Mechanical evaluation of porous titanium (Ti6Al4V) structures with electron beam melting (EBM)

Patient specific porous implants for the reconstruction of craniofacial defects have gained importance due to their better performance over their generic counterparts. The recent introduction of electron beam melting (EBM) for the processing of titanium has led to a one step fabrication of porous custom titanium implants with controlled porosity to meet the requirements of the anatomy and functions at the region of implantation. This paper discusses an image based micro-structural analysis and the mechanical characterization of porous Ti6Al4V structures fabricated using the EBM rapid manufacturing process. SEM studies have indicated the complete melting of the powder material with no evidence of poor inter-layer bonding. Micro-CT scan analysis of the samples indicate well formed titanium struts and fully interconnected pores with porosities varying from 49.75%-70.32%. Compression tests of the samples showed effective stiffness values ranging from 0.57(+/-0.05)-2.92(+/-0.17)GPa and compressive strength values of 7.28(+/-0.93)-163.02(+/-11.98)MPa. For nearly the same porosity values of 49.75% and 50.75%, with a variation in only the strut thickness in the sample sets, the compressive stiffness and strength decreased significantly from 2.92 GPa to 0.57 GPa (80.5% reduction) and 163.02 MPa to 7.28 MPa (93.54 % reduction) respectively. The grain density of the fabricated Ti6Al4V structures was found to be 4.423 g/cm(3) equivalent to that of dense Ti6Al4V parts fabricated using conventional methods. In conclusion, from a mechanical strength viewpoint, we have found that the porous structures produced by the electron beam melting process present a promising rapid manufacturing process for the direct fabrication of customized titanium implants for enabling personalized medicine.

Transthoracic fine-needle aspiration in the aetiological diagnosis of community-acquired pneumonia

Clin Microbiol Infect 2010; 16: 909–911

Abstract

To investigate the safety and practicability of conducting transthoracic fine‐needle aspiration (TFNA) in a general hospital setting, we applied the TFNA procedure to 20 patients hospitalized with community‐acquired pneumonia (CAP) within 36 h of admission. Also, a preliminary assessment was made of the potential value of adding TFNA to conventional methods of diagnostic microbiology. TFNA was easy to perform and caused little discomfort, and no serious adverse events were observed. In spite of ongoing antimicrobial treatment, a likely aetiological diagnosis was established for 14 of 20 (70%) of the patients. TFNA may provide important additional information on the aetiology of CAP.

Physiology of membrane oestrogen receptor signalling in reproduction

The best characterised oestrogen receptors (ERs) that are responsible for membrane-initiated oestradiol signalling are the classic ERs, ERalpha and ERbeta. When in the nucleus, these proteins are oestradiol activated transcription factors but, when trafficked to the cell membrane, ERalpha and ERbeta rapidly activate protein kinase pathways, alter membrane electrical properties, modulate ion flux and can mediate long-term effects through gene expression. To initiate cell signalling, membrane ERs transactivate metabotropic glutamate receptors (mGluRs) to stimulate Gq signalling through pathways using PKC and calcium. In this review, we discuss the interaction of membrane ERalpha with metabotropic glutamate receptor 1a (mGluR1a) to initiate rapid oestradiol cell signalling and its critical roles in female reproduction: sexual behaviour and oestrogen positive feedback of the luteinising hormone (LH) surge. Although long considered to be regulated by the long-term actions of oestradiol on gene transcription, recent results indicate that membrane oestradiol cell signalling is vital for a full display of sexual receptivity. Similarly, the source of pre-ovulatory progesterone necessary for initiating the LH surge is hypothalamic astrocytes. Oestradiol rapidly amplifies progesterone synthesis through the release of intracellular calcium stores. The ERalpha-mGluR1a interaction is necessary for critical calcium flux. These two examples provide support for the hypothesis that membrane ERs are not themselves G-protein receptors; rather, they use mGluRs to signal.

Expression profile of ovarian tumors: distinct signature of Sertoli–Leydig cell tumor

Epithelial ovarian tumors are the most common subtype of ovarian cancer. In this study, we reveal distinct expression signatures of previously uncharacterized ovarian carcinoma subtypes, including endometrioid component of mixed ovarian tumor and Sertoli–Leydig tumor. Both subtypes were compared to the most common and well-characterized ovarian epithelial carcinoma of the serous type. These comparisons were performed by complementaryDNA (cDNA) microarrays allowing high-fidelity measurements of the expression levels of 39,360 human individual cDNA species representing both known and unknown human genes. Functional analysis of differentially expressed genes in Sertoli–Leydig tumor revealed an upregulation in sonic hedgehog pathway, deregulation of several metabolic pathways especially in amino acid metabolism and overexpression of genes associated with protein synthesis, including ribosomal genes.

Patients with schizophrenia treated with aripiprazole, a multicentre naturalistic study

OBJECTIVE

The purpose was to carry out a naturalistic study on efficacy, safety and tolerability of aripiprazole during treatment of schizophrenia. Fifty-one patients with an ICD-10 diagnosis of schizophrenia and partial responders to prior antipsychotic medication were offered treatment with aripiprazole as monotherapy or in combination their prior medication. Inclusion criteria were lack of therapeutic effect or adverse events on former antipsychotic treatment.

METHOD

Six-month open multicentre naturalistic study with prospective assessments including Body Mass Index (BMI), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, Global Assessment of Functioning Scale (GAF) and adverse events.

RESULTS

A statistically significant improvement in the different measures of psychopathology and global functioning (CGI-S reduction 34.7%; GAF improvement 14%) was shown in combination with a statistically significant reduction in BMI of 2.9%. Nine patients (17.6%) did not complete the 6-month treatment.

CONCLUSION

In an open multicentre naturalistic study, aripiprazole showed to improve the severity of psychotic symptoms and the global level of functioning. However, many of the patients (47%) were also given another antipsychotic drug at the same time. Also, high compliance and few side effects were reported. However, because of the study design, the results must be interpreted conservatively.

Cross-reaction between mammalian cell entry (Mce) proteins of Mycobacterium tuberculosis

In addition to the previously cloned Mce1A and Mce1E genes of the Mce1 operon of Mycobacterium tuberculosis (Ahmad et al. Scand J Immunol 1999;50:510-8), Mce1B, Mce1D and Mce1F were cloned and expressed as glutathione-S-transferase (GST) fusion proteins in recombinant Escherichia coli. Polyclonal antibodies against a predicted B-cell epitope of each of the Mce1 proteins of M. tuberculosis were produced by immunizing rabbits with synthetic peptides coupled to keyhole limpet haemocyanin. These antibodies reacted specifically with the corresponding fusion protein, except for GST-Mce1F. A mouse monoclonal antibody, TB1-5 76C, raised against a synthetic 60-mer peptide corresponding to the residues 106-165 in the N-terminal part of Mce1A, reacted strongly with GST-Mce1A. The antibody cross-reacted with GST-Mce1F, but not with the other recombinant GST-Mce1 fusion proteins or free GST. Bioinformatic analysis revealed only slight homology between Mce1A and Mce1F, along the length of the polypeptide chains. Higher homology was found between the residues 106-165 of Mce1A and the residues 347-406, further into the mature Mce1F polypeptide chain. There was a striking, localized homology, indicating that the epitope reacting with the monoclonal antibody TB1-5 76C may be narrowed to the KRRITPKD region, the residues 131-138 in Mce1A corresponding to the residues 372-379 in Mce1F. This was confirmed in enzyme-linked immunosorbent assay, showing binding of TB1-5 76C to a 17-mer synthetic peptide containing the KRRITPKD sequence.

Outbreak of methicillin-resistant Staphylococcus aureus in a Norwegian hospital

Methicillin-resistant Staphylococcus aureus (MRSA) occurred sporadically in Norwegian hospitals in the 1960s and 1970s, but disappeared in the late 1970s for unknown reasons. Only 1 outbreak has subsequently been reported. We describe herein a second outbreak in a different hospital, this time featuring a more resistant strain. Staff and patients were screened immediately after detection of the first MRSA isolate. Colonized and infected patients were nursed using contact precautions, and the staff were not allowed to work until 3 nose samples were MRSA-negative. We treated colonized persons with topical administration of mupirocin to the nostrils and a chlorhexidine body wash. The outbreak affected 7 patients and 5 healthcare workers. Pulsed-field gel electrophoresis proved all isolates to be of the same type, and the MRSA phage type was M3. There was no sign of transmission of MRSA after contact precautions were implemented. MRSA was eradicated in 4 of the patients and all 5 healthcare workers. One patient died and 1 was still colonized 3 y after onset of the outbreak. Contact precautions proved to be sufficient to prevent transmission of MRSA.

Allantoin formation and urate and glutathione exchange in human muscle during submaximal exercise

Seven males performed two exhaustive cycling bouts (EX1 and EX2) at a work-rate of 90% of maximal oxygen uptake, separated by 60 min. During EX1 there was a significant accumulation of urate (from 0.16 +/- 0.02 to 0.27 +/- 0.03 micromol/kg d.w.) and allantoin (from 0.39 +/- 0.05 to 0.69 +/- 0.14 micromol/kg d.w.) in the muscle. An uptake of urate was observed in early recovery from EX1 (0-9 min: 486 +/- 136 micromol; p <.05). There was no exchange of total glutathione or cysteine over the muscle either during or after exercise, and muscle and plasma total glutathione remained unaltered (p <.05). The glycogen levels were lowered by 40% at the onset of EX2, yet the level of oxidative stress in EX1 and EX2 was similar as evidenced by a similar increase in muscle allantoin in both exercise bouts. The data suggest that urate is utilized as antioxidant in human skeletal muscle and that reactive oxygen species are formed in muscle during intense submaximal exercise. No net exchange of glutathione appears to occur over the muscle either at rest, during exercise or in recovery. Moreover, when an exhaustive exercise bout is repeated with lowered glycogen levels, the level of oxidative stress is not different than that of the first bout.

Tuberculosis notifications in Australia, 1999

Australia has one of the lowest incidence of tuberculosis in the world. The crude annual notification rate for tuberculosis (TB) has remained stable at between 5 and 6 per 100,000 population since 1991. In 1999, there were a total of 1,159 TB notifications in Australia of which 1,117 were new TB cases, and 42 were relapsed cases. The corresponding annual notification rate for new and relapsed TB was 5.9 and 0.2 per 100,000 population respectively. People born overseas accounted for 83 per cent of the notified cases. TB notification rates remain highest among overseas-born residents from high prevalence countries, and indigenous Australians. The lowest rates of disease are in the non-indigenous, Australian born population and data from the last 7 years indicate that the rate of tuberculosis in this population is continuing to fall.

Tumor suppressor p53 protein is a new target for the metastasis-associated Mts1/S100A4 protein: functional consequences of their interaction

A physical and functional interaction between the Ca(2+)-binding protein Mts1 (S100A4) and the tumor suppressor p53 protein is shown here for the first time. We demonstrate that Mts1 binds to the extreme end of the C-terminal regulatory domain of p53 by several in vitro and in vivo approaches: co-immunoprecipitation, affinity chromatography, and far Western blot analysis. The Mts1 protein in vitro inhibits phosphorylation of the full-length p53 and its C-terminal peptide by protein kinase C but not by casein kinase II. The Mts1 binding to p53 interferes with the DNA binding activity of p53 in vitro and reporter gene transactivation in vivo, and this has a regulatory function. A differential modulation of the p53 target gene (p21/WAF, bax, thrombospondin-1, and mdm-2) transcription was observed upon Mts1 induction in tet-inducible cell lines expressing wild type p53. Mts1 cooperates with wild type p53 in apoptosis induction. Our data imply that the ability of Mts1 to enhance p53-dependent apoptosis might accelerate the loss of wild type p53 function in tumors. In this way, Mts1 can contribute to the development of a more aggressive phenotype during tumor progression.

Measurement of regulated and unregulated exhaust emissions from a lawn mower with and without an oxidizing catalyst: a comparison of two different fuels

Relatively few emission characterization studies have been made on small engines used in garden equipment. The present investigation focuses on exhaust characterization from a lawn mower engine fueled with two different fuels in combination with and without an oxidizing catalyst. The compounds measured in the exhaust are carbon monoxide, hydrocarbons, nitrogen oxides, particulates, polycyclic aromatic hydrocarbons, methane, ethane, ethene, ethanol, and nitrous oxide. A significant reduction can be achieved by the use of a catalyst. By selection of the fuel, a significant reduction of certain carcinogenic compounds ("probably carcinogenic to humans" according to the IARC; benzo[a]pyrene and benzo[a]anthracene) may be achieved. The highest reduction improvement is achieved through the combination of an environmentally improved fuel, i.e., alkylate fuel, and a catalyst system. The data presented show that emissions from lawn mower engines are still relatively large although there is the potential for further improvements.