Determination of the optimal position of the lower extremity for femoral nerve block with ultrasonographic measurements: a prospective volunteer-based study

OBJECTIVE

The aim of the study was to determine the optimal position for femoral nerve block (FNB) under ultrasound guidance.

PATIENTS AND METHODS

We included fifty volunteers between 18-65 years of age in this study. The distances from the skin to the landmarks, which were taken as a reference for the ultrasound-guided FNB (apex point of the femoral artery = F12, lateral point = F9, and lower point = F6), were measured and compared in 3 different positions given to the lower extremity (neutral position: P1, 45° abduction: P2, and flexed knee: P3). The ease of application and the quality of the ultrasound images were evaluated at each measurement by assigning a subjective observer score and comparing them in three positions.

RESULTS

All three measurement points were found to be closest to the skin at position P3. However, the distances from F9 (p = 0.023) and F6 (p = 0.006) to the skin were significant. A significant difference was found between P1 and P3 in terms of the distance from F9 (p = 0.027) and F6 to the skin (p = 0.007). P3 was determined to be the position with the highest score for clarity of the ultrasonography images and ease of detection of the measurement points (p < 0.001). As the scores of ease of access to the femoral nerve (FN) and image clarity increased, the distance from the measurement point to the skin surface decreased, which was statistically significant.

CONCLUSIONS

The ideal position for ultrasound-guided FNB is the P3 position. As an alternative for patients with limited mobility, the P2 position can be used.

The comparison of 1-year results for mini and wide-size cap grafts applied to nasal tips

OBJECTIVE

In the present study, we evaluated patient satisfaction with cap grafts by Rhinoplasty Outcomes Evaluation (ROE) scores. Mini cap and wide cap grafts were applied.

PATIENTS AND METHODS

A total of 80 patients who underwent a rhinoplasty operation with cap graft application to the tip region were included in the study. According to the cap graft size, there were two groups: Group 1 consisted of 40 patients with cap graft size ≤7 cm (mini cap group). Group 2 comprised 40 patients with cap grafts ≥8 cm (wide cap group). Patients in groups 1 and 2 underwent evaluations based on the following criteria at preoperative, postoperative-1st month, and postoperative-1st year intervals: (1) Rhinoplasty Outcomes Evaluation Questionnaire (ROE), (2) tip projection (cm), (3) nasal dorsum length (cm), (4) tip projection ratio (Goode), (5) nasofrontal angle, and (6) nasolabial angle.

RESULTS

Postoperative 1st-month and 1st-year ROE scores of the wide cap group were significantly higher than those in the mini cap group (p<0.05). Preoperative tip projection ratio (Goode) values of the wide cap group were considerably higher than those in the mini cap group (p<0.05). There were no significant differences between tip projection, nasal dorsum length, nasofrontal angle, and nasolabial angle values of the mini cap and wide cap groups (p>0.05). Correlation tests showed that as preoperative ROE scores decreased, postoperative-1st month and 1st-year ROE scores increased (p<0.05). Postoperative 1st-month and postoperative 1st-year's ROE scores increased together (p<0.05). In the wide cap group, postoperative 1st-month and postoperative 1st-year's ROE scores increased compared to the mini cap group (p<0.05). As postoperative 1st-year nasolabial angle values increased, postoperative 1st-year ROE scores also increased (p<0.05).

CONCLUSIONS

We found that patients who received wide-cap rhinoplasty had increased postoperative ROE scores and higher satisfaction rates during the first month and first year. Postoperative higher nasolabial angle values were related to higher ROE scores and patient satisfaction in the postoperative 1st year.

Retinal nerve fiber layer and ophthalmic artery blood flow parameters in pseudoexfoliation syndrome and pseudoexfoliative glaucoma

OBJECTIVES

To investigate the relationship between ophthalmic artery (OA) blood flow parameters and retinal nerve fiber layer (RNFL) thickness in eyes with pseudoexfoliation (PEX).

METHODS

We compared PEX eyes without glaucoma (group A, n=53) and those with glaucoma (group B, n=18) with control eyes (group C, n=44). Subsequently, eyes in groups A and B were compared. Finally, OA color Doppler imaging measurements were recorded, and peripapillary RNFL analysis was performed.

RESULTS

The total RNFL measurements differed significantly among the groups (P=0.012), being thicker in group C than in group A (P=0.010) and significantly different between group B and groups A and C (both P=0.001). The peak systolic velocity (PSV) and end diastolic velocity (EDV) measurements of groups A and B were lower than those of group C (PSV: P=0.001 and P=0.001, respectively; EDV: P=0.001 and P=0.001, respectively). No significant difference was noted in resistive index (RI) measurements (P=0.370). In group B, significant negative correlations were noted between total RNFL and PSV (r=-0.743; P=0.001) and between total RNFL and EDV (r=-0.691; P=0.001), but not between total RNFL and RI measurements (P=0.548).

CONCLUSIONS

Pseudoexfoliation syndrome (PXS) with or without glaucoma was associated with a decrease in the PSV and EDV values of the OA. An extensive study may be needed to further explore the role of PXS in OA blood flow parameters. Total RNFL thickness values were lower in eyes with PEX than in those without.

Hyperpigmentation on head and neck caused by polymyxin B: A rare case

Polymyxin B was widely used to treat drug-resistant gram-negative bacteria and showed a better antibacterial effect. However, it is associated with some side effects. It should be remembered that polymyxin B may cause hyperpigmentation, albeit rare. This is a case report of a 68-year-old male patient who developed hyperpigmentation following treatment of a chest infection with polymyxin B. He was a known patient with chronic kidney diasease and chronic obstructive pulmonary disease followed up in the intensive care unit due to acute exacerbation of COPD. Later, polymyxin B treatment was started due to the development of pneumonia caused by the multidrug-resistant Acinetobacter baumannii. On the second day of polymyxin B treatment, hyperpigmentation developed in the face and neck region. The fact that the patient had chronic kidney disease possibly facilitated the development of skin hyperpigmentation due to the cumulative effect of polymyxin B. Hyperpigmentation which a rare side effect of polymyxin B may occur in those with underlying kidney disease.

Comprehensive biomarker analysis of patients with idiopathic pulmonary fibrosis and interstitial lung disease with healthy individuals

OBJECTIVE

Interstitial lung diseases (ILDs) are a group of diffuse parenchymal lung disorders that can be idiopathic [idiopathic pulmonary fibrosis (IPF)] or associated with other diseases and are characterized by varying degrees of inflammation and fibrosis with poor prognosis. Several indicators are essential in diagnosing these individuals and differentiating between IPF and ILD.

PATIENTS AND METHODS

The study involved 44 IPF patients, 22 ILD (non-IPF) patients, and 24 healthy people. We aimed to compare ILD (non-IPF) and IPF patient groups with each other and with healthy people in terms of interleukin (IL)-1, tumor necrosis factor-alpha (TNF-α), matrix metalloproteinase (MMP)-1, MMP-7, galectin (Gal)-3, IL-6, Krebs von den Lungen-6 (KL-6), total antioxidant status (TAS), total oxidant status (TOS), pyruvate kinase (PK), complete blood count (CBC), ferritin, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) features. Furthermore, it was intended to assess the patient groups in terms of visual semi-quantitative score (VSQS) (IPF alone), respiratory function tests (RFT), and 6-minute walk test (6MWT), also potential correlations between these tests and the previously indicated parameters.

RESULTS

MMP-1, MMP-7, Gal-3, IL-6, KL-6, forced vital capacity (FVC), % FVC, forced expiratory volume in 1 second (FEV1), % FEV1, TAS, TOS, and PK values significantly elevated in IPF and ILD. Weight, IL-1, MMP-1, MMP-7, Gal-3, IL-6, KL-6, % FVC, FEV1, % FEV1, eosinophil count, and % red blood cell distribution width (RDW) values differed between IPF and ILD. VSQS, 6MWT, and PK were substantially linked with MMP-1, MMP-7, Gal-3, IL-6, and KL-6 in IPF.

CONCLUSIONS

The factors investigated can be helpful in the diagnosis and distinction of IPF and ILD. In addition to focusing on the inflammatory environment in IPF and ILD patients, oxidant and antioxidant interactions must be studied.

The effect of TAP block use in postoperative analgesic in cesarean section

OBJECTIVE

TAP (transversus abdominis plane) block is an important parameter of multimodal analgesia in the control of postoperative pain in cesarean section cases. In our study, we aimed to compare the analgesic consumption, patient satisfaction rate, vital signs, and visual analog scale (VAS) scores of ASA II patients with and without TAP block in cesarean surgery.

PATIENTS AND METHODS

This study was designed as a retrospective review of prospectively collected data and an open-label and randomized clinical trial. The files of 180 patients who underwent elementary cesarean section between January 2019 and December 2019 were analyzed. The ASA score, anesthesia method, age, weight, height, parity, TAP block application, VAS score, analgesia duration, the additional analgesic requirement for maintenance, patient satisfaction, postoperative nausea, vomiting, urinary retention, and other complications were recorded. The 180 patients included in the study were divided into 6 groups: Group 1 - General anesthesia, Group 2 - General anesthesia + TAP block, Group 3 - Spinal anesthesia, Group 4 - Spinal anesthesia + TAP block, Group 5 - Epidural anesthesia, and Group 6 - Epidural anesthesia + TAP block.

RESULTS

There was no significant difference between the groups in terms of demographic variables. The VAS scores of the first 24 hours were significantly different for Group 1. VAS scores in the 1st and 3rd hours were significantly higher in Group 1 than in the other groups. The groups without TAP block had significantly higher VAS scores at the 12th hour. Furthermore, the VAS score in Group 6 at 24 hours was significantly the lowest, and the earliest analgesic requirement was in Group 1. When the number of analgesic needs of the patients in 24 hours was examined, Group 1 was found to be significantly the highest, and Group 6 was significantly the lowest of all groups.

CONCLUSIONS

The epidural anesthesia + TAP block Group had the lowest VAS score, the fewest analgesic requirements, the longest analgesia length, and the highest patient satisfaction.

Investigation of ideal ointment combination to use in septorhinoplasty or nasal flap surgeries

OBJECTIVE

We aimed to create an ideal ointment combination to provide fast wound healing with the highest patient comfort after nasal surgery and nasal flap surgery.

MATERIALS AND METHODS

Twenty-one male Wistar rats were included. The flap survival method was used. The rats' healing process was evaluated in all groups. After having the same surgical procedure, the following ointments were applied to flap borders twice a day for seven days in each of the groups. In group 1 (Control, n=7), Dexpanthenol 5% (Dex); in group 2, Dex, Ciprofloxacin 0.5 % (Cip) and Ephedrine hydrochloride 1% (Eph); in group 3, Dex+Cip+Eph and Ketoprofen 2.5% (Ket) was applied. On the seventh postoperative day, the size of the necrosis on the flap was evaluated.

RESULTS

Median necrotic areas on skin flaps were 36.00% sq mm in group 1, 23.00% sq mm in group 2, and 5.00% sq mm in group 3. Flap necrosis areas on skin flaps were group 3 <group 2 <group 1 (p adjusted <0.0175). The necrosis areas of groups 2 and 3 were significantly lower than the control group, and the necrosis areas of group 3 were significantly lower than group 2 (p adjusted <0.0175).

CONCLUSIONS

For the postoperative healing process and to prevent flap necrosis, the Dex+Cip+Eph+Ket combination was recommended in the first order. Dex+Cip+Eph combination also reduced skin necrosis in the flaps as the second order. Only Dex treatment is not enough for the completion of the healing process. The best results were provided by the Dex+Cip+Eph+Ket combination and recommended its usage after septorhinoplasty surgeries or nasal flap surgeries to prevent flap necrosis.

Effect of different clinical practices on postoperative pain in permanent mandibular molar teeth with symptomatic apical periodontitis: A randomized controlled clinical trial

Aims

This clinical study aimed to evaluate the effect of different clinical practices with endodontic emergency treatment on postoperative pain in mandibular permanent molar teeth with symptomatic apical periodontitis.

Methods

In the present study, root canal treatment was applied to 100 patients who met the inclusion criteria. Patients were randomly assigned to 5 groups (control, nonsteroidal anti-inflammatory drug [NSAID], NSAID and antihistaminic drug combination, placebo drug, and intracanal cryotherapy) using a web program. In the first visit, after preparation with the WaveOne Gold file system, calcium hydroxide (Ca(OH)₂) medicament was placed on the root canals. However, after the treatment of the patients was completed, six patients patients were excluded from the study because they did not come to the control appointment 7 days later. After the removal of Ca(OH)₂ medicament in the second session, the root canals were obturated according to cold lateral condensation technique and final restorations of the teeth were performed. Patients' preoperative and postoperative pain values (4-8-12-24-48 and 72 hours) determined by visual analog scale (VAS) were recorded. The data were analyzed statistically using analysis of variance, Kruskal-Wallis test, Friedman test, Wilcoxon test, and Chi-square test.

Results

According to the results of our study; there was no significant difference between the groups in terms of age, gender, preoperative pain, and postoperative analgesic requirement (P > 0.05). In all groups, there were significant differences between the values of different times (P < 0.05). While initial pain values were higher than the hours after treatment (P < 0.05), there was no significant difference between postoperative pain values (P > 0.05). When the groups in terms of pain scales measured at different times compared with each other; in all times there was no significant difference between the groups (P > 0.05).

Conclusion

It was observed that all clinical practices significantly reduced preoperative pain.

Inner mitochondrial membrane protein MPV17 mutant mice display increased myocardial injury after ischemia/reperfusion

MPV17 is an inner mitochondrial membrane protein whose mutation results in mitochondrial DNA (mtDNA) depletion diseases such as neurohepatopathy. MPV17 is expressed in several organs including the liver and kidneys. Here, we investigated its role and mechanism of action in cardiac ischemia/reperfusion (I/R) injury. Using isolated hearts from wild type and Mpv17 mutant (Mpv17^mut) mice, we found that mtDNA levels and normal cardiac function were similar between the groups. Furthermore, reactive oxygen species (ROS) generation, mitochondrial morphology, and calcium levels required to trigger mitochondrial permeability transition pore (mPTP) opening were all similar in normal/non-ischemic animals. However, following I/R, we found that mutant mice had poorer cardiac functional recovery and exhibited more mitochondrial structural damage. We also found that after I/R, Mpv17^mut heart mitochondria did not produce more ROS than wild type hearts but that calcium retention capacity was gravely compromised. Using immunoprecipitation and mass spectrometry, we identified ATP synthase, Cyclophilin D, MIC60 and GRP75 as proteins critical to mitochondrial cristae organization and calcium handling that interact with MPV17, and this interaction is reduced by I/R. Together our results suggest that MPV17 has a protective function in the heart and is necessary for recovery following insults to the heart.

Epithelium-off corneal cross-linking in progressive keratoconus: 6- year outcomes

PURPOSE

To evaluate the long-term results of corneal collagen cross-linking (CXL) with epithelium removal in patients with progressive keratoconus.

METHODS

This retrospective study included 27 eyes of 18 patients who underwent CXL surgery for progressive keratoconus between April 2009 and March 2012. Best-corrected visual acuity (BCVA), manifest refraction spherical equivalent (SE), maximum keratometry reading (K max), mean of the minimum and maximum keratometry readings (mean-K), central corneal thickness (CCT), and anterior and posterior elevation at the apex preoperatively and year 1, 3 and 6 were evaluated and compared. P values<0.05 were considered to be statistically significant.

RESULTS

Mean BCVA was 0.35±0.28 logMAR preoperatively and 0.23±0.20 logMAR 6 years after the procedure (P=0.01). Mean SE decreased from -4.3±2.45 diopters (D) to -3.91±2.12 D (P=0.03). Mean K max decreased from 49.6±3.2 D to 48.6±2.8 D (P=0.04), and mean-K decreased from 47.6±2.5D to 46.9±2.6 D (P=0.04). CCT decreased insignificantly from 466.5±32.1μm to 465.4±26.6μm (P=0.65). Mean anterior elevation at the apex decreased from 12.8±7.9 to 12±8.3μm (P=0.04), and posterior elevation decreased from 27.1±17.4μm to 26.8±18.5μm (P=0.27). Mean-K, max-K, BCVA and CCT showed no change over the last 5 years. After the first year, no significant change was observed in BCVA, SE, max-K, mean-K and CCT, which were therefore considered stable. On the other hand, anterior and posterior elevation readings continued to decrease up to 6 years after CXL.

CONCLUSION

Based on our 6-year results, CXL can halt progression of keratoconus and reduce the need for keratoplasty.

Effect of aflibercept on persistent macular edema secondary to central retinal vein occlusion

PURPOSE

To evaluate the efficacy of switching treatment from intravitreal ranibizumab to intravitreal aflibercept on the treatment of refractory macular edema secondary to central retinal vein occlusion (CRVO).

METHODS

In this retrospective study; 12 eyes with refractory macular edema secondary to CRVO after multiple monthly repeated intravitreal 0.5mg/0.05mL ranibizumab injections prior to switching therapy to intravitreal 2mg/0.05mL aflibercept, between March 2012 and April 2016 were reviewed. The follow-up time was 12 months. Changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), central retinal volume (CRV) and injection interval between baseline and month 1, 3, 6 and 12 after switching therapy to aflibercept were reviewed and evaluated.

RESULTS

Mean baseline CRT decreased from 516±101 mic. to 252±114 mic. at month 12 (P=0.008). Mean baseline CRV decreased from 8.74±2.13 mm³ to 6.82±1.64 mm³ at month 12 (P=0.005). Baseline BCVA improved from 0.73±0.21 to 0.53±0.17 logMAR at month 12 (P=0.004). Mean BCVA gain was two logMar lines (10 letters) at month 12. After switching therapy to aflibercept; the mean injection interval increased significantly from 1.34 months at baseline to 1.86 months at month 12, by an increase of 0.52 months (P=0.02).

CONCLUSION

Intravitreal aflibercept is evaluated to be presenting significant visual and anatomical improvements in patients with persistent macular edema due to CRVO despite previous intravitreal ranibizumab.

Mitochondrial inner membrane protein (mitofilin) knockdown induces cell death by apoptosis via an AIF-PARP-dependent mechanism and cell cycle arrest

Mitofilin is an inner membrane protein that has been defined as a mitochondria-shaping protein in controlling and maintaining mitochondrial cristae structure and remodeling. We determined the role of mitofilin in cell survival by investigating the mechanism underlying mitofilin knockdown-induced cell death by apoptosis. Cultured H9c2 myoblasts and HEK 293 cells were treated with mitofilin siRNA or scrambled siRNA for 24 h. Cell death (apoptosis), caspase 3 activity and cell cycle phases were assessed by flow cytometry, while cytochrome c release and intracellular ATP production were measured by ELISA. Mitofilin, apoptosis-inducing factor (AIF) and poly(ADP-ribose) polymerase (PARP) expression were measured by Western blot analysis and calpain activity was assessed using a calpain activity kit. Mitochondrial images were taken using electron microscopy. We found that mitofilin knockdown increases apoptosis mainly via activation of the AIF-PARP pathway leading to nuclear fragmentation that is correlated with S phase arrest of the cell cycle. Knockdown of mitofilin also led to mitochondrial swelling and damage of cristae that is associated with the increase in reactive oxygen species production and mitochondrial calpain activity, as well as a marked decrease in intracellular ATP production and mitochondrial membrane potential. Together, these results indicate that mitofilin knockdown by siRNA increases calpain activity that presumably leads to mitochondrial structural degradation resulting in a critical reduction of mitochondrial function that is responsible for the increase in cell death by apoptosis via an AIF-PARP mechanism and associated with nuclear fragmentation, and S phase arrest of the cell cycle.

Change in choroidal thickness after intravitreal injection for treatment of neovascular age-related macular degeneration: Ranibizumab versus aflibercept

PURPOSE

To compare the changes in subfoveal choroidal thickness after intravitreal ranibizumab or aflibercept injections for neovascular age-related macular degeneration (nAMD).

METHODS

In this retrospective study, 28 eyes with nAMD treated with 3 consecutive monthly injections of ranibizumab (IVR) and 24 eyes with nAMD treated with 3 consecutive monthly injections of aflibercept (IVA) between September 2012 and June 2016 were reviewed. The follow-up time was 6 months. Changes in two groups' best-corrected visual acuity (BCVA) and subfoveal choroidal thickness by using enhanced depth imaging optical coherence tomography at 1st, 3rd and 6th months were recorded and compared.

RESULTS

Choroidal thickness decreased significantly in eyes treated with IVR (P=0.015, 0.01 and 0.01, respectively) or IVA (P=0.001, 0.001 and ˂0.001, respectively) at 1, 3 and 6 months examination but IVA treated eyes presented a significantly further reduction in choroidal thickness when compared with ranibizumab (P=0.03, 0,04 and 0.03, respectively). There was no significant difference between aflibercept and ranibizumab group when change in BCVA from baseline compared at 1, 3 and 6th months (P=0.54, 0.06 and 0.37, respectively). There was no correlation between change in choroidal thickness and the BCVA outcomes in either group.

CONCLUSIONS

Subfoveal choroidal thickness decreased significantly after both of IVR and IVA injections in patients with nAMD. In conclusion, intravitreal injections of ranibizumab or aflibercept affect not only neovascular lesion but also the underlying choroid.

Evaluation of oxidative stress via total antioxidant status, sialic acid, malondialdehyde and RT-PCR findings in sheep affected with bluetongue

INTRODUCTION

Bluetongue (BT) is a non-contagious infectious disease of ruminants. The disease agent bluetongue virus (BTV) is classified in the Reoviridae family Orbivirus.

AIMS AND OBJECTIVES

The aim of this study was to determine serum malondialdehyde (MDA), total antioxidative stres (TAS), total sialic acid (TSA), ceruloplasmin, triglyceride, alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), cholesterol, creatinine, albumin, and total protein levels in sheep with and without bluetongue (BT).

MATERIALS AND METHODS

The study included 13 Sakiz crossbreed sheep, aged 1-4 years and usually in the last stage of pregnancy, as the BT group and a control group consisting of 10 healthy sheep. All sheep were clinically examined before collecting blood samples. Serum ALT, AST, cholesterol, triglyceride, albumin, GGT, total protein, creatinine and TAS levels were measured using commercially available kits as per manufacturer's recommendations using a Biochemistry Auto Analyzer (Sinnowa D280, China). Serum lipid peroxidation was estimated through a previously described method in which MDA reacts with thiobarbituric acid (TBA) to form a coloured complex at a maximum absorbance of 535 nm. The TSA value was measured at 549 nm using the method described by Warren (1959): sialic acid was oxidised to formyl-pyruvic acid, which reacts with TBA to form a pink product. The ceruloplasmin concentration was measured according to Sunderman and Nomoto (1970): ceruloplasmin and p-phenylenediamine formed a coloured oxidation product that was proportional to the concentration of serum ceruloplasmin. Real time RT-PCR and conventional RT-PCR were performed as described by Shaw and others (2007).

RESULTS

Biochemistry analysis of serum showed that in the BT group, TSA, MDA, triglyceride and ALT and AST were higher and that ceruloplasmin and TAS were lower than in the control group. Serum albumin, cholesterol, creatinine, total protein and GGT did not differ significantly between the two groups.

CONCLUSIONS

Serum triglyceride, ceruloplasmin, TSA, MDA and TAS concentrations may prove beneficial to the diagnosis, prognosis and biochemical analysis of BT.

Comparison of transepithelial corneal collagen crosslinking with epithelium-off crosslinking in progressive keratoconus

PURPOSE

To evaluate the safety and efficacy of transepithelial corneal collagen crosslinking (TE-CXL) as compared to epithelium-off crosslinking (epi-off CXL) in progressive keratoconus.

METHODS

Records of keratoconus patients treated with TE-CXL or epi-off CXL were reviewed retrospectively. Patients were included if they had at least 12months follow-up. Pre- and postoperative measurements of visual acuity, refractive errors, keratometry, corneal topography and pachymetry were assessed and compared.

RESULTS

There was no statistically significant difference between two groups at baseline in terms of demographic, refractive and corneal parameters. Mean maximum cone apex curvature (apical K) increased from 51.62±5. Eighty-four diopters (D) to 53.70±5.49 D in the TE-CXL group (n=17), and decreased from 52.02±4.07 D to 51.22±3.51 in the epi-off CXL group (n=19) at the end of the follow-up period. The difference between two groups was statistically significant (P=0.0002). An increase of≥1D in apical K was observed in two of 19 eyes (11%) in the epi-off CXL group, and 11 of 17 eyes (65%) in TE-CXL group at the last follow-up visit, compared to baseline (P<0.0001). Fourteen patients in the epi-off CXL group exhibited corneal edema that resolved without haze with topical corticosteroid treatment by 4months. No postoperative corneal edema was observed in TE-CXL group.

CONCLUSIONS

Although it is safe and well tolerated, TE-CXL does not effectively halt the progression of keratoconus. Epi-off CXL appears to be effective in stopping progression and even improves corneal parameters.

Different recovery methods and muscle performance after exhausting exercise: comparison of the effects of electrical muscle stimulation and massage

In this study we assessed the influence of the three different recovery interventions massage (MSG), electrical muscle stimulation (EMS), and passive rest (PR) on lactate disappearance and muscle recovery after exhausting exercise bouts. Twelve healthy male sport students participated in the study. They attended the laboratory on five test days. After measurement of V.O₂max and a baseline Wingate test (WG_b), the three recovery interventions were tested in random counterbalanced order. High intensity exercise, which consisted of six exhausting exercise bouts (interspersed with active recovery), was followed by MSG, EMS or PR application (24 minutes); then the final Wingate test (WG_f) was performed. Lactate, heart rate, peak and mean power, rating of perceived exertion (RPE), and total quality of recovery (TQR) were recorded. In WG_f mean power was significantly higher than in WG_b for all three recovery modalities (MSG 6.29%, EMS 5.33%, PR 4.84% increase, p < 0.05), but no significant differences in mean and peak power were observed between the three recovery modes (p > 0.05). The heart rate response and the changes in blood lactate concentration were identical in all three interventions during the entire protocol (p = 0.817, p = 0.493, respectively). RPE and TQR scores were also not different among the three interventions (p > 0.05). These results provide further evidence that MSG and EMS are not more effective than PR in the process of recovery from high intensity exercise.

Ascorbic Acid and gene expression: another example of regulation of gene expression by small molecules?

Ascorbic acid (vitamin C, AA) has long been considered a food supplement necessary for life and for preventing scurvy. However, it has been reported that other small molecules such as retinoic acid (vitamin A) and different forms of calciferol (vitamin D) are directly involved in regulating the expression of numerous genes. These molecules bind to receptors that are differentially expressed in the embryo and are therefore crucial signalling molecules in vertebrate development. The question is: is ascorbic acid also a signalling molecule that regulates gene expression?

We therefore present and discuss recent publications that demonstrate that AA regulates the expression of a battery of genes. We offer a clue to understanding the biochemical mechanism by which AA regulates gene expression. Finally we will discuss the question of a receptor for AA and its potential involvement in embryonic development and cell differentiation.

Database of queryable gene expression patterns for Xenopus

The precise localization of gene expression within the developing embryo, and how it changes over time, is one of the most important sources of information for elucidating gene function. As a searchable resource, this information has up until now been largely inaccessible to the Xenopus community. Here, we present a new database of Xenopus gene expression patterns, queryable by specific location or region in the embryo. Pattern matching can be driven either from an existing in situ image, or from a user-defined pattern based on development stage schematic diagrams. The data are derived from the work of a group of 21 Xenopus researchers over a period of 4 days. We used a novel, rapid manual annotation tool, XenMARK, which exploits the ability of the human brain to make the necessary distortions in transferring data from the in situ images to the standard schematic geometry. Developmental Dynamics 238:1379-1388, 2009. (c) 2009 Wiley-Liss, Inc.

Antiproliferative effect of ascorbic acid is associated with the inhibition of genes necessary to cell cycle progression

Background

Ascorbic acid (AA), or Vitamin C, is most well known as a nutritional supplement with antioxidant properties. Recently, we demonstrated that high concentrations of AA act on PMP22 gene expression and partially correct the Charcot-Marie-Tooth disease phenotype in a mouse model. This is due to the capacity of AA, but not other antioxidants, to down-modulate cAMP intracellular concentration by a competitive inhibition of the adenylate cyclase enzymatic activity. Because of the critical role of cAMP in intracellular signalling, we decided to explore the possibility that ascorbic acid could modulate the expression of other genes.

Methods and Findings

Using human pangenomic microarrays, we found that AA inhibited the expression of two categories of genes necessary for cell cycle progression, tRNA synthetases and translation initiation factor subunits. In in vitro assays, we demonstrated that AA induced the S-phase arrest of proliferative normal and tumor cells. Highest concentrations of AA leaded to necrotic cell death. However, quiescent cells were not susceptible to AA toxicity, suggesting the blockage of protein synthesis was mainly detrimental in metabolically-active cells. Using animal models, we found that high concentrations of AA inhibited tumor progression in nude mice grafted with HT29 cells (derived from human colon carcinoma). Consistently, expression of tRNA synthetases and ieF2 appeared to be specifically decreased in tumors upon AA treatment.

Conclusions

AA has an antiproliferative activity, at elevated concentration that could be obtained using IV injection. This activity has been observed in vitro as well in vivo and likely results from the inhibition of expression of genes involved in protein synthesis. Implications for a clinical use in anticancer therapies will be discussed.

Ascorbic acid is a regulator of the intracellular cAMP concentration: old molecule, new functions?

Recently, using an animal model of Charcot-Marie-Tooth human disorder, we showed that ascorbic acid (AA) represses PMP22 gene expression by acting on intracellular cAMP concentrations. In this work, we present kinetics data on the inhibitory effect of AA upon adenylate cyclase activity. The data show that this molecule acts as a competitive inhibitor of the enzyme, a finding that opens new pharmacological avenues.

Ascorbic acid inhibits PMP22 expression by reducing cAMP levels

Charcot-Marie-Tooth [CMT] syndrome is the most common hereditary peripheral neuropathy. CMT1A, which accounts for 50% of all CMT cases, usually results from triploidy of the PMP22 gene. Preclinical trials using an animal model show that disabled mice force-fed with high doses of ascorbic acid partially recover muscular strength after a few months of treatment, and suggest that high doses of ascorbic acid repress PMP22 expression. In this study, we demonstrated that ascorbic acid represses PMP22 gene expression by acting on intracellular cAMP levels and adenylate cyclase activity. This action is dose dependent and specific to ascorbic acid, since repression is not observed after treatment with other antioxidants. The new properties of ascorbic acid are discussed, along with the implications of these findings for CMT disease treatment.

Effect of 5-aminoimidazole-4-carboxamide riboside (AICA-r) on isolated thoracic aorta responses in streptozotocin-diabetic rats

Diabetes mellitus alters the vascular responsiveness to several vasoconstrictors and vasodilators. 5-amino-4-imidazole-carboxamide riboside (AICA-r), a nucleoside corresponding to AICA-ribotide and an intermediate of the de novo pathway of purine biosynthesis, was recently proposed as a new insulinotropic tool in non-insulin-dependent diabetes mellitus. The aim of the present study was to define whether AICA-r affects altered vascular responsiveness to vasoconstrictors and vasodilators in the thoracic aorta of neonatal streptozotocin (STZ)-diabetic rats. The results of this study indicate that a 1-month treatment with AICA-r significantly increases the body weight in diabetic rats; significantly decreases the blood glucose level of diabetic rats (from 302+/-47 to 135+/-11 mg/dL, p<0.001); does not significantly affect the fast, slow, and total components of responses to noradrenaline in all the experimental groups; reverses the increased Emax values of noradrenaline in diabetic rats to near-control values; reverses the completely abolished responses of acetylcholine (pD2 and percent relaxation) in diabetic rats to control values; and reverses the decreased pD2 values of sodium nitroprussiate in diabetic rats to control values. In conclusion, AICA-r treatment in neonatal STZ-diabetic rats improved increased blood glucose levels, accelerated weight gain, reversed endothelial dysfunction, and normalized vascular responses.

Effects of acid inhibition on somatostatin-producing cells in the rat gastric fundus

Somatostatin plays a role in the regulation of gastric acid secretion. Omeprazole, a potent inhibitor of gastric acid secretion, has been reported to cause either a significant decrease or increase in the formation of gastric somatostatin-producing cells. Therefore, we determined in the present study distribution patterns of somatostatin mRNA and protein in fundus mucosa of rats after long-term inhibition of gastric acid secretion. Female Sprague-Dawley rats were given 0, 20 and 100 mg/kg/day omeprazole, respectively, as gastric instillations during 2 months. Serum gastrin levels were significantly higher in the third group than in the other groups. The omeprazole-treated groups also showed an increase in the number of somatostatin-containing cells in fundus mucosa. Moreover, the intensity of somatostatin-positivity was higher in the treated groups than in the control group. We also observed an increase in the number of cells containing somatostatin mRNA in fundus mucosa of omeprazole-treated rats. These results suggest that long-term inhibition of acid secretion does not inhibit but stimulate somatostatin production in mucosa of rat gastric fundus.

Influence of lignin and its degradation products on enzymatic hydrolysis of xylan

The influence of lignin, lignin model compounds, and black liquor from the kraft pulping process on the hydrolysis of xylan by xylanase was investigated. Addition of vanillic acid, acetovanillone, and protocatechuic acid increased the rate of hydrolysis of xylan by as much as 18-50% at low concentrations, but reached maxima at about 0.05% concentration. Addition of vanillin caused a 15% improvement in xylan hydrolysis, while addition of guaiacol more than doubled the hydrolysis rate. Increasing concentrations of either lignin or black liquor also increased the hydrolysis rate of xylan. Circular dichroism spectroscopy indicated a change in the structure of xylanase in the presence of black liquor.

Effects of dopamine receptor agonists on food intake and rumen motility in dwarf goats

In ruminants, the dopaminergic regulation of feeding behaviour has not been investigated. Therefore, the effects of dopamine receptor agonists and antagonists on food intake and forestomach motility were studied in dwarf goats. Goats treated i.v. with bromocriptine (1 micrograms or 2.5 micrograms/kg body wt/min during 10 min) ate less food than when treated with saline. This inhibitory effect on food intake could not be prevented by the peripheral dopamine receptor antagonist domperidone (0.5 mg/kg body wt i.v.). In contrast, dopamine (i.v. 20 micrograms/kg body wt/min during 15 min), levodopa (i.v. 40 micrograms/kg body weight during 10 min), apomorphine (i.v. 2 micrograms/kg body wt/min during 10 min) and lisuride (i.v. 0.2 microgram/kg body wt/min during 15 min and 0.5 microgram/kg body wt during 10 min) failed to modify food intake. Given in association with benserazide, a decarboxylase inhibitor (i.v. 20 micrograms/kg body wt/min during 10 min), levodopa was still inactive as an anorectic agent. Levodopa, bromocriptine and lisuride administered at similar dose rates to those which were used in the food intake experiments, induced some clinical signs including inhibition of forestomach contractions. The inhibition of rumen contractions induced by these drugs was completely antagonized by domperidone pretreatment. These results, together with earlier in vivo and in vitro observations, suggest that the inhibitory effects of dopamine receptor agonists on forestomach contractions are due to interactions with peripheral dopaminergic receptors. The change in smooth muscle tension, which leads to a change in the signals transmitted via vagal afferents to the central nervous system, probably does not modify feeding behaviour in dwarf goats.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in food intake and forestomach motility of dwarf goats by recombinant bovine cytokines (IL-1 beta, IL-2) and IFN-gamma

The present study was carried out to investigate the effects of rboIL-1 beta, rboIL-2, and rboIFN-gamma on food intake and forestomach motility in conscious dwarf goats. The intravenous injection of rboIL-1 beta (1 micrograms kg-1) resulted in tachycardia and an immediate fever that reached peak values 45 and 180 min after injection. At 9 to 13 min after rboIL-1 beta administration, both frequency and amplitude of rumen contractions rapidly diminished, being minimal at 30 min; during the fever, all goats refused to eat. Compared with the fever induced by rboIL-1 beta, that caused by rboIFN-gamma (2 micrograms kg-1 IV) was delayed in onset. Although the biphasic fever after rboIFN-gamma was more pronounced than after rboIL-1 beta, the changes in forestomach motility, food intake, and heart rate were less than after rboIL-1 beta. No changes in rectal temperature, heart rate, forestomach motility, and food intake were observed after rboIL-2 (1 micrograms kg-1 IV) injection. These results strongly indicate that the effects of cytokines on body temperature can be dissociated from their effects on food intake. Furthermore, these data suggest a possible relationship between forestomach motility and food intake.

Food intake and rumen motility in dwarf goats. Effects of some serotonin receptor agonists and antagonists

The serotonergic regulation of feeding behaviour has not so far been studied in ruminants. Therefore, the effects of some serotonin (5-HT) receptor agonists and antagonists on food intake and forestomach motility were studied in dwarf goats. Goats ate less food when treated intravenously (IV) with the 5-HT precursor 5-HTP (25 micrograms, 50 micrograms or 100 micrograms kg-1 min-1 over 15 min) than when they were treated with 5-HT (which does not pass the blood-brain barrier) or with saline. Accordingly, IV dexfenfluramine infusions (50 micrograms or 100 micrograms kg-1 min-1 over 15 min), which induces release of brain 5-HT, also led to dose-related reductions in food intake. In contrast, no anorectic effects were observed after IV infusions with the selective 5-HT reuptake inhibitor fluoxetine (100 micrograms kg-1 min-1 over 15 min), the selective 5-HT1A agonist 8-OH-DPAT (0.5 micrograms kg-1 min-1 over 15 min), or eltoprazine (4 or 8 micrograms kg-1 min-1 over 15 min), a mixed 5-HT1A/5HT1B receptor agonist. None of the 5-HT antagonists tested gave any increase in food consumption in this model. Interestingly, the non-selective 5-HT receptor antagonist methysergide (360 micrograms/kg IV) reduced food intake. This effect was most noticeable at 3 h after injection. The 5-HT3 receptor antagonist ondansetron (IV 10 micrograms kg-1 min-1 over 15 min) and the peripheral 5-HT2 receptor antagonist xylamidine (IV 100 micrograms kg-1 min-1 over 10 min) failed to modify food intake. These results provide evidence for central serotonergic involvement in the control of feeding. However, this control system differs markedly in goats and rodents. Dexfenfluramine, 5-HTP and eltoprazine administered at similar dose rates to those used in the food intake experiments induced some clinical signs including inhibition of forestomach contractions. These results, together with our earlier in vivo and in vitro observations, suggest that the inhibitory effects of serotonin receptor agonists on forestomach contractions are due to interactions with both peripheral and central serotonergic receptors. The change in smooth muscle tension, which leads to a change in the signals transmitted via vagal afferents to the central nervous system, appears not to modify feeding behaviour in dwarf goats.