The role of hyperbaric oxygen in osteoradionecrosis-a prophylactic insight

BACKGROUND

Osteoradionecrosis (ORN) is an uncommon and debilitating consequence of head and neck radiotherapy and hyperbaric oxygen therapy (HBOT) has been advocated for prophylaxis prior to performing dentoalveolar procedures. The aim of this study was to evaluate a prophylactic HBOT protocol and describe the outcomes of susceptible individuals.

METHODS

A retrospective audit of adults who attended the Oral and Maxillofacial Surgery department at the Royal Adelaide Hospital (South Australia) who received dental extractions with a history of radiotherapy to the jaws from 2008 to 2020. Data including demographic information and outcomes of osteoradionecrosis and delayed healing was recorded.

RESULTS

A total of 121 individuals were eligible for case note review; 68.6% of individuals were male and 55.4% were aged over 67 years. Osteoradionecrosis occurred in 9.1% of individuals and delayed healing for 3.3%; fifteen individuals (12.4%) were unable to complete the HBOT protocol. The individuals who were diagnosed with ORN had a significant association with age (P = 0.006) and binary analysis showed alcohol consumption to be a significant predictor.

CONCLUSIONS

Prophylactic HBOT protocol had a lower proportion of individuals diagnosed with ORN and those who were diagnosed were more likely to be younger males and have current alcohol consumption.

NAC1 Regulates Somatic Cell Reprogramming by Controlling Zeb1 and E-cadherin Expression

Reprogramming somatic cells to induced pluripotent stem cells (iPSCs) is a long and inefficient process. A thorough understanding of the molecular mechanisms underlying reprogramming is paramount for efficient generation and safe application of iPSCs in medicine. While intensive efforts have been devoted to identifying reprogramming facilitators and barriers, a full repertoire of such factors, as well as their mechanistic actions, is poorly defined. Here, we report that NAC1, a pluripotency-associated factor and NANOG partner, is required for establishment of pluripotency during reprogramming. Mechanistically, NAC1 is essential for proper expression of E-cadherin by a dual regulatory mechanism: it facilitates NANOG binding to the E-cadherin promoter and fine-tunes its expression; most importantly, it downregulates the E-cadherin repressor ZEB1 directly via transcriptional repression and indirectly via post-transcriptional activation of the miR-200 miRNAs. Our study thus uncovers a previously unappreciated role for the pluripotency regulator NAC1 in promoting efficient somatic cell reprogramming.

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NAC1 is critical for efficient iPSC generation

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NAC1 facilitates NANOG binding to E-cadherin promoter

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NAC1 binds to Zeb1 promoter and represses its expression

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NAC1 binds to the miR-200 loci and indirectly activates E-cadherin expression

Breaking through the strength-ductility trade-off dilemma in an Al-Si-based casting alloy

Al-Si-based casting alloys have a great potential in various industrial applications. Common strengthening strategies on these alloys are accompanied inevitably by sacrifice of ductility, known as strength-ductility trade-off dilemma. Here, we report a simple route by combining rapid solidification (RS) with a post-solidification heat treatment (PHT), i.e. a RS + PHT route, to break through this dilemma using a commercial Al-Si-based casting alloy (A356 alloy) as an example. It is shown that yield strength and elongation to failure of the RS + PHT processed alloy are elevated simultaneously by increasing the cooling rate upon RS, which are not influenced by subsequent T6 heat treatment. Breaking through the dilemma is attributed to the hierarchical microstructure formed by the RS + PHT route, i.e. highly dispersed nanoscale Si particles in Al dendrites and nanoscale Al particles decorated in eutectic Si. Simplicity of the RS + PHT route makes it being suitable for industrial scaling production. The strategy of engineering microstructures offers a general pathway in tailoring mechanical properties of other Al-Si-based alloys. Moreover, the remarkably enhanced ductility of A356 alloy not only permits strengthening further the material by work hardening but also enables possibly conventional solid-state forming of the material, thus extending the applications of such an alloy.

Downregulation of hepatic acyl-CoA:diglycerol acyltransferase in chronic renal failure

Chronic renal failure (CRF) is associated with hypertriglyceridemia and elevated plasma VLDL and IDL concentrations. These events can be due to either increased production or depressed catabolism of triglyceride-rich lipoproteins. Several studies have documented downregulation of lipoprotein lipase, hepatic triglyceride lipase, and the VLDL receptor, leading to depressed clearance and elevated plasma concentration of triglyceride-rich lipoproteins and their remnants in CRF. However, the effect of CRF on the triglyceride biosynthetic pathway has not been explored. Diglycerol acyltransferase (DGAT) is a microsomal enzyme that joins acyl-CoA to 1,2 diacylglycerol and, as such, constitutes the final step in triglyceride biosynthesis. Two distinct forms of DGAT (DGAT-1 and -2) have thus far been identified. The present study was undertaken to examine the effect of CRF on DGAT gene expression and activity in the liver, which is the source of endogenous triglycerides in the circulation. Male Sprague-Dawley rats were studied 8 wk after 5/6 nephrectomy (CRF) or sham operation. DGAT-1 and DGAT-2 mRNA abundance and DGAT activity were quantified. The CRF group showed reduced creatinine clearance, elevated plasma triglycerides, and VLDL concentrations. This was accompanied by significant reductions in hepatic DGAT-2 mRNA abundance (P < 0.01) and total DGAT activity (P < 0.1), pointing to diminished hepatic triglyceride production capacity in CRF animals. In conclusion, CRF results in significant downregulation of hepatic DGAT gene expression and activity. Given the critical role of DGAT in triglyceride biosynthesis, the present study points to diminished, not increased, hepatic triglyceride synthetic capacity in CRF rats.

Microdissection and microcloning of rye (Secale cereale L.) chromosome 1R

Chromosome 1R was microdissected and collected from mitotic metaphase spreads of rye (Secale cereale L.) by using glass needles. The isolated chromosomes were amplified in vitro by Sau3A linker adaptor-mediated polymerase chain reaction (PCR). After amplification, the presence of rye-specific DNA was verified by Southern hybridization. The second-round PCR products from five 1R chromosomes were cloned into a plasmid vector to create a chromosome-specific library, which produced approximately 220,000 recombinant clones. Characterization of the microclone library showed that the 172 clones evaluated ranged in size from 300-1800 bp with an average size of 950 bp, of which approximately 42% were medium/high copy and 58% were low/unique copy clones. Chromosome in situ hybridization confirmed that the PCR products from microdissected chromosomes originated from chromosome 1R, indicating that many chromosome 1R-specific sequences were present in the library.

Myocardial bridges: effect of propranolol on systolic compression

Myocardial bridges may exert an ischemic effect on the myocardium and often warrant therapy including surgical correction in selected cases. Decrease in systolic compression after the administration of propranolol has not been reported. We report a patient who demonstrated angiographic systolic compression of the coronary artery with subsequent improvement on treatment with propranolol. The reduction in severity of systolic compression caused by propranolol may be due to the negative inotropic effect and perhaps from an increase in coronary artery vascular tone secondary to a beta-blocker with unopposed alpha effect. Further studies are needed to assess the efficacy of beta-blocker therapy in patients with myocardial bridging and the use of intravenous propranolol at the time of coronary angiography may have practical implications in selecting drug therapy for patients with symptomatic myocardial bridging.