A midline sagittal brain view depicted in Da Vinci's "Saint Jerome in the wilderness"

It is estimated that around the year 1480 Leonardo da Vinci painted Saint Jerome in the Wilderness, representing the saint during his years of retreat in the Syrian dessert where he lived the life of a hermit. One may interpret Leonardo's Saint Jerome in the Wilderness as St. Jerome practicing self-chastisement with a stone in his right hand, seemingly punching his chest repeatedly. The stone, the lion and a cardinal's hat are conventionally linked to the saint. A skull was also almost always present with the image of the saint symbolically representing penance. With careful analysis of the painting one can identify the skull which is hidden in an arc represented as a lion's tail. The image is of a hemicranium (midline sagittal view) showing the intracranial dura, including the falx and tentorium, and venous system with the sinuses and major deep veins. This may have been the first time when the intracranial sinuses and the major deep venous vessels were illustrated.

Association of baseline C-reactive protein and prior anti-tumor necrosis factor therapy with need for weekly dosing during maintenance therapy with adalimumab in patients with moderate to severe Crohn's disease

OBJECTIVE

A post hoc analysis of data from the adalimumab Crohn's disease (CD) maintenance trial (CHARM, NCT00077779), examining the relationship between adalimumab dosing and maintenance of remission and response in subgroups stratified by previous anti-TNF use and baseline CRP.

METHODS

All patients received open-label induction (adalimumab: 80 mg, week [wk] 0; 40 mg, wk 2). At wk 4, all patients were randomized to double-blind maintenance adalimumab (40 mg weekly or every other week [eow]) or placebo for 52 weeks. In this analysis, clinical remission (CDAI <150) and clinical response (CR-100) at wk 26 and wk 56 by baseline CRP (high: ≥ 10 mg/L, or low: <10 mg/L) and prior anti-TNF use were determined for patients with CR-70 at wk 4.

RESULTS

Of 498 patients in this analysis, 260 (52.2%) were anti-TNF-naïve. For anti-TNF-naïve patients, the wk 56 remission rates in the adalimumab groups were significantly greater than placebo (P < 0.05) for both high and low CRP cohorts, with no statistically significant differences between remission rates with eow and weekly dosing within each CRP cohort (high: 52.8% eow, 53.5% weekly; low: 34.7% eow, 41.9% weekly). For anti-TNF-exposed patients, wk 56 remission rates were higher than placebo with both eow and weekly dosing within each cohort; weekly dosing in the high CRP cohort and eow dosing in the low CRP cohort achieved statistical significance (P < 0.05). In the high CRP cohort, remission rate with weekly dosing (46.9%) was statistically significantly greater compared with eow dosing (22.5%). There were no significant differences between eow (23.1%) and weekly (37.0%) dosing in the low CRP group. For all subgroups, clinical remission (wk 26) and clinical response (wk 26 and wk 56) patterns were similar to those observed for wk 56 remission.

CONCLUSIONS

These subgroup analyses suggest that in patients with moderately to severely active CD, weekly dosing may be most effective in the anti-TNF-experienced patients with elevated CRP at baseline.

Bacillus cereus var. toyoi promotes growth, affects the histological organization and microbiota of the intestinal mucosa in rainbow trout fingerlings

In this preliminary study, we evaluated the effects of a gram-positive soil bacteria Bacillus cereus var. toyoi on the growth performance, digestive enzyme activities, intestinal morphology, and microbiota in rainbow trout Oncorhynchus mykiss fingerlings. Trout were maintained in a recirculation system and fed 2 diets: 1) a commercial trout feed deprived of the probiotic and 2) the same diet but with the spores of the probiotic bacteria dissolved in fish oil during the manufacturing of the feed (final concentration = 2 × 10(4) cfu/g). Each diet was tested in three 400-L cylindroconical tanks (125 fish per tank; initial density = 1.3 kg/m(3); 13.2°C) for a period of 93 d. The probiotic-supplemented diet promoted growth, and the final mean BW and standard length in fish fed the probiotic were 3.4% and 2.1%, respectively, which was greater than the control group (P < 0.05). Fish fed the probiotic showed a more homogeneous distribution in the final BW, with a greater frequency of individuals around the modal of the normal distribution of the population. This result is of practical importance because homogenous production lots can improve rearing practices, reducing hierarchical dominance situations arising from individuals of larger sizes. In addition, the probiotic-supplemented diet increased the level of leukocyte infiltration in the lamina propria of the intestinal mucosa, the number of goblet cells (P < 0.010), and villi height (P < 0.001) but did not affect villi width. The administration of the probiotic changed the intestinal microbiota as indicated by 16S rDNA PCR-restriction fragment length polymorphism. In this sense, fish fed the probiotic formed a well-defined cluster composed of 1 super clade, whereas compared control fish had a greater degree of diversity in their gut microbiota. These changes in gut microbiota did not affect the specific activity of selected pancreatic and intestinal digestive enzymes. These results indicate that the inclusion of the probiotic bacteria in trout feeds could be beneficial for the host by enhancing its intestinal innate immune function and promoting growth.

Acute stroke: basic concepts and use of imaging for clinicians

In this article we review basic and some advanced concepts of stroke imaging. The benefits and caveats of both CT and MRI are stressed and we attempt to familiarize the reader with current concepts regarding collateral brain circulation, its nature, and its importance in acute stroke.

The guidance of stem cell differentiation by substrate alignment and mechanical stimulation

Mesenchymal stem cells (MSC) represent a promising and clinically relevant cell source for tissue engineering applications. As such, guiding MSCs toward specific lineages and maintaining these phenotypes have been particularly challenging as the contributions of mechanical, chemical and structural cues to the complex differentiation process are largely unknown. To fully harness the potential of MSCs for regenerative medicine, a systematic investigation into the individual and combined effects of these stimuli is needed. In addition, unlike chemical stimulation, for which temporal and concentration gradients are difficult to control, mechanical stimulation and scaffold-based cues may be relatively more biomimetic and can be applied with greater control to ensure fidelity in MSC differentiation. The objective of this study is to investigate the role of nanofiber matrix alignment and mechanical stimulation on MSC differentiation, focusing on elucidating the relative contribution of each parameter in guided regeneration of functional connective tissues. It is observed that nanofiber alignment directs MSC response to physiological loading and that fibroblastic differentiation requires a combination of physiologically-relevant cell-material interactions in conjunction with mechanical stimulation. Importantly, the results of this study reveal that systemic and readily controllable cues, such as scaffold alignment and optimized mechanical stimulation, are sufficient to drive MSC differentiation, without the need for additional chemical stimuli. Moreover, these findings yield a set of fundamental design rules that can be readily applied to connective tissue regeneration strategies.

Solid-phase extraction procedure of polar benzene- and naphthalenesulfonates in industrial effluents followed by unequivocal determination with ion-pair chromatography/electrospray-mass spectrometry

Highly water soluble benzene- and naphthalenesulfonates are widely used in the chemical, pharmaceutical, tannery, paper, and textile industries. In this work, Isolute ENV+ polystyrene divinylbenzene sorbent was used for the enrichment of 14 benzene- and naphthalenesulfonates from industrial wastewaters. The elution step was performed by adding 1 mL of water containing ion-pair reagent (5 mM of triethylamine (TEA) and 5 mM of acetic acid at pH 6.5) and 9 mL of methanol at 1 mL/min. The most relevant contribution was the use of ion-pair liquid chromatography followed by an orthogonal electrospray interface coupled to mass spectrometry in the negative ionization mode with postcolumn addition at 0.2 mL/min of methanol in combination with a volatile substance (triethylamine) as an ion-pair reagent. [M-H](-) ion was the base peak using low fragmentor voltages of 80 V with the electrospray interface. Significant fragmentation of the quasimolecular [M-H](-) ion occurs at high fragmentor voltage, producing [M-SO(2)H](-), [M-SO(3)H](-), and [SO(3)](•)(-) as diagnostic ions. Collision-induced dissociation of the parent ions for the benzene- and naphthalenesulfonates studied gave the [SO(3)](•)(-) fragment ion common to sulfonated compounds. At high fragmentor voltages of 150 V, [M-SO(3)H](-) ion is more abundant and therefore has a larger peak than the [M-H](-) peaks for 1,5-naphthalenedisulfonate, 2,6-naphthalenedisulfonate, 1-hydroxy-3,6-naphthalenedisulfonate, 2-hydroxy-3,6-naphthalenedisulfonate, and 2-amino-1,5-naphthalenedisulfonate. Recoveries were higher than 70%, with relative standard deviations between 1.3 and 10.7% with the exception of two naphthalenesulfonate compounds that had recoveries between 26 and 41%. Limits of detection (signal-to-noise ratio, 3) ranging from 0.6 pg to 0.13 ng (0.03-6.48 μg/L) were achieved when 150 mL of groundwater was processed. The aromatic sulfonates 3-nitrobenzenesulfonate, 4-methylbenzenesulfonate, 4-chlorobenzenesulfonate, 1-hydroxy-4-naphthalenosulfonate, 1-amino-6-naphthalenosulfonate, 1-amino-7-naphthalenosulfonate, and 1-naphthalenesulfonate and the linear alkyl benzenesulfonates C(10)-LAS and C(11)-LAS were unequivocally identified and quantitatively determined in μg/L, in wastewater samples from wastewater treatment plants and textile and tannery industries. 2-Naphthalenesulfonate was found as a major pollutant at mg/L concentration levels.

Influence of lamb rennet paste on the lipolytic and sensory profile of Murcia al Vino cheese

The influence of lamb rennet paste (71.1% chymosin, 177 international milk-clotting units/mL, 4.57U/g of lipase activity) during the ripening of Murcia al Vino goat cheese was studied. The aim of this study was to improve the knowledge of the effect of lamb rennet paste on the lipolytic patterns in this type of cheese by reference to the evolution of total and free fatty acids. A sensory analysis was carried out to compare cheeses made with commercial and paste rennet. The rennet paste showed higher lipolytic activity, enhancing the production of short-chain free fatty acids. In addition, the cheese produced with lamb rennet paste had a slightly more bitter and piquant taste, making it an attractive commercial alternative that can be used to develop new varieties of goat cheese.

Usefulness of a large field of view sensor for physicochemical, textural, and yield predictions under industrial goat cheese (Murcia al Vino) manufacturing conditions

The applicability of a light backscatter sensor with a large field of view was tested for on-line monitoring of coagulation and syneresis in a goat cheese (Murcia al Vino) manufactured under industrial conditions. Cheesemaking was carried out concurrently in a 12-L pilot vat and a 10,000-L industrial vat following the normal cheesemaking protocol. Cheese moisture, whey fat content, hardness, springiness, and adhesiveness were measured during syneresis. The results obtained show that cutting time is best predicted by considering the coagulation ratio at the inflection point and the percentage increase in the ratio during coagulation, with no need for the first derivative. The large field of view reflectance ratio provided good results for the prediction of moisture content, yield, hardness, springiness, and adhesiveness of the final cheese.

Cerebral fat embolism detection with susceptibility-weighted images in sickle cell disease

Cerebral fat embolism is a known but feared complication of sickle cell disease, which leads to significant morbidity. Although trauma-related fat embolism is more frequent and its diagnosis is straightforward, fat embolism secondary to bone infarcts after vaso-occlusive events can be unrecognized. Lack of criteria make the clinical diagnosis of sickle cell disease related fat embolism challenging. The neuroimaging findings are helpful to support the clinical diagnosis. Magnetic resonance imaging findings of fat embolism have been described including those seen on susceptibility-weighted imaging. Even though susceptibility-weighted imaging has been used for the diagnosis of cerebral fat embolism due to trauma, to the best of our knowledge its use has not been described in patients with sickle cell disease. We report an uncommon case of a 60-year-old woman with sickle cell disease who developed cerebral fat embolism and in which the findings on susceptibility-weighted imaging were characteristic and established the diagnosis.

Sinonasal cavernous haemangioma: a case report

Cavernous haemangiomas arising in the paranasal sinuses are very rare. Even though the lesion is benign in nature, its imaging features are non-specific, leading to an incorrect pre-operative diagnosis in most patients. We present a case of a maxillary sinus cavernous haemangioma in a young male. The clinical presentation and imaging characteristics of this entity are reviewed.