Single photon emission computed tomography (SPECT) diagnostic accuracy in active unilateral condylar hyperplasia: Retrospective study

The aim of this study was to assess the diagnostic accuracy of single photon emission tomography (SPECT) in unilateral condylar hyperplasia (UCH). To this end, 3D morphometric changes of the mandibles in one year were assessed (T0 vs. T1) and compared over SPECT results in T1, in a sample of 40 patients. A contingency table was constructed based on these results for SPECT diagnostic accuracy evaluation, classifying patients as SPECT true-positive, true-negatives, false positives and false-negatives. Additionally, the morphometric analysis was used to describe the presentation of mandibular changes using principal component analysis (PCA) and non-parametric statistics. We obtained diagnostic accuracy results of sensitivity 81%, specificity 63%, positive predictor value (PPV) 59%, negative predictor value (NPV) 83% and accuracy 70%, showing that SPECT yields poor results regarding accuracy diagnostic performance. The morphometric analysis showed that individuals without progress of asymmetry and those with more progress differ particularly in a group of landmarks representing the mental region and the right mandibular body. Based on these landmarks, difference among the four SPECT-accuracy groups was statistically significant (p < 0.001), where the landmark showing the largest change within a year had a mean increase of 1.13 + 0.66 mm. Within the limitations of the study, it seems that SPECT alone is not suitable for making surgical decisions regarding condylectomy in active UCH. Follow up with morphological assessment methods are recommended for confirming an active UCH in combination with SPECT.

A Novel Chemical Profile of a Selective In Vitro Cholinergic Essential Oil from Clinopodium taxifolium (Kunth) Govaerts (Lamiaceae), a Native Andean Species of Ecuador

A novel chemical profile essential oil, distilled from the aerial parts of Clinopodium taxifolium (Kunth) Govaerts (Lamiaceae), was analysed by Gas Chromatography-Mass Spectrometry (GC-MS, qualitative analysis) and Gas Chromatography with Flame Ionization Detector (GC-FID, quantitative analysis), with both polar and non-polar stationary phase columns. The chemical composition mostly consisted of sesquiterpenes and sesquiterpenoids (>70%), the main ones being (E)-β-caryophyllene (17.8%), α-copaene (10.5%), β-bourbonene (9.9%), δ-cadinene (6.6%), cis-cadina-1(6),4-diene (6.4%) and germacrene D (4.9%), with the non-polar column. The essential oil was then submitted to enantioselective GC analysis, with a diethyl-tert-butyldimethylsilyl-β-cyclodextrin diluted in PS-086 chiral selector, resulting in the following enantiomeric excesses for the chiral components: (1R,5S)-(-)-α-thujene (67.8%), (1R,5R)-(+)-α-pinene (85.5%), (1S,5S)-(-)-β-pinene (90.0%), (1S,5S)-(-)-sabinene (12.3%), (S)-(-)-limonene (88.1%), (S)-(+)-linalool (32.7%), (R)-(-)-terpinen-4-ol (9.3%), (S)-(-)-α-terpineol (71.2%) and (S)-(-)-germacrene D (89.0%). The inhibition activity against acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) of C. taxifolium essential oil was then tested, resulting in selective activity against BChE with an IC50 value of 31.3 ± 3.0 μg/mL (positive control: donepezil, IC50 = 3.6 μg/mL).

PETCO2 gradient: a novel prognostic parameter in cardiopulmonary exercise testing

Background

Previous parameters such as peak VO2, VE/VCO2 slope and OUES have been described to be prognostic in heart failure (HF). The aim of this study was to identify further prognostic factors of cardiopulmonary exercise testing (CPET) in HF patients.

Methods

A retrospective analysis of HF patients who underwent CPET from January to November 2019 in a single centre was performed. PETCO2 gradient was defined by the difference between final PETCO2 and baseline PETCO2. HF events were defined as decompensated HF requiring hospital admission or IV diuretics, or decompensated HF resulting in death.

Results

A total of 64 HF patients were assessed by CPET, HF events occurred in 8 (12.5%) patients. Baseline characteristics are shown in table 1. Patients having HF events had a negative PETCO2 gradient while patients not having events showed a positive PETCO2 gradient (−1.5 [IQR −4.8, 2.3] vs 3 [IQR 1, 5] mmHg; p=0.004). A multivariate Cox proportional-hazards regression analysis revealed that PETCO2 gradient was an independent predictor of HF events (HR 0.74, 95% CI [0.61–0.89]; p=0.002). Kaplan-Meier curves showed a significantly higher incidence of HF events in patients having negative gradients, p=0.002 (figure 1).

Conclusion

PETCO2 gradient was demonstrated to be a prognostic parameter of CPET in HF patients in our study. Patients having negative gradients had worse outcomes by having more HF events.

Time to first event, decompensated heart

Funding Acknowledgement

Type of funding source: None

Novel Flavonoid Glycosides of Quercetin from Leaves and Flowers of Gaiadendron punctatum G.Don. (Violeta de Campo), used by the Saraguro Community in Southern Ecuador, Inhibit α-Glucosidase Enzyme

Gaiadandendron punctatum G.Don. (violeta de campo) is a plant used in traditional medicine by the Saraguro people, an ancient indigenous group that lives in southern Ecuador. From samples collected in the region, six glycoside flavonoids, five with quercetin and one with kaempferol as aglycon, were isolated and characterized from hydroalcoholic extracts of leaves and flowers. Rutin (2) was found in flowers and leaves, nicotiflorin (1) was found in flowers, artabotryside A (3) was found in leaves, and three novel quercetin flavonoid glycosides were isolated, elucidated, and characterized via 1D and 2D NMR experiments (¹H, ¹³C, COSY, DEPT, HMBC, HSQC, TOCSY, NOESY, ROESY), acid hydrolysis–derivatization–GC-MS analysis, HPLC-MS, IR, UV, and optical rotation. The new quercetin flavonoid glycosides were named hecpatrin (4) (isolated from leaves), gaiadendrin (5) (isolated from leaves), and puchikrin (6) (isolated from flowers). The hydroalcoholic extracts of the leaves presented antimicrobial activity against Micrococcus luteus, Staphylococcus aureus, and Enterococcus faecalis and the hydroalcoholic extract of the flowers was active against Micrococcus luteus. However, glycoside flavonoids presented scarce antimicrobial activity against bacteria. Hydroalcoholic extracts from leaves and flowers and their secondary metabolites showed inhibition against the α-glucosidase enzyme at different concentrations. Rutin, gaiadendrin, and nicotiflorin showed competitive α-glucosidase inhibition, while hecpatrin presented non-competitive inhibition.

Tissue factor variants induce monocyte transformation and transdifferentiation into endothelial cell-like cells

Essentials Monocytes (Mo) transdifferentiate into endothelial cell-like (ECL) cells. Mo induce tissue factor (TF) expression and secretion in microvascular endothelial cells (mECs). TF interacts with Mo in a paracrine fashion, inducing their transdifferentiation into ECL cells. TF generates a positive feedback crosstalk between Mo and mECs that promotes angiogenesis.

SUMMARY

Background Monocytes (Mo) increase neovascularization by releasing proangiogenic mediators and/or transdifferentiating into endothelial cell-like (ECL) cells. Recently, we have reported that Mo-microvascular endothelial cells (mECs) crosstalk induces mEC-tissue factor (TF) expression and promotes angiogenesis. However, the effect of TF on Mo remains unknown. Objective Here, we analyzed whether TF might exert angiogenic effects by inducing transdifferentiation of Mo. Methods Full-length TF (flTF) and alternatively spliced TF (asTF) were overexpressed in mECs, and their supernatants were added to Mo cultures. CD16 positivity and expression of vascular endothelial cell (VEC) markers in Mo were analyzed by fluorescence activated cell sorting. The capacity to form tube-like structures were visualized in three-dimensional cultures. Results In mECs flTF and asTF expression and release were increased in cultures with Mo-conditioned media. TF variants induced expansion of a CD16+ Mo subset and Mo transdifferentiation into ECL-cells expressing VEC markers that can form new microvessels. CD16+ Mo exposed to TF showed an increased expression of VE-cadherin, von Willebrand factor (VWF) and eNOS. Mo cultured with supernatants obtained from TF-silenced mECs did not transdifferentiate to ECL-cells or expressed VEC markers. Blocking β1-integrin in Mo significantly blocked the effects of the TF variants. Conclusions Mo induce mECs to express and release TF, which drives CD16- Mo to transform into CD16+ Mo and to transdifferentiate into ECL-cells that can form new microvessels. Our results reveal a TF-mediated positive feedback between mECs and Mo that stimulates Mo differentiation and induces angiogenesis.

Nonsurgical Therapies for Basal Cell Carcinoma: A Review

Basal cell carcinoma (BCC) is the most prevalent malignant tumor in humans and the local destruction of tissue that can result from excision has a significant impact on well-being. Treating BCC is costly for health care systems given the high incidence of this tumor, especially in older patients. Standard treatment involves either resection with histologic assessment of margins or Mohs micrographic surgery. Surgery is sometimes contraindicated, however, due to the presence of significant comorbidity or high cosmetic expectations. For such patients, nonsurgical treatments have become available. These alternatives can offer good local control of disease, preserve function, and achieve excellent cosmetic results.

[Interventional catheterization after the Norwood procedure]

INTRODUCTION AND OBJECTIVES

To carry out a retrospective analysis of the indications for, and the results and complications of interventional catheterization after the Norwood procedure.

METHODS

Between February 1993 and December 2006, 25 interventional catheterizations were performed in 14 patients who had undergone the Norwood procedure, prior to the Glenn or Fontan procedure.

RESULTS

Nine angioplasties were carried out for recoarctation in seven of the 14 patients (2 patients developed restenosis after their first angioplasty). Detachment of the left pulmonary artery occurred either immediately or during follow-up in 3 patients who underwent the classical Norwood procedure. Overall, 10 pulmonary artery angioplasties were required in 7 patients. Three patients needed embolization: one of venous collaterals (using coils), one of the left superior vena cava (using an Amplatzer duct occluder), and one of a left Blalock-Taussig shunt (using an Amplatzer duct occluder). Two patients required a cavopulmonary (Glenn) anastomosis, and another underwent fibrinolysis for thrombosis of the superior vena cava and pulmonary artery. Other findings, which were not treated percutaneously, included: stenosis of the supra-aortic trunk (n=6), femoral artery stenosis (n=2), femoral vein thrombosis (n=5), and subclavian vein thrombosis (n=1). The following complications were recorded: arterial ischemia (n=2), cardiac arrest or bradycardia (n=4), and transient atrioventricular block (n=1).

CONCLUSIONS

Following stage I of the Norwood procedure, the angiographic and hemodynamic assessments needed for the diagnosis and treatment of pulmonary artery or aortic arch stenosis must be carried out promptly. Although treating recoarctation by angioplasty can be effective, restenosis frequently occurs. With the Sano procedure, detachment of the left pulmonary artery, but not pulmonary artery stenosis, can be avoided. After stage II, the presence of venovenous collaterals must be ruled out, because they frequently require embolization. In these patients, interventional catheterization is associated with a higher incidence of complications than in other groups.

Semen alterations in porcine rubulavirus-infected boars are related to viral excretion and have implications for artificial insemination

Porcine rubulavirus (PoRV), also known as blue eye disease (BED) of swine, causes respiratory and reproductive problems in pigs at several developmental stages. To study the effect of PoRV infection on semen production, five boars were infected with 1 x 10(6) TCID(50)/ml of PoRV strain PAC-3 and evaluated for 59 days post inoculation (DPI). Infected boars developed reproductive tract pathology that included swelling of the testes and epididymides. Analysis of the semen showed that the infection had little effect on semen production in four animals, but semen from one boar showed severe alterations in sperm concentration, motility, and morphology. When motility was analyzed in BTS-diluted semen after 24, 48, or 72 h, alterations were detected in all boars. Furthermore, viral antigen was detected in semen, the seminal plasma fraction, or sperm fraction from all boars. These results showed that PoRV is excreted via semen and, therefore, artificial insemination is a potential route of dissemination.

[Use of coated stents in two patients with congenital heart defects and secondary vascular aneurysms]

The formation of an aneurysm in the aorta or pulmonary artery is a dangerous potential complication of surgical and angioplasty procedures involving these vessels. Treatment using covered stents has emerged as an effective alternative to surgery and the use of conventional stents. The authors report on 2 patients who were treated successfully by the implantation of covered stents in the aorta and pulmonary artery following angioplasty and surgery, respectively. We discuss the mechanisms of aneurysm formation and the efficacy and limitations of using covered stents in such patients.

Ion exchanged Fe-FER through H2O2-assisted decomplexation of organic salts

Decomplexation of organic ligands through redox titration has been applied to catalyst synthesis, developing an improved preparation method for Fe-ferrierite (Fe-FER), the catalyst showing excellent performance and durability for N2O decomposition under realistic conditions for nitric acid plants.

Unique selectivity of perfluorinated stationary phases with 2,2,2-trifluoroethanol as organic mobile phase modifier

The selectivity of Luna C18 Xterra C18 and Fluophase (perfluorinated C6) stationary phases has been investigated with aqueous acetonitrile, methanol and 2,2,2-trifluoroethanol mobile phases using linear solvation equations. The gradient retention times of a set of 60 compounds with known molecular descriptors have been determined. Linear solvation equations have been set up to describe the relationship between the gradient retention times and the molecular properties. The selectivity of the stationary phase/mobile phase systems was characterised by the regression coefficients of the molecular descriptors. The perfluorinated stationary phase showed very different selectivity using 2,2,2-trifluoroethanol (TFE) as co-solvent. Compounds with H-bond donor functionality were retained much less than in the other investigated high-performance liquid chromatography (HPLC) systems. This unique selectivity can be explained by the stronger adsorption of trifluoroethanol on the perfluorinated stationary phase surface, than on the hydrocarbon surface. It suggests the importance of the adsorbed organic modifiers in the separation mechanism during reversed-phase HPLC.

Identification of the gene at the pmg locus, encoding system II, the general amino acid transporter in Neurospora crassa

Mutations at the pmg locus in Neurospora crassa cause a deficiency in a transport system for a broad range of amino acids. We have isolated a gene that encodes a protein with a high degree of sequence similarity to the GAP1 general amino acid permease in Saccharomyces cerevisiae. Our data indicate that this is the gene at the pmg locus. It encodes a 572-residue protein with a molecular mass of 62,649 Da. The predicted secondary structure has 12 membrane-spanning regions, a feature characteristic of a superfamily of permease proteins. Inactivation of the gene yielded a mutant strain with the same phenotype as the pmg- strain, and a cosmid containing a functional copy of the gene rescued the pmg- strain. Although the pmg- strain has previously been assayed in a genetic background that contains mutations in genes for two other amino acid transport systems, we have found conditions in which the pmg- strain has an identifiable phenotype in an otherwise wild-type genetic background.

Biocompatibility in vitro tests of Zinalco

In this study, cultures of human lymphocytes were exposed for 48 h to aqueous suspensions of Zinalco, with different times of corrosion, to test the biocompatibility of this alloy and support its use in medical implants. The results show that the Zinalco concentrations assessed affect the mitotic index (MI) and some also increase the length of DNA migration measured in the comet assay in a significant manner; none of them showed clastogenic nor aneugenic effects. The authors conclude that Zinalco may be considered as an alternative biomaterial and suggest its use for short-term implants.