Does Gadolinium Deposition Lead to Metabolite Alteration in the Dentate Nucleus? An MRS Study in Patients with MS

BACKGROUND AND PURPOSE

Repeat contrast-enhanced MR imaging exposes patients with relapsing-remitting MS to frequent administration of gadolinium-based contrast agents. We aimed to investigate the potential metabolite and neurochemical alterations of visible gadolinium deposition on unenhanced T1WI in the dentate nucleus using MRS.

MATERIALS AND METHODS

This prospective study was conducted in a referral university hospital from January 2020 to July 2021. The inclusion criteria for case and control groups were as follows: 1) case: patients with relapsing-remitting MS, visible gadolinium deposition in the dentate nucleus (ribbon sign), >5 contrast-enhanced MR images obtained; 2) control 1: patients with relapsing-remitting MS without visible gadolinium deposition in the dentate nucleus, >5 contrast-enhanced MR images obtained; 3) control 2: patients with relapsing-remitting MS without visible gadolinium deposition in the dentate nucleus, <5 contrast-enhanced-MR images obtained; and 4) control 3: adult healthy individuals, with no contrast-enhanced MR imaging. Dentate nucleus and pontine single-voxel 12 × 12 × 12 MRS were analyzed using short TEs.

RESULTS

Forty participants (10 per group; 27 [67.5%] female; mean age, 35.6 [SD, 9.6] years) were enrolled. We did not detect any significant alteration in the levels of NAA and choline between the studied groups. The mean concentrations of mIns were 2.7 (SD, 0.73) (case), 1.5 (SD, 0.8) (control 1), 2.4 (SD, 1.2) (control 2), and 1.7 (SD, 1.2) (control 3) (P = .04). The mean concentration of Cr and mIns (P = .04) and the relative metabolic concentration (dentate nucleus/pons) of lipid 1.3/Cr (P = .04) were significantly higher in the case-group than in healthy individuals (controls 1-3). Further analyses compared the case group with cumulative control 1 and 2 groups and showed a significant increase in lactate (P = .02), lactate/Cr (P = .04), and Cr (dentate nucleus/pons) (P = .03) in the case group.

CONCLUSIONS

Although elevated concentrations of Cr, lactate, mIns, and lipid in the dentate nucleus of the case group indicate a metabolic disturbance, NAA and choline levels were normal, implying no definite neuronal damage.

The interplay between fasting, gut microbiota, and lipid profile

BACKGROUND

This study aimed to investigate the consequence of Ramadan fasting on gut bacterium (Bacteroides and Firmicutes), serum concentration for butyrate, and lipid profile.

METHODS

Thirty healthy subjects were enlisted and investigated two times (before and at the end of Ramadan). Fasting blood samples were obtained for measuring fasting blood sugar (FBS) and lipid profile and serum butyrate concentration. Anthropometrics variables were measured before and after Ramadan for all 30 subjects. Quantitative reverse transcription polymerase chain reaction (RT-PCR) analysis, targeting the genome of Bacteroides and Firmicutes was performed to determine its presence in the stool samples. Food intake was assessed by a 3-day food record before and after Ramadan. Statistical analysis was performed by SPSS ver.13 and Minitab ver.17. P < 0.05 considered the level of significance.

RESULTS

The study results showed that serum levels of butyrate significantly increase during the month from 0.23 ± 0.02 mM to 0.46 ± 0.03 mM (P < 0.05). The gut Bacteroides and Firmicutes increased by 21 and 13 percent after Ramadan compared to before (P < 0.05). The increment in Bacteroides occurred in both sexes, but Firmicutes significantly increased only in women. Food intake was decreased during Ramadan. Ramadan fasting caused significant reduction in BMI from 25.72 ± 0.58 kg/m2to 25.25 ± 0.55 kg/m² (P < 0.05). Serum levels of LDL, HDL, LDL/HDL ratio, and total cholesterol significantly decreased during Ramadan (P < 0.05). However, the decrease in FBS and TG level were not statistically significant (P > 0.05).

CONCLUSION

It can be stated that the promotion of Bacteroides and Firmicutes in the gut might play a crucial role in health promotion. However, more research is needed to achieve a definite conclusion.

Antibacterial, antibiofilm and antiquorum sensing effects of Thymus daenensis and Satureja hortensis essential oils against Staphylococcus aureus isolates

AIMS

The present study was conducted to investigate the effects of Thymus daenensis and Satureja hortensis essential oils (EOs) on the planktonic growth, biofilm formation and quorum sensing (QS) of some Staphylococcus aureus isolates (strong biofilm producers).

METHODS AND RESULTS

Minimum inhibitory concentration (MIC) of the EOs, inhibition of biofilm formation as well as disruption of preformed Staph. aureus biofilms were assessed. The antibiofilm activity of the EOs was determined using microtitre plate test (MtP) and scanning electron microscope (SEM). The QS inhibitory activity was also examined on the pregrown biofilms by gene expression analysis using quantitative real-time RT-polymerase chain reaction (PCR) of hld gene (RNAIII transcript). Moreover, tetrazolium-based colorimetric assay (MTT) was performed to detect cytotoxic effects of these EOs on the Vero cell line. Finally, the major components of the tested EOs were determined using Gas Chromatography-Mass Spectrometry (GC-MS). The MICs of T. daenensis and S. hortensis EOs against planktonic cells of the isolates were 0·0625 and 0·125 μl ml^-1 respectively. The minimum bactericidal concentrations for both of the EOs was 0·125 μl ml^-1 . The MtP test showed a significant inhibitory effect of the EOs on the biofilm formation and disruption at sub-MIC concentrations. These results were confirmed by SEM. Real-time PCR revealed a significant down-regulation of hld gene following treatment with MIC/2 concentration of S. hortensis EO. GC-MS analysis showed that carvacrol, terpinene and thymol were the major components of the applied EOs.

CONCLUSIONS

As selected EOs did not show significant cytotoxic effects even up to tenfold of MIC concentration, the applied EOs seem to be good candidates for preventing of biofilm formation of Staph. aureus cells.

SIGNIFICANCE AND IMPACT OF THE STUDY

The present study introduced T. daenensis and S. hortensis EOs as new antibiofilm, and S. hortensis EO as anti-QS herbal agents with natural origin against Staph. aureus.

Molecular analysis of the bacille Calmette-Guérin vaccine strain currently being used in Iran

BACKGROUND

In developing countries, tuberculosis (TB) infection control remains a challenge. The bacille Calmette-Guérin (BCG) vaccine is the only effective vaccine available for TB control. Iran uses a local BCG vaccine strain with an unknown substrain.

OBJECTIVE

To investigate the molecular characteristics of the current BCG strain being used in Iran using comparative genomics of the evolutionarily late strains, including BCG vaccines Pasteur, BCG-Danish, BCG-Glaxo, BCG-Prague, BCG-Frappier, BCG-Connaught and BCG-Moreau.

METHODS

A total of 67 different vials of BCG vaccine were cultured. DNA was extracted using the modified cetrimonium bromide (CTAB) method, and multiplex polymerase chain reaction (PCR) was performed to determine four target genomic regions of difference (RD) 1, RD8, RD16 and SenX3-RegX3, and to see whether RD2 and RD14 were present.

RESULTS

Our results showed that all studied batches were Mycobacterium bovis; molecular analysis revealed that the Iranian vaccine strains possess RD8, RD16 and SenX3-RegX3 regions but not RD1, RD2 and RD14. All of the vaccine batches analysed were compatible with BCG-Pasteur 1173p2, the original strain.

CONCLUSION

All of the BCG strains studied were recognised as the BCG-Pasteur 1173p2 strain. No genetic diversity among stocks and ready-for-use vaccine vials were detected.

Identification and determination of the fatty acid composition of Quercus brantii growing in southwestern Iran by GC-MS

This article reports the fatty acid composition of the oil extracts from Quercus brantii fruits growing in Kohgiloye va Boyer Ahmad province in southwestern Iran. The oil from Q. brantii fruits was extracted with hexane in Soxhlet apparatus and subsequently identified and determined by using gas chromatography-mass spectroscopy. The results revealed that the major fatty acids were oleic acid (52.99-66.14%), linoleic acid (10.80-11.11%), palmitic acid (8.08-10.06%), stearic acid (0.74-1.57%), α-linolenic acid (0.19-0.35%), erucic acid (0.12-0.15%) and arachidic acid (0.12-0.13%). The total proportion of unsaturated and saturated oil was 64.60-77.27% and 9.17-11.75%, respectively. Results indicate that the fruits of Q. brantii contained 0.19-0.35% omega-3, 10.92-14.77% omega-6 and 53.14-66.26% omega-9. Therefore, Q. brantii can be introduced as rich sources of fatty acid in food dietary and medical health.

Determination of trace elements in soil, leaves and fruits of Quercus brantii grown in southwestern Iran by atomic spectroscopy

Quercus brantii acorn is rich of some useful mineral elements such as K, Fe and Zn. The content of these mineral elements in Quercus are dependent on their region and environmental conditions. Q. brantii grown naturally in different regions of Iran especially in Kohgiloye va Boyer Ahmad province (southwestern of Iran). In this study total concentration of Fe, Zn and K elements were determined using atomic absorption and emission spectroscopy in fruits, leaves of Q. brantii and also in the soils where this plant was grown. Statistical evaluation (ANOVA test) was employed for all measurements. Results confirmed that the concentration of elements in fruit and leave depended on area which the plant is growth. The transport factor of elements was also considered.

Experimental simulation of personal dosimetry in production of medical radioisotopes by research reactor

Due to their work conditions, research reactor personnel are exposed to ionising nuclear radiations. Because the absorbed dose values are different for different tissues due to variations in sensitivity, in this work personal dosimetry has been performed under normal working conditions at anatomical locations relevant to more sensitive tissues as well as for the whole body by employing a Rando phantom and thermoluminescent dosemeters (TLDs). Fifty-two TLDs-100H were positioned at high-risk organ locations such as the thyroid, eyes as well as the left breast, which was used to assess the whole-body dose in order to study the absorbed doses originating from selected locations in the vicinity of the reactor. The results have employed the tissue weighting factors based on International Commission on Radiological Protection ICRP 103 and ICRP 60 and the measured results were below the dose limits recommended by ICRP. The mean effective dose rates calculated from ICRP 103 were the following: whole body, 30.64-6.44 µSv h(-1); thyroid, 1.22-0.23 µSv h(-1); prostate, 0.085-0.045 µSv h(-1); gonads, 1.00-0.51 µSv h(-1); breast, 3.68-0.77 µSv h(-1); and eyes, 33.74-7.01 µSv h(-1).

Evaluation of apoptosis-related genes: Fas (CD94), FasL (CD178) and TRAIL polymorphisms in Iranian multiple sclerosis patients

Multiple sclerosis (MS) is a central nervous system (CNS) demyelinating disease characterized by a relapsing-remitting course leading to progressive disability. Given the critical role of apoptosis-related genes in the maintenance of homeostasis in the immune privilege sites, mutations in these genes have a profound effect on occurring autoimmune diseases such as multiple sclerosis. In the current study, polymorphisms in the apoptosis-related genes: Fas _-670 A>G, FasL _-844C>T, FasLIVS2nt _124 A>G and TRAIL_1595C>T were analyzed in 107 Iranian patients suffering from MS and 112 unrelated healthy controls using PCR-RFLP method. Our results demonstrated that among Iranian patients with MS and controls being homozygous in Fas_670A/A, G/G and FasL_-844C/C, TT in the promoter region and homozygocity in the minor allele for FasLIVS2nt_124G/G and TRAIL_1595C/C, polymorphisms were not associated with the MS risk in Iranian patients when compared with normal controls. However, the Fas _-670G/G genotype had a borderline significantly increased frequency with secondary progressive MS type (X(2)=5.8, P=0.05). In conclusion, no statistical association was found between the Fas, FasL and TRAIL polymorphisms and the risk of MS in Iranian patients.

Speech impairment in primary hypothyroidism

OBJECTIVE

Thyroid hormone deficiency may affect human speech and voice. The aim of this study was to evaluate speech variables in patients with hypothyroidism.

DESIGN

A case control study.

PATIENTS

One hundred and twenty patients, 106 women and 14 men with symptoms and signs of thyroid failure; the diagnosis was confirmed by serum T4<4.5 μg/dl and serum TSH>10 mU/l. Eighty-eight normal subjects, 78 women and 10 men, age-, sex-, and smoking status- matched, served as controls.

MEASUREMENTS

All symptoms and signs of hypothyroidism were recorded. Serum T4, T3, and TSH concentrations were measured. Speech parameters were analyzed by the Visipitch III system model 3900 and multidimensional voice program software and compared to a group of normal subjects with no thyroid disease.

RESULTS

Mean age was 35.9±11.4 yr. Dryness in larynx and pharynx, dyspnea, and sensation of lump in the throat were reported by 53.49 and 43% of patients, respectively. Fundamental frequency, voice turbulence index, and soft phonation index were significantly different from control values. There was positive correlation between TSH concentration and variation in fundamental frequency and prevalence of voice disorders (37.2±31.2 vs 23.9±25.8 mU/l, p<0.003).

CONCLUSION

Frequent speech disturbances occur in patients with primary hypothyroidism.

Effect of adding ketamine to pethidine on postoperative pain in patients undergoing major abdominal operations: a double blind randomized controlled trial

To determine the effect of adding ketamine to pethidine in reducing post-operative pain in patients undergoing major abdominal operations, in a double blind randomized controlled trial, 100 patients aged 15-60 years who were candidate for elective major abdominal surgery allocated into two groups of pethidine + ketamine group (5 mg pethidine and 0.25 mg kg(-1) ketamine) or pethidine and placebo group (10 mg pethidine and NS) according to the regimen prescribed in postanesthesia care unit. Severity of pain (using visual analogue scale), prescribed dose of pethidine and side effects were recorded until 24 h after operation. Regarding post-operative pain, pethidine + ketamine group showed significant lower scores in all the times except 0 min, 2, 6 and 16 h. Nausea was significantly less frequent amongst pethidine + placebo group at times of 0, 15, 30 and 45 min (p < 0.05). Comparison of two groups did not show significant differences in prescribed pethedine dose in 0, 9, 12, 16, 20 and 24 h (p > 0.05). Yet, the mean dose of administered pethidine as rescue analgesic was significant lower in pethidine + ketamine group compared to pethidine + placebo group (112 +/- 31.5 mg vs. 133.5 +/- 24.5 mg, p < 0.001). In conclusion, our results showed that co-administration of ketamine and pethidine in postanesthesia care unit will improve postoperative pain and reduce narcotic consumption. It may, however, increase rate of postoperative nausea in the first hour after operation.

Effects of oral clonidine premedication on haemodynamic response to laryngoscopy and tracheal intubation: a clinical trial

The objective of this study was to evaluate the efficacy of pre-anesthetic orally administration of clonidine on pulse rate and blood stress response to laryngoscopy and tracheal intubation. In a double-blinded, randomized study, 274 ASA I and II subjects with age of 18 to 45 years scheduled for elective surgery under general anesthesia were enrolled. They were randomly allocated to receive oral clonidine (0.2 mg) or placebo as premedication 90-120 min before surgery. All the patients received Succinylcholine (1.5 mg kg(-1)) after induction of anesthesia with Fentanyl (50 microg) and Thiopentone (5 mg kg(-1)). The anesthesia was maintained with halothane (1.5 Mac) in 50% mixture of N2O/O2. Heart rate and systolic blood pressure were recorded before, immediately after and then every 5 min after intubation until 20 min. The Clonidine group showed a significant superiority over placebo in the prevention of increase in systolic blood pressure as well as heart rate over the intubation. A significant difference was observed in both heart rate and systolic blood pressures were significantly higher in Control group at three subsequent measurements following intubation. The results of this study suggest that orally administered clonidine in preanesthetic period, provides more haemodynamic stability and attenuates the stress response to laryngoscopy and intubation.