin.

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Microsurgical reconstruction of pharyngoesophageal defects—case series and critical review of the literature

Abstract

Background

The reconstructive goals after laryngopharyngoesophagectomy are the reestablishment of the digestive conduit, achievement of adequate swallowing, and voice restoration. The pharyngoesophageal segment is typically reconstructed with a jejunal or a fasciocutaneous free flap. The gastro-omental free flap offers unique advantages in high-risk surgical fields. The best reconstructive option is still a matter of controversy. A retrospective study was conducted to assess the morbidity and functional results of microsurgical pharyngoesophageal reconstructions performed at our institution in the last 16 years and compare them with the literature.

Methods

A retrospective review was conducted on patients who underwent pharyngoesophageal microsurgical reconstruction between 1999 and 2016 at a single institution. The perioperative morbidity, mortality, and functional outcomes were evaluated and compared with similar published case series.

Results

A total of 14 free flap reconstructions were performed, after pharyngolaryngoesophagectomy or pharyngoesophageal radionecrosis. Patients received jejunal, radial forearm, gastro-omental, or anterolateral thigh flaps. There was one flap failure and one perioperative death. The rates of stricture and fistula were 8.3 and 16.7%, respectively. Oral diet was achieved in all patients and 71% have been considered to have an intelligible speech. At 1-year post-op, 71.4% of the patients were alive and the 3-year survival rate was 35.7%.

Conclusions

The reconstruction of the pharyngoesophageal segment requires safe, reliable, and functional single-stage solutions. Fasciocutaneous flaps seem to provide better functional results and allow a shorter hospital stay, while enteric flaps appear to be more reliable in adverse surgical fields.

Level of Evidence: Level IV, therapeutic study.

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Optical Microresonators for Sensing and Transduction: A Materials Perspective

Optical microresonators confine light to a particular microscale trajectory, are exquisitely sensitive to their microenvironment, and offer convenient readout of their optical properties. Taken together, this is an immensely attractive combination that makes optical microresonators highly effective as sensors and transducers. Meanwhile, advances in material science, fabrication techniques, and photonic sensing strategies endow optical microresonators with new functionalities, unique transduction mechanisms, and in some cases, unparalleled sensitivities. In this progress report, the operating principles of these sensors are reviewed, and different methods of signal transduction are evaluated. Examples are shown of how choice of materials must be suited to the analyte, and how innovations in fabrication and sensing are coupled together in a mutually reinforcing cycle. A tremendously broad range of capabilities of microresonator sensors is described, from electric and magnetic field sensing to mechanical sensing, from single-molecule detection to imaging and spectroscopy, from operation at high vacuum to in live cells. Emerging sensing capabilities are highlighted and put into context in the field. Future directions are imagined, where the diverse capabilities laid out are combined and advances in scalability and integration are implemented, leading to the creation of a sensor unparalleled in sensitivity and information content.

Optical microresonators possess photonic and materials properties that make them sensors of unparalleled sensitivity. These structures confine light to microscale trajectories where their microenvironment can be repeatedly probed. In this manner, optical microresonators offer a diversity of sensing strategies, including chemical sensing down to single molecules, imaging, spectroscopy, electric and magnetic field sensing, and force and mass sensing.

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Ultrastable Near-Infrared Conjugated-Polymer Nanoparticles for Dually Photoactive Tumor Inhibition

It is highly desired that satisfactory photoactive agents with ideal photophysical characteristics are explored for potent cancer phototherapeutics. Herein, bifunctional nanoparticles of low-bandgap donor–acceptor (D–A)-type conjugated-polymer nanoparticles (CP-NPs) are developed to afford a highly efficient singlet-to-triplet transition and photothermal conversion for near-infrared (NIR) light-induced photodynamic (PDT)/photothermal (PTT) treatment. CP-NPs display remarkable NIR absorption with the peak at 782 nm, and perfect resistance to photobleaching. Photoexcited CP-NPs undergo singlet-to-triplet intersystem crossing through charge transfer in the excited D–A system and simultaneous nonradiative decay from the electron-deficient electron acceptor isoindigo derivative under single-wavelength NIR light irradiation, leading to distinct singlet oxygen quantum yield and high photothermal conversion efficiency. Moreover, the CP-NPs display effective cellular uptake and cytoplasmic translocation from lysosomes, as well as effective tumor accumulation, thus promoting severe light-triggered damage caused by favorable reactive oxygen species (ROS) generation and potent hyperthermia. Thus, CP-NPs achieve photoactive cell damage through their photoconversion ability for synergistic PDT/PTT treatment with tumor ablation. The proof-of-concept design of D–A-type conjugated-polymer nanoparticles with ideal photophysical characteristics provides a general approach to afford potent photoactive cancer therapy.

Ultrastable donor–acceptor low-bandgap conjugated-polymer nanoparticles are developed to afford a highly efficient singlet-to-triplet transition and nonradiative decay to simultaneously generate singlet oxygen and photohyperthermia for near-infrared photoactive tumor ablation.

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Fluoroarene Complexes with Small Bite Angle Bisphosphines: Routes to Amine−Borane and Aminoborylene Complexes

Fluoroarene complexes of the small bite angle bisphosphine Cy2PCH2PCy2 (dcpm) have been prepared: [Rh(dcpm)(η6-1,2−F2C6H4)][Al{OC(CF3)3}4] and [Rh(dcpm)(η6-1,2,3− F3C6H3)][Al{OC(CF3)3}4]. These complexes act as precursors to a previously inaccessible σ−amine−borane complex [Rh(dcpm)(η2-H3B·NMe3)][Al{OC(CF3)3}4] of a small bite-angle phosphine. This complex is a poor catalyst for the dehydrocoupling of H3B·NMe2H. Instead, formation of the bridging borylene complex [{RhH(µ−dcpm)}2(µ−H)(µ−BNMe2)][Al{OC(CF3)3}4] occurs, which has been studied by NMR, mass spectrometry, crystallographic and DFT techniques. This represents a new route to bridging borylene complexes.

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In Situ Electrochemistry of Rechargeable Battery Materials: Status Report and Perspectives

The development of rechargeable batteries with high performance is considered to be a feasible way to satisfy the increasing needs of electric vehicles and portable devices. It is of vital importance to design electrodes with high electrochemical performance and to understand the nature of the electrode/electrolyte interfaces during battery operation, which allows a direct observation of the complicated chemical and physical processes within the electrodes and electrolyte, and thus provides real-time information for further design and optimization of the battery performance. Here, the recent progress in in situ techniques employed for the investigations of material structural evolutions is described, including characterization using neutrons, X-ray diffraction, and nuclear magnetic resonance. In situ techniques utilized for in-depth uncovering the electrode/electrolyte phase/interface change mechanisms are then highlighted, including transmission electron microscopy, atomic force microscopy, X-ray spectroscopy, and Raman spectroscopy. The real-time monitoring of lithium dendrite growth and in situ detection of gas evolution during charge/discharge processes are also discussed. Finally, the major challenges and opportunities of in situ characterization techniques are outlined toward new developments of rechargeable batteries, including innovation in the design of compatible in situ cells, applications of dynamic analysis, and in situ electrochemistry under multi-stimuli. A clear and in-depth understanding of in situ technique applications and the mechanisms of structural evolutions, surface/interface changes, and gas generations within rechargeable batteries is given here.

In situ characterization techniques of rechargeable battery materials, applied for the investigation of structural evolution, surface/interface changes, and monitoring of gas generation during battery operation, pave the way for unveiling the battery storage mechanism and its performance fading routes, and provide a fruitful strategy to design electrode materials with superb electrochemical performance. The current challenges and potential development perspectives are summarized with the aim of expanding battery applications.

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Numerical Analysis of Tribology Behavior of Materials

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Challenges and Perspectives for NASICON-Type Electrode Materials for Advanced Sodium-Ion Batteries

Sodium-ion batteries (SIBs) have attracted increasing attention in the past decades, because of high overall abundance of precursors, their even geographical distribution, and low cost. Apart from inherent thermodynamic disadvantages, SIBs have to overcome multiple kinetic problems, such as fast capacity decay, low rate capacities and low Coulombic efficiencies. A special case is sodium super ion conductor (NASICON)-based electrode materials as they exhibit – besides pronounced structural stability – exceptionally high ion conductivity, rendering them most promising for sodium storage. Owing to the limiting, comparatively low electronic conductivity, nano-structuring is a prerequisite for achieving satisfactory rate-capability. In this review, we analyze advantages and disadvantages of NASICON-type electrode materials and highlight electrode structure design principles for obtaining the desired electrochemical performance. Moreover, we give an overview of recent approaches to enhance electrical conductivity and structural stability of cathode and anode materials based on NASICON structure. We believe that this review provides a pertinent insight into relevant design principles and inspires further research in this respect.

Sodium super ion conductor (NASICON)-based electrode materials, exhibiting pronounced structural stability and exceptionally high ion conductivity are promising materials for sodium storage. Here, challenges and perspectives of NASICON-type electrode materials are discussed, electrode structure design principles for obtaining the desired electrochemical performance are highlighted. Recent progress in enhancing electrical conductivity and structural stability of NASICON materials is summarized.

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Lipids of the Tail Gland, Body and Muzzle Fur of the Red Fox, Vulpes vulpes

Abstract

The tail gland of the red fox (Vulpes vulpes) secretes lipids containing volatile terpenes used in social communication. We have analysed lipids extracted from fur of the tail gland, body (flanks) and muzzle of foxes. GC–MS showed a novel group of iso-valerate and tiglate monoesters of alkane-1,2-diols (C18:0–22:0). There was also a larger group of Type II diesters in which a second, longer chain, fatty acid (FA) was attached to the free alcohol group. LC–MS showed the full range of diol diesters, mostly C36:0–50:0, with smaller amounts of the corresponding mono-unsaturated tiglate esters. An additional group of diesters with higher MW (C49:0–62:0) containing two long-chain FA was present in the lipids of body and muzzle fur. After saponification and GC–MS, 98 fatty acids were characterized as their methyl esters. Apart from the C5 FA, most were saturated n-, iso-, anteiso- or other methyl-branched FA (C12:0–28:0) whose structures were determined by a combination of their mass spectra and Kovats retention indices. Several FA have not previously been found in nature or in vertebrates. Thirty-four alkane-1,2-diols were found as their TMS derivatives, mostly n-, iso- or anteiso-isomers of C16:0–25:0. The tail gland had the greatest amount of wax esters, from a greater variety of FA and diols, but lacked the esters with two long-chain FA. These findings show that fox skin lipids comprise mono- and di-esters of alkane-1,2-diols, and exhibit enormous complexity due to the diversity of their constituent FA, diols and the many possible isomers of their esters.

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Numerical Analysis of Tribology Behavior of Materials

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Metal–Organic-Framework-Derived Hybrid Carbon Nanocages as a Bifunctional Electrocatalyst for Oxygen Reduction and Evolution

The oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) are cornerstone reactions for many renewable energy technologies. Developing cheap yet durable substitutes of precious-metal catalysts, especially the bifunctional electrocatalysts with high activity for both ORR and OER reactions and their streamlined coupling process, are highly desirable to reduce the processing cost and complexity of renewable energy systems. Here, a facile strategy is reported for synthesizing double-shelled hybrid nanocages with outer shells of Co-N-doped graphitic carbon (Co-NGC) and inner shells of N-doped microporous carbon (NC) by templating against core–shell metal–organic frameworks. The double-shelled NC@Co-NGC nanocages well integrate the high activity of Co-NGC shells into the robust NC hollow framework with enhanced diffusion kinetics, exhibiting superior electrocatalytic properties to Pt and RuO₂ as a bifunctional electrocatalyst for ORR and OER, and hold a promise as efficient air electrode catalysts in Zn–air batteries. First-principles calculations reveal that the high catalytic activities of Co-NGC shells are due to the synergistic electron transfer and redistribution between the Co nanoparticles, the graphitic carbon, and the doped N species. Strong yet favorable adsorption of an OOH* intermediate on the high density of uncoordinated hollow-site C atoms with respect to the Co lattice in the Co-NGC structure is a vital rate-determining step to achieve excellent bifunctional electrocatalytic activity.

A new strategy is developed for constructing a hollow nanostructured bifunctional oxygen reduction reaction/oxygen evolution reaction electrocatalyst with integrated high activity and fast kinetics by surface-stabilized heterogeneous contraction of core–shell metal–organic frameworks. The resultant double-shelled hybrid nanocages with an outer shell of mesoporous Co-N-doped graphitic carbon and an inner shell of microporous N-doped carbon exhibit superior electrocatalytic performance to noble metals for oxygen reduction and evolution reactions.

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Carbon Nanotube–Multilayered Graphene Edge Plane Core–Shell Hybrid Foams for Ultrahigh-Performance Electromagnetic-Interference Shielding

Materials with an ultralow density and ultrahigh electromagnetic-interference (EMI)-shielding performance are highly desirable in fields of aerospace, portable electronics, and so on. Theoretical work predicts that 3D carbon nanotube (CNT)/graphene hybrids are one of the most promising lightweight EMI shielding materials, owing to their unique nanostructures and extraordinary electronic properties. Herein, for the first time, a lightweight, flexible, and conductive CNT–multilayered graphene edge plane (MLGEP) core–shell hybrid foam is fabricated using chemical vapor deposition. MLGEPs are seamlessly grown on the CNTs, and the hybrid foam exhibits excellent EMI shielding effectiveness which exceeds 38.4 or 47.5 dB in X-band at 1.6 mm, while the density is merely 0.0058 or 0.0089 g cm⁻³, respectively, which far surpasses the best values of reported carbon-based composite materials. The grafted MLGEPs on CNTs can obviously enhance the penetration losses of microwaves in foams, leading to a greatly improved EMI shielding performance. In addition, the CNT–MLGEP hybrids also exhibit a great potential as nano-reinforcements for fabricating high-strength polymer-based composites. The results provide an alternative approach to fully explore the potentials of CNT and graphene, for developing advanced multifunctional materials.

Carbon nanotube–multilayered graphene edge plane core–shell hybrid foams are fabricated by chemical vapor deposition methods for the first time. The seamless junctions of multilayered graphene edge planes on the carbon nanotubes endow the hybrids with potential applications as high-performance nanocomposites and ultrahigh-performance lightweight electromagnetic-interference shielding materials.

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3D Printing All-Aromatic Polyimides using Mask-Projection Stereolithography: Processing the Nonprocessable

High-performance, all-aromatic, insoluble, engineering thermoplastic polyimides, such as pyromellitic dianhydride and 4,4′-oxydianiline (PMDA–ODA) (Kapton), exhibit exceptional thermal stability (up to ≈600 °C) and mechanical properties (Young's modulus exceeding 2 GPa). However, their thermal resistance, which is a consequence of the all-aromatic molecular structure, prohibits processing using conventional techniques. Previous reports describe an energy-intensive sintering technique as an alternative technique for processing polyimides with limited resolution and part fidelity. This study demonstrates the unprecedented 3D printing of PMDA–ODA using mask-projection stereolithography, and the preparation of high-resolution 3D structures without sacrificing bulk material properties. Synthesis of a soluble precursor polymer containing photo-crosslinkable acrylate groups enables light-induced, chemical crosslinking for spatial control in the gel state. Postprinting thermal treatment transforms the crosslinked precursor polymer to PMDA–ODA. The dimensional shrinkage is isotropic, and postprocessing preserves geometric integrity. Furthermore, large-area mask-projection scanning stereolithography demonstrates the scalability of 3D structures. These unique high-performance 3D structures offer potential in fields ranging from water filtration and gas separation to automotive and aerospace technologies.

High-performance, thermoplastic, fully aromatic polyimide structures are 3D printed for the first time using mask-projection stereolithography (MPSL). Synthesis of soluble, photo-crosslinkable polyamic diacrylate ester enables MPSL upon dissolution in a solvent. The 3D organogels with micrometer-scale resolution undergo conversion to a 3D polyimide on thermal imidization without loss in part fidelity. Mechanically robust, high-performance, fully aromatic 3D polyimide is obtained.

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Anode Improvement in Rechargeable Lithium–Sulfur Batteries

Owing to their theoretical energy density of 2600 Wh kg⁻¹, lithium–sulfur batteries represent a promising future energy storage device to power electric vehicles. However, the practical applications of lithium–sulfur batteries suffer from poor cycle life and low Coulombic efficiency, which is attributed, in part, to the polysulfide shuttle and Li dendrite formation. Suppressing Li dendrite growth, blocking the unfavorable reaction between soluble polysulfides and Li, and improving the safety of Li–S batteries have become very important for the development of high-performance lithium sulfur batteries. A comprehensive review of various strategies is presented for enhancing the stability of the anode of lithium sulfur batteries, including inserting an interlayer, modifying the separator and electrolytes, employing artificial protection layers, and alternative anodes to replace the Li metal anode.

Anodes play an important role in resolving the issues of conventional lithium sulfur batteries. This review introduces the most recent progress in anodes for lithium–sulfur batteries. To suppress the corrosion reaction occurred and the formation of Li dendrites on the surface of lithium metal, various strategies are summarized. Employing alternative anodes for sulfur-based rechargeable batteries is also discussed.

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Fabrication of Millimeter-Long Carbon Tubular Nanostructures Using the Self-Rolling Process Inherent in Elastic Protein Layers

Millimeter-long conducting fibers can be fabricated from carbon nanomaterials via a simple method involving the release of a prestrained protein layer. This study shows how a self-rolling process initiated by polymerization of a micropatterned layer of fibronectin (FN) results in the production of carbon nanomaterial-based microtubular fibers. The process begins with deposition of carbon nanotube (CNT) or graphene oxide (GO) particles on the FN layer. Before polymerization, particles are discrete and nonconducting, but after polymerization the carbon materials become entangled to form an interconnected conducting network clad by FN. Selective removal of FN using high-temperature combustion yields freestanding CNT or reduced GO microtubular fibers. The properties of these fibers are characterized using atomic force microscopy and Raman spectroscopy. The data suggest that this method may provide a ready route to rapid design and fabrication of aligned biohybrid nanomaterials potentially useful for future electronic applications.

Millimeter-long conducting fiberscan be fabricated from carbon nanomaterials via a simple method involving the release of a prestrained protein layer. Before the self-rolling process, nanoparticles are discrete, but after self-rolling process the nanoparticles become entangled to form an interconnected network clad. Selective removal of the protein layer yields a long freestanding, conducted carbon nanotube or graphene oxide microtubular fiber.

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Conductive Carbon Nitride for Excellent Energy Storage

Conductive carbon nitride, as a hypothetical carbon material demonstrating high nitrogen doping, high electrical conductivity, and high surface area, has not been fabricated. A major challenge towards its fabrication is that high conductivity requires high temperature synthesis, but the high temperature eliminates nitrogen from carbon. Different from conventional methods, a facile preparation of conductive carbon nitride from novel thermal decomposition of nickel hydrogencyanamide in a confined space is reported. New developed nickel hydrogencyanamide is a unique precursor which provides self-grown fragments of ⋅NCN⋅ or NCCN and conductive carbon (C-sp²) catalyst of Ni metal during the decomposition. The final product is a tubular structure of rich mesoporous and microporous few-layer carbon with extraordinarily high N doping level (≈15 at%) and high extent of sp² carbon (≈65%) favoring a high conductivity (>2 S cm⁻¹); the ultrahigh contents of nongraphitic nitrogen, redox active pyridinic N (9 at%), and pyrrolic N (5 at%), are stabilized by forming NiN bonds. The conductive carbon nitride harvests a large capacitance of 372 F g⁻¹ with >90% initial capacitance after 10 000 cycles as a supercapacitor electrode, far exceeding the activated carbon electrodes that have <250 F g⁻¹.

Conductive carbon nitride, simultaneously gaining high nitrogen doping and high electrical conductivity, is obtained from novel space-confined reaction. Nickel hydrogencyanamide provides self-grown fragments of ⋅NCN⋅ or NC−CN and conductive carbon (C-sp²) catalyst of Ni metal during the decomposition. The final product is a tubular structure of extraordinarily high N doping level (≈15 at%) and high conductivity (>2 S cm⁻¹).

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The Influence of Oxygen Atoms on Conformation and π–π Stacking of Ladder-Type Donor-Based Polymers and Their Photovoltaic Properties

A novel ladder-type donor pyran-bridged indacenodithiophene (IDTP) is developed by introducing two oxygen atoms into indacenodithiophene unit. IDTP possesses a twisted backbone and leads to facially asymmetric arrangement of side chains, resulting in enhanced local π–π stacking of according polymer poly[(5,5,11,11-tetrakis(4-octylphenyl)-5,11-dihydrothieno[2′,3′:5,6]pyrano[3,4-g]thieno[3,2-c]isochromene)-alt-4,7-(5-fluoro-2,1,3-benzothiadiazole)] (PIDTP)-FBT, which shows extended absorption range. Moreover, oxygen atoms render deeper highest occupied molecular orbital (HOMO) levels of poly[indacenodithiophene-alt-4,7-(5-fluoro-2,1,3-benzothiadiazole)] (PIDTP)-FBT compared with PIDT-FBT, therefore bringing a higher open-circuit voltage (V_oc).

Two oxygen atoms are inserted into indacenodithiophene (IDT) core structure, generating a novel ladder-type donor unit pyran-bridged IDT (IDTP), which shows a facially asymmetric side chain arrangement, resulting in denser π–π stacking of the corresponding polymer poly[(5,5,11,11-tetrakis(4-octylphenyl)-5,11-dihydrothieno[2′,3′:5,6]pyrano[3,4-g]thieno[3,2-c]isochromene)-alt-4,7-(5-fluoro-2,1,3-benzothiadiazole)] (PIDTP-FBT). A deeper highest occupied molecular orbital (HOMO) level is also obtained by PIDTP-FBT due to the inductive effect of oxygen atoms, giving higher open circuit voltage in the solar cell devices.

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Phase-Separable Polyisobutylene Palladium-PEPPSI Precatalysts: Synthesis and Application in Buchwald–Hartwig Amination

This paper reports the efficient synthesis of the first class of polyisobutylene(PIB)-supported palladium-PEPPSI precatalyst (PEPPSI = pyridine-enhanced precatalyst preparation, stabilization, and initiation). The new complexes are employed in Buchwald–Hartwig amination of aryl chlorides and are found to be reasonably active in the titled cross-coupling reaction. The supported catalysts are tested in polar (1,4-dioxane and 1,2-dimethoxyethane) as well as in aliphatic reaction media (toluene and n-heptane) and display superior activity in the highly lipophilic solvent (n-heptane). The catalytic efficacy of PIB-Pd-PEPPSI precatalyst is measured to be comparable to its nonsupported analog. Pd-leaching is determined by inductively coupled plasma mass spectrometry (ICP-MS) after a simple liquid/liquid extraction and is found to be 2 ppb in the product phase, translating into a recovery of ≈99.8% of the palladium.

Polyisobutylene-supported palladium PEPPSI is used for Buchwald–Hartwig amination of aryl chlorides.

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A Facile Approach Toward Scalable Fabrication of Reversible Shape-Memory Polymers with Bonded Elastomer Microphases as Internal Stress Provider

The present communication reports a novel strategy to fabricate reversible shape-memory polymer that operates without the aid of external force on the basis of a two-phase structure design. The proof-of-concept material, crosslinked styrene-butadiene-styrene block copolymer (SBS, dispersed phase)/polycaprolactone-based polyurethane (PU, continuous phase) blend, possesses a closely connected microphase separation structure. That is, SBS phases are chemically bonded to crosslinked PU by means of a single crosslinking agent and two-step crosslinking process for increasing integrity of the system. Miscibility between components in the blend is no longer critical by taking advantage of the reactive blending technique. It is found that a suitable programming leads to compressed SBS, which serves as internal expansion stress provider as a result. The desired two-way shape-memory effect is realized by the joint action of the temperature-induced reversible opposite directional deformabilities of the crystalline phase of PU and compressed SBS, accompanying melting and orientated recrystallization of the former. Owing to the broadness of material selection and manufacturing convenience, the proposed approach opens an avenue toward mass production and application of the smart polymer.

A reversible shape-memory polymer is prepared, simply by reactive blending of semicrystalline polymer and elastomer. Temperature-induced reversible shrinkage and extension of the components leads to reversible shape-memory effect of the programmed polymer blend without the intervention of external stress. The proposed approach is easy to be popularized due to the broad scope of raw materials and convenient procedures of material preparation.

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BacterioFiles 298 - Bacteria Boost Bone Buildup

This episode: Gut microbes can even affect formation/remodeling of bones!

(8.5 MB, 9.3 minutes)

Show notes: 

Journal Paper:
Yan J, Herzog JW, Tsang K, Brennan CA, Bower MA, Garrett WS, Sartor BR, Aliprantis AO, Ch...

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Elevated levels of serum IgM anti-phosphatidylserine-prothrombin complex antibodies in patients with cancer-associated vasculitis

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Comments regarding “four cases of mucous membrane pemphigoid with clinical features of oral lichen planus”

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Photodermatitis in a woman on antiretroviral therapy: report of a rare cutaneous adverse drug reaction of efavirenz and review of literature

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Sporotrichosis masquerading as pyoderma gangrenosum

Abstract

Sporotrichosis is a subcutaneous mycosis with a worldwide distribution caused by species of the Sporothrix schenkii complex. Since 1998, it has reached epidemic proportions in the city of Rio de Janeiro, Brazil, via transmission from infected cats to humans. The species identified as the primary cause was Sporothrix brasiliensis.

This article is protected by copyright. All rights reserved.

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European Surveillance System on Contact Allergies (ESSCA): results with the European baseline series, 2013/14

Abstract

Background

Contact allergy is a common condition and can severely interfere with daily life or professional activities. Due to changes in exposures, a consequence of introduction of new substances, new products or formulations, and regulatory intervention, the spectrum of contact sensitisation changes.

Objective

To evaluate the current spectrum of contact allergy to allergens present in the European baseline series (EBS) across Europe.

Methods

Retrospective analysis of data collected by the European Surveillance System on Contact Allergies (ESSCA, www.essca-dc.org) in consecutively patch tested patients, 2013/14, in 46 departments in 12 European countries.

Results

Altogether, 31689 patients were included in the analysis. Compared to a similar analysis in 2004, the prevalence of contact allergy to methylisothiazolinone went up to around 20% in several departments. In comparison, contact allergy to the metals nickel, cobalt and chromium remained largely stable, at 18.1, 5.9 and 3.2%, respectively, similar to mostly unchanged prevalences with fragrance mix I, II and Myroxylon pereirae (Balsam of Peru) at 7.3, 3.8 and 5.3%, respectively. In the subgroup of departments diagnosing (mainly) patients with occupational contact dermatitis, the prevalence of work-related contact allergies such as to epoxy resin or rubber additives was increased, compared to general dermatology departments.

Conclusion

Continuous surveillance of contact allergy based on network data offers the identification of time trends or persisting problems, and thus enables focussing in-depth research (subgroup analyses, exposure analysis) on areas where it is needed.

This article is protected by copyright. All rights reserved.

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Diphenylcyclopropenone for the treatment of cutaneous in-transit melanoma metastases – results of a prospective, non-randomised, single centre study

Abstract

Background

Current treatments for in-transit melanoma (ITM) metastases are frequently invasive and do not improve overall survival. Recently there has been increasing investigation into the use of topical agents for ITM. Diphenylcyclopropenone or diphencyprone (DPCP) is a novel, topical agent that has been reported to have immune-sensitising properties useful in the treatment of ITM.

Objective

To assess the clinical outcomes of patients treated within a prospective, non-randomised, non-comparative study using DPCP for cutaneous in-transit melanoma metastases.

Methods

A review was conducted assessing the outcomes of 58 patients prospectively treated using DPCP. Patients had satellite or in-transit disease (stage IIIB+), with all lesion morphology types included. The patients were treated through a single, specialised clinic with regular outpatient follow-up. DPCP was topically applied as an aqueous cream in 0.005% - 1% concentrations once to twice per week for up to 24 - 48 hours duration. To assess variables associated with response, a per-protocol statistical analysis was performed.

Results

Fifty-four patients were treated who satisfied eligibility criteria for analysis. The overall response rates were: complete response 22%, partial response 39%, stable disease 24% and progressive disease 15%. The mean time to CR was 10.5 months, mean duration of CR (disease-free interval) 12.3 months and recurrence rate in complete responders 41.2%. Lesion morphology was predictive of clinical benefit with a higher response in epidermotropic disease (P <0.05).

Conclusions

DPCP provided a well-tolerated, convenient and efficacious treatment for cutaneous in-transit melanoma metastases. Identifying patterns of response may assist treatment selection and improve patient-rated outcomes.

This article is protected by copyright. All rights reserved.

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Elevated levels of serum IgM anti-phosphatidylserine-prothrombin complex antibodies in patients with cancer-associated vasculitis

http://ift.tt/2ruRbk9

Comments regarding “four cases of mucous membrane pemphigoid with clinical features of oral lichen planus”

http://ift.tt/2sNYkAd

Photodermatitis in a woman on antiretroviral therapy: report of a rare cutaneous adverse drug reaction of efavirenz and review of literature

http://ift.tt/2ruO6ko

Polysaccharide production by lactic acid bacteria: from genes to industrial applications

Abstract

The ability to produce polysaccharides with diverse biological functions is widespread in bacteria. In lactic acid bacteria (LAB), production of polysaccharides has long been associated with the technological, functional and health-promoting benefits of these microorganisms. In particular, the capsular polysaccharides and exopolysaccharides have been implicated in modulation of the rheological properties of fermented products. For this reason, screening and selection of exocellular polysaccharide-producing LAB has been extensively carried out by academia and industry. To further exploit the ability of LAB to produce polysaccharides, an in-depth understanding of their biochemistry, genetics, biosynthetic pathways, regulation and structure–function relationships is mandatory. Here, we provide a critical overview of the latest advances in the field of glycosciences in LAB. Surprisingly, the understanding of the molecular processes involved in polysaccharide synthesis is lagging behind, and has not accompanied the increasing commercial value and application potential of these polymers. Seizing the natural diversity of polysaccharides for exciting new applications will require a concerted effort encompassing in-depth physiological characterization of LAB at the systems level. Combining high-throughput experimentation with computational approaches, biochemical and structural characterization of the polysaccharides and understanding of the structure–function–application relationships is essential to achieve this ambitious goal.

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Experimental evolution and the adjustment of metabolic strategies in lactic acid bacteria

Abstract

Experimental evolution of microbes has gained lots of interest in recent years, mainly due to the ease of strain characterisation through next-generation sequencing. While evolutionary and systems biologists use experimental evolution to address fundamental questions in their respective fields, studies with lactic acid bacteria are often more directed by applied questions. Insight into population and genome dynamics are valuable for experimental design and data interpretation, and it is becoming increasingly apparent how different constraints limit and govern the outcome of microbial adaptation to a selective environment. Examples for such constraints are the finite membrane and cellular space which can lead to trade-offs between cellular strategies. A powerful perspective is that of resource allocation, which allows cells to maximise fitness. This impacts on metabolic strategies that have different protein/resource demands. This review focuses on parameters and forces that shape cellular optimisation processes and that are determining for the outcome of laboratory evolution experiments. Phenotypic changes of experimentally evolved lactic acid bacteria will be discussed in the light of the selection conditions and the prevailing constraints.

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Attractiveness of black and white modified Shannon traps to phlebotomine sandflies (Diptera, Psychodidae) in the Brazilian Amazon Basin, an area of intense transmission of American cutaneous leishmaniasis

Authors: Andreia Fernandes Brilhante, Márcia Moreira de Ávila, Jailson Ferreira de Souza, Antônio Ralph Medeiros-Sousa, Priscila Bassan Sábio, Marcia Bicudo de Paula, Rodrigo Espindola Godoy, Leonardo Augusto Kohara Melchior, Vânia Lúcia Brandão Nunes, Cristiane de Oliveira Cardoso and Eunice Aparecida Bianchi Galati.
Parasite Vol. 24 , page 20
Keywords: Phlebotomine ; Attraction ; Shannon traps ; Anthropophily ; American cutaneous leishmaniasis ; Amazonia.

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The heat shock protein 90 of Toxoplasma gondii is essential for invasion of host cells and tachyzoite growth

Authors: Hongchao Sun, Xunhui Zhuo, Xianfeng Zhao, Yi Yang, Xueqiu Chen, Chaoqun Yao and Aifang Du.
Parasite Vol. 24 , page 22
Keywords: Toxoplasma gondii ; Heat shock protein 90 ; Invasion ; Differentiation ; Replication.

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Human spiruridiasis due to Physaloptera spp. (Nematoda: Physalopteridae) in a grave of the Shahr-e Sukhteh archeological site of the Bronze Age (2800–2500 BC) in Iran

Authors: Mahsasadat Makki, Jean Dupouy-Camet, Seyed Mansour Seyed Sajjadi, František Moravec, Saied Reza Naddaf, Iraj Mobedi, Hossein Malekafzali, Mostafa Rezaeian, Mehdi Mohebali, Faranak Kargar and Gholamreza Mowlavi.
Parasite Vol. 24 , page 18
Keywords: Paleoparasitology ; Human spiruridiasis ; Shahr-e Sukhteh ; Iran ; Physaloptera spp..

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Rhadinorhynchus oligospinosus n. sp. (Acanthocephala, Rhadinorhynchidae) from mackerels in the Pacific Ocean off Peru and related rhadinorhynchids in the Pacific, with notes on metal analysis

Authors: Omar M. Amin and Richard A. Heckmann.
Parasite Vol. 24 , page 19
Keywords: Acanthocephala ; Rhadinorhynchus oligospinosus n. sp. ; Peru ; Pacific mackerels ; Description ; EDAX analysis.

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Parasitic diseases of camels in Iran (1931–2017) – a literature review

Authors: Alireza Sazmand and Anja Joachim.
Parasite Vol. 24 , page 21
Keywords: dromedary ; Bactrian camel ; Camelus ; review ; Iran.

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Bilateral ischaemic optic neuropathy and retinopathy along with cortical infarct in a case of Takayasu disease

Description

A 27-Year-old female presented with complaints of sudden onset visual loss along with right sided deviation of the angle of mouth since past 30 days. Vision loss had worsened in the last week. There was history of severe headache which was not associated with vomiting. There was no history of any other neurological deficit or prior systemic illness. Examination for cranial nerve function revealed a left sided upper motor neuron facial nerve palsy and rest of the neurological examination was within normal limits. On ocular examination, the patient had best-corrected visual acuity of light perception (PL) in right eye (RE) and 6/36 in left eye (LE). A grade four relative afferent pupillary defect was noted in RE, while slit lamp examination and tonometry were normal. On fundus examination, RE optic disc had yellowish-white pallor while LE optic disc had temporal pallor (figure 1A,B). Multiple retinal...

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Saksenaea vasiformis infection in an immunocompetent patient in rural Australia

An 81-year-old man from rural Australia presented with right pretibial cellulitis 7 days after minor trauma against furniture. He failed to improve despite antibiotics and surgical debridement. Subsequent cultures grew the rare fungus Saksenaea vasiformis, which was treated with further surgical debridement, amphotericin B and posaconazole. This was successful and the patient made a full recovery. We present the case and discuss lessons learnt.

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QUAD fever: beware of non-infectious fever in high spinal cord injuries

A case of cervical spinal cord injury and quadriparesis with prolonged fever is being described. Initially, the patient received treatment for well-documented catheter-related bloodstream infection. High spiking fever returned and persisted with no obvious evidence of infection. The usual non-infectious causes too were carefully excluded. QUAD fever or fever due to spinal cord injury itself was considered. The pathogenetic basis of QUAD fever is unclear but could be attributed to autonomic dysfunction and temperature dysregulation. Awareness of this little known condition could help in avoiding unnecessary antimicrobial therapy and in more accurate prognostication. Unlike several previous reported cases that ended fatally, the present case ran a relatively benign course. The spectrum of presentations may therefore be broader than hitherto appreciated.

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Tumour necrosis factor (TNF) inhibitor-induced isolated pleural granulomas: a rare adverse effect

A 53-year-old man with a history of Crohn's disease on infliximab, presented with several weeks of cough and dyspnoea. He had a right-sided pleural effusion, found to be exudative with lymphocytic predominance. He underwent right-sided video-assisted thoracic surgery (VATS) with biopsies and pleurodesis. Histopathology showed pleural-based non-caseating granulomas with unremarkable lung parenchyma. Cultures were only positive for Propionibacterium acnes. 8 months later, he was found to have a left-sided exudative, lymphocytic predominant pleural effusion. Left-sided VATS and biopsies again showed pleural-based non-caseating granulomas with normal lung parenchyma. Having ruled out an active infection and malignant lesions, we diagnosed infliximab-induced pleural granulomas. Infliximab was stopped. The patient continues to do well at 6 years of follow-up. We believe this is the first report of tumour necrosis factor (TNF) inhibitor-induced isolated pleural granulomas. P. acnes and cytokine imbalance might be responsible for the pathogenesis of TNF inhibitor-induced granulomas.

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A case of recurrent, multifocal anastomosing haemangiomas

Anastomosing haemangiomas are relatively rare lesions, with a renal predilection, and which, given their imaging and pathologic appearance, mimic aggressive malignancies such as angiosarcoma. The imaging characteristics of this case are informative when evaluating a vascular lesion of the adrenal gland.

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Internal carotid artery occlusion and stroke as a complication of cisplatin-based chemotherapy for metastatic testicular germ cell tumour

Testicular tumours are the most common tumours in young men. Germ cell tumours (GCTs) account for 95% of all testicular cancers, and the non-seminomatous type (NSGCT) accounts for 50% of all GCTs. Cisplatin-based chemotherapy is curative in up to 90% of patients, but it is not without its inherent risks. Ischaemic stroke is a very uncommon, but severe complication of cisplatin-based chemotherapy. Strokes in young patients cause a disproportionately large economic impact by leaving victims disabled during their most productive years and strains the healthcare system with expensive hospital stays. We present a case of a young male patient with past medical history of metastatic NSGCT with the sudden onset of dysarthria, left hemiplegia and ipsilateral hemisensory loss 3 days after receiving cisplatin-based chemotherapy. Subsequent studies revealed a stroke involving the right middle cerebral artery territory secondary to an acute right internal carotid occlusion.

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Ominous triad triggered by high-dose glucocorticosteroid therapy

Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis—a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy. Our patient's condition was further aggravated by a circulatory shock, haemodynamic relevant bleeding from a duodenal ulcer and psychotic symptoms. In the intensive care unit, intravenous insulin infusion, fluid resuscitation, catecholamine support, electrolyte supplementation, endoscopic haemoclipping and antibiotic and antipsychotic treatment were administered, leading to a continuous improvement of the patient's health state.

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Chest X-ray of a patient with history of pleural effusion

The presented chest X-ray depicts the thoracic duct anatomy of a 50-year-old man who underwent heart transplantation. His postoperative course was complicated by Candida mediastinitis, treated with débridements and closure of the anterior chest wound with myocutaneous flaps. Postoperatively, he had persistent output from a right-sided chest tube. The fluid appeared milky and its triglycerides level was elevated at 254 mg/dL. The drainage persisted despite a low fat diet. The interventional radiologist identified a leak in the upper thoracic duct. It was embolised with coil and onyx. After the procedure, the chylous pleural effusions resolved. The thoracic duct has been visualised on subsequent chest X-rays (figures 1 and 2).

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Port site endometrioma: a rare cause of abdominal wall pain following laparoscopic surgery

Endometriomas are a rare cause of abdominal wall pain. We report a case of a port site endometrioma presenting with an umbilical swelling. The patient underwent a laparoscopy for pelvic endometriosis 6 months previously and presented with a swelling around her umbilical port site scar associated with cyclical pain during menses. Ultrasound scan reported a well-defined lesion in the umbilicus and MRI scanning excluded other pathology. As she was symptomatic, she underwent an exploration of the scar and excision of the endometrioma with resolution of her symptoms. Precautions should be taken to reduce the risk of endometrial seeding during laparoscopic surgery. All tissues should be removed in an appropriate retrieval bag and the pneumoperitoneum should be deflated completely before removing ports to reduce the chimney effect of tissue being forced through the port site. The diagnosis should be considered in all women of reproductive age presenting with a painful port site scar.

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Multipathogenic necrotising supraglottitis in an immunocompetent patient

Supraglottitis is a potentially life-threatening condition. It is now uncommon due to the Haemophilus influenzae type B vaccination and is more recently caused by Streptococcus pneumoniae, S. pyogenes, H. influenzae non-type B, H. parainfluenzae, Staphylococcus aureus and Pasteurella multocida. Very rarely, it can cause necrotising supraglottitis/epiglottitis, and this has been reported in immunocompromised individuals. We present a unique case of multipathogenic supraglottitis causing laryngeal fibrinoid necrosis in an immunocompetent patient. During his admission, the patient was critically unwell and required surgical intervention and tracheostomy. However, he made a full recovery with no persisting morbidity. We believe that this was owed to the aggressive antimicrobial therapy, timely surgical management of the disease process and the patientâ™s immunocompetency.

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An unusual case of Escherichia coli O157:H7 infection with pseudomembranous colitis-like lesions associated with haemolytic-uraemic syndrome and neurological sequelae

A 75-year-old man was admitted with abdominal pain and fresh rectal bleeding. Significantly, he had no risk factors for Clostridium difficile infection. An abdominal CT demonstrated colonic thickening, and flexible sigmoidoscopy identified pseudomembranous colitis-like lesions. After initial treatment as C. difficile colitis, a stool sample revealed Escherichia coli O157:H7 infection. Antibiotic therapy was stopped due to the risk of lysis-mediated toxin release, but unfortunately, the patient continued to deteriorate. He developed several of the severe sequelae of E. coli O157:H7 infection, including haemolytic-uraemic syndrome with an acute kidney injury necessitating haemofiltration, plus progressively severe seizures requiring escalating antiepileptic treatment and intubation for airway protection. After a prolonged intensive care admission and subsequent recovery on the ward, our patient was discharged alive.

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Bilateral ischaemic optic neuropathy and retinopathy along with cortical infarct in a case of Takayasu disease

Description

A 27-Year-old female presented with complaints of sudden onset visual loss along with right sided deviation of the angle of mouth since past 30 days. Vision loss had worsened in the last week. There was history of severe headache which was not associated with vomiting. There was no history of any other neurological deficit or prior systemic illness. Examination for cranial nerve function revealed a left sided upper motor neuron facial nerve palsy and rest of the neurological examination was within normal limits. On ocular examination, the patient had best-corrected visual acuity of light perception (PL) in right eye (RE) and 6/36 in left eye (LE). A grade four relative afferent pupillary defect was noted in RE, while slit lamp examination and tonometry were normal. On fundus examination, RE optic disc had yellowish-white pallor while LE optic disc had temporal pallor (figure 1A,B). Multiple retinal...

http://ift.tt/2rLFoNZ

Internal carotid artery occlusion and stroke as a complication of cisplatin-based chemotherapy for metastatic testicular germ cell tumour

Testicular tumours are the most common tumours in young men. Germ cell tumours (GCTs) account for 95% of all testicular cancers, and the non-seminomatous type (NSGCT) accounts for 50% of all GCTs. Cisplatin-based chemotherapy is curative in up to 90% of patients, but it is not without its inherent risks. Ischaemic stroke is a very uncommon, but severe complication of cisplatin-based chemotherapy. Strokes in young patients cause a disproportionately large economic impact by leaving victims disabled during their most productive years and strains the healthcare system with expensive hospital stays. We present a case of a young male patient with past medical history of metastatic NSGCT with the sudden onset of dysarthria, left hemiplegia and ipsilateral hemisensory loss 3 days after receiving cisplatin-based chemotherapy. Subsequent studies revealed a stroke involving the right middle cerebral artery territory secondary to an acute right internal carotid occlusion.

http://ift.tt/2sh3m7m

Saksenaea vasiformis infection in an immunocompetent patient in rural Australia

An 81-year-old man from rural Australia presented with right pretibial cellulitis 7 days after minor trauma against furniture. He failed to improve despite antibiotics and surgical debridement. Subsequent cultures grew the rare fungus Saksenaea vasiformis, which was treated with further surgical debridement, amphotericin B and posaconazole. This was successful and the patient made a full recovery. We present the case and discuss lessons learnt.

http://ift.tt/2sgGMM4

QUAD fever: beware of non-infectious fever in high spinal cord injuries

A case of cervical spinal cord injury and quadriparesis with prolonged fever is being described. Initially, the patient received treatment for well-documented catheter-related bloodstream infection. High spiking fever returned and persisted with no obvious evidence of infection. The usual non-infectious causes too were carefully excluded. QUAD fever or fever due to spinal cord injury itself was considered. The pathogenetic basis of QUAD fever is unclear but could be attributed to autonomic dysfunction and temperature dysregulation. Awareness of this little known condition could help in avoiding unnecessary antimicrobial therapy and in more accurate prognostication. Unlike several previous reported cases that ended fatally, the present case ran a relatively benign course. The spectrum of presentations may therefore be broader than hitherto appreciated.

http://ift.tt/2rLMpOz

Tumour necrosis factor (TNF) inhibitor-induced isolated pleural granulomas: a rare adverse effect

A 53-year-old man with a history of Crohn's disease on infliximab, presented with several weeks of cough and dyspnoea. He had a right-sided pleural effusion, found to be exudative with lymphocytic predominance. He underwent right-sided video-assisted thoracic surgery (VATS) with biopsies and pleurodesis. Histopathology showed pleural-based non-caseating granulomas with unremarkable lung parenchyma. Cultures were only positive for Propionibacterium acnes. 8 months later, he was found to have a left-sided exudative, lymphocytic predominant pleural effusion. Left-sided VATS and biopsies again showed pleural-based non-caseating granulomas with normal lung parenchyma. Having ruled out an active infection and malignant lesions, we diagnosed infliximab-induced pleural granulomas. Infliximab was stopped. The patient continues to do well at 6 years of follow-up. We believe this is the first report of tumour necrosis factor (TNF) inhibitor-induced isolated pleural granulomas. P. acnes and cytokine imbalance might be responsible for the pathogenesis of TNF inhibitor-induced granulomas.

http://ift.tt/2sgMDkq

A case of recurrent, multifocal anastomosing haemangiomas

Anastomosing haemangiomas are relatively rare lesions, with a renal predilection, and which, given their imaging and pathologic appearance, mimic aggressive malignancies such as angiosarcoma. The imaging characteristics of this case are informative when evaluating a vascular lesion of the adrenal gland.

http://ift.tt/2rLxUKW

Ominous triad triggered by high-dose glucocorticosteroid therapy

Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis—a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy. Our patient's condition was further aggravated by a circulatory shock, haemodynamic relevant bleeding from a duodenal ulcer and psychotic symptoms. In the intensive care unit, intravenous insulin infusion, fluid resuscitation, catecholamine support, electrolyte supplementation, endoscopic haemoclipping and antibiotic and antipsychotic treatment were administered, leading to a continuous improvement of the patient's health state.

http://ift.tt/2rM5osi

Chest X-ray of a patient with history of pleural effusion

The presented chest X-ray depicts the thoracic duct anatomy of a 50-year-old man who underwent heart transplantation. His postoperative course was complicated by Candida mediastinitis, treated with débridements and closure of the anterior chest wound with myocutaneous flaps. Postoperatively, he had persistent output from a right-sided chest tube. The fluid appeared milky and its triglycerides level was elevated at 254 mg/dL. The drainage persisted despite a low fat diet. The interventional radiologist identified a leak in the upper thoracic duct. It was embolised with coil and onyx. After the procedure, the chylous pleural effusions resolved. The thoracic duct has been visualised on subsequent chest X-rays (figures 1 and 2).

http://ift.tt/2sgWl6v

Port site endometrioma: a rare cause of abdominal wall pain following laparoscopic surgery

Endometriomas are a rare cause of abdominal wall pain. We report a case of a port site endometrioma presenting with an umbilical swelling. The patient underwent a laparoscopy for pelvic endometriosis 6 months previously and presented with a swelling around her umbilical port site scar associated with cyclical pain during menses. Ultrasound scan reported a well-defined lesion in the umbilicus and MRI scanning excluded other pathology. As she was symptomatic, she underwent an exploration of the scar and excision of the endometrioma with resolution of her symptoms. Precautions should be taken to reduce the risk of endometrial seeding during laparoscopic surgery. All tissues should be removed in an appropriate retrieval bag and the pneumoperitoneum should be deflated completely before removing ports to reduce the chimney effect of tissue being forced through the port site. The diagnosis should be considered in all women of reproductive age presenting with a painful port site scar.

http://ift.tt/2rLEPUr

Multipathogenic necrotising supraglottitis in an immunocompetent patient

Supraglottitis is a potentially life-threatening condition. It is now uncommon due to the Haemophilus influenzae type B vaccination and is more recently caused by Streptococcus pneumoniae, S. pyogenes, H. influenzae non-type B, H. parainfluenzae, Staphylococcus aureus and Pasteurella multocida. Very rarely, it can cause necrotising supraglottitis/epiglottitis, and this has been reported in immunocompromised individuals. We present a unique case of multipathogenic supraglottitis causing laryngeal fibrinoid necrosis in an immunocompetent patient. During his admission, the patient was critically unwell and required surgical intervention and tracheostomy. However, he made a full recovery with no persisting morbidity. We believe that this was owed to the aggressive antimicrobial therapy, timely surgical management of the disease process and the patientâ™s immunocompetency.

http://ift.tt/2rLCAjX

An unusual case of Escherichia coli O157:H7 infection with pseudomembranous colitis-like lesions associated with haemolytic-uraemic syndrome and neurological sequelae

A 75-year-old man was admitted with abdominal pain and fresh rectal bleeding. Significantly, he had no risk factors for Clostridium difficile infection. An abdominal CT demonstrated colonic thickening, and flexible sigmoidoscopy identified pseudomembranous colitis-like lesions. After initial treatment as C. difficile colitis, a stool sample revealed Escherichia coli O157:H7 infection. Antibiotic therapy was stopped due to the risk of lysis-mediated toxin release, but unfortunately, the patient continued to deteriorate. He developed several of the severe sequelae of E. coli O157:H7 infection, including haemolytic-uraemic syndrome with an acute kidney injury necessitating haemofiltration, plus progressively severe seizures requiring escalating antiepileptic treatment and intubation for airway protection. After a prolonged intensive care admission and subsequent recovery on the ward, our patient was discharged alive.

http://ift.tt/2sh3ljO

From basal cell morphogenesis to the alopecia induced by hedgehog inhibitors: connecting the dots

Summary

The deciphering of the hedgehog (Hh) signaling pathway implicated in the tumorigenesis of basal cell carcinoma (BCC), led to the development of targeted drug therapies, e.g. the hedgehog pathway inhibitors (HPI), vismodegib and sonidegib. In the skin, physiologic Hh signaling is activated in growing hair follicles, where it is required for proliferation of the epithelium of hair follicles during morphogenesis and for their postnatal growth. The effects of HPI treatment leading to the regression of BCC and the development of alopecia, underpin the central role of the Hh pathway in BCC formation as well as hair cycling. Given the fact that BCC is a follicular- driven tumor, it is a fine tuning of events that regulate hair cycling, that may drive towards the formation of benign follicular hamartomas or malignant BCC neoplasms. The Wnt/β-catenin signaling interacts with the Hh signaling during HF morphogenesis, normal hair cycling and BCC development. The aim of this review is to present how key molecular events implicated in Hh pathway crosstalk in the hair follicle are also involved in BCC pathogenesis and result in the alopecia developed by HPI treatment.

This article is protected by copyright. All rights reserved.

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Oral ofloxacin and clindamycin as an alternative to the classic rifampicin/clindamycin in hidradenitis suppurativa: retrospective analysis of 65 patients

Rifampicin/Clindamycin (RC) combination is recommended as first line therapy in moderate to severe Hidradenitis Suppurativa (HS) by European S1 guidelines (1–3), notably because a large variety of microorganisms have been isolated from HS lesions: most represented bacteria appear to be Staphylococcus aureus, Coagulase negative staphylococci (CoNS) and anaerobic bacteria from normal skin flora. It has been hypothesized that these bacteria could play a central role in the initiation and maybe in the maintenance of HS lesions, possibly by being a source of antigens in a dysregulated immune response.

This article is protected by copyright. All rights reserved.

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Letter to the Editor concerning the article “Long term complications of Stevens-Johnson syndrome/Toxic epidermal necrolysis: The spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multi-disciplinary follow up

We read with great interest, the review paper by Lee et al. on the long term complications of Stevens-Johnson syndrome and toxic epidermal necrolysis. We would like to congratulate the authors on this important and excellent overview. This review demonstrated that SJS/TEN has a severe, chronic phase with major physical morbidities. We wish to raise awareness to the major emotional complications among survivors; as was found in our study published in the British Journal of Dermatology by Dodiuk-Gad et al.

This article is protected by copyright. All rights reserved.

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The importance of risk communication and documentation for patients with cutaneous adverse drug reactions

We read with interest Teo et al.'s recently published article examining cutaneous adverse drug reactions (cADR) referred to an inpatient liaison dermatology service.¹ The authors assessed the number and types of cADR encountered and subsequent documentation.¹ The diagnosis and management of cADR has been recognised by NICE Guidelines on Drug Allergy as a high-priority area for quality improvement.² We commend Teo and colleagues¹ for examining an essential, yet often overlooked, component of health service quality. We would like to further highlight the importance of risk communication, documentation and patient-centred care, aspects that are imperative for severe cADR.

This article is protected by copyright. All rights reserved.

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Familial seborrhoeic keratosis associated with multiple “pure reticulated acanthomas” and infundibulocystic basal cell carcinomas

Abstract

Background

A variety of genodermatoses with multiple cutaneous tumors with germline genetic alterations such as Gorlin syndrome with PTCH1 gene mutations have been described. Other cutaneous syndromes have been associated with somatic gene mutations, such as FGFR3 in familial seborrhoeic keratosis.

Objective

We describe the clinical, dermoscopic, and histopathological features of multiple cutaneous lesions, mostly infundibulocystic basal cell carcinomas and pure reticulated acanthomas, present in a family affected by familial seborrhoeic keratosis. In addition, we tested for possible germline alterations in the FGFR3 and PTCH1 genes.

Methods

Ten members of one family were clinically examined. Ninety-two skin biopsy specimens were evaluated. Blood samples from six subjects were analyzed for FGFR3 and PTCH1 germline alterations. We review the literature concerning genetic FGFR3 alterations in seborrhoeic keratosis.

Results

Subjects of all generations affected by familial seborrhoeic keratosis also presented other skin tumors which corresponded histologically to reticulated acanthomas without apocrine or sebaceous differentiation as well as infundibulocystic basal cell carcinomas. In addition, two novel germline variants, p.Pro449Ser (c.1345C>T) in FGFR3 gene and p.Pro725Ser (c.2173C>T) in exon 14 of PTCH1 gene were identified in five subjects.

Conclusion

We characterize for the first time the clinical, dermoscopic and histopathological features of multiple reticulated acanthomas without apocrine or sebaceous differentiation, for which we propose the term "pure reticulated acanthoma", and infundibulocystic basal cell carcinomas, associated with familial seborrhoeic keratosis. We identified FGFR3 and PTCH1 germline polymorphisms whose influence in the development of reticulated acanthomas is unknown.

This article is protected by copyright. All rights reserved.

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Electro-clinical criteria and surgical outcome: Is there a difference between mesial and lesional temporal lobe epilepsy?

Objectives

Mesial temporal lobe epilepsy syndrome (MTLE) with specific electrophysiological and clinical characteristics and hippocampal sclerosis (HS) on MRI is considered the prototype of a syndrome with good surgical prognosis. Ictal onset zones in MTLE have been found to extend outside the hippocampus and neocortical seizures often involve mesial structures. It can, thus, be questioned whether MTLE with HS is different from lesional temporal epilepsies with respect to electro-clinical characteristics and surgical prognosis. We assessed whether MTLE with HS is distinguishable from lesional TLE and which criteria determine surgical outcome.

Methods

People in a retrospective cohort of 389 individuals with MRI abnormalities who underwent temporal lobectomy, were divided into "HS only" or "lesional" TLEs. Twenty-six presented with dual pathology and were excluded from further analysis. We compared surgical outcome and electro-clinical characteristics.

Results

Over half (61%) had "HS only." Four electro-clinical characteristics (age at epilepsy onset, febrile seizures, memory dysfunction and contralateral dystonic posturing) distinguished "HS only" from "lesional" TLE, but there was considerable overlap. Seizure freedom 2 years after surgery (Engel class 1) was similar: 67% ("HS only") vs 69% ("lesional" TLE). Neither presence of HS nor electro-clinical criteria was associated with surgical outcome.

Conclusions

Despite small differences in electrophysiological and clinical characteristics between MTLE with HS and lesional TLE, surgical outcomes are similar, indicating that aetiology seems irrelevant in the referral for temporal surgery.

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Controlled population-based comparative study of USA and international adult [55-74] neurological deaths 1989-2014

Objectives

A population-based controlled study to determine whether adult (55-74 years) neurological disease deaths are continuing to rise and are there significant differences between America and the twenty developed countries 1989-91 and 2012-14.

Method

Total Neurological Deaths (TND) rates contrasted against control Cancer and Circulatory Disease Deaths (CDD) extrapolated from WHO data. Confidence intervals compare USA and the other countries over the period. The Over-75's TND and population increases are examined as a context for the 55-74 outcomes.

Results

Male neurological deaths rose >10% in eleven countries, the other countries average rose 20% the USA 43% over the period. Female neurological deaths rose >10% in ten counties, averaging 14%, the USA up 68%. USA male and female neurological deaths increased significantly more than twelve and seventeen countries, respectively. USA over-75s population increased by 49%, other countries 56%. Other countries TND up 187% the USA rose fourfold. Male and female cancer and CDD fell in every country averaging 26% and 21%, respectively, and 64% and 67% for CDD. Male neurological rates rose significantly more than Cancer and CCD in every country; Female neurological deaths rose significantly more than cancer in 17 countries and every country for CDD. There was no significant correlation between increases in neurological deaths and decreases in control mortalities.

Conclusions

There are substantial increases in neurological deaths in most countries, significantly so in America. Rises in the 55-74 and over-75's rates are not primarily due to demographic changes and are a matter of concern warranting further investigation.

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From basal cell morphogenesis to the alopecia induced by hedgehog inhibitors: connecting the dots

Summary

The deciphering of the hedgehog (Hh) signaling pathway implicated in the tumorigenesis of basal cell carcinoma (BCC), led to the development of targeted drug therapies, e.g. the hedgehog pathway inhibitors (HPI), vismodegib and sonidegib. In the skin, physiologic Hh signaling is activated in growing hair follicles, where it is required for proliferation of the epithelium of hair follicles during morphogenesis and for their postnatal growth. The effects of HPI treatment leading to the regression of BCC and the development of alopecia, underpin the central role of the Hh pathway in BCC formation as well as hair cycling. Given the fact that BCC is a follicular- driven tumor, it is a fine tuning of events that regulate hair cycling, that may drive towards the formation of benign follicular hamartomas or malignant BCC neoplasms. The Wnt/β-catenin signaling interacts with the Hh signaling during HF morphogenesis, normal hair cycling and BCC development. The aim of this review is to present how key molecular events implicated in Hh pathway crosstalk in the hair follicle are also involved in BCC pathogenesis and result in the alopecia developed by HPI treatment.

This article is protected by copyright. All rights reserved.

http://ift.tt/2tioc4D

Oral ofloxacin and clindamycin as an alternative to the classic rifampicin/clindamycin in hidradenitis suppurativa: retrospective analysis of 65 patients

Rifampicin/Clindamycin (RC) combination is recommended as first line therapy in moderate to severe Hidradenitis Suppurativa (HS) by European S1 guidelines (1–3), notably because a large variety of microorganisms have been isolated from HS lesions: most represented bacteria appear to be Staphylococcus aureus, Coagulase negative staphylococci (CoNS) and anaerobic bacteria from normal skin flora. It has been hypothesized that these bacteria could play a central role in the initiation and maybe in the maintenance of HS lesions, possibly by being a source of antigens in a dysregulated immune response.

This article is protected by copyright. All rights reserved.

http://ift.tt/2sILUdj

Letter to the Editor concerning the article “Long term complications of Stevens-Johnson syndrome/Toxic epidermal necrolysis: The spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multi-disciplinary follow up

We read with great interest, the review paper by Lee et al. on the long term complications of Stevens-Johnson syndrome and toxic epidermal necrolysis. We would like to congratulate the authors on this important and excellent overview. This review demonstrated that SJS/TEN has a severe, chronic phase with major physical morbidities. We wish to raise awareness to the major emotional complications among survivors; as was found in our study published in the British Journal of Dermatology by Dodiuk-Gad et al.

This article is protected by copyright. All rights reserved.

http://ift.tt/2tiqdxs

The importance of risk communication and documentation for patients with cutaneous adverse drug reactions

We read with interest Teo et al.'s recently published article examining cutaneous adverse drug reactions (cADR) referred to an inpatient liaison dermatology service.¹ The authors assessed the number and types of cADR encountered and subsequent documentation.¹ The diagnosis and management of cADR has been recognised by NICE Guidelines on Drug Allergy as a high-priority area for quality improvement.² We commend Teo and colleagues¹ for examining an essential, yet often overlooked, component of health service quality. We would like to further highlight the importance of risk communication, documentation and patient-centred care, aspects that are imperative for severe cADR.

This article is protected by copyright. All rights reserved.

http://ift.tt/2sIF9bg

Familial seborrhoeic keratosis associated with multiple “pure reticulated acanthomas” and infundibulocystic basal cell carcinomas

Abstract

Background

A variety of genodermatoses with multiple cutaneous tumors with germline genetic alterations such as Gorlin syndrome with PTCH1 gene mutations have been described. Other cutaneous syndromes have been associated with somatic gene mutations, such as FGFR3 in familial seborrhoeic keratosis.

Objective

We describe the clinical, dermoscopic, and histopathological features of multiple cutaneous lesions, mostly infundibulocystic basal cell carcinomas and pure reticulated acanthomas, present in a family affected by familial seborrhoeic keratosis. In addition, we tested for possible germline alterations in the FGFR3 and PTCH1 genes.

Methods

Ten members of one family were clinically examined. Ninety-two skin biopsy specimens were evaluated. Blood samples from six subjects were analyzed for FGFR3 and PTCH1 germline alterations. We review the literature concerning genetic FGFR3 alterations in seborrhoeic keratosis.

Results

Subjects of all generations affected by familial seborrhoeic keratosis also presented other skin tumors which corresponded histologically to reticulated acanthomas without apocrine or sebaceous differentiation as well as infundibulocystic basal cell carcinomas. In addition, two novel germline variants, p.Pro449Ser (c.1345C>T) in FGFR3 gene and p.Pro725Ser (c.2173C>T) in exon 14 of PTCH1 gene were identified in five subjects.

Conclusion

We characterize for the first time the clinical, dermoscopic and histopathological features of multiple reticulated acanthomas without apocrine or sebaceous differentiation, for which we propose the term "pure reticulated acanthoma", and infundibulocystic basal cell carcinomas, associated with familial seborrhoeic keratosis. We identified FGFR3 and PTCH1 germline polymorphisms whose influence in the development of reticulated acanthomas is unknown.

This article is protected by copyright. All rights reserved.

http://ift.tt/2tia3o7

Global Epidemiology of Hepatocellular Carcinoma (HCC Epidemiology)

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Equal Treatment and Outcomes for Everyone with Multiple Myeloma: Are We There Yet?

Abstract

Multiple myeloma treatment has changed tremendously over recent years leading to overall improvement in patient outcomes. With therapeutic advancements, patient care has become increasingly complex and variability is seen in healthcare delivery as well as outcomes when various patient subgroups are analyzed based on sociodemographic factors. It is imperative to understand this variability so that while overall the outcomes get better, specific focus is placed on subgroups that may remain disadvantaged and may not be able to fully access the advancements in therapeutics. Research in multiple myeloma has specifically looked at several such patient subgroups based on socioeconomic status, age, race/ethnicity, insurance carrier, and geographic location that may affect healthcare utilization and patient outcomes. Exploring and understanding these would certainly help address disparities and lead to further equity in healthcare access and, hopefully, patient outcomes.

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Positional changes of maxillary central incisors following orthodontic treatment using single-crown implants as fixed reference markers

Abstract

Objectives

This follow-up study (1) compares tooth displacement of central incisors in patients with and without pre-implant orthodontic treatment and (2) investigates whether sex, age, or orthodontic retention have an effect on tooth displacement after the insertion of single-crown implants.

Materials and Methods

Fifty-seven patients – thirty-seven with (test group) and twenty without pre-implant orthodontic treatment (control group) – were rehabilitated with 89 single-crown implants in the upper maxilla. Clinical and radiographic data, clinical photographs, and dental casts were collected during baseline examinations after prosthetic rehabilitation and at the final follow-up examination at least 5 years later. A total of 114 dental casts were digitalized and aligned using a software program to measure changes in the positions of the central incisors.

Results

After a follow-up period of at least five years, 87% of the central incisors measured in the test group were displaced >0.25 mm vertically compared with 70% in the control group. Seventy-eight percent of the test group teeth had moved >0.25 mm horizontally compared with 55% in the control group. These differences were not significant, and there were no significant correlations with patient age or sex.

Conclusion

The majority of patients had minor vertical (60%) or horizontal (67%) tooth displacement of the central incisors (0.25–0.75 mm) after a minimum follow-up period of 5 years. This study found no significant differences in tooth displacement comparing patients with and without pre-implant orthodontic treatment. No significant effect of sex, age, orthodontic retention, or implant location was observed on tooth displacement.

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Surgical treatment of peri-implantitis intrabony lesions by means of deproteinized bovine bone mineral with 10% collagen: 7-year-results

Abstract

Objectives

The aim of this study was to evaluate the long-term results of the surgical treatment of single peri-implantitis intrabony defects, by means of deproteinized bovine bone mineral with 10% collagen (DBBMC).

Material and Methods

The original population consisted of 26 patients with one crater-like defect, around either sandblasted and acid-etched (SLA) or titanium plasma-sprayed (TPS) dental implants, with a probing depth (PD) ≥6 mm and no implant mobility (Roccuzzo et al. J Clin Periodontol. 2011; 38: 738). Implants were mechanically debrided and treated using EDTA gel and chlorhexidine gel. The bone defects were filled with DBBMC, and the flap was sutured around the non-submerged implant. Patients were placed on an individually tailored supportive periodontal therapy (SPT).

Results

Two patients were lost to follow-up. During SPT, additional antibiotic and/or surgical therapy was necessary in eight implants, and four of these were removed for biologic complications. At 7-year, the survival rate was 83.3% for SLA implants and 71.4% for TPS. PD was significantly reduced from 6.6 ± 1.3 to 3.2 ± 0.7 mm in SLA and 7.2 ± 1.5 to 3.4 ± 0.6 mm in TPS. Bleeding on probing decreased from 75.0 ± 31.2% to 7.5 ± 12.1% (SLA) and from 90.0 ± 12.9% to 30.0 ± 19.7% (TPS). When successful therapy was defined as PD ≤5 mm, absence of bleeding/suppuration on probing, and no further bone loss, treatment success was obtained in 2 of 14 (14.3%) of the TPS and in 7 of 12 (58.3%) of the SLA implants.

Conclusions

Seven years after surgical treatment with DBBMC, patients, in an adequate SPT, maintained sufficient peri-implant conditions in many cases, particularly around SLA implants. Nevertheless, some patients required further treatment and some lost implants. The clinical decision on whether implants should be treated or removed should be based on several factors, including implant surface characteristics.

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Clinical and radiographic evaluation of early loaded narrow-diameter implants: 5-year follow-up of a multicenter prospective clinical study

Abstract

Objective

This study was initiated to evaluate the 5-year implant survival rate and marginal bone levels around a 3.0-mm implant when replacing a single tooth in the anterior region.

Materials and methods

The study was designed as a prospective, single-arm, multicenter clinical study. Patients missing 12, 22, 32, 31, 41 or 42 teeth were included, and implants of 3.0 mm diameter and different lengths were placed by a one-stage surgery protocol. Definitive cemented crowns were placed 6–10 weeks later. Clinical and radiographic measurements were taken at implant installation, at loading and at the 6-, 12-, 24-, 36-, 48- and 60-month follow-up visits.

Results

Sixty-nine patients with 97 implants were included in this study. Four implants were lost before loading (4.12% failure rate). Implant marginal bone levels did not differ statistically after the 1-year follow-up visit. After 5 years, no bone loss was observed for 50.60% of the implants and only 8.43% of them lost more than 1 mm. Similarly, probing pocket depths and gingival zenith scores did not change significantly.

Conclusions

The use of the two-piece narrow 3.0-mm titanium dental implant for the restoration of upper lateral or lower incisors is safe and results in stable marginal bone levels and probing pocket depths after 5 years of function.

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Schisandrin B Prevents Hind Limb from Ischemia-Reperfusion-Induced Oxidative Stress and Inflammation via MAPK/NF-κB Pathways in Rats

Schisandrin B (ScB), isolated from Schisandra chinensis (S. chinensis), is a traditional Chinese medicine with proven cardioprotective and neuroprotective effects. However, it is unclear whether ScB also has beneficial effects on rat hind limb ischemia/reperfusion (I/R) injury model. In this study, ScB (20 mg/kg, 40 mg/kg, and 80 mg/kg) was administered via oral gavage once daily for 5 days before the surgery. After 6 h ischemia and 24 h reperfusion of left hind limb, ScB reduced I/R induced histological changes and edema. ScB also suppressed the oxidative stress through decreasing MDA level and increasing SOD activity. Moreover, above changes were associated with downregulated TNF-α mRNA expression and reduced level of IL-1 in plasma. Meanwhile, ScB treatment downregulated activation of p38MAPK, ERK1/2, and NF-κB in ischemic skeletal muscle. These results demonstrate that ScB treatment could prevent hind limb I/R skeletal muscle injury possibly by attenuating oxidative stress and inflammation via p38MAPK, ERK1/2, and NF-κB pathways.

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Genetic Variant of Kalirin Gene Is Associated with Ischemic Stroke in a Chinese Han Population

Introduction. Ischemic stroke is a complex disorder resulting from the interplay of genetic and environmental factors. Previous studies showed that kalirin gene variations were associated with cardiovascular disease. However, the association between this gene and ischemic stroke was unknown. We performed this study to confirm if kalirin gene variation was associated with ischemic stroke. Methods. We enrolled 385 ischemic stroke patients and 362 controls from China. Three SNPs of kalirin gene were genotyped by means of ligase detection reaction-PCR method. Data was processed with SPSS and SHEsis platform. Results. SNP rs7620580 (dominant model: OR = 1.590, p = 0.002 and adjusted OR = 1.662, p = 0.014; additive model: OR = 1.490, p = 0.002 and adjusted OR = 1.636, p = 0.005; recessive model: OR = 2.686, p = 0.039) and SNP rs1708303 (dominant model: OR = 1.523, p = 0.007 and adjusted OR = 1.604, p = 0.028; additive model: OR = 1.438, p = 0.01 and adjusted OR = 1.476, p = 0.039) were associated with ischemic stroke. The GG genotype and G allele of SNP rs7620580 were associated with a risk for ischemic stroke with an adjusted OR of 3.195 and an OR of 1.446, respectively. Haplotype analysis revealed that A–T–G,G-T-A, and A-T-A haplotypes were associated with ischemic stroke. Conclusions. Our results provide evidence that kalirin gene variations were associated with ischemic stroke in the Chinese Han population.

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Issue Cover (June 2017)

Cover image by Naoki Ihara, Ai Nakashima, Naosuke Hoshina, Yuji Ikegaya and Haruki Takeuchi

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A scaling method to individualise muscle force capacities in musculoskeletal models of the hand and wrist using isometric strength measurements

Abstract

Because the force-generating capacities of muscles are currently estimated using anatomical data obtained from cadaver specimens, hand musculoskeletal models provide only a limited representation of the specific features of individual subjects. A scaling method is proposed to individualise muscle capacities using dynamometric measurements and electromyography. For each subject, a strength profile was first defined by measuring net moments during eight maximum isometric contractions about the wrist and metacarpophalangeal joints. The capacities of the five muscle groups were then determined by adjusting several parameters of an initial musculoskeletal model using an optimisation procedure which minimised the differences between measured moments and model estimates. Sixteen volunteers, including three particular participants (one climber, one boxer and one arthritic patient), were recruited. Compared with the initial literature-based model, the estimated subject-specific capacities were on average five times higher for the wrist muscles and twice as high for the finger muscles. The adjustments for particular subjects were consistent with their expected specific characteristics, e.g. high finger flexor capacities for the climber. Using the subject-specific capacities, the model estimates were markedly modified. The proposed protocol and scaling procedure can capture the specific characteristics of the participants and improved the representation of their capacities in the musculoskeletal model.

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