Point-based superimposition of a digital dental model on to a three-dimensional computed tomographic skull: an accuracy study in vitro

We investigated the accuracy of point-based superimposition of a digital dental model on to a 3-dimensional computed tomographic (CT) skull with intact dentition. The physical model was scanned by CT to give a virtual skull model, and a plaster dental model was taken and laser-scanned to give a digital dental model. Three different background investigators were recruited and calibrated to make the point-based superimposition, and afterwards were asked to repeat 5 superimpositions each. Five bone-to-tooth measurements for the maxilla and 6 for the mandible were selected to indicate the relation of teeth to skull. Repeated measures were made on the physical model to act as a control group, and on the virtual model to act as the test group. The absolute agreement intra-class correlation coefficient (ICC) was used to assess the intra/inter-investigator reliability; Bland-Altman analysis was used to calculate the general differences, limits of agreement, and precision ranges of the estimated limits. Inter/intra-investigator reliability was excellent with ICC varying from 0.986 to 1; Bland-Altman analysis indicated that general difference was 0.01 (0.25)mm, the upper limit of agreement was 0.50mm and the lower limit -0.47 mm, and the precision range for the upper limit was 0.43 mm to 0.57 mm and for the lower limit -0.54 mm to -0.40 mm. Clinically acceptable accuracy can be achieved using a direct point-based method to superimpose a digital dental model on to a 3-dimensional CT skull.

Amyloid-β induces NLRP1-dependent neuronal pyroptosis in models of Alzheimer's disease

Increasing evidence has shown the aberrant expression of inflammasome-related proteins in Alzheimer's disease (AD) brain; these proteins, including NLRP1 inflammasome, are implicated in the execution of inflammatory response and pyroptotic death. Although current data are associated NLRP1 genetic variants with AD, the involvement of NLRP1 inflammasome in AD pathogenesis is still unknown. Using APPswe/PS1dE9 transgenic mice, we found that cerebral NLRP1 levels were upregulated. Our in vitro studies further showed that increased NLRP1-mediated caspase-1-dependent ‘pyroptosis' in cultured cortical neurons in response to amyloid-β. Moreover, we employed direct in vivo infusion of non-viral small-interfering RNA to knockdown NLRP1 or caspase-1 in APPswe/PS1dE9 brain, and discovered that these NLRP1 or caspase-1 deficiency mice resulted in significantly reduced neuronal pyroptosis and reversed cognitive impairments. Taken together, our findings indicate an important role for NLRP1/caspase-1 signaling in AD progression, and point to the modulation of NLRP1 inflammasome as a promising strategy for AD therapy.

Mapping p53 mutations in low-grade glioma: a voxel-based neuroimaging analysis

BACKGROUND AND PURPOSE

Brain tumor location has proved to be a prognostic factor that may be associated with features of neoplastic origin. Mutation of p53 is an atypical genetic change that occurs during tumorigenesis. Thus, a potential correlation may exist between tumor location and p53 status. The purpose of the current study was to identify anatomic characteristics of mutant p53 expression by using quantitative neuroimaging analyses.

MATERIALS AND METHODS

Preoperative MR images from 182 patients with histologically confirmed low-grade gliomas were retrospectively analyzed. All tumors were manually marked and registered to the standard space. Using a voxel-based lesion-symptom mapping analysis, we located brain regions associated with a high occurrence of p53 mutation and corrected them by using a permutation test. The acquired clusters were further included as a factor in survival analyses.

RESULTS

Statistical analysis demonstrated that the left medial temporal lobe and right anterior temporal lobe were specifically associated with high expression of mutant p53. Kaplan-Meier curves showed that tumors located in these regions were associated with significantly worse progression-free survival compared with tumors occurring elsewhere.

CONCLUSIONS

Our voxel-level imaging analysis provides new evidence that genetic changes during cancer may have anatomic specificity. Additionally, the current study suggests that tumor location identified on structural MR images could potentially be used for customized presurgical outcome prediction.

Genetic tuning of the novel avian influenza A(H7N9) virus during interspecies transmission, China, 2013

A novel avian influenza A(H7N9) virus causing human infection emerged in February 2013 in China. To elucidate the mechanism of interspecies transmission, we compared the signature amino acids of avian influenza A(H7N9) viruses from human and non-human hosts and analysed the reassortants of 146 influenza A(H7N9) viruses with full genome sequences. We propose a genetic tuning procedure with continuous amino acid substitutions and reassorting that mediates host adaptation and interspecies transmission. When the early influenza A(H7N9) virus, containing ancestor haemagglutinin (HA) and neuraminidase (NA) genes similar to A/Shanghai/05 virus, circulated in waterfowl and transmitted to terrestrial poultry, it acquired an NA stalk deletion at amino acid positions 69 to 73. Then, receptor binding preference was tuned to increase the affinity to human-like receptors through HA G186V and Q226L mutations in terrestrial poultry. Additional mammalian adaptations such as PB2 E627K were selected in humans. The continual reassortation between H7N9 and H9N2 viruses resulted in multiple genotypes for further host adaptation. When we analysed a potential association of mutations and reassortants with clinical outcome, only the PB2 E627K mutation slightly increased the case fatality rate. Genetic tuning may create opportunities for further adaptation of influenza A(H7N9) and its potential to cause a pandemic.

Use of bone mesenchymal stem cells to treat rats with acute liver failure

This study aimed to isolate mesenchymal stem cells from bone mesenchymal stem cells (BMSCs), determine their therapeutic potential for treating rats with acute liver failure (ALF), further explore the factors that induce liver failure mechanisms, and elucidate the role of bone marrow stem cell therapy and BMSCs on liver homing. We found that differentiation potential was present in BMSCs expressing high levels of CD29 and CD90. These cells improved liver functioning in vivo after transplantation into rat livers with D-galactosamine damage, as evidenced by the levels of alanine aminotransferase and aspartate aminotransferase returning to normal (low levels) in recipient ALF rats. A significant improvement in the liver functional test and histological findings was observed in the transplantation group after 120 and 168 h of transplantation (P < 0.05). Histological data revealed that hepatocyte cell apoptosis was lower in the transplantation group compared to the control groups (P < 0.05), and that the transplantation of BMSCs reduced liver inflammation, decreased hepatic denaturation and necrosis, and promoted liver regeneration. These ameliorations were not recorded in the control groups. The results of in situ hybridization, immunofluorescence staining, and Western blot confirmed the presence of transplanted BMSCs in recipient rat livers. Stromal cell derived factor-1 alpha and vascular endothelial growth factor were significantly upregulated after the intraportal transplantation of BMSCs, with significantly higher levels being found in the portal vein and the tail vein groups (P < 0.05). In conclusion, BMSCs have a therapeutic effect against ALF rats, evoke endogenous repair mechanisms in the liver, and may represent a novel form of therapeutic intervention for the disease. Furthermore, intraportal transplantation serves as a more effective pathway compared to tail vein transplantation.

Difference between ferritin genes overexpressing in transgenic tobacco

With the development of molecular biology techniques, intron was known as playing an imperative role in gene's expression and regulation. Transgenic tobacco IN lines overexpressing InFer1 gene and NT lines overexpressing NtFer1 cDNA gene were obtained, and the exogenous gene expression were confirmed by molecular test. Then for iron content of transgenic tobacco lines and non-transformants as a physiological indicator in status of different iron concentration were measured, and results indicated that the iron content of transgenic tobacco was more than that of non-transformants. In high Fe (II) condition, the NT lines showed higher level in plant height, fresh weight and iron content then that of IN lines, while NT lines showed lower in Malondialdehyde content then IN lines. In soil condition, IN lines showed higher level in plant height, fresh weight, chlorophyll, photosynthesis rate, iron content then that of NT lines. It indicates that intron could play a vital role for improved protective enzyme activity level while reducing reactive oxygen damage and also could help to inhibit the absorption of aborting iron.

Transcutaneous electric acupoint stimulation reduces intra-operative remifentanil consumption and alleviates postoperative side-effects in patients undergoing sinusotomy: a prospective, randomized, placebo-controlled trial

BACKGROUND

Although opioids are widely used as analgesics in general anaesthesia, they have unpleasant side-effects and can delay postoperative recovery. Acupuncture and related techniques are effective for acute and chronic pain, and reduces some side-effects. We assessed the effect of transcutaneous electric acupoint stimulation (TEAS) on intra-operative remifentanil consumption and the incidences of anaesthesia-related side-effects.

METHODS

Sixty patients undergoing sinusotomy were randomly assigned to TEAS or control group. TEAS consisted of 30 min of stimulation (6-9 mA, 2/10 Hz) on the Hegu (LI4), Neiguan (PC6), and Zusanli (ST36) before anaesthesia. The patients in the control group had the electrodes applied, but received no stimulation. Bispectral index was used to monitor the depth of anaesthesia. Perioperative haemodynamics were recorded, and peripheral blood samples were collected to measure the levels of mediators of surgical stress. The primary end point was intraoperative remifentanil consumption and the secondary endpoints were recovery quality and anaesthesia-related side-effects.

RESULTS

Patients in the TEAS group required 39% less remifentanil during surgery than controls [0.0907 (SD 0.026) μg kg(-1) min(-1) vs 0.051 (0.018) μg kg(-1) min(-1)]. There were no differences in intra-operative haemodynamics or surgical stress between groups. However, the time to extubation and recall in the control group was 16.8 (6.8) min and 23.0 (5.0) min, respectively, significantly longer than that in the TEAS group (P<0.01). TEAS also decreased the incidence of dizziness and pruritus within the first 24 h after surgery (P<0.01).

CONCLUSION

The use of TEAS significantly reduced intra-operative remifentanil consumption and alleviated postoperative side-effects in patients undergoing sinusotomy.

CLINICAL TRIAL REGISTRATION

The trial was registered at clinicaltrials.gov (NCT01700855).

Prognostic value of 1p deletion for multiple myeloma: a meta-analysis

INTRODUCTION

Previous studies have indicated that a deletion on the short arm of chromosome 1 negatively predicts survival in patients with multiple myeloma (MM). Due to the small sample size in each study, we performed this meta-analysis to comprehensively investigate the association between the 1p deletion and survival in patients with MM.

METHODS

A literature search was conducted in both foreign and Chinese databases, including SinoMed, CNKI, Wanfang, PubMed, EMBASE, and Scopus. Hazard ratios (HR) with 95% confidence intervals (CI) for overall survival (OS) and progression-free survival (PFS) in 11 eligible articles were extracted or calculated to analyze the pooled HR, which was estimated by fixed-effect or random-effect models based on the heterogeneity between included articles. A subgroup analysis and a meta-regression were conducted, and Galbraith plots were generated to examine any possible heterogeneity.

RESULTS

The HRs for OS were available in nine articles, whereas five articles discussed HRs for PFS. The HR with 95%CI was 1.989 (95%CI 1.522-2.600, P = 0.017, I(2)  = 57.1%) when comparing the OS of patients with 1p deletion with the OS of those without this deletion. For PFS, 1p deletion still predicted a poor prognosis (HR 2.11, 95%CI 1.54-2.88, P = 0.292, I(2)  = 19.3%). Moreover, the subgroup analysis suggested that either the deleted gene on 1p or techniques for detecting chromosome abnormalities contributed to the heterogeneity, which was partially consistent with the results derived from a meta-regression analysis and the Galbraith plot method.

CONCLUSION

Our meta-analysis provides globally quantifiable confirmation of the adverse prognostic role of 1p deletion in OS and PFS for patients with MM.

Establishment of reference range for thyroid hormones in normal pregnant women in China's coastal area

PURPOSE

The current study aims to establish reference ranges for thyroid hormones in normal pregnant women during their pregnancy period.

MATERIALS AND METHODS

A one-time cross-sectional survey was conducted on 490 normal pregnant women and 51 nonpregnant women (control). The serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free tetraiodothyronine (FT4) levels were measured.

RESULTS

The serum FT3 and FT4 levels in pregnant women decreased gradually from the first to the last three months of pregnancy (p < 0.01). The serum TSH level increased gradually during the whole pregnancy (p < 0.01), and was significantly lower than the control (p < 0.01) in the first three months. However, in the middle and last three months of pregnancy, TSH was higher than the control (p < 0.01).

CONCLUSIONS

The thyroid hormone levels in normal pregnant women are different from those in non-pregnant women; significant differences exist among the three stages of pregnancy.

Abstract P4-06-05: Transcriptional heterogeneity correlates with chemotherapy sensitivity in triple negative breast cancer and varies by molecular subtype

Purpose: Different molecular subtypes of breast cancer are believed to have different degrees of molecular heterogeneity. However, the heterogeneity of breast cancer subtypes has not been formally compared. The goal of this analysis was to develop metrics of global transcriptional heterogeneity, compare heterogeneity across breast cancer subtypes and assess whether heterogeneity metrics correlate with sensitivity to chemotherapy in basal-like cancers.

Methods: Affymetrix U133A gene expression data from 836 breast cancers (basal n = 219, HER2-like n = 147, luminal A n = 343, luminal B n = 127) were analyzed. Among the basal-like cancers, 128 received neoadjuvant chemotherapy (pathologic complete response, pCR, n = 44; residual disease, RD, n = 94). Molecular class was assigned by the PAM50 classifier. We used the average pairwise Pearson distance, the sum of eigenvalues of the correlation matrix and multi-dimensional scaling dispersions of the probe set expression values to quantify heterogeneity. Distribution of each metric within the different subtypes was estimated from 500 bootstrapped cohorts of 80 cases in each subtype. We used analysis of variance (ANOVA) to evaluate the significance of the differences in heterogeneity between subtypes.

Results: All three heterogeneity metrics yielded concordant results. Within subtypes, heterogeneity was greatest in basal-like cancers followed by HER2-like, luminal B and luminal A (see figure). Luminal A cancers were distinctly less heterogeneous than the rest. Basal-like cancers with RD were more heterogeneous than those with pCR. The best metric to separate basal tumors with pCR versus RD was the sum of eigenvalues shown below.

Conclusion: Breast cancer molecular subtypes differ in transcriptional heterogeneity. Luminal A cancers have the lowest within group heterogeneity while basal like cancers have the highest. Among the basal-like cancers, those with high chemotherapy sensitivity (pCR) are more homogeneous than those with RD suggesting that transcriptional heterogeneity might be contributing to increased resistance to therapy in this subgroup.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-06-05.

[Triggers of bulimia and compulsion attacks: validation of the "Start" questionnaire]

AIM

There are few published studies on the triggers of binge eating in anorexia nervosa of binge/purging subtype (BPAN), bulimia nervosa (BN) and binge eating disorder (BED).

PATIENTS AND METHODS

We validated in 29 patients (10 BPAN, 10 BN and 9 BED) the perspicuity, the clarity and the intra- (doubles) and inter- (test-retest) reproducibility of a 24-item Start questionnaire on the triggers of binge eating. Then the Start questionnaire was administered to 176 patients (65 BPAN, 62 BN and 59 BED patients) being 27.5+9.1 yr old, having 15+9 binge eating (BE) episodes/week, with a mean binge duration of 1 hr 36min (+ 38min)/day.

RESULTS

BE episodes occurred mainly during the second part of the day: afternoon after work (67% of the patients), "tea" time (55%), evening after dinner (42%) and at night (22%). The principal place for BE episodes was at home (96%). The BED patients avoided binges at the parents' home (89%) more often than the BPAN (62%, P<0.02). The binges occurred mainly in the living room (44%), in the kitchen (43%), and less in the bedroom (31%). Hunger pangs seemed to be a trigger of binges in 31% of the patients, and a stronger trigger in BED (42%) than in the BPAN and BN patients (24%; P=0.04). Binge eating episodes could occur despite a high satiety level (just after lunch or dinner) in 29% of the BN and in 16% of the BED patients (P<0.02). Concerning food, the major triggers were high energy-density food (77%) and comfort food (60%), such as chocolate, cakes, bread and pasta. The food consumed for binge episodes (in-binge food) was more often a strong trigger than the other food (not used for binges): olfaction (19% versus 10%), sight (52% versus 25%) and placing in the mouth (71% versus 26%; P<0.02 for all, in the 3 groups). Being tired could be a strong trigger in 37% of the patients, but "being aroused" in the other 38 % of the patients. Stressful events (65%), anxiety (74%), "being under pressure" or irritated (51% and 55%) were of course major triggers in a majority of the patients, as well as sadness (61%), feeling of powerlessness (62%), inefficiency (73%) and depressive state (71%). Flashback from traumatism (sexual trauma in 17% of the patients) was a strong trigger of binges more often in BPAN and BED (44%) than in BN (23%; P<0.05). The binge eating was painful (and "not at all a pleasure") in 69% of the patients, but could also be a relaxing behavior in 31% of the patients, more often in the BED (43%) than in the BPAN patients (20%; P<0.05). The binge eating behavior was quoted as obsessive in 63% of BPAN, 92% of BN and only 34% of BED patients (P<0.001). The patients said that they were unable to avoid the binge (76% of the patients), more often in BPAN and BN than in BED patients (P<0.01). As a whole, 62% of BPAN, 89% of BN and only 4 % of BED patients (P<0.05) were unable to avoid purging (vomiting). In 12% of the cases, there was a pleasure felt when binging. For the other patients, shame, filth and incapacity were the feelings related to binges in 58% of the BPAN, 45% of BN and 43% of BED patients (P<0.04). The global score of addiction (zero=not addicted, 10=very addicted) was 8.56+1.2 in BPAN, 8.42+1.5 in BN and 6.74+1.1 in BED patients (NS between BPAN and BN; P<0.01 between BPAN and BN on the one hand and BED on the other).

CONCLUSION

The present study has demonstrated the usefulness of the Start questionnaire. It also evidences the key role of intrinsic factors, both metabolic and emotional, as strong triggers for binge eating episodes in BPAN, BN and BED. It has also demonstrated the role of environmental determinants.

Estimation of CYP2D6*10 genotypes on citalopram disposition in Chinese subjects by population pharmacokinetic assay

WHAT IS KNOWN AND OBJECTIVE

There is great interindividual variability in citalopram (CIT) pharmacokinetics. We attempted to establish a population pharmacokinetic (PPK) model of CIT in Chinese healthy subjects, to evaluate the effect of genetic polymorphism on CIT pharmacokinetics and to compare the PPK and non-compartmental (NCA) assays in the estimation of CIT bioequivalence.

METHODS

Blood samples of 23 healthy subjects were collected after administration of CIT; plasma concentration of CIT was analysed using LC/MS-MS. CYP2C19 and CYP2D6*10 genotypes were determined. PPK model was established by using nonlinear mixed-effect modelling (NONMEM). The model was evaluated using goodness-of-fit plots and relative error measurements. Bioequivalence of CIT was evaluated by both PPK and NCA method.

RESULTS AND DISCUSSION

The estimated population absorption rate constant (ka ), clearance (CL/F) and volume of distribution (Vd/F) in Chinese healthy subjects are 0.64 L/h, 12.7 L/h and 705 L, respectively. Different CYP2C19 and CYP2D6 genotypes have impacts on CIT pharmacokinetics. There is about 5.5% decrement of CL/F for each CYP2C19*2 or CYP2D6*10 allele. The 90% confidence interval of CIT bioavailability obtained from NCA and PPK model were 96.4-105.4% and 92.5-103.4%, respectively.

WHAT IS NEW AND CONCLUSION

The PPK of CIT is best characterized by a one-compartment disposition model with first-order absorption. CYP2C19 and CYP2D6 genotypes have impacts on the CL/F of CIT. Bioequivalence of CIT can be estimated by both NCA and PPK model.

Effect of hyperoxia on pulmonary SIgA and its components, IgA and SC

Purpose

Oxygen therapy (hyperoxia) is essential for the treatment of some neonatal critical care conditions. The lung is the primary target for the changes induced by hyperoxia. Secretory immunoglobulin A (SIgA), IgA and secretory component (SC) reflect the local immunity in the respiratory tract induced by hyperoxia.

Methods

The enzyme-linked immunosorbent assay, immunohistochemistry staining, Western blot and Real-time PCR were used to detect the levels of cytokines, IgA and SIgA in bronchoalveolar lavage as well as IgA and SC/pIgR in pulmonary tissue.

Results

The levels of IgA and SIgA in BAL fluid were gradually increased following neonatal rat development. Compared with air-inhaling group, in the hyperoxia group IgA, SIgA and other cytokines except IL-1 in BAL fluid were significantly elevated on the 3rd, 5th and 7th days, but on the 10th day TNF-α, SIgA and IgA rapidly decreased. In the hyperoxia group, both the protein expression of SC/pIgR and the mRNA expression of SC/pIgR were remarkably increased on the 3rd, 5th and 7th days, but were significantly decreased on the 10th day, respectively. Conclusion: The large amount of SIgA, IgA and SC in the early period of hyperoxia might protect the lungs of the neonatal rats against acute pulmonary injury, however, in the late period of hyperoxia, the abruptly drop of SIgA and its component might lead to pulmonary immunity abnormality. In hyperoxia, the increased expression of cytokines might contribute to the expression of IgA and SC.

Unstable distal radius fractures: restoration of the radial length with use of special palmar fixed-angle plate

PURPOSE

To describe the radiological and clinical outcome of unstable distal radius fractures treated with use of a palmar locking plate designed especially to restore the length of the radius.

PATIENTS AND METHODS

19 patients (6 men and 13 women) with an average age of 55 (23-71) years with an unilateral unstable distal radius fracture were treated with open reduction and internal fixation with use of an special palmar locking plate. In the distal long hole of this plate a longitudinal gear drive mechanism is integrated, in which a digital knob device consisting of a handle with a serrated ring is inserted. By turning the handle the distal fragments which are fixed to the plate by locking screws are pushed distally with respect to the shaft fragment until the correct length of the radius is restored. The patients were followed for 12 months. During last follow-up, standard radiography, functional results and pain scores were assessed.

RESULTS

All fractures united uneventfully with no secondary displacement, and no superficial or deep infection. Ulna variance measured on average - 0.8±1.5 mm. Wrist extension averaged 63°, wrist flexion averaged 59°. Grip strength averaged 82% of the contralateral uninjured side.

CONCLUSION

The used special gear drive plate allows accurate restoration of the length of the radius even in unstable fractures with good clinical results.

N-acetylcysteine attenuates subcutaneous administration of bleomycin-induced skin fibrosis and oxidative stress in a mouse model of scleroderma

BACKGROUND

Several lines of evidence suggest that the generation of reactive oxygen species (ROS) is of major importance in the pathogenesis of scleroderma, and thus antioxidant therapy may be useful for patients with an impaired oxidative defence mechanism.

AIM

To examine the effect of N-acetylcysteine (NAC) on skin fibrosis and oxidative stress in a bleomycin (BLM)-induced mouse model of scleroderma.

METHODS

We used this mouse model to evaluate the effect of NAC on skin fibrosis and oxidative stress. Skin fibrosis was evaluated by histopathological examination and hydroxyproline content. To measure lipid peroxidation, we used a thiobarbituric acid-reactive species, malondialdehyde (MDA). Oxidative protein damage (carbonyl content) and the activities of catalase (CAT) and superoxide dismutase (SOD) were determined to evaluate oxidative stress in the skin tissue.

RESULTS

Treatment with NAC attenuated the skin fibrosis induced by BLM, significantly reducing the MDA and protein carbonyl content in these mice. SOD activity in BLM-only mice and BLM plus NAC-treated mice was increased compared with control mice. However, there was no significant difference in skin SOD activity of mice treated with both BLM and NAC compared with those treated with BLM only. In addition, CAT activity was not altered in the BLM plus NAC mice.

CONCLUSIONS

NAC treatment attenuates skin fibrosis in a BLM-induced mouse model of scleroderma, and this is associated with diminished oxidative stress. The results suggest that NAC may be a potential therapeutic agent for patients with scleroderma.