Description of Aphelenchoides persicus sp. n. (Nematoda: Aphelenchoididae) from Iran

During a survey on the soil nematodes, a population of the genus Aphelenchoides was collected around the rhizosphere of persimmon in Guilan Province, Iran. The morphological and molecular characters confirmed the new species, namely A. persicus sp. n. The new species is characterized by a female body length (699-1068 μm), lip region offset from the rest of the body by a slight constriction, lateral fields with six incisures, stylet 12-13.5 μm long, with a clear basal swelling, excretory pore ca 1.5 metacorpal length posterior to base of the metacorpus, post uterine sac elongate, about 4-7 times than the vulval body diameter; conical female tail with a single centrally located mucron with tiny projection close to the tail tip, male body length (663-908 μm), and spicule well developed with rounded condylus, blunt conical rostrum, and a hook-like tip of dorsal limb. The new species belongs to the Group 2 category of Aphelenchoides species and was similar to seven known species with six lateral field incisures, including A. allius, A. chinensis, A. meghalayensis, A. nechaleos, A. paranechaleos, A. parasexlineatus, and A. sexlineatus. The molecular phylogeny based on 28S rDNA revealed that the new species stands close to A. hamospiculatus (MN931591; MN931592) and two unidentified Aphelenchoides (KY769057; LC583315). The measurements, line illustrations, LM photographs, and phylogenetic analysis are given for the new species.

The Rationality to Requesting in-ward Magnetic Resonance Imaging Investigation

Background

Magnetic Resonance imaging (MRI) is a valuable diagnostic tool by its non-invasive/non-ionizing nature.

Objective

This study aims to determine justification of MRI in hospitalized patients at a tertiary provincial referent medical center in a one-year period.

Material and Methods

In the present retrospective and descriptive cross-sectional study, 438 admitted patients referred for MRI during 2017 were selected using systematic random sampling. The age, gender, investigated organ, the specialty of requesting physician, MRI with and without contrast, MRI diagnostic outcome were collected using checklists. Descriptive statistics and chi-square test were used for data analysis.

Results

The mean age of the patients was 42±26 years-old and female represented 53% of enrolled patients. The most and less prevalent investigated organs were the cerebrum and the orbit. After excluding cancer diagnosis, cancer staging, and therapeutic follow-up exams, MRI request was oriented in 64.3% and 77.2% of positive results was concordant with aforementioned diagnostic orientation (P<0.001). Oriented diagnostic MRI requesting is influenced by age, medical specialists and, investigated organ (P<0.001). The positive MRI is influenced significantly by oriented MRI request, gender, medical specialists and investigated organ (P<0.001). The diagnosis concordance of MRI is influenced significantly by oriented MRI request, medical specialists and investigated organ (P<0.001).

Conclusion

Appropriate implementation of medical imaging requires boosting employed rationality by the concerned physicians. The current suboptimal results to requesting MRI rationality should mandate supplementary educational programs as to incite the medical corpus more closely implementing the published medical practice guidelines.

P53 IHC Result as a Prognostic Tool in MDS

Background & Objective

Some of the patients with myelodysplastic syndrome (MDS) are categorized as good prognosis based on the Revised International Prognostic Scoring System (IPSS-R). However, these patients may have poor clinical outcomes. It seems that the current diagnostic tools and IPSS-R cannot consider genetic factors for determining the prognosis of MDS patients.

Methods

This cross-sectional study included all adult MDS patients of both genders who were admitted from March 2015 to March 2020 to the Hematology wards of two educational tertiary hospitals in Iran (Namazi and Faghihi, affiliated with Shiraz University of medical sciences). Study data included relevant retrospective data from medical records and the results of immunohistochemical p53 staining on bone marrow biopsies.

Results

Of the 84 patients, 65 (77.4%) showed p53 expression in bone marrow. They had shorter median survival than those without p53 expression. Considering both variables of P53 IHC results and IPSS-R score, the patients who died with low-risk IPSS-R score presented high p53 expression.

Conclusion

This study shows that the investigation of p53 expression by IHC at the time of diagnosis is a valuable indicator of survival rate in MDS patients. These data suggest that the immunohistochemical analysis of p53 can be a prognostic tool for MDS and should be used as an adjunct test to make decisions on the best therapeutic choice.

SARAspeech-Feasibility of automated assessment of ataxic speech disturbance

Ataxias are a group of movement disorders that are characterized by progressive loss of balance, impaired coordination and speech disturbance, which together lead to markedly reduced quality of life. Speech disturbance is clinically diagnosed, but methods for objective assessment of severity are lacking. Using 71 sets of speech recordings from ataxia patients, we developed an automated classification system. With a tolerance of ±1 point, this classification system correctly predicted experts' ratings of speech disturbance according to item 4 of the Scale for Assessment and rating of ataxia (SARA) in 80% of cases. We thereby demonstrate feasibility of computer-assisted voice analysis for automated assessment of severity of speech disturbance.

V-NeuroStack: Open-source 3D time stack software for identifying patterns in neuronal data

Understanding functional correlations between the activities of neuron populations is vital for the analysis of neuronal networks. Analyzing large-scale neuroimaging data obtained from hundreds of neurons simultaneously poses significant visualization challenges. We developed V-NeuroStack, a novel network visualization tool to visualize data obtained using calcium imaging of spontaneous activity of neurons in a mouse brain slice as well as in vivo using two-photon imaging. V-NeuroStack creates 3D time stacks by stacking 2D time frames for a time-series dataset. It provides a web interface to explore and analyze data using both 3D and 2D visualization techniques. Previous attempts to analyze such data have been limited by the tools available to visualize large numbers of correlated activity traces. V-NeuroStack's 3D view is used to explore patterns in dynamic large-scale correlations between neurons over time. The 2D view is used to examine any timestep of interest in greater detail. Furthermore, a dual-line graph provides the ability to explore the raw and first-derivative values of activity from an individual or a functional cluster of neurons. V-NeuroStack can scale to datasets with at least a few thousand temporal snapshots. It can potentially support future advancements in in vitro and in vivo data capturing techniques to bring forth novel hypotheses by allowing unambiguous visualization of massive patterns in neuronal activity data.

Evaluation of CT Scan Diagnostic Value in the Novel Coronavirus Disease and Presenting a Corona CT Severity Index

BACKGROUND

Several diagnostic methods have been proposed and evaluated for the COVID-19 disease. However, the published studies have reported different diagnostic values for these methods.

AIMS

The present study aimed to evaluate the diagnostic performance and accuracy of CT in the novel corona virus disease (COVID-19) and to develop and present a Corona CT severity index.

METHODS

The CT diagnostic performance was measured based on sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy, and RT-PCR was regarded as a standard. Patients' CT reports were evaluated by a radiologist, and scoring and calculating of the CT severity index were performed.

RESULTS

Of 208 patients, 82 showed positive and 126 showed negative RT-PCR results with a positive frequency of 39.4% (95% CI, 32.7-46.4). The chest CT scan related to 136 patients indicated COVID-19, whereas their initial RT-PCR assays of 56 patients were negative. Considering RT-PCR results as reference standard, the sensitivity, specificity, and accuracy of chest CT to indicate COVID-19 infection was 100%, 55.6% (95% CI 46.4-64.4%), and 72.8% (95% CI 66.2-78.8%), respectively. The severity of pulmonary involvement was assigned with different grades. For 60.7% of patients with severity grades of 2 to 6, who showed the involvement of at least one lung lobe in CT, PCR retrieved negative results.

CONCLUSION

CT scan represents an appropriate sensitivity as well as a consistently higher specificity to diagnose COVID-19 pneumonia than PCR. It can be regarded as a primary tool to detect the current COVID-19 in epidemic regions.

Contrast-associated acute kidney injury in elderly; a mini-review on nursing prospectives

Contrast medium is used daily for accurate and effective diagnostic procedures. They are often necessary to provide an exact diagnosis and are almost safe and effective when used correctly. However contrast media can sometimes be life-threatening especially in elderly, since the elderly suffer from several problems. Aging is frequently accompanied by chronic diseases like chronic renal failure, comorbidity, frailty and disability. Therefore, it is important to know how reactions to contrast agents manifest and how to manage them immediately. Decreased kidney functions are sometimes seen after intravenous contrast media injection therefore radiologists should monitor all stages of the contrast injection. Accordingly, the medical team should have information on the complications, prevention and care of the patients under contrast media.

Diagnostic value of the candidate microRNAs in thyroid fine-needle aspiration biopsy (FNAB) samples

Background Thyroid cancer (TC) is known to be the most common endocrine malignancy with an incidence rate which has increased by 2.3-fold over the past 30 years. Approximately, 30% of the thyroid fine-needle aspiration biopsy (FNAB) outcomes are indecisive. Moreover, researchers recognized multiple differentially expressed microRNAs (miRNAs) as candidate diagnostic markers for thyroid nodules. The purpose of this study was to identify thyroid tumor-associated miRNAs in FNAB with the capacity to be developed as unique biomarkers. Materials and methods According to the study design, a quantitative real time reverse transcription polymerase chain reaction (qRT-PCR) was applied to evaluate the expression levels of nine miRNAs (Let7, miR-34a, miR-146b, miR-221, miR-151, miR-155, miR-181b, miR-222 and miR-375) among 224 FNA samples as the training set. Results The findings of this study revealed that miR-181b and miR-146b are the best predictors to diagnose benign thyroid FNA samples from malignant samples. However, the remaining miRNAs were co-expressed and had no significant effect on the predictor model. On the other hand, sensitivity and specificity of miR-181b and miR-146b were reported at 83.0%-83.0% and 83.0%-66.0%, respectively. Conclusions According to the results of this study, miR-146b and miR-181b might be considered as adjunct markers contributing to thyroid FNAB in tumor types. In addition, miR-146b and miR-181b were recognized as biomarkers for discriminating benign thyroid nodules from malignant ones. It is suggested that further prospective clinical trials be conducted to evaluate the accuracy of such findings in a larger cohort and determine the clinical uses.

P724Antibody treatment against pathological pancreatic islet amyloid polypeptide (IAPP) aggregates restores endothelial dysfunction in human-IAPP transgenic rats

Background

Islet amyloid polypeptide (IAPP; or amylin) is produced in pancreatic B-cells and co-secreted with insulin in response to nutrients. In insulin resistance and type 2 diabetes (T2D), higher secretion and impaired processing of IAPP results in its aggregation, contributing to amyloid-induced apoptosis of pancreatic B-cells. Insight into IAPP's role in diabetic endothelial dysfunction is scarce.

Purpose

Rats transgenic for human IAPP (hIAPP), which in contrast to rodent IAPP produces amyloid deposits and contributes to diabetes due to B-cell failure, were studied to understand the mechanisms of endothelial dysfunction in T2D and test the vasoprotective actions of an anti-hIAPP antibody.

Methods

Male hemizygous transgenic Sprague-Dawley rats with islet B-cell expression of hIAPP (TG) and wild-type (WT) controls were sacrificed at 2, 3, 6- and 9-months age to assess endothelial function. In a second experiment, TG rats received weekly injections of antibody against aggregated hIAPP (3 mg/kg; TG-Ab) from 3–12 months of age; TG and WT controls received PBS. Oral glucose tolerance was assessed before harvesting. At the respective time points (12 mts in exp. 2), thoracic aortic rings were isolated and subjected to ex vivo isometric tension recording. After contraction with norepinephrine (NE 1x10–7 mol/L), cumulative relaxation responses were performed to glucagon-like peptide-1 (GLP-1; 10–12 to 10–6 mol/L) and insulin (10–11 to 10–6 mol/L). Pancreas and aortic arch samples were used for immunostaining of hIAPP antibody engagement.

Results

GLP-1 and insulin-mediated vasodilation was impaired in 3 month-old TG rats compared to WT. Glucose intolerance appeared in TG rats at 6 months in comparison to WT (p<0.0001), indicating that endothelial dysfunction in TG rats precedes the onset of glucose intolerance. Anti-hIAPP antibody showed selectivity against aggregated IAPP in pancreatic islets, but there was no target engagement in the aortic arch, questioning a pathogenic role of IAPP deposition in the aortic wall. At 12 months, glucose control in TG-Ab rats was improved in comparison to TG control rats (p<0.013). Vasodilatation in TG-Ab rats was restored in response to GLP-1 (35.5% ± 4.6 vs. 16.0% ± 3.1 in TG controls), similar to that of WT rats (35.5% ± 6.5). Vasodilatation in response to insulin (48.9% ± 4.2) was improved in comparison to both TG (29.4% ± 3.0) and WT controls (32.5% ± 5.7) (p<0.0001; 2-way ANOVA, n=6–11 for all groups.

Conclusion

Early endothelial dysfunction develops in hIAPP rats compared to WT. Endothelial dysfunction is restored by the anti-hIAPP antibody treatment via improved oral glucose tolerance, but it remains unclear whether this effect is due to a local action in the aorta or a secondary effect, e.g. due to a reduction in pancreatic IAPP deposition.

P729The functional relevance of bile acids in the improvement of HDL-mediated endothelial protection after bariatric surgery

Introduction

Roux-en-Y gastric bypass (RYGB) reduces cardiovascular mortality. We showed that high density lipoproteins (HDL)-mediated vasoprotection is improved early after RYGB. Circulating BAs increase upon RYGB and contribute to the weight-loss independent metabolic improvements after surgery. Bile acids (BA) are signaling molecules increasingly recognized as regulators of cardiometabolic homeostasis. BAs circulate in the blood either free or bound to albumin and HDL. The signaling role of HDL-bound BAs (HDL-BAs) is unknown. Indeed, HDL may facilitate BA delivery directly to endothelial cells where BA may synergize with HDL to promote vasoprotection.

Purpose

We studied whether RYGB changes the composition of HDL-BA and whether HDL functional properties may be modulated by specific BA bound to HDL.

Methods

HDL were isolated by ultracentrifugation from 29 morbidly obese patients before and 1 year after RYGB. The HDL-BA composition was determined by liquid chromatography-mass spectrometry (LC/MS-MS) and HDL vasoprotective properties were evaluated ex-vivo in human aortic endothelial cells (HAEC). The size and abundance of HDL particles were determined by NMR spectroscopy in plasma.

Results

The increase in total BA concentrations observed in plasma 1 year after RYGB also translated into higher concentrations (up to 25%) of BA bound to HDL. Moreover, obesity-induced HDL dysfunction was reversed after surgery, as shown by improved HDL-mediated endothelial NO production, anti-apoptotic effects and cholesterol efflux capacity. The size function analyses showed a post-operative shift towards larger HDL. After RYGB there was a remodeling of BA bound to HDL, which are either agonists of the endothelial nuclear farnesoid X receptor (FXR), e.g. chenodeoxy-CA (CDCA), cholic acid (CA) or for the membrane TGR5 receptor, e.g. deoxy-CA (DCA). The composition-function analysis revealed that among all BA subclasses, the specific enrichment in CA and in CDCA bound to HDL correlated with an improved endothelial anti-apoptotic capacity of HDL (R −0.52, p=0.006 for CA-HDL and R −0.35, p=0.07 for CDCA-HDL). Further, the exogenous loading of CA onto healthy native HDL isolated from human serum significantly enhanced their endothelial anti-apoptotic function. In the case of obese, dysfunctional, pro-apoptotic HDL, exogenous CA loading was able to restore HDL anti-apoptotic function.

Conclusion

Exogenous loading of CA restored HDL anti-apoptotic function of HDL from obese patients mimicking the beneficial remodeling of BA bound to HDL observed after RYGB. These results suggest a crucial interaction between endothelial cells and BA in the improvement of HDL's vasoprotective properties.

Acknowledgement/Funding

Swiss national Science Foundation Ambizione and PRIMA grant to EO

Implementation and adoption of advanced care planning in the elderly trauma patient

Background

Geriatric trauma has high morbidity and mortality, often requiring extensive hospital stays and interventions. The number of geriatric trauma patients is also increasing significantly and accounts for a large proportion of trauma care. Specific geriatric trauma protocols exist to improve care for this complex patient population, who often have various comorbidities, pre-existing medications, and extensive injury within a trauma perspective. These guidelines for geriatric trauma care often suggest early advanced care planning (ACP) discussions and documentation to guide patient and family-centered care.

Methods

A provincial ACP program was implemented in April of 2012, which has since been used by our level 1 trauma center. We applied a before and after study design to assess the documentation of goals of care in elderly trauma patients following implementation of the standardized provincial ACP tool on April 1, 2012.

Results

Documentation of ACP in elderly major trauma patients following the implementation of this tool increased significantly from 16 to 35%. Additionally, secondary outcomes demonstrated that many more patients received goals of care documentation within 24 h of admission, and 93% of patients had goals of care documented prior to intensive care unit (ICU) admission. The number of trauma patients that were admitted to the ICU also decreased from 17 to 5%.

Conclusion

Early advanced care planning is crucial for geriatric trauma patients to improve patient and family-centered care. Here, we have outlined our approach with modest improvements in goals of care documentation for our geriatric population at a level 1 trauma center. We also outline the benefits and drawbacks of this approach and identify the areas for improvement to support improved patient-centered care for the injured geriatric patient. Here, we have provided a framework for others to implement and further develop.

Electronic supplementary material

The online version of this article (10.1186/s13017-018-0201-6) contains supplementary material, which is available to authorized users.

Exploring factors that impact activity participation of children and adolescents with severe developmental disabilities

BACKGROUND

Despite the benefits of social participation, children and adolescents with developmental disabilities (DD) are often excluded from taking part in social activities. There is a gap in the literature about the factors that contribute to adequate participation of children with severe DD in particular and the barriers to their participation. Taking an ecological perspective, the purpose of this study was to examine child, family and community variables that may impact the activity participation of children and adolescents with severe DD.

METHODS

A total of 197 parents of children with severe DD (4-19 years) completed a survey, addressing a wide range of child, family and community related variables, as well as a measure of activity participation.

RESULTS

Overall, the final model significantly accounted for 30% of the variance in activity participation. Higher adaptive behaviour, greater parental socialisation and placement in an integrated school programme were significant predictors of greater activity participation.

CONCLUSION

Child, family and community factors were all important in understanding the activity participation of children with severe DD, thus supporting the value of an ecological approach. Suggestions for future research and clinical implications are discussed.

Color doppler indices of proximal and distal parts of middle cerebral artery in fetuses with intrauterine growth restriction

INTRODUCTION

Intrauterine growth restriction (IUGR) is a major clinical issue for pregnant women. The purpose of this study was to evaluate color Doppler indices of the proximal and distal parts of the middle cerebral artery (MCA) of the fetus.

METHODS

In this cross-sectional study, 350 pregnant patients, with gestation age of 32-40 who were suspected to have intrauterine growth restriction, participated. The patients were referred for color Doppler sonography at the Imam Reza Hospital (Kermanshah, Iran) from May 2011 to September 2012. The following indices were measured for the proximal and distal part of the MCA: pulsatility index (PI), resistive index (RI), fetal heart rate (FHR), systolic to diastolic (S/D) ratio, and peak systolic velocity (PSV). The data were analyzed applying Tukey's-test, Paired-Samples t-test, and simple linear regression analysis using SPSS 19.

RESULTS

Average age of the mother, the frequency of pregnancy, and fetus gestational age were 27.79±0.17 years, 2.09±1.3, and 34.19±2.52 weeks, respectively. For gestation age of <36weeks, all Doppler indices of the distal part of the fetus MCA were significantly different from those of proximal part (p<0.05). Comparing indices of gestation age <36 weeks with those of >36 weeks, significant difference was found between the Doppler indices of the proximal parts as well as for the distal parts (p<0.05).

CONCLUSION

Measurement of fetus MCA indices may depend to the sampling location; however, this needs further investigation in order to find a clear probe location.

Investigating the effectiveness of transactional analysis therapy group on improving parent–child relationship among adolescent girls in Tehran City

Introduction

Adolescence has significant effect on parental relationship. Group therapy in transactional analysis method is an effective method for the treatment program.

Aim

Therefore, in this study, transactional analysis group therapy to improve the quality of parent–child relationship in adolescent female, were used.

Method

The sample was 40 adolescence high school girls were divided randomly into an experimental group and a control group. Both groups responded to measures of parent–child relationships. Eight sessions of one and a half hours, the components of the experimental group was trained in transactional analysis. The results were analyzed using t-test.

Findings

The results showed significant effect of transactional analysis group therapy on parent–child relationship adolescence, compared with the control group.

Results

Transactional analysis in the area of parent–child relationship requires further attention.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Transcript analysis in two alfalfa salt tolerance selected breeding populations relative to a non-tolerant population

With the growing limitations on arable land, alfalfa (a widely cultivated, low-input forage) is now being selected to extend cultivation into saline lands for low-cost biofeedstock purposes. Here, minerals and transcriptome profiles were compared between two new salinity-tolerant North American alfalfa breeding populations and a more salinity-sensitive western Canadian alfalfa population grown under hydroponic saline conditions. All three populations accumulated two-fold higher sodium in roots than shoots as a function of increased electrical conductivity. At least 50% of differentially expressed genes (p < 0.05) were down-regulated in the salt-sensitive population growing under high salinity, while expression remained unchanged in the saline-tolerant populations. In particular, most reduction in transcript levels in the salt-sensitive population was observed in genes specifying cell wall structural components, lipids, secondary metabolism, auxin and ethylene hormones, development, transport, signalling, heat shock, proteolysis, pathogenesis-response, abiotic stress, RNA processing, and protein metabolism. Transcript diversity for transcription factors, protein modification, and protein degradation genes was also more strongly affected in salt-tolerant CW064027 than in salt-tolerant Bridgeview and salt-sensitive Rangelander, while both saline-tolerant populations showed more substantial up-regulation in redox-related genes and B-ZIP transcripts. The report highlights the first use of bulked genotypes as replicated samples to compare the transcriptomes of obligate out-cross breeding populations in alfalfa.

Harmonic reduction of Direct Torque Control of six-phase induction motor

In this paper, a new switching method in Direct Torque Control (DTC) of a six-phase induction machine for reduction of current harmonics is introduced. Selecting a suitable vector in each sampling period is an ordinal method in the ST-DTC drive of a six-phase induction machine. The six-phase induction machine has 64 voltage vectors and divided further into four groups. In the proposed DTC method, the suitable voltage vectors are selected from two vector groups. By a suitable selection of two vectors in each sampling period, the harmonic amplitude is decreased more, in and various comparison to that of the ST-DTC drive. The harmonics loss is greater reduced, while the electromechanical energy is decreased with switching loss showing a little increase. Spectrum analysis of the phase current in the standard and new switching table DTC of the six-phase induction machine and determination for the amplitude of each harmonics is proposed in this paper. The proposed method has a less sampling time in comparison to the ordinary method. The Harmonic analyses of the current in the low and high speed shows the performance of the presented method. The simplicity of the proposed method and its implementation without any extra hardware is other advantages of the proposed method. The simulation and experimental results show the preference of the proposed method.

Examining the social participation of children and adolescents with Intellectual Disabilities and Autism Spectrum Disorder in relation to peers

BACKGROUND

Participation in social and physical activities has a number of benefits for children with or without disabilities. However, individuals with disabilities are often excluded from taking part in social activities. Most of the research on activity participation has focused on adults or youth with milder disabilities. However, children and adolescents with severe and complex needs, including those with autism, are often excluded from this type of research because of their complexities and level of functioning. Thus, we examined the social participation and friendships of children and adolescents with severe developmental disabilities, with and without autism, compared with peers without developmental disabilities.

METHODS

We compared the activity participation and friendships of typically developing children (n = 210), children with an intellectual disability (ID only; n = 186), and children with autism spectrum disorder plus intellectual disability (ID + ASD; n = 232) between the ages of 3 and 19 years. Parents of these children completed a survey, which included questions about their children's participation in six activities, and the number and quality of their children's friendships.

RESULTS

Children and adolescents with ID only and ID + ASD were reported to participate in significantly fewer activities and to participate much less frequently than typically developing peers. Those with ID only and ID + ASD were reported to have fewer friends and poorer quality of friendships. In addition, those with ID + ASD participated even less frequently in some activities and had fewer friends relative to those with ID only.

CONCLUSION

It is important to find ways to increase the social and activity participation of children and adolescents with ID only and ID + ASD. Future research should examine the barriers to such participation and factors that impact social participation in this population.

Efficacy of Multidetector-Row Computed Tomography as a Practical Tool in Comparison to Invasive Procedures for Visualization of the Biliary Obstruction

Introduction:

Recently, multidetector computed tomography (MDCT) has been introduced into clinical practice. MDCT has become the noninvasive diagnostic test of choice for detailed evaluation of biliary obstruction.

Aim:

the main objective of the present study was to evaluate the diagnostic value of MDCT compared to invasive procedures for detecting biliary obstruction causes.

Material and Methods:

Since February 2009 until May 2011 fifty biliary obstruction patients based on clinical, laboratory or ultrasonographic findings, were evaluated by Multidetector-row computed tomography. The causes of biliary obstruction, which was identified using. MDCT were classified into three categories: calculus, benign stricture, and malignancy. Final diagnosis was conducted based on percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangiopancreatography, biopsy, or surgery. The MDCT diagnosis and were compared with the final diagnosis.

Results:

A correct diagnosis of causes of biliaryobstruction was made on the basis of MDCT findings for 44 of the total 50 patients. Two patients with chronic pancreatitis were incorrectly diagnosed with a pancreatic head adenocarcinoma on the basis of MDCT findings. One patient with biliary stone was incorrectly diagnosed with a periampullary adenocarcinoma on the basis of MDCT findings. The Sensitivity, specificity and accuracy of MDCT in the diagnosis of causes of biliary obstruction were 94.12% and87.87% and94.6% respectively.

Conclusion:

Based on the findings of this study MDCT has an excellent image quality, providing valuable information about the biliary tree and other abdominal organs. The use of advanced image processing, including maximum intensity projection and multiplanar reconstruction (especially coronal or sagittal reformatted images), allows superior visualization of the biliary tree and vascular structures. Three-dimensional reconstruction images complement axial images by providing a more anatomically meaningful display of the lesion and its relationship to adjacent structures, and accurate determining the craniocaudal extent of the lesion. High accuracy, wide availability and ease of use, make the MDCT the imaging modality of choice for evaluation of biliary obstruction.

Study of 60Co as gamma source in backscatter gamma densitometers

In this work the performance of backscatter gamma densitometer is studied using 60Co as gamma source. The ability of the densitometer to determine the liquid's interfaces in multi-phase flows was assessed. The aim mainly was to investigate the possibility of using 60Co in this system. Furthermore, a comparison between 60Co and was done. The obtained results indicate that 60Co can be advantageous in this regard.

A landscape of hairy and twisted: hunting for new trichome mutants in the Saskatoon Arabidopsis T-DNA population

A total of 88 new Arabidopsis lines with trichome variation were recovered by screening 49,200 single-seed descent T3 lines from the SK activation-tagged population and from a new 20,000-line T-DNA insertion population (called pAG). Trichome variant lines were classified into 12 distinct phenotype categories. Single or multiple T-DNA insertion sites were identified for 89% of these mutant lines. Alleles of the well-known trichome genes TRY, GL2 and TTG1 were recovered with atypical phenotype variation not reported previously. Moreover, atypical gene expression profiles were documented for two additional mutants specifying TRY and GL2 disruptions. In remaining mutants, ten lines were disrupted in genes coding for proteins not implicated in trichome development, five were disrupted in hypothetical proteins and 11 were disrupted in proteins with unknown function. The collection represents new opportunities for the plant biology community to define trichome development more precisely and to refine the function of individual trichome genes.

Effect of frequency on entrance and propagation pattern of high-frequency (radiofrequency) electrical currents in biologic tissues

BACKGROUND

Radiofrequency electrical currents have a tendency to move toward the center of the bulk of biologic tissues.

OBJECTIVES

To evaluate the effect of the frequency of currents on their entrance and propagation pattern in biologic tissues.

MATERIALS AND METHODS

Three electrosurgical generators with 0.4, 1.5, and 3 MHz frequency outputs were studied. Current was applied using a metallic needle introduced into a piece of cow liver, with different amounts of energy delivered at multiple points. Cross-sections of the liver were then studied for tissue effect. The diameters of the coagulated areas at the deepest and most superficial parts were measured. The tendency of the currents for penetration in the deeper layers of tissue rather than in the superficial layers was assessed using the superficial diameter/deep diameter ratio.

RESULTS

Diameter of coagulated area was larger around deeper parts than around superficial parts of the electrode. No correlation between frequency of current and the superficial/deep diameter ratio of the coagulation zone was found.

CONCLUSION

Radiofrequency currents have a tendency to move toward the center of the tissue. Frequency of current over the range of 0.4-3 MHz did not show any effect on this tendency.

Taheri-Saramad x-ray detector (TSXD): a novel high spatial resolution x-ray imager based on ZnO nano scintillator wires in polycarbonate membrane

A novel x-ray imager based on ZnO nanowires is designed and fabricated. The proposed architecture is based on scintillation properties of ZnO nanostructures in a polycarbonate track-etched membrane. Because of higher refractive index of ZnO nanowire compared to the membrane, the nanowire acts as an optical fiber that prevents the generated optical photons to spread inside the detector. This effect improves the spatial resolution of the imager. The detection quantum efficiency and spatial resolution of the fabricated imager are 11% and <6.8 μm, respectively.

Complications of using laryngeal mask airway during anaesthesia in patients undergoing major ear surgery

Use of the laryngoscope and tracheal tube during general anaesthesia results in many complications such as sore throat, cough, vocal cord paralysis, compulsory injection of muscle relaxants for tube insertion and risky emergence of anaesthesia. This study investigated the use of laryngeal mask airway (LMA) as a safe and complication-free device in patients undergoing ear surgery. This is a retrospective cross-sectional study on a population comprising patients from 3 to 70 years of age who have undergone major ear surgery, in Amir Alam Hospital, from 1999 to 2006. Laryngeal mask airway replaced the tracheal tube in all patients. Of the 2000 patients who underwent major ear surgery with general anaesthesia using LMA, 246 (12.3%) developed haemodynamic instability. A significant relationship was observed between age and haemodynamic instability (p value = 0.03); 14.9% of these patients were aged between 16 and 40 years and 20% were aged > 60 years. No relationship was observed between the occurrence of this complication and duration of surgery (p value = 0.2). Furthermore, no significant relationship was observed between sex and haemodynamic instability. In conclusion, considering the low rate of complications with laryngeal mask airway, replacing tracheal tube with this device in major ear surgery will lead to a noticeable decrease in associated complications.

Comparison of cryotherapy and curettage for the treatment of pyogenic granuloma: a randomized trial

BACKGROUND

Pyogenic granuloma is a benign vascular lesion of the skin and mucous membranes. Many different treatments have been used, with variable success rates.

OBJECTIVES

To evaluate and compare the effects of cryotherapy and curettage in the treatment of pyogenic granuloma.

METHODS

Eighty-nine patients with pyogenic granuloma were randomized to receive cryotherapy with liquid nitrogen or curettage and electrodesiccation. Forty patients in the cryotherapy group and 36 patients in the curettage group completed the study period.

RESULTS

Among the patients who completed the study, treatment resulted in complete resolution of all lesions after one to three sessions (mean 1.42) in the cryotherapy group and after one to two sessions (mean 1.03) in the curettage group. The difference between the two groups was statistically significant (P < 0.001). Twenty-three patients (57.5%) in the cryotherapy group and 25 patients (69%) in the curettage group had no scar or pigmentation abnormality. Except for cosmetic problems, no other side-effect or complication was recorded in the study.

CONCLUSIONS

This study showed that both cryotherapy and curettage are safe and effective. Curettage had the advantage of fewer treatment sessions required to achieve resolution and better cosmetic results. We suggest that curettage could be the first-line treatment for pyogenic granuloma.

Cryotherapy in the treatment of pyogenic granuloma

BACKGROUND

Pyogenic granuloma is a benign, acquired, proliferative vascular lesion of the skin and mucous membranes. Many different treatments have been used for pyogenic granuloma with variable success rates.

OBJECTIVE

To evaluate the efficacy of cryotherapy in the treatment of pyogenic granuloma.

METHODS

In a prospective observational study, 135 patients with pyogenic granuloma were treated with cryotherapy using liquid nitrogen. The patients were followed up every 3 weeks until 3 months after disappearance of the lesion.

RESULTS

Complete resolution of the pyogenic granuloma was achieved in all patients after a mean of 1.58 treatments (range, 1-4 treatments). At the end of follow-up period, there was a flat imperceptible scar, smaller than the treated lesion, in 16 patients (11.8%). A hypertrophic scar, 3 mm in diameter, was observed in one patient. Hypopigmentation was observed in seven patients (5.1%). No other complication or side-effect was recorded in the study.

CONCLUSIONS

We believe that pyogenic granuloma can be treated simply and effectively with cryotherapy.

[Displacement of the instantaneous center of rotation of the humeral head during abduction: implication for scapulohumeral muscular function]

PURPOSE OF THE STUDY

To date, studies of glenohumeral stress forces have been based on the notion of a unique center of rotation situated at the geometric center of the humeral head. Early work, e.g. Fisher et al in 1977, suggested that the instantaneous center of rotation can migrate during abduction producing muscle vectors with variable moments and consequently variable stress forces. We conducted a kinematic analysis of the shoulder forces during continuous movement.

MATERIAL AND METHODS

An imaging device commonly used for angiography enabled acquisition of one image per second during a continuous movement of abduction. Images were obtained for twenty healthy shoulders in ten subjects.

RESULTS

The instantaneous center of rotation was not situated at the geometric center of the humeral head. Although interindividual variability was significant, the preferential positions of the instantaneous center of rotation implied a constant reproducible succession of gliding, rolling, and translation in variable proportions during the abduction movement. When the same movement was performed with a 3500g load held in the hand, the ICR migrated towards the upper part of the humeral head implying a predominance of the rolling motion over the gliding and translation motions. Between 40 degrees and 60 degrees glenohumeral abduction, the instantaneous center of rotation exhibited a metaphyseal displacement producing a longer lever arm for the supaspinatus and an abduction function for the infraspinatus and the subscapularis, unrecognized to date. After 60 degrees, medialization of the instantaneous center of rotation lengthened the lever arm of the deltoid.

DISCUSSION

A valid analysis of the glenohumeral stress forces must take into consideration the localization of the instantaneous center of rotation. In the clinical setting, our findings demonstrate that the infraspinatus and the subscapularis play an important role which must be considered both in surgery and in rehabilitation.

Naevus comedonicus of the scalp

We report the case of a 3-year-old boy with naevus comedonicus, characterized by confluent clusters of dilated follicular orifices plugged with keratinous material that resemble open comedones, located on the scalp.

Silver nitrate cautery in aphthous stomatitis: a randomized controlled trial

BACKGROUND

Aphthous stomatitis is a painful, recurrent disease of the oral mucous membrane. Silver nitrate sticks have been used for a long time to provide pain relief for the duration of an aphthous ulceration, with only one application. Silver nitrate causes chemical cauterization and increases the depth of injury.

OBJECTIVES

To study the effect of chemical cautery with silver nitrate in reducing pain of aphthous ulceration and to determine if this treatment shortens or prolongs healing.

METHODS

In a randomized, patient-blinded, placebo-controlled study, 97 patients with painful minor oral aphthous ulceration were randomized to receive silver nitrate cautery or placebo. The severity of pain was rated on a three-category scale (severe, mild, none) and was recorded each day until the seventh day after the procedure. The lesion size was recorded at the time of the procedure and on the seventh day afterwards. In the treatment group, the ulcer was gently painted with a silver nitrate stick until it turned white. In the placebo group, the ulcer was gently painted with a placebo stick.

RESULTS

In the treatment group, 33 of 47 patients (70%) evaluated and in the placebo group, four of 38 patients (11%) evaluated had reduction in severity of pain 1 day after the procedure. The difference was statistically significant (P < 0.001). On the seventh day after the procedure, the ulcers were completely re-epithelialized in 39 patients (83%) in the treatment group and in 34 patients (89%) in the placebo group. The difference was not statistically significant (P = 0.39).

CONCLUSIONS

The results of our study showed that one application of silver nitrate can decrease the severity of pain in aphthous ulceration without significantly shortening or prolonging healing time. We did not observe any side-effects in our study. The effect is rapid and lasts for the duration of the lesion. The treatment is simple and cost-effective in patients with infrequent recurrences.

Aortobronchial fistula after endovascular stent graft repair of the thoracic aorta

Endovascular stent graft repair of descending thoracic aortic aneurysms has been recently introduced as an alternative to conventional graft replacement of the diseased aorta. As experience with this new technique accumulates, complications may occur. We herein report the case of a patient in whom we observed distal migration with leak of an endovascular stent graft previously inserted in the descending thoracic aorta, associated with an aortobronchial fistula. The urgent surgical treatment undertaken, which consisted of graft replacement of the previously stented aorta, had a fatal outcome.

Secretion of 17 alpha-hydroxyprogesterone, androstenedione, and estrogens by porcine granulosa and theca interna cells in culture

The steroid secreting activities of dispersed granulosa and theca interna cells from preovulatory follicles of prepubertal gilts 72 h after pregnant mare's serum gonadotropin treatment (750 IU) were compared. The cells were cultured for 24 h with or without steroid substrate (10(-8) to 10(-5) M progesterone, 17 alpha-hydroxyprogesterone, or androstenedione), FSH (100 ng/mL), LH (100 ng/mL), and cyanoketone (0.25 microM, an inhibitor of 3 beta-hydroxysteroid dehydrogenase). Granulosa cells cultured alone secreted mainly progesterone. Theca interna cells secreted mainly 17 alpha-hydroxyprogesterone and androstenedione, with secretion being markedly enhanced by LH. In the presence of cyanoketone, which inhibited endogenous progesterone production, theca interna but not granulosa cells were able to convert exogenous progesterone to 17 alpha-hydroxyprogesterone and androstenedione, and exogenous 17 alpha-hydroxyprogesterone to androstenedione and estradiol-17 beta in high yield. The secretion of the latter steroids from exogenous substrates was unaffected by LH. Theca interna cells secreted more estradiol-17 beta than did granulosa cells in the absence of aromatizable substrate, but estradiol-17 beta secretion by the latter was markedly increased after the addition of androstenedione. These apparent differences in steroid secreting activity between the cell types suggest that the enzymes responsible for conversion of C21 to C19 steroids, i.e., 17 alpha-hydroxylase and C17,20-lyase, reside principally in the theca interna cells. However, aromatase activity appears to be much higher in granulosa cells.