Effect of Replacing Race With Apolipoprotein L1 Genotype in Calculation of Kidney Donor Risk Index

Renal allografts from deceased African American donors with two apolipoprotein L1 gene (APOL1) renal-risk variants fail sooner than kidneys from donors with fewer variants. The Kidney Donor Risk Index (KDRI) was developed to evaluate organ offers by predicting allograft longevity and includes African American race as a risk factor. Substituting APOL1 genotype for race may refine the KDRI. For 622 deceased African American kidney donors, we applied a 10-fold cross-validation approach to estimate contribution of APOL1 variants to a revised KDRI. Cross-validation was repeated 10 000 times to generate distribution of effect size associated with APOL1 genotype. Average effect size was used to derive the revised KDRI weighting. Mean current-KDRI score for all donors was 1.4930 versus mean revised-KDRI score 1.2518 for 529 donors with no or one variant and 1.8527 for 93 donors with two variants. Original and revised KDRIs had comparable survival prediction errors after transplantation, but the spread in Kidney Donor Profile Index based on presence or absence of two APOL1 variants was 37 percentage points. Replacing donor race with APOL1 genotype in KDRI better defines risk associated with kidneys transplanted from deceased African American donors, substantially improves KDRI score for 85-90% of kidneys offered, and enhances the link between donor quality and recipient need.

Neurosensory evaluation of inferior alveolar nerve after bilateral sagittal split ramus osteotomy of mandible

Mandibular skeletal deformities are mostly corrected by Sagittal Split Ramus Osteotomy. One of the main complications of Bilateral Sagittal Split Ramus Osteotomy is impairement of sensory function of Inferior Alveolar Nerve.

OBJECTIVES

To evaluate the occurrence of neurosensory disturbance by comparing the subjective and objective assessment of neurosensory responses after bilateral sagittal split ramus osteotomy.To assess the progress of recovery from the first post operative day till six months. To explain the factors causing neurosensory disturbances.

METHOD

A series of 24 patients with clinically and radiographically diagnosed mandibular skeletal deformity were treated with Bilateral Sagittal Split Ramus Osteotomy. For evaluation of the neurosensory responses, the parameters consist of subjective and objective test in order to compare the subjective and objective assessment.

RESULTS

On the first post operative day neurosensory disturbances were seen in all the patients. Recovery of sensation was seen in all the patients at the end of this study.

CONCLUSION

The incidence of functional nerve disturbances is acceptable, since the progression towards recovery is inevitable. Prolonged neurosensory disturbance is greatly related to the degree of manipulation of the inferior alveolar nerve.

Electrodeposited-hydroxide surface-covered porous nickel–cobalt alloy electrodes for efficient oxygen evolution reaction

Herein, we present the electrochemical fabrication of a hydroxide surface-covered nickel–cobalt alloy and its superior catalytic activity towards the electrochemical oxygen evolution reaction in alkaline media.

Minimizing Relapse in Mandibular Asymmetry Correction by BSSRO with Intentional Osteotomy of Distal Segment: A Prospective Study

INTRODUCTION

Surgical correction of the patients with mandibular asymmetry by bilateral sagittal split ramus osteotomy (BSSRO) creats remarkable results in the immediate post operative period, but it carries a high risk of relapse by powerful muscle forces and the osteotomized segments. To minimize this risk, literatures highlight the procedure of an intentional osteotomy and stripping of muscles. A prospective study was conducted in Government Dental College, Kottayam, Kerala, to assess the effect of intentional osteotomy of posterior part of distal segment and stripping of medial pterygoid muscle on the proximal segment on affected side in mandibular asymmetry patients treated with BSSRO.

MATERIALS AND METHODS

20 patients above 18 years with mandibular asymmetry underwent surgical correction by BSSRO setback and rotation. Clinical evaluation and postero anterior cephalogram (PA Ceph) were used to assess relapse. PA cephalogram taken post operatively at 2 weeks, 6 months and 1year were compared using cephalometric parameters by Grummons analysis to assess relapse. Paired t test and Chi-square test was used to analyse quantitative and qualitative parameters respectively with statistical significance of p < 0.05.

RESULTS

Barring Methodological errors which is inevitable, the amount of relapse was not statistically significant with respect to dental midline, chin midline and frontal photograph.

CONCLUSION

Intentional osteotomy of posterior part of distal segment and stripping of medial pterygoid muscle on the affected side can prevent relapse in patients who underwent surgical correction of mandibular asymmetry by BSSRO set back and rotation.

Identification of novel small molecules that bind to the loop2 region of sclerostin - an in silico computational analysis

The goal of this study was to identify small molecular weight compounds that bind to sclerostin using in-silico methods because of the established importance of sclerostin-based therapies for the treatment of disease characterized by low bone mass. The zinc database (Zdb) revealed that nine potential molecules bind to the loop2 region (functional site) of sclerostin with ADME/T properties that are within an acceptable range defined for human use. Compounds 30160056 and 56871042 showed the highest docking score. Density functional theory (by HOMO, LUMO and MESP analysis) and MM/GBSA analysis showed that four compounds 30160056, 56871042, 72112226 and 43920281 exhibit high stability among the nine small molecules identified. Induced Docking Fit and Pymol software analyses revealed that the identified compounds differ in the interaction with amino acids in the loop2 region of sclerostin. Six compound exhibited interaction with Ile95 and 2 compounds with Asn93, an amino acid in the loop2 region known to be involved in sclerostin's inhibitory effect, suggesting that the identified compounds have the potential to bind and neutralize sclerostin function. Furthermore, compound 43920281 showed a low risk of toxicity and drug-like characteristic features compared to all nine identified compounds. In conclusion, in silico analysis identified a novel compound 43920281 as a potent anti-sclerostin therapeutic for drug development for the treatment of osteoporosis.

Tuberculous osteomyelitis of mandibular condyle: A rare encounter

Tuberculosis (TB), one of the oldest known microbial infectious diseases affecting humans has continued to burden our healthcare system over generations. Conventionally, primary TB usually manifests as a pulmonary infection. However, the last decade has witnessed increasing reports of extrapulmonary infections. It's often atypical clinical presentations require a high degree of clinical suspicion, especially in the developing countries with a high incidence of this infectious disease. In this report, we present one such case of tuberculous osteomyelitis of the mandibular condyle where the patient reported with the complaint of swelling on the left side of the face with no apparent systemic manifestation.

Thymoquinone induces apoptosis and increase ROS in ovarian cancer cell line

Nigella sativa is also known for its properties as a traditional herbal healing for many ailments. In this study, the anticancer properties of thyomquinone (TQ), the active ingredient of N. sativa, were studied using ovarian cancer cell line (Caov-3 cells). The anti-proliferative activity of TQ was determined using MTT and the apoptosis was investigated using Flowcytometry and Annexin-V Assays. Multiparameteric cytotoxicity bioassays were used to quantify the changes in cell permeability and mitochondrial membrane potential. Reactive oxygen species (ROS) and apoptosis-involved cell markers were examined to verify cell death mechanism. The MTT-assay showed that TQ induces anti-proliferative activity on Caov-3 with an IC50 of 6.0±0.03 μg/mL, without any cytotoxic activity towards WRL-68 normal hepatocytes. A significant induction of early phase of apoptosis was shown by annexin-V analysis. Treatment of Caov-3 cells with TQ induces decreases in plasma membrane permeability and mitochondrial membrane potential. Visible decrease in the nuclear area was also observed. A significant decrease is observed in Bcl-2 while Bax is down-regulated. TQ-triggered ROS-mediated has found to be associated with Hsp70 dysregulation, an indicator of oxidative injury. We found that TQ induced anti-cancer effect involves intrinsic pathway of apoptosis and cellular oxidative stress. Our results considered collectively indicated that thyomquinone may be a potential agent for ovarian cancer drug development.

Opposing effects of Sca-1(+) cell-based systemic FGF2 gene transfer strategy on lumbar versus caudal vertebrae in the mouse

Our previous work showed that a Sca-1⁺ cell-based FGF2 therapy was capable of promoting robust increases in trabecular bone formation and connectivity on the endosteum of long bones. Past work reported that administration of FGF2 protein promoted bone formation in red marrow but not in yellow marrow. The issue as to whether the Sca-1⁺ cell-based FGF2 therapy is effective in yellow marrow is highly relevant to its clinical potential for osteoporosis, as most red marrows in a person of an advanced age, are converted to yellow marrows. Accordingly, this study sought to compare the osteogenic effects of this stem cell-based FGF2 therapy on red marrow-filled lumbar vertebrae with those on yellow marrow-filled caudal vertebrae of young adult W⁴¹/W⁴¹ mice. The Sca-1⁺ cell-based FGF2 therapy drastically increased trabecular bone formation in lumbar vertebrae, but the therapy not only did not promote bone formation but instead caused substantial loss of trabecular bone in caudal vertebrae. The lack of an osteogenic response was not due to insufficient engraftment of FGF2-expressing Sca-1⁺ cells or inadequate FGF2 expression in caudal vertebrae. Previous studies have demonstrated that recipient mice of this stem cell-based FGF2 therapy developed secondary hyperparathyroidism and increased bone resorption. Thus, the loss of bone mass in caudal vertebrae might in part be due to an increase in resorption without a corresponding increase in bone formation. In conclusion, the Sca-1⁺ cell-based FGF2 therapy is osteogenic in red marrow but not in yellow marrow.

A Comparative Study of 3-Dimensional Titanium Versus 2-Dimensional Titanium Miniplates for Open Reduction and Fixation of Mandibular Parasymphysis Fracture

INTRODUCTION

Three dimensional titanium plating system was developed by Farmand in 1995 to meet the requirements of semi rigid fixation with lesser complication. The purpose of this in vivo prospective study was to evaluate and compare the clinical effectiveness of three dimensional and two dimensional Titanium miniplates for open reduction and fixation of mandibular parasymphysis fracture.

MATERIALS AND METHODS

Thirty patients with non-comminuted mandibular parasymphysis fractures were divided randomly into two equal groups and were treated with 2 mm 3D and 2D miniplate system respectively. All patients were systematically monitored at 1st, 2nd, 3rd, 6th week, 3rd and 6th month postoperatively. The outcome parameters recorded were severity of pain, infection, mobility, occlusion derangement, paresthesia and implant failure. The data so collected was analyzed using independent t test and Chi square test (α = .05).

RESULTS

The results showed that one patient in each group had post-operative infection, occlusion derangement and mobility (p > .05). In Group A, one patient had paresthesia while in Group B, two patients had paresthesia (p > .05). None of the patients in both the groups had implant failure. There was no statistically significant difference between 3D and 2D miniplate system in all the recorded parameters at all the follow-ups (p > .05).

CONCLUSION

3D miniplates were found to be better than 2D miniplates in terms of cost, ease of surgery and operative time. However, 3D miniplates were unfavorable for cases where fracture line was oblique and in close proximity to mental foramen, where they were difficult to adapt and more chances for tooth-root damage and inadvertent injury to the mental nerve due to traction.

Using Body Mass Index to Predict Needle Length in Fluoroscopy-Guided Lumbar Punctures

BACKGROUND AND PURPOSE

Predicting the appropriate needle length to use in oblique interlaminar-approach fluoroscopy-guided lumbar punctures in patients with a large body mass index is difficult. Using the wrong needle length can lead to an increased radiation dose and patient discomfort. We hypothesized that body mass index could help determine the appropriate needle length to use in patients.

MATERIALS AND METHODS

We randomly selected patients who underwent oblique interlaminar-approach fluoroscopy-guided lumbar punctures and had cross-sectional imaging of the lumbar spine within 1 year of imaging (n = 50). The distance from the skin to the midlumbar spinal canal (skin-canal distance) at the level of the lumbar puncture was measured by using an oblique angle of 8.6°, which is an average of angles most often used to perform the procedure. A formula was devised using the skin-canal distance and body mass index to predict the appropriate needle length, subsequently confirmed in 45 patients.

RESULTS

The body mass index and skin-canal distance were significantly higher (P < .001) in patients who underwent fluoroscopy-guided lumbar puncture with 5- or 7-inch needles (n = 22) than in patients requiring 3.5-inch needles (n = 28). Using linear regression, we determined the formula to predict the needle length as Skin-Canal Distance (inches) = 0.077 × Body Mass Index + 0.88. We found a strong correlation (P < .001) between the predicted and actual skin canal distance in 45 patients, and our formula better predicted the skin-canal distance than others.

CONCLUSIONS

We designed a formula that uses body mass index to predict the appropriate needle length in oblique interlaminar-approach fluoroscopy-guided lumbar punctures and validated it by demonstrating a strong correlation between the predicted and actual skin-canal distance.

Controlled reverse pulse electrosynthesized spike-piece-structured Ni/Ni(OH)2 interlayer nanoplates for electrochemical pseudocapacitor applications

An ultrathin Ni/Ni(OH)2 hybrid electrode has been synthesized using a controlled reverse pulse modulated electrochemical approach and demonstrated as an advanced pseudocapacitor material having a remarkable specific capacitance and excellent cycling performance.

One Size Does Not Fit All--Regional Variation in the Impact of the Share 35 Liver Allocation Policy

Allocation policies for liver transplantation underwent significant changes in June 2013 with the introduction of Share 35. We aimed to examine the effect of Share 35 on regional variation in posttransplant outcomes. We examined two patient groups from the United Network for Organ Sharing dataset; a pre-Share 35 group composed of patients transplanted between June 17, 2012, and June 17, 2013 (n = 5523), and a post-Share group composed of patients transplanted between June 18, 2013, and June 18, 2014 (n = 5815). We used Kaplan-Meier and Cox multivariable analyses to compare survival. There were significant increases in allocation Model for End-stage Liver Disease (MELD) scores, laboratory MELD scores, and proportions of patients in the intensive care unit and on mechanical, ventilated, or organ-perfusion support at transplant post-Share 35. We also observed a significant increase in donor risk index in this group. We found no difference on a national level in survival between patients transplanted pre-Share 35 and post-Share 35 (p = 0.987). Regionally, however, posttransplantation survival was significantly worse in the post-Share 35 patients in regions 4 and 10 (p = 0.008 and p = 0.04), with no significant differences in the remaining regions. These results suggest that Share 35 has been associated with transplanting "sicker patients" with higher MELD scores, and although no difference in survival is observed on a national level, outcomes appear to be concerning in some regions.