Longitudinal Comparative Analysis of Semi-Automated Aqueous Flare Measurements with Clinical Grading and Visual Outcomes in Uveitic Eyes

PURPOSE

To evaluate the correlation between longitudinal changes in aqueous flare measured by laser flare photometer (LFP), best-corrected visual acuity (BCVA), and clinical grade using both Standardization of Uveitis Nomenclature (SUN) and modified SUN (MSUN) scales uveitis patients.

METHODS

Patients were classified according to both SUN and MSUN grading scales. LFP measurements were acquired (Kowa FM-700) at each visit. Mean change in LFP was assessed longitudinally, comparing with those in visual acuity, SUN, and MSUN grading scales.

RESULTS

Mean change in LFP was correlated to those in BCVA (p = .018), SUN scale (p < .001), and MSUN scale (p = .008). Cases within same initial SUN (0 and 1+) and MSUN (0.5+ and 1+) grades and different longitudinal flare prognosis (decreased/unchanged/increased) had significantly different initial LFP values (all p < .05).

CONCLUSIONS

LFP measurement is beneficial in monitoring inflammatory activity. Cases of identical clinical flare scores with different clinical prognosis may be predicted by LFP.

Blue light versus green light fundus autofluorescence in normal subjects and in patients with retinochoroidopathy secondary to retinal and uveitic diseases

PURPOSE

The aim of this study is to evaluate the differences in the fundus autofluorescence (FAF) signal between the blue light autofluorescence (BAF) from Spectralis® (Heidelberg, CA) and green light autofluorescence (GAF) 200TxTM (OPTOS, UK, in normal subjects and in patients with retinochoroidopathies (RC).

METHODS

In this prospective study, FAF was performed using BL (λ = 488 nm) and GL (λ = 532 nm) on normal subjects and patients with RC. The corresponding pairs of BAF and GAF images from both groups were analyzed using Photoshop. The strength of the FAF signal was measured on a gray scale, where optic disc was a standard to indicate absence of AF. In addition, gray values obtained from three identical points (foveal center, and points of hypo and hyper autofluorescence) in the corresponding BAF and GAF images of normal and RC subjects were divided by the optic disc value to calculate autofluorescence signal ratio (R). The R values at fovea (R1), hypoautofluorescent point (R2), and hyperautofluorescent point (R3) were compared between BAF and GAF modalities, in normal and in RC subjects separately.

RESULTS

One hundred six pairs (106 eyes) of FAF images analyzed (37 pairs: normal and 69 pairs: RC subjects). In normal subjects, the mean R1, R2, and R3 values for BAF were (1.5 ± 0.88, 1.23 ± 0.58, and 4.73 ± 2.85, respectively) and for GAF were (0.78 ± 0.20, 0.78 ± 0.20, and 1.62 ± 0.39, respectively). Similarly, in subjects with RC, the mean R1, R2, and R3 values for BAF were (1.68 ± 1.02, 1.66 ± 1.15, and 7.75 ± 6.82, respectively) and for GAF were (0.95 ± 0.59, 0.79 ± 0.45, and 2.50 ± 1.65, respectively). The mean difference in the R1, R2, and R3 ratios between BAF and GAF in normal and in RC subjects was statistically significant (p < 0.001). The strength of the correlation (r) between ratios for BAF and GAF was weak or not statistically significant in both normal and RC subjects (p > 0.05).

CONCLUSION

The distribution and intensity of the AF signal differ in BAF and GAF and cannot be used interchangeably. In BAF, optic disc signal is always weaker than in other areas, which was not true for GAF where optic disc signal was stronger than fovea and hypoautofluorescent point in both groups.

Transcatheter Aortic Valve Implantation (TAVI): First Case in Bangladesh

We came across an 81 years old male with symptomatic severe aortic stenosis. He was hypertensive and had history of CABG 9 years back. Due to his advanced age and co morbidities, he was at high surgical risk. He underwent transcatheter aortic valve implantation in our centre (United Hospital Ltd) in July 2017 and no complications occurred during or in the peri-procedural period. He had good functional and haemodynamic results at 3 months follow-up.

A Mesopore-Dependent Catalytic Cracking of n-Hexane Over Mesoporous Nanostructured ZSM-5

Herein, pore size, crystalinity, and Si/Al ratio of mesoporous ZSM-5 (MFI) nanocrystals was controlled by synthesis parameters, such as surfactant concentration ([3-(trimethoxysilyl)propyl] hexa-decyl dimethyl ammonium chloride), sodium hydroxide concentrations, synthesis temperature and time. The morphology, surface structure and composition of the MFI particles was systematically investigated. More notably, the mesopore-dependent catalytic activity of ZSM-5 was evaluated by studying the cracking of n-hexane. The findings suggest the porosity has pronounced impact on the catalytic activity, selectivity and stability of ZSM-5 nanocrystals. Critical surface attributes such as nature of acid sites (Brønsted and Lewis), concentration, and strength are obtained by the infrared study of adsorbed probe molecules (pyridine) and the temperature programmed desorption. In spite of being weaker in Si/Al ratio or acidic strength, mesoporous catalysts showed more stable and efficient cracking of n-hexane suggesting that acidity seems not the predominant factor operative in the activity, selectivity and stability.

A novel fabrication methodology for sulfur-doped ZnO nanorods as an active photoanode for improved water oxidation in visible-light regime

Incorporation of foreign moiety in the lattice of semiconductors significantly alters their optoelectronic behavior and opens a plethora of new applications. In this paper, we report the synthesis of sulfur-doped zinc oxide (S-doped ZnO) nanorods by reacting ZnO nanorods with diammonium sulfide in vapor phase. Microscopic investigation revealed that the morphological features, such as, the length (2-4 μm) and width (100-250 nm) of the original hexagonal ZnO nanorods remained intact post-sulfidation. X-ray photoelectron spectroscopy analysis of the sulfide sample confirmed the incorporation of sulfur into ZnO lattice. The optical measurements suggested the extension of absorption threshold into visible region upon sulfidation. Photoelectrochemical (PEC) activities of pure and S-doped ZnO nanorods were compared for water oxidation in visible light (λ > 420 nm), which showed several-fold increment in the performance of S-doped ZnO sample; the observed amelioration in the PEC activity was rationalized in terms of preferred visible light absorption and low resistance of sulfide sample, as evidenced by optical and electrochemical impedance spectroscopy.

Single-Pot Synthesis of ⟨001⟩-Faceted N-Doped Nb2O5/Reduced Graphene Oxide Nanocomposite for Efficient Photoelectrochemical Water Splitting

Due to exciting catalytic activity and selectivity, tailoring of nanocatalysts consisting of preferred crystal facets and desired structural properties remains at the forefront of materials engineering. A facile one-step nonhydrolytic solvothermal synthesis of a nanocomposite of reduced graphene oxide and one-dimensional nitrogen-doped Nb2O5 (N-NbOx) with exposed ⟨001⟩ facet is described. Triethylamine performed the dual role as nitrogen source and capping agent to control the size and unidirectional growth of Nb2O5 nanocrystallites. The nanocomposite showed efficient visible-light-mediated (λ > 420 nm) water splitting in a photoelectrochemical cell. A plausible mechanism for the formation of N-NbOx nanorods and improved photoelectrochemical efficacy in terms of their oriented growth is proposed.

Naltrexone treatment in clomiphene resistant women with polycystic ovary syndrome

BACKGROUND

Endogenous opiates may affect various aspects of reproductive and metabolic function in patients with polycystic ovary syndrome (PCOS). This study evaluated long-term inhibition of the opioid system using naltrexone in clomiphene citrate (CC)-resistant women with PCOS.

METHODS

A group of 30 infertile females with PCOS were evaluated; all subjects were obese, hyperandrogenic and hyperinsulinemic; 16 patients were amenorrhic and 14 were oligomenorrhic. All subjects received natrexone (50 mg p.o. daily) for 6 months. Patients who did not ovulate after 12 weeks of naltrexone monotherapy, also received CC (starting at 50 mg/day for 5 days and, for non-responders, increasing it up to 150 mg/day).

RESULTS

Of the 30 women, 3 ovulated during naltrexone monotherapy and 19 of the remaining 27 ovulated during naltrexone + CC therapy. There were no conceptions during naltrexone monotherapy, but 9 of 27 women (33.3%) conceived during naltrexone + CC; there was one missed abortion at 9 weeks, one preterm delivery at 34 weeks and seven term live births. Naltrexone therapy was also followed by significant reductions in BMI, fasting serum insulin, luteinizing hormone (LH), LH/follicle-stimulating hormone ratio and testosterone.

CONCLUSIONS

In this preliminary trial, naltrexone improved endocrine and metabolic function in women with CC-resistant PCOS. Furthermore, naltrexone restored CC sensitivity in the majority of subjects, resulting in a significant number of pregnancies.

Identification of simple sequence repeat markers for utilizing wide-compatibility genes in inter-subspecific hybrids in rice (Oryza sativa L.)

Although pronounced heterosis in inter-subspecific hybrids was known in rice for a long time, its utilization for hybrid rice breeding has been limited due to their hybrid sterility (HS). For the last two decades, however, a few inter-subspecific hybrids have been developed by incorporating wide-compatibility genes (WCG) that resolve HS, into parental lines of these inter-subspecific hybrids. For effective use of WCG, it is necessary to find convenient markers linked to WCG of practical importance. In this paper, initially a set of simple sequence repeat (SSR) markers in the vicinity of known WCG loci identified based on comparative linkage maps have been surveyed in a population derived from the three-way cross- IR36/Dular//Akihikari, where a known donor of WCG Dular was crossed to a representative indica and japonica cultivar. Of the five parental polymorphic markers, RM253 and RM276 were found to be closely linked to the WCG locus S5 at a distance of 3.0 and 2.8 cM, respectively. Later, loci for HS were examined in three F(2) populations derived from inter-subspecific crosses, with same set of SSR markers. The locus S8 was confirmed to have major influence on HS in the F(2 )population derived from CHMRF-1/Taichung65 since two SSR markers in its vicinity, RM412 and RM141, co-segregated with HS at a map distance of 7.6 and 4.8 cM, respectively. In the F(2) population derived from the cross BPT5204/Taipei309, three SSR markers in the vicinity of S5, RM50, RM276 and RM136 co-segregated with HS at a map distance of 4.2, 3.2 and 7.8 cM, respectively. In the third F(2 )population derived from Swarna/Taipei309, the SSR markers in the vicinity of S5, RM225, RM253, RM50, RM276 and RM136 were identified to co-segregate with HS at a map distance of 3.2, 2.6, 3.4, 2.6 and 6.6 cM, respectively. These results indicated a clear picture of WCG in Dular as well as the predominant role of HS alleles at S5 locus. The identified SSR markers are expected to be used for incorporation of WCG into parental lines in hybrid rice breeding to solve HS in inter-subspecific hybrids.

Human papillomavirus infection among Egyptian females with cervical carcinoma: relationship to spontaneous apoptosis and TNF-alpha

OBJECTIVES

This study was designed to detect HPV type-16 in Cervical carcinoma (CC) tissue specimens. The results were correlated with clinicopathological parameters of the carcinoma, with spontaneous apoptosis and with immunoreactivity to TNF-alpha antibodies.

METHODS

Fresh frozen tissue specimens representing 30 cases of cervical carcinoma as well as 20 normal cervical tissues (NCT) were the subjects of this study. HPV-16 DNA was detected by Polymerase Chain Reaction (PCR). The occurrence of spontaneous apoptotic cell death was analyzed by the apoptosis assay. Apoptotic cells were also counted by light microscopy and the apoptotic index (AI) was calculated. Electron microscopy was used to confirm the morphology of apoptotic cells. TNF-alpha was quantified using EIA kit.

RESULTS

HPV-16 DNA was more frequent in CC than in NCT. No correlation was observed between HPV infection and grade, stage or pathologic type of CC. The occurrence of spontaneous apoptosis was significantly higher in CC than in NCT, where it was correlated to advanced tumor stage and tumor pathology being more in adenocarcinoma (AC) than in squamous cell carcinoma (SCC). Moreover, AI was negatively correlated to HPV-16 infection. TNF-alpha levels were significantly higher in CC vs. NCT, where they were positively correlated to advanced tumor stage. TNF-alpha levels were correlated to DNA fragmentation and AI (r = 0.47 and 0.57 respectively). A cut-off value for TNF-alpha was calculated to be 9.1 pg/mg protein (using ROC curve). At the determined cut-off point the sensitivity was 70% and the specificity was 80%.

CONCLUSIONS

HPV infection, high levels of TNF-alpha and spontaneous apoptosis were strongly associated with malignant phenotype of cervical tissues. Rate of spontaneous apoptosis was higher in AC compared to SCC. On the other hand, HPV negativity was correlated with AI. Moreover, TNF-alpha and apoptotic cell death were correlated to each other as well as to tumor progression. No correlation was detected between TNF-alpha and HPV-16 infection.

Solitary metastasis from occult follicular carcinoma of the thyroid mimicking trigeminal neurinoma--case report

A 50-year-old woman presented with an extremely uncommon case of solitary metastasis from follicular carcinoma of the thyroid, which presented clinically as trigeminal neurinoma. Neuroimaging detected a tumor in the right petrous apex, which was removed surgically. Histological examination showed metastatic follicular carcinoma of the thyroid. However, no primary tumor was detected by various investigations. The tumor recurred twice, and was treated surgically both times. The patient finally agreed to adjuvant therapy for the suspected primary. Radiotherapy was performed followed by complete thyroidectomy. Examination of the gross specimen found the tumor nodule. Clinically significant metastasis can arise from histologically benign and silent follicular thyroid neoplasms.

New scope in angiogenesis: role of vascular endothelial growth factor (VEGF), NO, lipid peroxidation, and vitamin E in the pathophysiology of pre-eclampsia among Egyptian females

OBJECTIVES

The purpose of this study was to investigate the role of VEGF, NO, MDA, and Vitamin E in the pathophysiology of preeclampsia (PE) among Egyptian women.

PATIENTS AND METHODS

Our study included 20 pregnant women with mild PE, 40 pregnant women with severe PE, 20 normal control women and 20 normal control pregnant women. Plasma from all women were subjected to estimation of VEGF using ELISA kit, estimation of nitrates (as end product of NO) and MDA by chemical methods and measurement of Vitamin E using HPLC.

RESULTS

The obtained data from this study revealed that, VEGF may be used as a useful marker for PE which is elevated in plasma of women with PE (mild and severe) compared to controls. VEGF could differentiate between PE and controls at a cut-off value of: 70 ng/mL with a sensitivity of 95% and a specificity of 90%. Moreover, at a cut-off value of 250 ng/mL, VEGF could discriminate mild PE from severe PE with a sensitivity of 77.5% and a specificity of 85%. With respect to nitrate levels, they were significantly elevated in normal pregnant women compared with normal controls. Meanwhile, nitrate levels showed a highly significant decrease in PE in relation to both controls, explaining the vasoconstriction and high blood pressure occurring in preeclamptic women. Correlation analysis revealed significant inverse correlation between nitrate levels and VEGF. Lipid peroxidation as indicated by MDA was enhanced in preeclamptic women as compared to healthy controls. The increase in MDA levels was correlated to the severity of PE. A highly significant fall in vitamin E as an antioxidant-scavenging vitamin was seen in preeclamptic women as compared to the controls. Also, a significant drop in the vitamin level was found in severe PE in comparison to mild PE. The oxidant/antioxidant correlation was illustrated by the inverse correlation between vitamin E and MDA(r = -0.837, p = 0.000).

CONCLUSION

The findings from this study indicated that VEGF may be used as a clinically useful biomarker for PE for better diagnosis, to differentiate between mild and severe PE, and may also be a target for therapeutic intervention of PE. The increase in levels of VEGF together with reduction in NO levels could confirm the existence of vascular reactivity and endothelial disturbance in PE. The decrease in the vasodilator, NO may in part lead to the vasospasm of preeclampsia, which consequently produces hypoxia. The latter may be a cause of an elevation of VEGF (angiogenic factor) levels in PE. Meanwhile, elevated levels of lipid peroxides together with impaired antioxidant defense mechanisms may play a role in the etiology of PE.

Cis-platinum-induced immunosuppression: relationship to melatonin in human peripheral blood mononuclear cells

OBJECTIVES

The purpose of this study was to investigate the immunomodulatory effect of melatonin (MLT) on human peripheral blood mononuclear cells (PBMC) and to address its effects on Cis-platinum (CDDP)-induced cytotoxicity.

METHODS AND RESULTS

The obtained data from this study revealed that treatment of cells with MLT (100 microg/ml) for 24 h enhanced cell viability. When cells were exposed to CDDP (5 microg/ml), cell proliferation in response to phytohaemagglutinin (PHA) stimulation was reduced by 49.63% compared to control cells as detected by 3[H]-thymidine uptake. Furthermore, Cis-platinum significantly depleted intracellular glutathione (GSH) levels by approximately 47% below that of untreated cells and led to apoptotic changes in the target cells as evidenced by DNA fragmentation (45% compared to 5% in control cells as measured by diphenylamine assay). DNA fragmentation was also confirmed by agarose gel electrophoresis. However, MLT enhanced cell proliferation by approximately 8.63% above the control values, and counteracted the antiproliferative effect of CDDP. The GSH levels were significantly increased in response to MLT (71% above control values) and it protected the cells against GSH depletion induced by CDDP. Moreover, DNA fragmentation and laddering produced by CDDP were significantly reduced or even disappeared when the cells were pretreated with MLT or the latter was simultaneously added with CDDP.

CONCLUSIONS

The findings from this study indicated that melatonin is a potent immunomodulatory hormone that protects PBMC against cis-platinum-induced immunosuppressive effects. These effects might improve the patients' response to cis-platinum therapy and, therefore, their survival rates.

Evaluation of some tissue and serum biomarkers in prostatic carcinoma among Egyptian males

OBJECTIVES

The purpose of this study is to evaluate the role of soluble E-cadherin as a serum marker and bcl-2 and DNA content as tissue markers in characterization and management of prostatic adenocarcinoma (PC) among Egyptian males.

DESIGN AND METHODS

The study group included 71 patients with prostatic adenocarcinoma, 30 patients with benign prostatic hyperplasia (BPH), and 20 normal male subjects. Serum soluble E-cadherin (sE-cadherin) and PSA were quantified by ELISA and MEIA (microparticle enzyme immunoassay) techniques, respectively. Tissue samples were investigated for bcl-2 chromosomal translocation t(14;18) by polymerase chain reaction (PCR) together with detection of bcl-2 protein expression by immunohistochemistry. The results were correlated with DNA content (as defined by flow cytometric analysis) and also with traditional clinicopathologic parameters.

RESULTS

Our data revealed that, serum PSA was superior to sE-cadherin as a marker for PC with a sensitivity of 83% compared to 59% in case of E-cadherin at the same specificity (96.6%). Combination of both markers raised the sensitivity to 90%. E-cadherin correlated with Gleason score. Ploidy status, synthetic phase fraction (SPF), and proliferation index (PI) correlated significantly with tumor Gleason score. PI was also correlated to clinical stage. bcl-2 protein was overexpressed in 14% of PC and it showed a trend for correlation with tumor Gleason score (p = 0.06). We failed to detect chromosomal t(14;18) in the bcl-2 gene in all the studied tumors.

CONCLUSIONS

E-Cadherin is a clinically useful biomarker in PC specially in combination with PSA. DNA content changes and bcl-2 oncogene may account for tumorogenesis and may assist in prognostication of PC.

In vitro buffering capacity of residual peritoneal dialysate fluid: implications for peritoneal dialysis therapy

The buffering capacity of the residual peritoneal dialysate fluid from each of 5 patients undergoing continuous ambulatory peritoneal dialysis was assessed by titrating with fresh, conventional, acidic, and lactate-containing peritoneal dialysis solutions. It was found that residual fluids had considerable buffering capacity.