CT Based Tumor Radiomics with Machine Learning Classifiers for Molecular Subtyping of Diffuse Large B Cell Lymphoma

PURPOSE/OBJECTIVE(S)

Diffuse large B-cell lymphoma (DLBL) has been classified into two distinct molecular subtypes based on their cell of origin- namely germinal center B-cell-like (GCB) and activated B-cell-subtype (ABC) based on Han's algorithm. These two entities are also prognostically distinct. We assessed CT based tumor radiomic features using machine learning classifiers to distinguish the two molecular subtypes.

MATERIALS/METHODS

One hundred one patients were accrued in the study after institutional ethics committee approval. GCB subtype was diagnosed in 59 while 42 patients were ABC subtype. Lesion with maximum SUV was delineated using a semi-automated segmentation tool (3D slicer) and radiomic features were extracted using Pyradiomics. A total of 1030 features were extracted including Shape features, first, second, third, higher order and wavelet-based features. Recursive feature elimination was used for feature selection and optimal 10 features were selected. Five machine learning (ML) tools were used to build a model to sub- classify the two molecular subtypes. (Table -1) Model performance was assessed using Accuracy, Precision, Recall, F1 score and Area under curve of receiver operating characteristic curve. The models were constructed by two methods.1) A 5-fold internal cross validation strategy & 2) splitting the data into training (70%) and validation set (30%).

RESULTS

Recursive feature elimination using a random forest algorithm method was used to select 7 radiomic features. These 7 features were then used to build the model using the 5 ML classifiers. Of the five classifiers, Random Forest Classifier (RFC) using a 70:30 training: test strategy was the best performer among all the ML models, with the highest accuracy of 80%, AUC of 0.87, recall(sensitivity), f1score(specificity) & precision (Positive Predictive value; PPV) or precision of 82% respectively. When an internal 5-fold cross validation strategy was used, RFC again performed better than other ML classifiers with an accuracy of 75%, AUC of 0.80, recall of 79%, PPV of 77% and specificity of 79%.

CONCLUSION

The machine-learning based Radiomics features extracted from pre-treatment CT images can provide a simple and non-invasive method for the prediction of DLBL molecular subtypes with favorable predictive accuracy. The Random Forest Classifier was the most accurate in distinguishing GCB subtype from the ABC subtype.

A Liquid Biopsy-Based Approach to Isolate and Characterize Adipose Tissue-Derived Extracellular Vesicles from Blood

Obesity is a major risk factor for multiple chronic diseases. Anthropometric and imaging approaches are primarily used to assess adiposity, and there is a dearth of techniques to determine the changes in adipose tissue (AT) at the molecular level. Extracellular vesicles (EVs) have emerged as a novel and less invasive source of biomarkers for various pathologies. Furthermore, the possibility of enriching cell or tissue-specific EVs from the biofluids based on their unique surface markers has led to classifying these vesicles as "liquid biopsies", offering valuable molecular information on hard-to-access tissues. Here, we isolated small EVs from AT (sEVAT) of lean and diet-induced obese (DIO) mice, identified unique surface proteins on sEVAT by surface shaving followed by mass spectrometry, and developed a signature of five unique proteins. Using this signature, we pulled out sEVAT from the blood of mice and validated the specificity of isolated sEVAT by measuring the expression of adiponectin, 38 adipokines on an array, and several adipose tissue-related miRNAs. Furthermore, we provided evidence of sEV applicability in disease prediction by characterizing sEVAT from the blood of lean and DIO mice. Interestingly, sEVAT-DIO cargo showed a stronger pro-inflammatory effect on THP1 monocytes compared to sEVAT-Lean and a significant increase in obesity-associated miRNA expression. Equally important, sEVAT cargo revealed an obesity-associated aberrant amino acid metabolism that was subsequently validated in the corresponding AT. Lastly, we show a significant increase in inflammation-related molecules in sEVAT isolated from the blood of nondiabetic obese (>30 kg/m2) individuals. Overall, the present study offers a less-invasive approach to characterize AT.

The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews

BACKGROUND

Telemedicine services have been increasingly used to facilitate post-treatment cancer survivorship care, including improving access; monitoring health status, health behaviors, and symptom management; enhancing information exchange; and mitigating the costs of care delivery, especially since the COVID-19 pandemic. To inform guidance for the use of telemedicine in the post-COVID era, the aim of this overview of systematic reviews (SRs) was to evaluate the efficacy of, and survivor engagement in, telemedicine interventions in the post-treatment survivorship phase, and to consider implementation barriers and facilitators.

METHODS

PubMed, Cochrane CENTRAL, CINAHL, Embase, and Web of Science databases were searched. SRs that examined the use of telemedicine in the post-treatment phase of cancer survivorship, published between January 2010 and April 2021, were included. Efficacy data were synthesized narratively. Implementation barriers and facilitators were synthesized using the Consolidated Framework for Implementation Research.

RESULTS

Twenty-nine SRs were included. A substantive body of evidence found telemedicine to benefit the management of psychosocial and physical effects, particularly for improving fatigue and cognitive function. There was a lack of evidence on the use of telemedicine in the prevention and surveillance for recurrences and new cancers as well as management of chronic medical conditions. This overview highlights a range of diverse barriers and facilitators at the patient, health service, and system levels.

CONCLUSIONS

This review highlights the benefits of telemedicine in addressing psychosocial and physical effects, but not in other areas of post-treatment cancer survivorship care. This large review provides practical guidance for use of telemedicine in post-treatment survivorship care.

Dynamics of structural relaxation in bioactive 45S5 glass

Kinetics of physical aging in archetypic 45S5 bioactive silicate glass composition with different types of phase separation are studied in situ below the glass transition temperature (T _g). The qualitative nature of aging is found to be almost independent of the structural differences on the micrometer scale. A well-expressed step-like behavior in the enthalpy recovery kinetics is observed for aging temperatures T _a ∼ 0.90T _g and T _a ∼ 0.85T _g, which, however, disappears when the aging occurs at T _a ∼ 0.95T _g. The overall kinetics are described by a stretched-exponential function with stretching exponent close to 3/7 at T _a ∼ 0.95T _g, and 1/3 when the aging temperature drops to ∼0.90T _g and below. The values correlate well with the predictions of Phillips' diffusion-to-traps and percolating fractals models. Appearance of step-like behavior at larger departure from T _g is attributed to the hierarchical scheme of approaching equilibrium based on an alignment-shrinkage mechanism of physical aging proposed earlier for chalcogenide glasses.

Rotating lattice single crystal architecture on the surface of glass

Defying the requirements of translational periodicity in 3D, rotation of the lattice orientation within an otherwise single crystal provides a new form of solid. Such rotating lattice single (RLS) crystals are found, but only as spherulitic grains too small for systematic characterization or practical application. Here we report a novel approach to fabricate RLS crystal lines and 2D layers of unlimited dimensions via a recently discovered solid-to-solid conversion process using a laser to heat a glass to its crystallization temperature but keeping it below the melting temperature. The proof-of-concept including key characteristics of RLS crystals is demonstrated using the example of Sb₂S₃ crystals within the Sb-S-I model glass system for which the rotation rate depends on the direction of laser scanning relative to the orientation of initially formed seed. Lattice rotation in this new mode of crystal growth occurs upon crystallization through a well-organized dislocation/disclination structure introduced at the glass/crystal interface. Implications of RLS growth on biomineralization and spherulitic crystal growth are noted.

Frequency of bacterial isolates and pattern of antimicrobial resistance in patients with hematological malignancies: A snapshot from tertiary cancer center

BACKGROUND

Infections are the most important cause of mortality in patients with high-risk febrile neutropenia. Emergence of multi-drug resistant organisms (MDROs) has become a major challenge for hemato-oncologists. Knowledge of the prevalent organisms and their antimicrobial sensitivity can help deciding the empirical therapy at individual centers and allows timely measures to reduce the risk of antimicrobial resistance.

AIMS

To evaluate the frequency of bacterial isolates from all the samples and the pattern of bacterial bloodstream infections and incidence of MDROs.

SETTINGS AND DESIGN

This is a retrospective analysis from a tertiary care cancer center.

MATERIALS AND METHODS

From January to June 2014 information on all the samples received in Department of Microbiology was collected retrospectively. The data from samples collected from patients with hematological cancers were analyzed for types of bacterial isolates and antimicrobial sensitivity.

RESULTS

A total of 739 isolates were identified with 67.9% of isolates being Gram-negative. The predominant Gram-negative organisms were Escherichia coli, Psuedomonas spp. and Klebsiella spp. Among the bacterial bloodstream infections, 66% were Gram-negative isolates. MDROs constituted 22% of all isolates in blood cultures. Incidence of resistant Gram-positive organisms was low in the present dataset (methicillin resistant Staphylococcus aureus and vancomycin-resistant enterococci-1.3%).

CONCLUSIONS

The analysis reconfirms the Gram-negative organisms as the predominant pathogens in bacteremia seen in patients with hematological cancers. The high frequency of multi-drug resistance in the dataset calls for the need of emergency measures to curtail further development and propagation of resistant organisms.

Insights into the mechanism of natural terpenoids as NF-κB inhibitors: an overview on their anticancer potential

The transcription factor, nuclear factor kappa B (NF-kB) is one of the principal inducible protein in mammals known to control the gene expression in many critical physiological responses such as oxidative stress, inflammation etc. and has been shown to play an important role in the pathogenesis of cancer. Terpenoids are major constituents present in nutritionally used fruits, vegetables and different spices which possess various pharmacological action including anticancer activity. Various terpenoids, viz. monoterpenoids, sesquiterpenoids, diterpenoids, sesterterpenoids, triterpenoids, tetraterpenoids and polyterpenoids inhibit NF-kB signa-ling pathway through IkB phosphorylation, DNA binding, p65 translocation etc. Keeping in mind these facts, the present review revealed the anti-cancer potential of naturally occurring terpenoids highlighting their mechanism of NF-kB inhibition. This review also focuses on some of the naturally occurring terpenoids belonging to various chemical categories with potential inhibitory effects on NF-kB and their role in the treatment of cancer.

Bioglass in Alveolar Bone Regeneration in Orthodontic Patients: Randomized Controlled Clinical Trial

This study was designed as a split-mouth randomized controlled clinical trial to evaluate the effects of a novel bioactive glass scaffold-tailored amorphous multiporous (TAMP)-for the preservation of alveolar bone following tooth extraction in class II orthodontic patients. TAMP scaffolds were prepared and sterilized. Patients were screened for eligibility, and 6 patients accounting for 14 extraction sockets were included in this stage. Sockets were randomly allocated to either control (left empty) or test (grafted with TAMP scaffold particles). Follow-up was done after 1, 2, 4, 8, and 12 to 17 wk with digital periapical radiographs to evaluate changes in crestal bone height and bone mineral density (BMD), 3-dimensional volumetric analysis of impression casts, and histologic analysis of core biopsies. Furthermore, alveolar bone marrow mesenchymal stem cells were cultured from control and test sockets following biopsy retrieval to evaluate the ability of TAMP bioactive glass scaffolds to recruit host progenitor cells. Results showed that sockets grafted with TAMP bioactive glass scaffolds better preserved height after 3 mo where mesially 57.1% of test cases showed preservation of socket height, compared with 28.6% of control cases. Distally, this was 42.9% of test cases versus none of the control cases. Regarding BMD, the test sides had higher BMD in all 3 sections of the socket, with the greatest reduction in BMD found in the coronal third. Results were not statistically significant. Histologically, sockets grafted with TAMP bioactive glass scaffolds showed a distinct pattern of bone healing characterized by vertical trabeculae and large vascularized marrow spaces with sockets showing corticalization. Volumetric analysis showed a better preservation of socket contour with TAMP bioactive glass scaffolds. TAMP bioactive glass scaffolds appeared to enhance the recruitment of stem cells from the grafted sockets. In conclusion, TAMP scaffolds appear to better preserve alveolar bone following extraction and allow for a more active bone modeling and remodeling process( ClinicalTrials.gov identifier:NCT01878084). Knowledge Transfer statement: The results of this study set the stage for the recommended use of novel biomimetic scaffolds, such as the tailored amorphous multiporous bioactive glass for preservation of the socket following extraction. This can be valuable for patients and clinicians alike when deciding on long-term prosthetic alternatives that not only result in immediate bone preservation but will accommodate the dynamic nature of bone.

Treatment results in advanced stage Hodgkin's lymphoma: a retrospective study

BACKGROUND

Hodgkin's lymphoma displays distinct epidemiological attributes in Asian population thus making it relevant to study whether there are any differences in treatment outcomes too when treated with current standard of care.

AIM

To evaluate the treatment outcomes of de-novo advanced stage HL in adults.

MATERIALS AND METHODS

This retrospective study included de-novo advanced stage HL patients (≥15 years) registered at our center from January 2004 to December 2007. Treatment outcomes were measured in terms of response rates, overall survival (OS) and progression-free survival (PFS). Overall and PFS were calculated with Kaplan-Meier methodology and Cox-proportional hazards model was used for multivariate analysis to identify prognostic factors.

RESULTS

There were 125 patients (males 77%) who received minimum one cycle of chemotherapy with median age of 32 years (Range 15-65 years). Stage IV disease was seen in (46 patients) 37%; 75% (94 patients) patients had B symptoms. International prognostic score (IPS) ≤4 was seen in 95/112 (85%) patients. ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy was given to 94%. Radiation to residual/bulky sites was given to 36% (45 patients). Response data was available for 112 patients; complete response in 76%; partial response in 10 % and progressive disease in 3 patients. Nineteen deaths (progressive disease-7, toxicity-8, unrelated cause-4) were observed. At median follow-up of 28 months, estimated 5-year OS and PFS were 60% and 58%, respectively. On multivariate analysis, IPS and response to treatment were significant factors for both OS and PFS.

CONCLUSIONS

The treatment outcomes in this study are comparable with the published literature with limited follow-up data.

Engineering the optical response of a-Se thin films by employing morphological disorder

In this article, we experimentally demonstrate for the first time that photobleaching (PB) can be induced in morphologically disordered a-Se thin film, an observation which is opposite of the previously well-known photodarkening (PD) effects in morphologically ordered films. Further, the optical response of the film shows many fold increase with increase in control beam intensity. To explain the observed extraordinary phenomenon, we have proposed a model based on the morphological disorder of a modified surface and its subsequent photo-annealing. Our results demonstrate an efficient and yet simple new method to engineer the optical response of photosensitive thin films. We envision that this process can open up many avenues in optical field-enhanced absorption-based technologies.

Study of Ga incorporation in glassy arsenic selenides by high-resolution XPS and EXAFS

Effect of Ga addition on the structure of vitreous As2Se3 is studied using high-resolution X-ray photoelectron spectroscopy and extended X-ray absorption fine structure techniques. The "8-N" rule is shown to be violated for Ga atoms and, possibly, for certain number of As atoms. On the contrary, Se keeps its 2-fold coordination according to "8-N" rule in the amorphous phase throughout all the compositions. Crystalline inclusions appear in the amorphous structure of the investigated glasses at Ga concentrations greater than 3 at. %. These inclusions are presumably associated with Ga2Se3 crystallites and transition phases/defects formed at the boundaries of these crystallites and host amorphous matrix. The existence of Ga-As and Se-Se bonds in the samples with higher Ga content is supported by present studies.

Clinico-pathological impact of cytogenetic subgroups in B-cell chronic lymphocytic leukemia: experience from India

BACKGROUND

The present study of 238 B-cell Chronic Lymphocytic Leukemia (B-CLL) patients were undertaken to seek the prevalence and to evaluate clinico-pathological significance of recurrent genetic abnormalities such as del(13q14.3), trisomy 12, del(11q22.3) (ATM), TP53 deletion, del(6q21) and IgH translocation/deletion.

MATERIALS AND METHODS

We applied interphase - fluorescence in situ hybridization (FISH) on total 238 cases of B-CLL.

RESULTS

Our study disclosed 69% of patients with genetic aberrations such as 13q deletion (63%), trisomy 12 (28%), 11q deletion (18%), 6q21 deletion (11%) with comparatively higher frequency of TP53 deletion (22%). Deletion 13q displayed as a most frequent sole abnormality. In group with coexistence of ≥2 aberrations, 13q deletion was a major clone indicating del(13q) as a primary event followed by 11q deletion, TP53 deletion, trisomy 12, 6q deletion as secondary progressive events. In comparison with del(13q), trisomy 12, group with coexistence of ≥2 aberrations associated with poor risk factors such as hyperleukocytosis, advanced stage, and multiple nodes involvement. In a separate study of 116 patients, analysis of IgH abnormalities revealed either partial deletion (24%) or translocation (5%) and were associated with del(13q), trisomy 12, TP53 and ATM deletion. Two of 7 cases had t(14;18), one case had t(8;14), and four cases had other variant IgH translocation t(?;14).

CONCLUSION

Detail characterization and clinical impact are necessary to ensure that IgH translocation positive CLL is a distinct pathological entity. Our data suggests that CLL with various cytogenetic subsets, group with coexistence of ≥2 aberrations seems to be a complex cytogenetic subset, needs more attention to understand biological significance and to seek clinical impact for better management of disease.

Role of Ge:As ratio in controlling the light-induced response of a-Ge(x)As(35-x)Se65 thin films

In this paper, we present interesting results on the quantification of photodarkening (PD), photobleaching (PB) and transient PD (TPD) in a-Ge_xAs_35−xSe₆₅ thin films as a function of network rigidity. Composition dependent light-induced responses of these samples indicate that there exist two parallel competing mechanisms of instantaneous PD arising from the As part of the network, and PB arising from the Ge part of the network. Raman spectra of the as-prepared and illuminated samples provide first direct evidence of the light-induced structural changes: an increase in AsSe_3/2 pyramidal and GeSe_4/2 corner-sharing tetrahedra units together with new Ge-O bond formation and decrease in energetically unstable edge sharing GeSe_4/2 tetrahedra. Importantly, for a fixed Se concentration, Ge:As ratio plays the critical role in controlling the net light-induced response rather than the much believed rigidity of the glassy network.

Recurrent Perianal Sinus in Young Girl Due To Pre-sacral Epidermoid Cyst

Pre-sacral epidermoid cysts are rare development cysts resulting from dysembryogenesis mostly diagnosed in middle aged women. We report a case of pre-sacral epidermoid cyst presenting with recurrent perianal sinus in young girl. Generally pre-sacral epidermoid cysts are seen in adult age group but it is rare presentation in young age group. We report a rare case of presacral epidermoid cyst occurring in a young female.

Coexistence of fast photodarkening and slow photobleaching in Ge19As21Se60 thin films

We experimentally demonstrate the coexistence of two opposite photo-effects, viz. fast photodarkening (PD) and slow photobleaching (PB) in Ge(19)As(21)Se(60) thin films, when illuminated with a laser of wavelength 671 nm. PD appears to begin instantaneously upon light illumination and saturates in tens of seconds. By comparison, PB is a slower process that starts only after PD has saturated. Both PD and PB follow stretched exponential dependence on time. Modeling of overall change as a linear sum of two contributions suggests that the changes in As and Ge parts of glass network respond to light effectively independent of each other.

Fabrication of nano-macroporous glass-ceramic bioscaffold with a water soluble pore former

Recently, several methods have been reported for fabricating tailored amorphous multi porosity bioscaffolds for bone regeneration and tissue engineering. In particular, the melt-quench-heat-etch method appears attractive for making large and/or complex shape structures or fibers for flexible products. However, often the macropore size has been limited to <100 μm. In this paper we report an improved method for fabricating nano-macroporous soda lime phosphosilicate glass using sucrose as a macropore former. The composite compact consisting of soda lime phosphosilicate glass and sucrose powders is pressed in a die at room temperature. 3D interconnected macroporous structure is formed first by dissolving the sucrose part in water at room temperature, and then sintering the compact at temperatures above the glass transition temperature. Thus, interconnected macropores with controlled size (≥100 microns) are formed readily. The sintering heat-treatment also induces nanoscale phase separation, which is then exploited for introducing nanoscale porosity. For the latter goal, the sample is leached in HCl under optimized conditions to yield desired nano-macroporous glass for bone scaffold or other applications.

Colon-targeted quercetin delivery using natural polymer to enhance its bioavailability

The aim of the present study is to develop a polymer (Guar Gum)-based matrix tablet (using quercetin as a model drug) with sufficient mechanical strength, and promising in vitro mouth-to-colon release profile. By definition, an oral colonic delivery system should retard drug release in the stomach and small intestine, and allow complete release in the colon. By drug delivery to the colon would therefore ensure direct treatment at the disease site, lower dosing, and fewer systemic side effects. Quercetin is antioxidant in nature and used to treat colon cancer, but they have poor absorption in the upper part of the gastrointestinal tract (GIT). As a site for drug delivery, the colon offers a near neutral pH, reduced digestive enzymatic activity, a long transit time, and an increased responsiveness to absorption enhancers. By achieving a colon-targeted drug delivery system, the absorption of quercetin may be increased, which leads to better bioactivity in fewer doses.

Evaluation of 3D nano-macro porous bioactive glass scaffold for hard tissue engineering

Recently, nano-macro dual-porous, three-dimensional (3D) glass structures were developed for use as bioscaffolds for hard tissue regeneration, but there have been concerns regarding the interconnectivity and homogeneity of nanopores in the scaffolds, as well as the cytotoxicity of the environment deep inside due to limited fluid access. Therefore, mercury porosimetry, nitrogen absorption, and TEM have been used to characterize nanopore network of the scaffolds. In parallel, viability of MG 63 human osteosarcoma cells seeded on scaffold surface was investigated by fluorescence, confocal and electron microscopy methods. The results show that cells attach, migrate and penetrate inside the glass scaffold with high proliferation and viability rate. Additionally, scaffolds were implanted under the skin of a male New Zealand rabbit for in vivo animal test. Initial observations show the formation of new tissue with blood vessels and collagen fibers deep inside the implanted scaffolds with no obvious inflammatory reaction. Thus, the new nano-macro dual-porous glass structure could be a promising bioscaffold for use in regenerative medicine and tissue engineering for bone regeneration.

Optimizing The Metalloid Content in Bulk Metallic Glasses

We have studied the effect of phosphorus content on the formation and properties of bulk Pd-Cu-P and Pd-Ni-P metallic glasses. It was found that the molar volumes of the Pd-Ni-P bulk glasses plotted as a function of P content follow a straight line whereas those for the Pd-Cu-P glasses follow two straight lines of different slopes, intersecting at a critical P concentration. The transition in molar volume behavior is attributed to a change in the alloy's short-range order with increasing P content. The origin of this structural change is discussed based on x-ray photoelectron spectroscopy (XPS) measurements.

AC Conductivity of Crystalline Materials and Glasses Ascribed to ADWPs

The behavior of the frequency dependence of the conductivity, σ(ω), of numerous crystalline materials and glasses is close to an ω1.0 dependence in the limit of low temperatures and/or high frequencies (referred to as the “nearly constant loss”, or NCL, regime). Detailed analysis of this behavior, including the frequency dependence of both ε′ and ε″, shows that it can be described phenomenologically as produced by a broad distribution of asymmetric double-well potentials (ADWPs) with low activation energies. In order to obtain an understanding of the atomic origins of such potentials, we investigate the composition dependence of this behavior in such materials as crystalline CeO2:1%Y3+ ceramics with variable [Y3+] and alkali germanate glasses with variable alkali concentration. The appearance of a discrete loss peak in CeO2: 1%Y3+ helps us understand the ADWPs as due to “off-symmetry” configurations that undergo wiggling motion between adjacent minimum-energy positions.

Immunophenotypic profile of acute leukemia: critical analysis and insights gained at a tertiary care center in India

BACKGROUND

To analyze the spectrum of various types and subtypes of acute leukemia.

METHODS

Two thousand five hundred and eleven consecutive new referral cases of acute leukemia (AL) were evaluated based on WHO classification.

RESULTS

It included 1,471 cases (58%) of acute lymphoblastic leukemia (ALL), 964 cases (38%) of acute myeloid leukemia (AML), 45 cases (1.8%) of chronic myelogenous leukemia in blast crisis (CMLBC), 37 cases (1.5%) of biphenotypic acute leukemia (BAL), 1 case of Triphenotypic AL, and 2 cases of acute undifferentiated leukemia (AUL). Common subtypes of ALL were B-cell ALL (76%), which comprised of intermediate stage/CALLA positive (73%), early precursor/proBALL (3%). T-cell ALL constituted 24% (351 cases) of ALL. Common subtypes of AML included AMLM2 (27%), AMLM5 (15%), AMLM0 (12%), AMLM1 (12%), APML (11%), and AML t(8;21) (9%). CMLBC was commonly of myeloid blast crisis subtype (40 cases).

CONCLUSION

B-cell ALL was the commonest subtype in children and AML in adults. Overall incidence of AML in adults was low (53% only). CD13 was most sensitive and CD117 most specific for determining myeloid lineage. A minimal primary panel of nine antibodies consisting of three myeloid markers (CD13, CD33, and CD117), B-cell lymphoid marker (CD19), T-cell marker (CD7), with CD45, CD10, CD34, and HLADR could assign lineage to 92% of AL. Cytogenetics findings lead to a change in the diagnostic subtype of myeloid malignancy in 38 (1.5%) cases.

Development of nano-macroporous soda-lime phosphofluorosilicate bioactive glass and glass-ceramics

We have extended the usefulness of bioactive glass-ceramics for the repair and reconstruction of hard tissues by introducing F ions that are known to be beneficial, especially in dentistry. Nano-macro multimodal porosity in soda-lime phosphofluorosilicate bulk samples was introduced by the recently developed melt-quench-heat-etch method. The choice of starting glass composition is based on 48SiO2-2.7P2O5-xCaF2-yCaO-zNa2O where x = 0, 1, 4, 8, 10, 12, and (y + z) = 49.3-x (mol%). The effect of thermal and chemical treatment on the microstructure of samples is characterized by SEM, XRD and EDX. We find the formation of many crystalline phases, but mainly sodium calcium silicate, calcium phosphate, fluorapatite and calcium silicate. The bioactivity of soda-lime phosphofluorosilicate glass-ceramics is assessed by monitoring the formation of hydroxyl apatite (HA) layer: fluorapatite phase accelerates the rate of HA layer formation; the initial composition and multi-modal porosity are other key parameters that impact the formation of HA. The present porous glass-ceramics should be superior candidates for use in dental bone regeneration.

Single stage craniofacial reconstruction for fronto-nasal encephalocele and hypertelorism in an adult

The fronto-nasal type of fronto-ethmoidal encephalocele is one of the more common subtype of anterior encephaloceles. We discuss different aspects and difficulties in the management of fronto-nasal encephalocele in a 30-year-old woman. Fronto-nasal encephaloceles present a difficult scenario in adults, mainly due to large gliotic herniating brain tissue, large bony and dural defect, increase in the size of paranasal sinuses, and scars from previous surgeries. However, all difficulties can be overcome after applying the principles of craniofacial reconstructions, i.e. correction of bone defect with autologus split calvarial graft, dural closure with autologous pericranial graft and correction of hypertelorism.

Mid-IR biosensor: detection and fingerprinting of pathogens on gold island functionalized chalcogenide films

Antibody (human IgG, anti-E. coli O157:H7, and anti-Salmonella) complexes on the surface of IR-transparent Ge-containing chalcogenide glass films were formed via thiol chemistry on 20-nm-thick gold islands. As a first step, the protocol was validated by monitoring fluorescently tagged targets to validate binding. FT-IR spectroscopy confirmed that the coating of the films with 20-nm gold did not have a significant effect on the propagation and penetration of IR evanescent waves through the film. The films functionalized with anti-E. coli O157:H7 and anti-Salmonella antibodies were used to detect E. coli O157:H7 and S. enteriditis through label-free IR fingerprinting. Highly selective detection of bacterial targets was achieved at both the species (E. coli vs. S. enteriditis) and strain level (E. coli O157:H7 vs E. coli K12). A mid-infrared approach could thus be used as a biosensor as well as a molecular fingerprinting tool.

Role of κ- and δ-opioid receptors in the antinociceptive effect of oxytocin in formalin-induced pain response in mice

Oxytocin has been implicated in the modulation of somatosensory transmission such as nociception and pain. The present study investigates the effect of oxytocin on formalin-induced pain response, a model of tonic continuous pain. The animals were injected with 0.1 ml of 1% formalin in the right hindpaw and the left hindpaw was injected with an equal volume of normal saline. The time spent by the animals licking or biting the injected paw during 0-5 min (early phase) and 20-25 min (late phase) was recorded separately. Oxytocin (25, 50, 100 microg/kg, i.p.) dose dependently decreased the licking/biting response, both in the early as well as the late phases. The antinociceptive effect of oxytocin (100 microg/kg, i.p.) was significantly attenuated in both the phases by a higher dose of the non-selective opioid receptor antagonist naloxone (5 mg/kg, i.p.), MR 2266 (0.1 mg/kg, i.p.), a selective kappa-opioid receptor antagonist and naltrindole (0.5 mg/kg, i.p.), a selective delta-opioid receptor antagonist but not by a lower dose of naloxone (1 mg/kg, i.p.) or beta-funaltrexamine (2.5 microg/mouse, i.c.v.), a selective mu-opioid receptor antagonist. Nimodipine, a calcium channel blocker (1 and 5 mg/kg, i.p.) produced a dose-dependent analgesic effect. The antinociceptive effect of oxytocin was significantly enhanced by the lower dose of nimodipine (1 mg/kg, i.p.) in both the phases. Chronic treatment with oxytocin (100 microg/kg/day, i.p. daily for 7 days) did not produce tolerance in both the phases of formalin-induced pain response. The results thus indicate that oxytocin displays an important analgesic response in formalin test; both kappa- and delta-opioid receptors as well as voltage-gated calcium channels seem to be involved in the oxytocin-induced antinociception.

Antidepressant-associated mania in late life

BACKGROUND

Elderly patients can present with mania for the first time late in life, and some elders treated with antidepressants can present with mania. Clinical characteristics of antidepressant-associated mania (AAM) in late life have not been examined.

OBJECTIVES

The aims of the study were to identify elders with AAM and to compare selected clinical characteristics to those of manic elders who had not been treated with an antidepressant. We hypothesized that AAM patients would have later age at presentation of bipolar disorder.

METHODS

We retrospectively reviewed inpatients with manic disorder who were aged >or=60 years. The sample was selected from admissions prior to 1990.

RESULTS

AAM patients (n = 11) were more often experiencing first manic episode, and they had later age at onset of first manic episode, compared to non-AAM patients (n = 46). Most of the AAM patients had been treated with tricyclic agents.

CONCLUSIONS

These preliminary findings invite further investigation. Related studies may contribute to risk-benefit analyses for the use of particular antidepressants in the elderly. Also, first episode mania in late life may prove to be a useful model of vulnerability to AAM.

Synthesis and characterization of catalysts produced from paper mill sludge. I. Determination Of NOx removal capability

Characteristics and catalytic properties of a series of carbon-based catalysts (CBCs) produced from paper mill sludge were evaluated. The major processes involved in the production of the catalysts were chemical activation, impregnation, pyrolysis, and post pyrolysis rinsing. The porous structure, catalytic activity and thermostability of the catalysts were tailored during the production stage by introducing hetero-atoms (zinc chloride, and ferric nitrate) in the carbon structure. Characterization of the produced CBCs included determination of the surface area, pore size, and pore size distribution (PSD) from standard N2-adsorption isotherm data. The extent of graphitization and the presence of metal crystals were identified from X-ray diffraction (XRD). The limit of the catalyst gasification was estimated from thermogravimetric analysis (TGA) conducted in an oxidized environment. The NOx reduction capability of the produced catalysts was evaluated in the presence of carbon monoxide using a fixed bed reactor. The reaction temperature ranged from 300 to 500 degrees C. It was shown that paper mill sludge is an excellent precursor for the production of CBCs with NOx removal capability of 66-94%. The catalytic capability of the produced CBCs varied according to the method of production, catalyst surface properties (surface area, pore structure, PSD), metal composition and reaction temperature. The highest NOx removal capacity was observed for the catalytic reactions carried out at 400 degrees C. The mesoporous catalyst produced with a Zn:Fe molar ratio of 1:0.5 exhibited the maximum NOx removal catalytic activity of 94%.