The normalizing effects of the CYP46A1 activator efavirenz on retinal sterol levels and risk factors for glaucoma in Apoj-/- mice

Apolipoprotein J (APOJ) is a multifunctional protein with genetic evidence suggesting an association between APOJ polymorphisms and Alzheimer's disease as well as exfoliation glaucoma. Herein we conducted ocular characterizations of Apoj^-/- mice and found that their retinal cholesterol levels were decreased and that this genotype had several risk factors for glaucoma: increased intraocular pressure and cup-to-disk ratio and impaired retinal ganglion cell (RGC) function. The latter was not due to RGC degeneration or activation of retinal Muller cells and microglia/macrophages. There was also a decrease in retinal levels of 24-hydroxycholesterol, a suggested neuroprotectant under glaucomatous conditions and a positive allosteric modulator of N-methyl-D-aspartate receptors mediating the light-evoked response of the RGC. Therefore, Apoj^-/- mice were treated with low-dose efavirenz, an allosteric activator of CYP46A1 which converts cholesterol into 24-hydroxycholesterol. Efavirenz treatment increased retinal cholesterol and 24-hydroxycholesterol levels, normalized intraocular pressure and cup-to-disk ratio, and rescued in part RGC function. Retinal expression of Abcg1 (a cholesterol efflux transporter), Apoa1 (a constituent of lipoprotein particles), and Scarb1 (a lipoprotein particle receptor) was increased in EVF-treated Apoj^-/- mice, indicating increased retinal cholesterol transport on lipoprotein particles. Ocular characterizations of Cyp46a1^-/- mice supported the beneficial efavirenz treatment effects via CYP46A1 activation. The data obtained demonstrate an important APOJ role in retinal cholesterol homeostasis and link this apolipoprotein to the glaucoma risk factors and retinal 24-hydroxycholesterol production by CYP46A1. As the CYP46A1 activator efavirenz is an FDA-approved anti-HIV drug, our studies suggest a new therapeutic approach for treatment of glaucomatous conditions.

Low-Dose Anti-HIV Drug Efavirenz Mitigates Retinal Vascular Lesions in a Mouse Model of Alzheimer's Disease

A small dose of the anti-HIV drug efavirenz (EFV) was previously discovered to activate CYP46A1, a cholesterol-eliminating enzyme in the brain, and mitigate some of the manifestation of Alzheimer's disease in 5XFAD mice. Herein, we investigated the retina of these animals, which were found to have genetically determined retinal vascular lesions associated with deposits within the retinal pigment epithelium and subretinal space. We established that EFV treatment activated CYP46A1 in the retina, enhanced retinal cholesterol turnover, and diminished the lesion frequency >5-fold. In addition, the treatment mitigated fluorescein leakage from the aberrant blood vessels, deposit size, activation of retinal macrophages/microglia, and focal accumulations of amyloid β plaques, unesterified cholesterol, and Oil Red O-positive lipids. Studies of retinal transcriptomics and proteomics identified biological processes enriched with differentially expressed genes and proteins. We discuss the mechanisms of the beneficial EFV effects on the retinal phenotype of 5XFAD mice. As EFV is an FDA-approved drug, and we already tested the safety of small-dose EFV in patients with Alzheimer's disease, our data support further clinical investigation of this drug in subjects with retinal vascular lesions or neovascular age-related macular degeneration.

Unusual Near-Horizon Cosmic-Ray-like Events Observed by ANITA-IV

ANITA's fourth long-duration balloon flight in 2016 detected 29 cosmic-ray (CR)-like events on a background of 0.37_{-0.17}^{+0.27} anthropogenic events. CRs are mainly seen in reflection off the Antarctic ice sheets, creating a phase-inverted waveform polarity. However, four of the below-horizon CR-like events show anomalous noninverted polarity, a p=5.3×10^{-4} chance if due to background. All anomalous events are from locations near the horizon; ANITA-IV observed no steeply upcoming anomalous events similar to the two such events seen in prior flights.

Observation of an Unusual Upward-Going Cosmic-Ray-like Event in the Third Flight of ANITA

We report on an upward traveling, radio-detected cosmic-ray-like impulsive event with characteristics closely matching an extensive air shower. This event, observed in the third flight of the Antarctic Impulsive Transient Antenna (ANITA), a NASA-sponsored long-duration balloon payload, is consistent with a similar event reported in a previous flight. These events could be produced by the atmospheric decay of an upward-propagating τ lepton produced by a ν_{τ} interaction, although their relatively steep arrival angles create tension with the standard model neutrino cross section. Each of the two events have a posteriori background estimates of ≲10^{-2} events. If these are generated by τ-lepton decay, then either the charged-current ν_{τ} cross section is suppressed at EeV energies, or the events arise at moments when the peak flux of a transient neutrino source was much larger than the typical expected cosmogenic background neutrinos.

Characteristics of Four Upward-Pointing Cosmic-Ray-like Events Observed with ANITA

We report on four radio-detected cosmic-ray (CR) or CR-like events observed with the Antarctic Impulsive Transient Antenna (ANITA), a NASA-sponsored long-duration balloon payload. Two of the four were previously identified as stratospheric CR air showers during the ANITA-I flight. A third stratospheric CR was detected during the ANITA-II flight. Here, we report on characteristics of these three unusual CR events, which develop nearly horizontally, 20-30 km above the surface of Earth. In addition, we report on a fourth steeply upward-pointing ANITA-I CR-like radio event which has characteristics consistent with a primary that emerged from the surface of the ice. This suggests a possible τ-lepton decay as the origin of this event, but such an interpretation would require significant suppression of the standard model τ-neutrino cross section.

In vitro fatigue resistance of glass ionomer cements used in post-and-core applications

STATEMENT OF PROBLEM

New glass ionomer cements exhibit better mechanical properties than their older counterparts. However, there is concern about their use as a core material in post-and-core applications.

PURPOSE

This in vitro study evaluated the fatigue resistance of 2 new glass ionomer cements, Shofu Hi-Dense and Fuji IX GP, and compared their mechanical behavior as a core material under masticatory load with a silver-reinforced glass ionomer (ESPE Ketac-Silver) and a silver amalgam (Cavex Avaloy LC).

MATERIAL AND METHODS

A total of 100 commercial plastic teeth were divided into 4 groups of 25 specimens each. Titanium posts were placed in the prepared root canals, and cores were built up in amalgam, silver-reinforced glass ionomer cement, and the 2 new glass ionomer cements. The post-and-core specimens were prepared for full cast metal crowns, which were fabricated and cemented with glass ionomer cement. Twenty specimens from each group were placed in a mastication simulator and cyclically loaded with a 400 N force for 1.5 million cycles. The 5 remaining specimens were used as controls. The specimens were sectioned and observed macroscopically and microscopically to determine the number of defects (alterations) in each material. Observed defects were verified with the Kruskal-Wallis test, and the 4 core materials were ranked with the Tukey multiple comparisons test.

RESULTS

The mean rank sum values of the defects were as follows: Cavex Avaloy LC Amalgam (16.75), Fuji IX GP (38.50), Shofu Hi-Dense (39.53), and ESPE Ketac-Silver (67.22). The amalgam alloy was significantly different (P< .05) from the others.

CONCLUSION

Under the conditions of this study, the 2 new glass ionomer cements used as core materials showed a higher number of defects than amalgam. These results suggest that their fatigue resistance may be inadequate for post-and-core applications.

830-nm irradiation increases the wound tensile strength in a diabetic murine model

BACKGROUND AND OBJECTIVE

The purpose of this study was to investigate the effects of low-power laser irradiation on wound healing in genetic diabetes.

STUDY DESIGN/MATERIALS AND METHODS

Female C57BL/Ksj/db/db mice received 2 dorsal 1 cm full-thickness incisions and laser irradiation (830 nm, 79 mW/cm(2), 5.0 J/cm(2)/wound). Daily low-level laser therapy (LLLT) occurred over 0-4 days, 3-7 days, or nonirradiated. On sacrifice at 11 or 23 days, wounds were excised, and tensile strengths were measured and standardized.

RESULTS

Nontreated diabetic wound tensile strength was 0.77 +/- 0.22 g/mm(2) and 1.51 +/- 0.13 g/mm(2) at 11 and 23 days. After LLLT, over 0-4 days tensile strength was 1.15 +/- 0.14 g/mm(2) and 2.45 +/- 0.29 g/mm(2) (P = 0.0019). Higher tensile strength at 23 days occurred in the 3- to 7-day group (2.72 +/- 0.56 g/mm(2) LLLT vs. 1.51 +/- 0.13 g/mm(2) nontreated; P < or = 0.01).

CONCLUSION

Low-power laser irradiation at 830 nm significantly enhances cutaneous wound tensile strength in a murine diabetic model. Further investigation of the mechanism of LLLT in primary wound healing is warranted.

The double-inlay technique: a new concept and improvement in design

Gold and ceramic have long been used in prosthetic dentistry. In the posterior region, it is possible to use both materials with the double-inlay technique to add the strength of metal to the esthetics of ceramic. The problem, however, remains the volume of tooth reduction required to avoid ceramic fracture. This article describes a modification of the double-inlay technique that makes use of a pin system. This modified technique permits good retention while avoiding excessive tooth reduction.

Fatigue testing and microscopic evaluation of post and core restorations under artificial crowns

STATEMENT OF PROBLEM

Coronoradicular reconstruction techniques of pulpless teeth include prefabricated post systems that retain a core material such as silver amalgam, composite, glass ionomer, or modified glass ionomer cement. Mechanical properties of these materials are critical to sustain masticatory forces.

PURPOSE

This in vitro study compared the mechanical resistance of 3 core materials (silver amalgam, composite, and silver-reinforced glass ionomer) under masticatory conditions.

MATERIAL AND METHODS

Industrially fabricated teeth were used and a total of 75 specimens were divided into 3 groups of 25 specimens. Titanium canal posts were placed, followed by core buildups in amalgam, composite, or glass ionomer. Teeth were prepared for full cast crowns and the crowns were fabricated and cemented with glass ionomer cement. Twenty specimens from each group were placed in a mastication simulator cyclically loading the teeth with a 400 N force for 1.5 million cycles. The 5 remaining specimens were used as controls. Teeth were sectioned and observed macroscopically and microscopically to determine the rate of defects for each material. Observed defects were verified with the Kruskal-Wallis test. The 3 core materials were ranked with the Tukey multiple comparison test.

RESULTS

Significant differences of mechanical behavior were found for the 3 materials. At P <.01, silver amalgam was significantly superior to composite and glass ionomer. Composite was significantly superior to glass ionomer.

CONCLUSION

Cores fabricated with amalgam had the lowest rate of defects when tested under artificial crowns. Glass ionomer, when used as a core material under artificial crowns, showed the highest rate of defects after an instantaneous load of 400 N for a 1,500,000 repetition cycle.

Unusual foreign body in the urethra

Numerous cases of intraurethral foreign bodies of great variety and unusual nature have been reported. Such foreign bodies are usually introduced for sexual stimulation and/or during an intoxicated or confused state. Resulting symptoms usually involve the urinary frequency, dysuria, nocturia, hematuria, gross bleeding per urethra, difficulty in voiding, or complete urinary retention. Depending on the type of foreign body and its location, various methods of removal have been described, including meatotomy, cystoscopy, internal or external urethrotomy, suprapubic cystostomy, Fogarty catheterization, and injection of solvents. The most frequent complications are urethritis, urethral tear with periurethral abscess and/or fistula, hemorrhage, and urethral diverticuli. We report a case of an intraurethral fishhook with its complications and treatment. The diagnosis should be considered in high-risk patients with lower and urinary tract signs and symptoms.