Metal Complexes Containing Homoleptic Diorganoselenium(II) Ligands: Synthesis, Characterization and Investigation of Optical Properties

[(Z)-2'-{2-C6H5-(4H)-oxazol-5-one}CHC6H4]2Se (5, L1) and [(Z)-4'-{2-C6H5-(4H)-oxazol-5-one}CHC6H4]2Se (6, L2) were prepared, structurally characterized and used as ligands to obtain new metal complexes of types [MX(Ln)] [L1: M = Ag, X = OTf (7); M = Au, X = Cl (13); L2: M = Ag, X = OTf (8); M = Au, X = Cl (14)], [(MX)2(Ln)] [M = Ag, X = OTf, L1 (9); L2 (10)], [ZnCl2(Ln)] [L1 (15); L2 (16)] and [Ag(Ln)][PF6] [L1 (11); L2 (12)]. The silver complexes 7 and 8 were ionic species (1:1 electrolytes) in a MeCN solution, while in the solid state, the triflate fragments were bonded to the silver cations. Similarly, the 2:1 complexes 9 and 10 were found to behave as 1:2 electrolytes in a MeCN solution, but single-crystal X-ray diffraction demonstrated that compound 9 showed the formation of a dimer in the solid state: a tetranuclear [Ag(OTf)]4 built through bridging triflate ligands was coordinated by two bridging organoselenium ligands through the nitrogen from the oxazolone ring and the selenium atoms in a 1κN:2κSe fashion. Supramolecular architectures supported by intermolecular C-H∙∙∙π, C-H∙∙∙O, Cl∙∙∙H and F∙∙∙H interactions were observed in compounds 4, 5 and 9. The compounds exhibited similar photophysical properties, with a bathochromic shift in the UV-Vis spectra caused by the position of the oxazolone ring on the phenyl ring attached to the selenium atoms.

Contribution of Saccharomyces and Non-Saccharomyces Yeasts on the Volatile and Phenolic Profiles of Rosehip Mead

The resurgence of mead, a honey-based fermented beverage, is attributed to the increasing consumption of fermented foods and beverages, driven by its distinct flavors and perceived health benefits. This study investigates the influence of different yeast strains, namely Saccharomyces cerevisiae var. bayanus, and Torulaspora delbrueckii, on the volatile and phenolic compounds of these beverages. Analytical techniques, including HPLC-DAD and GS/MS, were employed to analyze the chemical composition of the beverages. ANOVA analysis of variance was conducted to assess differences in the volatile and phenolic compounds. The findings reveal that yeast selection significantly impacts the chemical profiles of the beverages. Saccharomyces cerevisiae fermentation preserves rosehip-specific flavonoids and phenolic acids. Sequential fermentation with Torulaspora delbrueckii demonstrated proficiency in generating esters, contributing to fruity and floral aromas in the beverages. This study investigates the importance of yeast selection in shaping the chemical composition of rosehip mead, providing insights into the distinct characteristics conferred by different yeast strains. By optimizing yeast selection and fermentation techniques, the overall quality and diversity of these beverages can be enhanced.

L-Poly(lactic acid) Production by Microwave Irradiation of Lactic Acid Obtained from Lignocellulosic Wastes

L-polylactic acid (PLA), a semi-crystalline aliphatic polyester, is one of the most manufactured biodegradable plastics worldwide. The objective of the study was to obtain L-polylactic acid (PLA) from lignocellulosic plum biomass. Initially, the biomass was processed via pressurized hot water pretreatment at a temperature of 180 °C for 30 min at 10 MPa for carbohydrate separation. Cellulase and the beta-glucosidase enzymes were then added, and the mixture was fermented with Lacticaseibacillus rhamnosus ATCC 7469. The resulting lactic acid was concentrated and purified after ammonium sulphate and n-butanol extraction. The productivity of L-lactic acid was 2.04 ± 0.18 g/L/h. Then, the PLA was synthesized in two stages. Firstly, lactic acid was subjected to azeotropic dehydration at 140 °C for 24 h in the presence of xylene, using SnCl₂ (0.4 wt.%) as a catalyst, resulting in lactide (CPLA). Secondly, microwave-assisted polymerization was carried out at 140 °C for 30 min with 0.4 wt.% SnCl₂. The resulting powder was purified with methanol to produce PLA with 92.1% yield. The obtained PLA was confirmed using electrospray ionization mass spectrometry, nuclear magnetic resonance, thermogravimetric analysis, Fourier transform infrared spectroscopy, scanning electron microscopy, and X-ray diffraction. Overall, the resulting PLA can successfully replace the traditional synthetic polymers used in the packaging industry.

β-Ketophosphonates with Pentalenofuran Scaffolds Linked to the Ketone Group for the Synthesis of Prostaglandin Analogs

β-Ketophosphonates with pentalenofurane fragments linked to the keto group were synthesized. The bulky pentalenofurane skeleton is expected to introduce more hindrance in the prostaglandin analogues of type III, greater than that obtained with the bicyclo[3.3.0]oct(a)ene fragments of prostaglandin analogues I and II, to slow down (retard) the inactivation of the prostaglandin analogues by oxidation of 15α-OH to the 15-keto group via the 15-PGDH pathway. Their synthesis was performed by a sequence of three high yield reactions, starting from the pentalenofurane alcohols 2, oxidation of alcohols to acids 3, esterification of acids 3 to methyl esters 4 and reaction of the esters 4 with lithium salt of dimethyl methanephosphonate at low temperature. The secondary compounds 6b and 6c were formed in small amounts in the oxidation reactions of 2b and 2c, and the NMR spectroscopy showed that their structure is that of an ester of the acid with the starting alcohol. Their molecular structures were confirmed by single crystal X-ray determination method for 6c and XRPD powder method for 6b.

Mental health of israeli employees with autism spectrum disorders following COVID-19-related changes in employment status

Introduction

The COVID-19 pandemic caused employment related challenges worldwide. Adults diagnosed with Autism Spectrum Disorders (ASD) are especially vulnerable, due to pre-existing employment challenges, intolerance to changes and uncertainty and high levels of related anxiety.

Objectives

To examine COVID-19 related changes in work experiences and mental health of employees with ASD who held a steady job before the COVID-19 outbreak.

Methods

Data were collected from 23 participants diagnosed with ASD (4 females), aged 20–49, who answered an online administered survey at two timepoints: prior to the COVID-19 outbreak, and during the outbreak. Self-reports included measures of background and employment status; mental health (General Health Questionnaire-12); job satisfaction (Minnesota Satisfaction Questionnaire); and satisfaction of psychological needs at work (Psychological Need Satisfaction and Frustration – Work domain).

Results

Participants who continued to physically attend work maintained pre-COVID-19 levels on all assessed variables. Participants who transitioned to remote work from home preserved their salary levels and job satisfaction, but showed a marginally significant deterioration in mental health and a significant decrease in the satisfaction of their needs for competence and autonomy at work. Unemployed participants showed a significant decrease in mental health.

Conclusions

Results highlight employment as a protective factor from the potential negative implications of COVID-19 on mental-health of employees with ASD. Employees who transition to working from home require personalized work-support plans due to the possible negative effects of this transition on mental health. Maintaining the routine of physically reporting to work should be preferred, when possible.

Ultrasound-assisted Strecker synthesis of novel 2-(hetero)aryl-2-(arylamino)acetonitrile derivatives

This work describes an efficient, simple, and ecofriendly sonochemical procedure for the preparation of new α-(arylamino)acetonitrile derivatives C-substituted with phenothiazine or ferrocene units. The synthetic protocol is based on the Strecker reaction of a (hetero)aryl aldimine substrate with trimethylsilyl cyanide (TMSCN) in poly(ethylene glycol) (PEG) solution. The advantages of the sonochemical versus the conventional α-(arylamino)acetonitrile synthesis are the significantly shorter reaction time (30 min instead of 72 hours), the higher purity and the easier separation of the product that precipitated from the reaction mixture in crystalline form as depicted by scanning electron microscopy (SEM) analysis. The single crystal X-ray diffraction analysis disclosed the arrangement of the α-(arylamino)acetonitrile molecules in the aggregated crystalline state as a racemic mixture. The mutagenic/antimutagenic potential for three representative derivatives containing phenothiazinyl, ferrocenyl, and phenyl units, respectively, was evaluated by the Ames Salmonella/microsome test using S. typhimurium TA98 and TA100 strains with and without metabolic activation. The preliminary screening results pointed out that the C-(hetero)aryl-α-(arylamino)acetonitrile derivatives can be considered genotoxically safe and possibly antimutagenic.

Excess Ascorbate is a Chemical Stress Agent against Proteins and Cells

Excess ascorbate (as expected in intravenous treatment proposed for COVID-19 management, for example) oxidizes and/or degrades hemoglobin and albumin, as evidenced by UV-vis spectroscopy, gel electrophoresis, and mass spectrometry. It also degrades hemoglobin in intact blood or in isolated erythrocytes. The survival rates and metabolic activities of several leukocyte subsets implicated in the antiviral cellular immune response are also affected. Excess ascorbate is thus an unselective biological stress agent.

Novel Phenothiazine-Bridged Porphyrin-(Hetero)aryl dyads: Synthesis, Optical Properties, In Vitro Cytotoxicity and Staining of Human Ovarian Tumor Cell Lines

We report here the synthetic procedure applied for the preparation of new AB₃-type and trans-A₂B₂ type meso-halogenophenothiazinyl-phenyl-porphyrin derivatives, their metal core complexation and their peripheral modification using Suzuki-Miyaura cross coupling reactions with various (hetero)aryl (phenothiazinyl, 7-formyl-phenothiazinyl, (9-carbazolyl)-phenyl and 4-formyl-phenyl, phenyl) boronic acid derivatives. The meso-phenothiazinyl-phenyl-porphyrin (MPP) dyes family was thus extended by a series of novel phenothiazine-bridged porphyrin-(hetero)aryl dyads characterized by UV-Vis absorption/emission properties typical to the porphyrin chromophore, slightly modulated by increasing the size of peripheral substituents. Three phenothiazine-bridged porphyrin-heteroaryl dyads with fluorescence emission above 655 nm were selected as fluorophores in red spectral region for applications in cellular staining of human ovarian tumors. In vitro experiments of cell metabolic activity displayed a moderate toxicity on human ovarian tumor cell lines (OVCAR-3, cisplatin-sensitive A2780 and cisplatin-resistant A2780cis respectively). Visualization of the stained living cells was performed both by fluorescence microscopy imaging and by fluorescence lifetime imaging under two photon excitation (TPE-FLIM), confirming their cellular uptake and the capability of staining the cell nucleus.

Nitrogen-Doped Graphene: The Influence of Doping Level on the Charge-Transfer Resistance and Apparent Heterogeneous Electron Transfer Rate

Three nitrogen-doped graphene samples were synthesized by the hydrothermal method using urea as doping/reducing agent for graphene oxide (GO), previously dispersed in water. The mixture was poured into an autoclave and placed in the oven at 160 °C for 3, 8 and 12 h. The samples were correspondingly denoted NGr-1, NGr-2 and NGr-3. The effect of the reaction time on the morphology, structure and electrochemical properties of the resulting materials was thoroughly investigated using scanning electron microscopy (SEM) Raman spectroscopy, X-ray powder diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), elemental analysis, Cyclic Voltammetry (CV) and electrochemical impedance spectroscopy (EIS). For NGr-1 and NGr-2, the nitrogen concentration obtained from elemental analysis was around 6.36 wt%. In the case of NGr-3, a slightly higher concentration of 6.85 wt% was obtained. The electrochemical studies performed with NGr modified electrodes proved that the charge-transfer resistance (Rct) and the apparent heterogeneous electron transfer rate constant (Kapp) depend not only on the nitrogen doping level but also on the type of nitrogen atoms found at the surface (pyrrolic-N, pyridinic-N or graphitic-N). In our case, the NGr-1 sample which has the lowest doping level and the highest concentration of pyrrolic-N among all nitrogen-doped samples exhibits the best electrochemical parameters: a very small Rct (38.3 Ω), a large Kapp (13.9 × 10-2 cm/s) and the best electrochemical response towards 8-hydroxy-2'-deoxyguanosine detection (8-OHdG).

Detection of 8-Hydroxy-2'-Deoxyguanosine Biomarker with a Screen-Printed Electrode Modified with Graphene

In this work we present the preparation of graphene material by exfoliation of graphite rods via pulses of current in electrolyte, containing a mixture of boric acid (0.05 M) and sodium chloride (0.05 M). The material was morphologically and structurally characterized by SEM/TEM/HR-TEM, XRD and FTIR techniques. TEM investigation of graphene flakes deposited onto carbon-coated grids allowed the visualization of thin and transparent regions, attributed to few-layer graphene (FLG), as well as thick and dark regions attributed to multi-layer graphene (MLG). The mixed composition of the material was additionally confirmed by XRD, which further indicated that the amount of FLG within the sample was around 83%, while MLG was around 17%. The performance of a screen-printed electrode (SPE) modified with graphene (SPE-Gr) was tested for 8-hydroxy-2′-deoxyguanosine detection. The graphene-modified electrode had a higher sensitivity in comparison with that of SPE, both in standard laboratory solutions (phosphate buffered saline—PBS) and in human saliva.

UV-light mediated green synthesis of silver and gold nanoparticles using Cornelian cherry fruit extract and their comparative effects in experimental inflammation

The purpose of our study is to investigate the comparative effects of materials based on silver and gold nanoparticles functionalized with polyphenols from Cornus Mas extract (AgNPs-CM and AuNPs-CM) in vivo on experimental inflammation. The nanoparticles were obtained at room temperature under UV irradiation and were characterized by different methods: ultraviolet-visible spectroscopy, transmission electron microscopy, X ray diffraction, Fourier transform infrared spectroscopy and dynamic light scattering. The modulatory effects of AgNPs-CM and AuNPs-CM on inflammation were quantified by oxidative stress parameters, pro and anti-inflammatory cytokines levels and apoptosis assessment at 2 h, 24 and 48 h after induction of inflammation with carrageenan in the paw tissue of Wistar rats. Our results showed that silver and gold nanoparticles only partial and for a short period have mobilized the antioxidant defense mechanisms. In addition, they diminished inflammation and apoptosis in the early stage while later, at 48 h, exerted an immunomodulatory effect, activated ERK ½ and induced apoptosis. The photoreduced silver and gold nanoparticles, functionalized with natural compounds, modulated the inflammation in a similar manner in the soft tissue injected with carrageenan. In order to decipher the mechanisms involved in interactions of metallic nanoparticles with biological systems and for a complete assessment of the risks and benefits of these products in clinical practice long term studies are necessary.

A long-range tautomeric effect on a new Schiff isoniazid analogue, evidenced by NMR study and X-ray crystallography

Isoniazid analogues were cyclized through acid catalysis by closing a THF ring, as favoured by Baldwin's rules (5-exo-trig).

Fe(III) - Sulfide interaction in globins: Characterization and quest for a putative Fe(IV)-sulfide species

The present study reports findings regarding the contrast between H₂S interaction with bovine hemoglobin (Hb) and horse heart myoglobin (Mb), in terms of binding and dissociation kinetics, affinities, and mechanism. At pH9.5, oxidation of ferric-sulfide adducts in presence of no free sulfide, using hexachloroiridate as oxidant is examined using stopped-flow UV-vis, EPR, vibrational spectroscopy and mass spectrometry. Oxidation of the ferric-sulfide adduct in such conditions occurs with a putative unstable Fe(IV)-sulfide adduct as intermediate that finally leads to a paramagnetic ferric species with distinct EPR features. As detected by MS spectrometry, this final species appears to be a truncated form of globin at a distinct Tyr. In case of Hb, only β-chain is truncated at Tyr144.

Enhancing conflict negotiation strategies of adolescents with autism spectrum disorder using video modeling

Adolescents with autism spectrum disorder (ASD) have particular difficulty in negotiating conflict. A randomized control trial (RCT) was carried out to determine whether the negotiation strategies of adolescents with ASD would be enhanced via a 6-week intervention based on a video modeling application. Adolescents with ASD, aged 12-18 years, were randomly divided into an intervention group (n = 36) and a non-treatment control group (n = 25). Participants' negotiating strategies prior to and following the intervention were measured using the Five Factor Negotiation Scale (FFNS; Nakkula & Nikitopoulos, 1999) and the ConflicTalk questionnaire (Kimsey & Fuller, 2003). The results suggest that video modeling is an effective intervention for improving and maintaining conflict negotiation strategies of adolescents with ASD.

Testing antiplatelet and antioxidant activity of the extract of seven varieties of Allium cepa L

Background: The extracts of Allium cepa are known for their medical use: antioxidant, antiinflammatory, antimicrobial, fibrinolytic and antiplatelet properties. Our study aims to establish, using in vitro tests, the antiplatelet and antioxidant character, the link between them and the extract acidity, from seven varieties of A. cepa. Methodology: The qualitative and quantitative presence of polyphenols and anthocyanins in the extracts was determined using UV-Vis and HPLC. Quantitative determination of the thiosulfinates compounds was calculated using their reaction with 4-mercaptopyridine. Antioxidant character was determined using 3 methods (FC, DPPH and TEAC), and antiplatelet effect was measured by in vitro tests on platelet rich plasma obtained from human blood. Principal Findings/Results: The white variety of A. cepa has the most alkaline pH, the largest amount of thiosulfinate compounds and the most powerful antiplatelet effect, but a very small amount of flavonoids and an antioxidant effect almost nonexistent, in contrast with red variety of A. cepa which is the opposite. Conclusions/Significance: The white variety of A. cepa had very high anitiplatelet activity suggesting the potential use of A. cepa extract in treating cardiovascular diseases.

Validation of the Capsule Endoscopy Crohn's Disease Activity Index (CECDAI or Niv score): a multicenter prospective study

BACKGROUND AND STUDY AIMS

The Capsule Endoscopy Crohn's Disease Activity Index (CECDAI or Niv score) was devised to measure mucosal disease activity using video capsule endoscopy (VCE). The aim of the current study was to prospectively validate the use of the scoring system in daily practice.

METHODS

This was a multicenter, double-blind, prospective, controlled study of VCE videos from 62 consecutive patients with isolated small-bowel Crohn's disease. The CECDAI was designed to evaluate three main parameters of Crohn's disease: inflammation (A), extent of disease (B), and stricture (C), in both the proximal and distal segments of the small bowel. The final score was calculated by adding the two segmental scores: CECDAI = ([A1 × B1] + C1) + ([A2 × B2] + C2). Each examiner in every site interpreted 6 - 10 videos and calculated the CECDAI. The de-identified CD-ROMs were then coded and sent to the principal investigator for CECDAI calculation.

RESULTS

The cecum was reached in 72 % and 86 % of examinations, and proximal small-bowel involvement was found in 56 % and 62 % of the patients, according to the site investigators and principal investigator, respectively. Significant correlation was demonstrated between the calculation of the CECDAI by the individual site investigators and that performed by the principal investigator. Overall correlation between endoscopists from the different study centers was good, with r = 0.767 (range 0.717 - 0.985; Kappa 0.66; P < 0.001). There was no correlation between the CECDAI and the Crohn's Disease Activity Index or the Inflammatory Bowel Disease Quality of Life Questionnaire or any of their components.

CONCLUSION

A new scoring system of mucosal injury in Crohn's disease of the small intestine, the CECDAI, was validated. Its use in controlled trials and/or regular follow-up of these patients is advocated.

Prospective multicenter performance evaluation of the second-generation colon capsule compared with colonoscopy

BACKGROUND AND STUDY AIMS

A second-generation capsule endoscopy system, using the PillCam Colon 2, was developed to increase sensitivity for colorectal polyp detection compared with the first-generation system. The performance of this new system is reported.

PATIENTS AND METHODS

In a five-center feasibility study, second-generation capsule endoscopy was prospectively compared with conventional colonoscopy as gold standard for the detection of colorectal polyps and other colonic disease, in a cohort of patients scheduled for colonoscopy and having known or suspected colonic disease. Colonoscopy was independently performed within 10 hours after capsule ingestion. Capsule-positive but colonoscopy-negative cases were counted as false-positive.

RESULTS

104 patients (mean age 49.8 years) were enrolled; data from 98 were analyzed. Patient rate for polyps of any size was 44 %, 53 % of these patients having adenomas. No adverse events related to either procedure were reported. The capsule sensitivity for the detection of patients with polyps >or= 6 mm was 89 % (95 % confidence interval [CI] 70 - 97) and for those with polyps >or= 10 mm it was 88 % (95 %CI 56 - 98), with specificities of 76 % (95 %CI 72 - 78) and 89 % (95 %CI 86 - 90), respectively. Both polyps missed by colonoscopy and mismatch in polyp size by study definition lowered specificity. Overall colon cleanliness for capsule endoscopy was adequate in 78 % of patients (95 %CI 68 - 86).

CONCLUSIONS

The new second-generation colon capsule endoscopy is a safe and effective method for visualizing the colon and detecting colonic lesions. Sensitivity and specificity for detecting colorectal polyps appear to be very good, suggesting a potential for improved accuracy compared with the first-generation system. Further prospective and comparative studies are needed.

Violation of distribution symmetry in statistical evaluation of absolute enantioselective synthesis

Enantiomeric excesses obtained in absolute enantioselective synthesis by chiral autocatalysis (Soai-reaction) were statistically analyzed. Two sets of parallel experiments, which were performed under chemically different conditions, are available. One group contains 37, while the other contains 84 preparative results. The former group shows some interesting tendencies but does not give conclusive statistical results. The sample of 84 parallel experiments, providing 39 R- and 45 S-excesses have shown that these data represent two distinct, non-symmetric sets with different non-Gaussian distributions. Clear S preference was found.

Violation of Distribution Symmetry in Statistical Evaluation of Absolute Enantioselective Synthesis

Enantiomeric excesses obtained in absolute enantioselective synthesis by chiral autocatalysis (Soai-reaction) were statistically analyzed. Two sets of parallel experiments, which were performed under chemically different conditions, are available. One group contains 37, while the other contains 84 preparative results. The former group shows some interesting tendencies but does not give conclusive statistical results. The sample of 84 parallel experiments, providing 39 R- and 45 S-excesses have shown that these data represent two distinct, non-symmetric sets with different non-Gaussian distributions. Clear S preference was found.

Tacrolimus-Induced Intestinal Angioedema: Diagnosis by Capsule Endoscopy

Small intestinal angioedema has been reported with angiotensin converting enzyme inhibitors therapy, but not in implanted patients treated with tacrolimus. We present a kidney transplanted patient, hospitalized with severe diarrhea, diagnosed with tacrolimus-induced intestinal angioedema with abdominal computerized tomography and capsule endoscopy. To the best of our knowledge this is the first described case of tacrolimus-induced small bowel angioedema diagnosed with capsule endoscopy.

Switching from tacrolimus to sirolimus halts the appearance of new sebaceous neoplasms in Muir-Torre syndrome

Little is known about the effects of immunosuppression on patients with hereditary nonpolyposis colorectal cancer (HNPCC). We describe a kidney transplant recipient with unrecognized Muir-Torre syndrome in whom the administration of a tacrolimus-based regimen led to the eruption of multiple sebaceous tumors. The patient was later found to harbor an MSH2 mutation. Switching to a sirolimus-based regimen resulted in arrest of the disease. When the patient was switched back to tacrolimus, new facial lesions rapidly appeared. Switching again to sirolimus resulted again in halting the appearance of new lesions. This finding is in line with the known antiangiogenic activity of sirolimus and reports on the regression of cutaneous Kaposi's sarcoma in kidney transplant recipients switched from another immunosuppressive regimen to sirolimus. Further studies on the potential use of sirolimus for the treatment of de novo tumors in immunosuppressed kidney transplant recipients with HNPCC are warranted.

The diagnostic challenge of peritoneal mesothelioma

The differential diagnosis of diffuse malignant intraabdominal process in women may be a strenuous and long process. We report such a challenging, problematic case of peritoneal mesothelioma and present review of literature in search for best differentiating technique.

Intrapartum spontaneous rupture of liver hemangioma

A 28-year-old pregnant woman presented at 35 weeks' gestation to obstetric triage with vague abdominal symptoms, stable vital signs and a non-reassuring fetal heart rate. During Cesarean section, intraperitoneal hemorrhage was noted, secondary to spontaneous rupture of a liver hemangioma. We present the perioperative management of a patient with liver hemangioma, along with a review of the literature.

Granulomatous inflammation of the breast in a pregnant woman: report of a case with fine needle aspiration diagnosis

BACKGROUND

Granulomatous inflammation of the breast is an inflammatory process with multiple etiologies. It can accompany breast carcinoma or be idiopathic. It often presents clinically in a fashion mimicking carcinoma. Idiopathic granulomatous mastitis is strongly associated with lactation and is reported to occur in postpartum patients. This is the second fine needle aspiration (FNA) report of idiopathic granulomatous inflammation in the breast of a pregnant woman.

CASE

A 27-year-old, 7-month-pregnant woman presented with a hard nodule in her right breast; on ultrasound examination it showed mixed echogenicity, suspicious for carcinoma. FNA showed granulomatous inflammation. The smears were highly cellular, with many clusters of and single epithelioid cells displaying moderate pleomorphism and prominent nucleoli in a background composed of neutrophils, plasma cells, lymphocytes and multinucleated cells. Core needle biopsy revealed a nonnecrotizing, granulomatous lesion.

CONCLUSION

The diagnosis of granulomatous inflammation can be challenging, and the cytologic features can be difficult to separate from those of carcinoma. The relatively rare occurrence of this lesion and its cytologic features make it a potentially difficult diagnosis and diagnostic pitfall.

Intrapartum spontaneous rupture of liver hemangioma

A 28-year-old pregnant woman presented at 35 weeks' gestation to obstetric triage with vague abdominal symptoms, stable vital signs and a non-reassuring fetal heart rate. During Cesarean section, intraperitoneal hemorrhage was noted, secondary to spontaneous rupture of a liver hemangioma. We present the perioperative management of a patient with liver hemangioma, along with a review of the literature.

Renal outcome and vascular morbidity in systemic lupus erythematosus (SLE): lack of association with the angiotensin-converting enzyme gene polymorphism

OBJECTIVES

The angiotensin-converting enzyme (ACE) gene polymorphism has been associated with worse outcome in various chronic glomerular disorders and in hypertension. Because nephritis and vascular morbidity are prominent determinants of outcome in systemic lupus erythematosus (SLE), we studied the distribution and prognostic effect the ACE genotype might have on the outcome of SLE.

METHODS

Fifty-six consecutive Israeli SLE patients and 48 (sex and ethnic origin matched) healthy individuals were evaluated for the ACE genotype by a polymerase chain reaction-based assay. The clinical and laboratory parameters of the patients as well as the SLE disease activity index (SLEDAI) and the presence of hypertension, diabetes mellitus, ischemic heart disease, congestive heart failure, and stroke were correlated with the ACE genotype.

RESULTS

The distribution of the ACE genotype D/D, D/I, and I/I in the lupus group was 59%, 36%, and 5%, respectively, similar to the distribution in the control group (54%, 31%, and 15%, respectively). We failed to find any significant association between the ACE genotype and disease manifestations, SLEDAI, renal function, or cardiovascular and cerebrovascular morbidity. The clinical and laboratory parameters associated with renal outcome and vascular morbidity in our cohort are described.

CONCLUSIONS

No difference was found between the distribution of the ACE genotype in lupus patients and the general population in Israel. Renal function as well as cardiovascular and cerebrovascular morbidity among Israeli patients with SLE are disease-related and independent of the ACE gene polymorphism.

Western immunoblotting of cereal proteins with monoclonal antibodies to wheat gliadin to investigate coeliac disease

Western immunoblotting was used to investigate the binding of two monoclonal antibodies raised against unfractionated wheat gliadin to different cereal protein fractions separated by SDS-PAGE. Our results confirm the presence of considerable epitope sharing between the gliadin subfractions as well as barley and rye prolamins; however, there was less binding of these antibodies to bands present in oat avenins and maize zeins. The pattern of binding of one of these two antibodies to different cereal prolamins as well as to Frazer's fraction III corresponds closely to the known toxicity of these proteins to patients with coeliac disease.

Detection of wheat gliadin contamination of gluten-free foods by a monoclonal antibody dot immunobinding assay

Unfractionated wheat gliadin was used to produce murine monoclonal antibodies to gliadin. A dot immunobinding assay, using these antibodies, was developed to detect possible gliadin contamination of nominally gluten-free flour, using dilute ethanol extracts spotted onto nitrocellulose membranes. The sensitivity of the assay was less than 10 micrograms/ml of unfractionated gliadin which permitted the detection of trace amounts of gliadin present in certain wheat starch based 'gluten-free' products. The assay detected not only wheat gliadin, but also prolamine extracts of rye, barley and oats; maize, soya and potato extracts as well as the control proteins casein and ovalbumin, gave negative results. The assay is of value as a simple and rapid method of screening foods for their suitability for consumption by patients with coeliac disease.

Monoclonal antibody ELISA to quantitate wheat gliadin contamination of gluten-free foods

A sensitive reproducible monoclonal antibody-based sandwich ELISA has been developed to measure the gliadin content of foods. Using the assay we have confirmed that nominally gluten-free products based on wheat starch contain trace amounts of gliadin. The level of gliadin contamination in these foods is sufficient to cause relapse of coeliac disease in specific patients. We have also examined the cross-reactivity of different cereal proteins in the assay and found good correlation with their known toxicity to patients with coeliac disease.

The medical assessment of mentally retarded children in hospital

Most subnormal patients in hospitals are not there because they require active hospital treatment. Leck, Gordon and McKeown (1967), Pilkington (1966) and Tizard (1964) have suggested that respectively 0·4 per cent, 10 per cent and 12 per cent of the hospitalized patients they studied were admitted as the result of medical advice, or were in need of ‘detailed specialist day to day diagnosis, care and treatment’. This study is part of a computer evaluation of medical data concerning 285 severely retarded children, admitted to hospital for very varying periods during 1964–1966. Altogether 375 admissions took place but of these 86 were readmissions, so there were 289 ‘primary’ admissions, 4 of whom had no traceable documentation, thus 285 (76 per cent) of the 375 admissions were studied.