miRNAs and exosomal miRNAs in lung cancer: New emerging players in tumor progression and therapy response

Non-coding RNAs have shown key roles in cancer and among them, short RNA molecules are known as microRNAs (miRNAs). These molecules have length less than 25 nucleotides and suppress translation and expression. The functional miRNAs are produced in cytoplasm. Lung cancer is a devastating disease that its mortality and morbidity have undergone an increase in recent years. Aggressive behavior leads to undesirable prognosis and tumors demonstrate abnormal proliferation and invasion. In the present review, miRNA functions in lung cancer is described. miRNAs reduce/increase proliferation and metastasis. They modulate cell death and proliferation. Overexpression of oncogenic miRNAs facilitates drug resistance and radio-resistance in lung cancer. Tumor microenvironment components including macrophages and cancer-associated fibroblasts demonstrate interactions with miRNAs in lung cancer. Other factors such as HIF-1α, lncRNAs and circRNAs modulate miRNA expression. miRNAs have also value in the diagnosis of lung cancer. Understanding such interactions can pave the way for developing novel therapeutics in near future for lung cancer patients.

Biological and therapeutic viewpoints towards role of miR-218 in human cancers: Revisiting molecular interactions and future clinical translations

Understanding the exact pathogenesis of cancer is difficult due to heterogenous nature of tumor cells and multiple factors that cause its initiation and development. Treatment of cancer is mainly based on surgical resection, chemotherapy, radiotherapy and their combination, while gene therapy has been emerged as a new kind of therapy for cancer. Post-transcriptional regulation of genes has been of interest in recent years and among various types of epigenetic factors that can modulate gene expression, short non-coding RNAs known as microRNAs (miRNAs) have obtained much attention. The stability of mRNA decreases by miRNAs to repress gene expression. miRNAs can regulate tumor malignancy and biological behavior of cancer cells and understanding their function in tumorigenesis can pave the way towards developing new therapeutics in future. One of the new emerging miRNAs in cancer therapy is miR-218 that increasing evidence highlights its anti-cancer activity, while a few studies demonstrate its oncogenic function. The miR-218 transfection is promising in reducing progression of tumor cells. miR-218 shows interactions with molecular mechanisms including apoptosis, autophagy, glycolysis and EMT, and the interaction is different. miR-218 induces apoptosis, while it suppresses glycolysis, cytoprotective autophagy and EMT. Low expression of miR-218 can result in development of chemoresistance and radio-resistance in tumor cells and direct targeting of miR-218 as a key player is promising in cancer therapy. LncRNAs and circRNAs are nonprotein coding transcripts that can regulate miR-218 expression in human cancers. Moreover, low expression level of miR-218 can be observed in human cancers such as brain, gastrointestinal and urological cancers that mediate poor prognosis and low survival rate.

Extremely Low Frequency Magnetic Fields Induce mTOR and Hsa_Circ_100338 Expression Changes in Gastric Cancer and Normal Fibroblast Cell Lines

OBJECTIVE

Extremely low-frequency magnetic field (ELF-MF) exposure, as a targeted tumor therapy, presents several potential advantages. In this research, we investigated effects of different ELF-MF intensities on cell viability and expression levels of the mammalian target of rapamycin (mTOR) and hsa_circ_100338 in the normal fibroblast (Hu02) and human gastric adenocarcinoma (AGS) cell lines.

MATERIALS AND METHODS

In this experimental study, cell lines of AGS and Hu02, were cultured under the exposure of ELFMF with magnetic flux densities (MFDs) of 0.25, 0.5, 1 and 2 millitesla (mT) for 18 hours. The 3-(4, 5-dimethylthiazoyl-2- yl)-2, 5-diphenyltetrazolium bromide (MTT) assay was used to evaluate the cell viability. Relative expression of mTOR and hsa_circ_100338 RNAs was estimated by quantitative real-time polymerase chain reaction (qRT-PCR) technique.

RESULTS

Viability of the normal cells was significantly increased at MFDs of 0.5, 1 and 2 mT, while viability of the tumor cells was significantly decreased at MFD of 0.25 and increased at MFD of 2 mT. Expression level of mTOR was significantly increased at the all applied MFDs in the normal cells, while it was significantly decreased at MFDs of 0.25 and 0.5mT in the tumor cells. MFDs of 1 and 2 mT in tumor cells inversely led to the increase in mTOR expression. hsa_circ_100338 was downregulated in MFD of 0.25 mT and then it was increased parallel to the increase of MFD in the normal and tumor cells.

CONCLUSION

Results of the present study indicated that ELF-MF at MFDs of 0.25 and 0.5 mT can lead to decrease in the both mTOR and hsa_circ_100338 expression levels. Given the role of mTOR in cell growth, proliferation and differentiation, in addition to the potential role of hsa_circ_100338 in metastasis, expression inhibition of these two genes could be a therapeutic target in cancer treatment.

EVALUATION OF BCL2 AND ITS REGULATORY MIRS, MIR-15-B AND MIR-16 EXPRESSION CHANGES UNDER THE EXPOSURE OF EXTREMELY LOW-FREQUENCY ELECTROMAGNETIC FIELDS ON HUMAN GASTRIC CANCER CELL LINE

In this research, changes in the expression of B-cell lymphoma 2 (BCL2), miR-15-b and miR-16 in human adenocarcinoma gastric cancer cell line (AGS) following the exposure to magnetic flux densities (MFDs) of 0.2 and 2 mT continuously and discontinuously (1.5 h on/1.5 h off) for 18 h were investigated. Changes in the cell viability were evaluated by the MTT assay. Real-time PCR was used to evaluate the expression changes of BCL2, miR-15-b and miR-16. The results showed that extremely low frequency electromagnetic field (ELF-EMF) could significantly reduce the viability of AGS cells in the continuous MFD of 2 mT. The BCL2 expression was significantly decreased following the exposure to continuous MFDs of 0.2 and 2 mT and discontinuous MFD of 2 mT. The expressions of miR-15-b and miR-16 were significantly increased in continuous and discontinuous MFD of 2 mT. According to the results, weak and moderate extremely low-frequency electromagnetic fields can change the expressions of BCL2, miR-15-b and miR-16.

Up-regulation of miR-144 and miR-375 in the human gastric cancer cell line following the exposure to extremely low-frequency electromagnetic fields

PURPOSE

Recently, therapeutic effects of extremely low-frequency electromagnetic field (ELF-EMF) as complementary and alternative medicine, used in the oncology field to control disease symptoms. Micro RNAs (miRs) are responsible for the post-transcriptional regulation of gene expression in the cell. This study aimed to evaluate the expression changes of miR-144 and miR-375 in the human gastric adenocarcinoma cell line (AGS) under the exposure of ELF-EMF.

MATERIALS AND METHODS

AGS cells were exposed to magnetic flux densities of 0.2 and 2 mT for 18 h, continuously and discontinuously (1.5 h on/1.5 h off). Cell viability was evaluated by MTT assay. Changes of miR-144 expression levels in AGS cells immediately after exposure and 18 and 36 h after the exposure cut-off was calculated by QRT-PCR.

RESULTS

The cell viability of AGS cells was decreased under the exposure of 0.2 and 2 mT EMFs when compared to the control. Up-regulation of miR-144 and miR-375 were observed in AGS cells under the exposure of magnetic fields.

CONCLUSIONS

The results indicated that the miR levels were significantly decreased 18 and 36 h after finishing the exposure, but not reached the normal range. The results of this investigation indicated that weak and moderate intermittent 50 Hz ELF-EMFs can induce changes in miRNA expression.

Changes in NOTCH1 gene and its regulatory circRNA, hsa_circ_0005986 expression pattern in human gastric adenocarcinoma and human normal fibroblast cell line following the exposure to extremely low frequency magnetic field

The effect of an extremely low-frequency magnetic field (ELF-MFs) on the expression levels of NOTCH1 and its regulatory circular RNA (circ-RNA) in gastric cancer has not yet investigated. This study aimed to find the expression changes of NOTCH1 and its regulatory circ-RNA, hsa_circ_0005986, in human gastric adenocarcinoma cell line (AGS) and human normal fibroblast (Hu02) cells fallowing the exposure to discontinuously magnetic flux densities (MFDs) of 0.25, 0.5 ,1 and 2 millitesla (mT) for 18h in comparison to unexposed cells. In addition, the effect of various MFDs on viability of tumor and normal cells was investigated. The cell viability was evaluated by MTT assay. The relative expression of NOTCH1and hsa_circ_0005986 mRNAs was analyzed by quantitative Real-time PCR. The viability of tumor cells was decreased under the exposure of MFs, while the normal cells viability was increased. NOTCH1 was significantly down-regulated in AGS cells and up-regulated in Hu02 cells at all MFDs. The expression changes of NOTCH1 in tumor and  normal cells was depended to the MFD of MFs. According to our results, the tumor and normal cells show different behavior at the molecular level in various MFDs in terms of NOTCH1 and hsa_circ_0005986 expression level. Decrease in tumor cell survival following the exposure to ELF-MFs may be the result of decreased in the expression level of NOTCH1 and its Reg-circ-RNA. These magnetic field-reducing effects on cancer cell survival through the change on the expression of genes involved in the proliferation and progression of cancer can be a new key in cancer treatment.

Diagnostic accuracy of two-dimensional coronary angiographic derived fractional flow reserve

Background

Non-invasive fractional flow reserve (NiFFR) is an emerging method for evaluating the functional significance of a coronary lesion during diagnostic coronary angiography (CAG). The method relies on the computational flow dynamics and the 3D reconstruction of the vessel extracted from CAG. In the present study, we sought to evaluate the diagnostic performance and applicability of 2D-based NiFFR.

Methods

In this prospective observational study, we evaluated 2D-based NiFFR in 279 candidates for invasive CAG and invasive FFR. NiFFR was calculated via 2 methods: variable NiFFR, in which the contrast transport time was extracted from the angiographic view, and fixed NiFFR, in which a prespecified frame count was applied.

Results

The final analysis was performed on 245 patients (250 lesions). Variable NiFFR had an area under the receiver operating characteristic curve of 81.5%, an accuracy of 80.0%, a sensitivity of 82.2%, a specificity of 82.2%, a negative predictive value of 91.4%, and a positive predictive value of 63.6%. The mean difference between FFR and NiFFR was −0.0244 ±0.0616 (P≤0.0001). A pressure wire-free hybrid strategy was possible in 68.8% of our population with variable NiFFR.

Conclusions

Our 2D-based NiFFR yielded results comparable to those derived from 3D-based software. Our findings should, however, be confirmed in larger trials.

Pressure wire-free hybrid strategy

Funding Acknowledgement

Type of funding source: None

Comparison between cheatham-platinum stent and self-expandable uncovered nitinol stent in patients with coarctation of aorta – a randomized controlled trial

Background

Endovascular treatment is considered the main therapeutic approach for native coarctation of aorta (CoA) in adult patients. Balloon-expandable stents (BE) have been introduced as the primary choice for coarctoplasty. However during the recent years, self-expandable (SE) stents with acceptable radial force have been suggested as an alternative. Still, no randomized controlled (RCT) trials have compared the efficacy and safety of both strategies.

Methods

The present study is a prospective, single center, parallel-group, open-label RCT on patients with native CoA (Figure). Patients were randomized into Bare Cheatham-Platinum Stents and Uncovered Nitinol Stent (SE). All patients were scheduled to be followed in 1-, 6-, 12-month and 36-month intervals. The present report, focuses on the one-year outcome of the study.

Results

Of 101 patients with native CoA referred to our center, 93 patients have been randomized into BE- (47 patients) and SE-arm (46 patients). One year follow up is scheduled to be completed on March 2020. In the preliminary analysis of 62 patients, 1 intraprocedural stent migration has occurred in each group. No aortic perforation was detected in the study. Vascular access site complications were similar between the two groups (3 (6.3%) in BE versus 1 (2.1%) in SE, p value= 0.432). One nonfatal stroke occurred in BE group. No mortality or bailout surgical repair happened in one year study in the two groups. One patient with re-coarctations were detected during one year follow up in each of the groups (p value=0.210). No aortic pseudoaneurysm or aneurysmal formation were observed in 12-month follow up aortic CT angiography.

Conclusion

The preliminary results showed no significant difference in efficacy and safety of both treatment modalities. The final result is pending.

Study Flow Chart

Funding Acknowledgement

Type of funding source: None

Investigation of uranium (VI) adsorption by polypyrrole

The purpose of this study was to investigate the adsorption of uranium (VI) ions on the polypyrrole adsorbent. Polypyrrole was synthesized by a chemical method using polyethylene glycol, sodium dodecylbenzenesulfonate, and cetyltrimethylammonium bromide as the surfactant and iron (III) chloride as an oxidant in the aqueous solution. The effect of various surfactants on the synthesized polymers and their performance as the uranium adsorbent were investigated. Adsorbent properties were characterized by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) techniques. The effect of different parameters such as pH, contact time, initial metal ion concentrations, adsorbent dose, and the temperature was investigated in the batch system for uranium adsorption process. It has been illustrated that the adsorption equilibrium time is 7min. The results showed that the Freundlich model had the best agreement and the maximum adsorption capacity of polypyrrole for uranium (VI) was determined 87.72mg/g from Langmuir isotherm. In addition, the mentioned adsorption process was fast and the kinetic data were fitted to the Pseudo first and second order models. The adsorption kinetic data followed the pseudo-second-order kinetic model. Moreover, the thermodynamic parameters ΔG⁰, ΔH⁰ and ΔS⁰ showed that the uranium adsorption process by polypyrrole was endothermic and spontaneous.

Association between adipokine and myeloperoxidase levels in patients with coronary artery disease

The adipokines, leptin and adiponectin, have a prominent role in the pathogenesis of coronary artery disease (CAD). The inflammatory enzyme, myeloperoxidase (MPO) also has an important role in the pathogenesis of CAD. Association of the adipokines with MPO remains to be resolved in patients with CAD. In this case-control study, 100 patients with CAD and 100 control subjects were appropriately recruited. Angiographic evaluation assigned the presence of CAD. Plasma leptin, adiponectin and MPO concentrations were measured using immunoassay methods. Other conventional cardiovascular risk factors were also recorded. Leptin and MPO concentrations were significantly increased in CAD patients compared to control subjects (25.38 ± 5.91 ng/ml vs. 3.68 ± 1.95 ng/mL and 52.85 ± 12.90 ng/mL vs.  23.00 ± 3.60 ng/mL, P=0.001, respectively). In contrast, adiponectin was significantly decreased in CAD patients compared to control subjects (5.62 ± 1.15 µg/mL vs. 9.25 ± 1.8, P = 0.001). There was a strong positive association between leptin and MPO concentrations only in CAD patients (P = 0.01). In contrast, a significant inverse association was found between adiponectin and MPO concentrations in CAD patients (P = 0.01). The associations also were significant after adjustment for other conventional risk factors (P = 0.001). Considering the presence of significant association between leptin and MPO, as well as adiponectin and MPO in patients with CAD, it may be inferred that the contribution of the adipokines in the pathogenesis of CAD may be, in part, through affecting the MPO concentration.

Association of plasma leptin, homocysteine and nitric oxide levels with the presence and unstability of coronary artery disease

AIM

Leptin and total homocysteine (tHcy) may participate in the pathogenesis of coronary artery disease (CAD) through nitric oxide (NO) depletion. We sought to investigate whether leptin, tHcy and NO are suitable predictors of CAD.

PATIENTS & METHODS

This study contained 50 control subjects and 50 stable and 50 unstable angina patients. Plasma leptin, tHcy and NO levels were determined using enzyme immunoassay, HPLC fluorescence and spectrophotometric methods, respectively. Other conventional risk factors were also determined.

RESULTS

Leptin and tHcy levels were highest in unstable angina patients, followed by stable angina patients and then controls (p < 0.001). Controls had significantly higher NO than patients (p <0.001). Leptin and tHcy had a positive and NO a negative association with the presence of CAD.

CONCLUSIONS

Some athrogenic effects of leptin may be mediated by affecting tHcy and NO levels. Plasma leptin, tHcy and NO levels showed significant contribution to CAD prediction and discrimination.

Association between HDL particles size and myeloperoxidase/ paraoxonase-1 (MPO/PON1) ratio in patients with acute coronary syndrome

Myeloperoxidase (MPO) and paraoxonase-1 (PON1) are inflammatory and anti-inflammatory enzymes, respectively that have been involved in the pathogenesis of coronary artery disease (CAD). In this study we sought to evaluate the relations of MPO and PON1 with high density lipoprotein (HDL) mean size in patients with acute coronary syndrome (ACS). Collectively, 50 control subjects and 50 patients with ACS were participated in this study. MPO level and PON1 activity was determined using immunoassay and colorimetric methods, respectively. HDL mean size was determined by a dynamic light scattering methodology. Other clinical risk factors were also determined by standard methods. The MPO/PON1 ratio amount was significantly higher in patients with ACS (1.49±1.10) than in control subjects (0.21±0.14) (P&lt;0.01). There was a significant correlation between MPO/PON1 ratio and HDL mean size in patients with ACS. Amount of the enzymes and their relations to HDL particle size in patients with ACS may play a part in the pathogenesis of ACS. Also, MPO/PON1 ratio may be a robust predictor of ACS.

Ovarian vein thrombosis

Ovarian vein thrombosis is a well-known but rare entity, which can occur during the post-partum period. This condition has also been associated with inflammatory and malignant processes within the pelvis. Untreated, complications of ovarian vein thrombosis can be significant due to the associated sepsis and risk of pulmonary embolism. Diagnosis can be made with confidence using ultrasound, computed tomography or magnetic resonance imaging. Treatment of ovarian vein thrombosis is particularly important in the post-partum patients, with anticoagulation therapy being the current recommendation.

A Randomized Controlled Trial on the Hemostasis of Femoral Artery Using Topical Hemostatic Agent

Objective: Evaluation of the effect of using a topical hemostatic agent named “ChitoHem®” on different factors on patients undergoing diagnostic coronary angiography. Methods: The present blind, randomized, controlled study included 124 patients randomly divided into 2 groups. In the treatment group following femoral sheath removal, ChitoHem® powder and in the control group conventional hemostatic procedure was applied. Results: In the treatment group, time to hemostasis, ambulation, and the use of sandbag were significantly shorter compared with the control group, respectively (4.6 ± 1.3 vs 12.4 ± 4.4 minutes, 3.5 ± 2.7 vs 23.0 ± 1.73 hours and 1.6 vs 98.4%; P < .05). There were no significant differences in hematoma formation and re-bleeding between the 2 groups. Conclusion: It was exhibited ChitoHem® topical hemostatic powder used on treatment patients undergoing diagnostic coronary angiography was statistically superior at reducing the time to hemostasis and ambulation as well as the use of sandbags compared with manual compression in control group.

Mechanical loading affects the energy metabolism of intervertebral disc cells

Research has shown that mechanical loading affects matrix biosynthesis of intervertebral disc (IVD) cells; however, the pathway(s) to this effect is currently unknown. Cellular matrix biosynthesis is an energy demanding process. The objective of this study was to investigate the effects of static and dynamic compressive loading on energy metabolism of IVD cells. Porcine annulus fibrosus (AF) and nucleus pulposus (NP) cells seeded in 2% agarose were used in this experiment. Experimental groups included 15% static compression and 0.1 and 1 Hz dynamic compression at 15% strain magnitude for 4 h. ATP, lactate, glucose, and nitric oxide (NO) contents in culture media, and ATP content in cell-agarose construct were measured using biochemical assays. While the total ATP content of AF cells was promoted by static and dynamic loading, only 1 Hz dynamic loading increased total ATP content of NP cells. Increases in lactate production and glucose consumption of AF cells suggest that ATP production via glycolysis is promoted by dynamic compression. ATP release and NO production of AF and NP cells were significantly increased by dynamic loading. Thus, this study clearly illustrates that static and dynamic compressive loading affect IVD cell energy production while cellular responses to mechanical loading were both cell type and compression type dependent.

Can MRI predict the diagnosis of endometrial carcinosarcoma?

AIM

To ascertain whether magnetic resonance imaging (MRI) can be used to suggest a diagnosis of endometrial carcinosarcoma.

MATERIALS AND METHODS

A retrospective imaging review was performed of the MRI images of 39 patients with endometrial carcinosarcoma. Anteroposterior and longitudinal dimensions of the uterus and measurement of the endometrial thickness were taken in the sagittal plane. The ratio of antero-posterior measurement to endometrial thickness was calculated. The same measurements were taken on 50 patients with endometrial adenocarcinoma. A two-tailed t-test and receiver operator characteristic analysis were performed on these measurements for both patient groups.

RESULTS

There was a statistically significant difference between the longitudinal (p=0.0084) and anteroposterior (p=0.00036) dimensions of the uterus of the two groups. There was also a statistically significant difference between the ratios of anteroposterior dimension to endometrial thickness (p=0.00018). The optimal cut-off ratio above which the radiologist should be alerted to a potential diagnosis of endometrial carcinosarcoma was shown to be 0.63.

CONCLUSION

MRI can be helpful in suggesting a diagnosis of endometrial carcinosarcoma with the help of some simple measurements.

Recurrent ovarian carcinoma presenting as a solitary metastasis to the kidney

Unusual sites for recurrent ovarian metastases include extrahepatic solid organs (except the spleen), bone and the abdominal wall. We report a rare renal recurrence of ovarian malignancy and its imaging features.

Metastatic gestational trophoblastic tumour presenting as spontaneous subcapsular renal haematoma

We describe a rare case of metastatic choriocarcinoma, which presented with acute left loin pain due to a subcapsular haematoma secondary to a bleeding renal metastasis. The renal metastasis was embolised to prevent further bleeding. To our knowledge, presentation of gestational trophoblastic tumour (GTT) with such symptoms has not been described in the recent literature. Our case illustrates that, although rare, non-gynaecological symptoms can be the first presentation of metastatic choriocarcinoma in the appropriate clinical settings. It also demonstrates that the acute bleed from a renal metastasis can be effectively managed by embolisation.

New developments in the use of tricyclic antidepressants for the management of pain

In recent years, tricyclic antidepressant drugs have experienced a resurgence in their use as valuable pharmacological tools in the treatment of pain. Along with the evolution in our understanding of their analgesic mechanisms of action, there have been concurrent breakthroughs regarding their indications for use and modes of administration. This review focuses on recent advances in our understanding of how antidepressant drugs exert their antinociceptive effects, and new developments regarding their clinical application.

Cyclooxygenase-2 and antagonists in pain management

Non-steroidal anti-inflammatory drugs are widely used for the treatment of pain and inflammation by inhibiting the formation of prostaglandins. However, their use is limited by their side-effects, including gastrointestinal, renal function, cardiovascular and platelet function. Cyclooxygenase activity is the principal target for the action of non-steroidal anti-inflammatory drugs. Two isoforms of cyclooxygenase have been characterized: (i) cyclooxygenase-1, which is found in many tissues and is generally constitutively expressed and synthesizes prostanoids that mediate homeostatic functions; and (ii) cyclooxygenase-2, the inducible isoform, which is mainly expressed at sites of injury or inflammation and synthesizes prostanoids that mediate inflammation, pain and fever. These findings led to the development of selective cyclooxygenase-2 inhibitors, with comparable anti-inflammatory and analgesic properties to traditional non-steroidal anti-inflammatory drugs, but with significantly fewer side-effects. However, these new selective cyclooxygenase-2 inhibitors are not risk free, and care should be taken when using these drugs, especially with elderly patients with multiple medical problems. Finally, the future is bright for the broader usage of these agents in the treatment of diseases other than inflammation and pain, such as Alzheimer's disease, colonic polyp and colon cancer, just to name a few.

Evaluation of accommodative Insufficiency with the Visual Analogue Scale (VAS)

PURPOSE

The purpose of this study was to evaluate whether asthenopic symptoms in schoolchildren diagnosed with accommodative insufficiency (AI) and graded with the Visual Analogue Scale (VAS) could be correlated with the degree of accommodative deficiency in these children, and to investigate if VAS grading of the asthenopic symptoms could be used as an instrument to indicate the level of improvement of AI.

METHODS

Forty-nine children (mean age 10.2 years +/- 2.7) diagnosed with AI graded their degree of asthenopia on the VAS before and after a 12-week treatment period wearing individually dispensed reading glasses.

RESULTS

The improvement in accommodation after treatment was statistically significant (p < 0.001) and 83.7% of the children obtained normal accommodative amplitude in relation to age. The reduction in asthenopic symptoms as graded with the VAS was also statistically significant (p < 0.001) after treatment and 89.9% of the children obtained a normal VAS score. However, no correlation between the degree of accommodative deficiency and the VAS grading could be found, neither before nor after treatment.

DISCUSSION

Based on these results we conclude that the visual analogue scale (VAS) cannot be used as an instrument to indicate the degree of accommodative deficiency nor can it be used to indicate the level of improvement during the course of treatment. However, the VAS can be used as an instrument to verify and document whether or not asthenopic symptoms are present, and therefore also to indicate when symptoms have been relieved.

Magnetic resonance imaging of the lumbar spine in asymptomatic professional fast bowlers in cricket

Low back injuries account for the greatest loss of playing time for professional fast bowlers in cricket. Previous radiological studies have shown a high prevalence of degeneration of the lumbar discs and stress injuries of the pars interarticularis in elite junior fast bowlers. We have examined MRI appearance of the lumbar spines of 36 asymptomatic professional fast bowlers and 17 active control subjects. The fast bowlers had a relatively high prevalence of multi-level degeneration of the lumbar discs and a unique pattern of stress lesions of the pars interarticularis on the non-dominant side. The systems which have been used to classify the MR appearance of the lumbar discs and pars were found to be reliable. However, the relationship between the radiological findings, pain and dysfunction remains unclear.

Metastatic spinal cord syndromes: imaging appearances and treatment planning

Metastatic spinal cord syndromes usually result from neural compression by adjacent vertebral disease but are occasionally caused by intradural or intramedullary disease. MRI is the most accurate method for evaluation of such syndromes. Knowledge of the relevant imaging appearances and therapeutic options enables the radiologist to make an accurate assessment of the extent of disease and contribute information relevant to treatment planning.

[Mixed cryoglobulinemia with monoclonal IgA and biclonal IgM during hepatitis C virus infection]

Cryoglobulins are immunoglobulins that precipitate at low temperature and dissolve when warmed. According to Brouet, their classification relies upon the immunochemical study: type I comprises monoclonal immunoglobulins (IGG), when types II and III include both monoclonal and polyclonal components. During C hepatitis, the presence of a cryoglobulin, essentially made of mixed G-IGG and M-IGG, is a common feature with a prevalence of 40 to 80%. The authors report a case of a 63-year patient who presented with a vascular purpura and a peripheral polyneuropathy in a context of C hepatitis infection. The cryoglobulin found was composed of a monoclonal kappa A-IgG associated with a biclonal kappa and lambda M-IgG. No decrease of normal IgGs was found. This type of cryoglobulin does not belong to Brouet's classification, and argues for a new and more pertinent classification to be proposed.

A single intravenous injection of KRN5500 (antibiotic spicamycin) produces long-term decreases in multiple sensory hypersensitivities in neuropathic pain

Neuropathic pain is a significant clinical problem. Currently, there are no drugs that produce complete amelioration of this type of pain. We have previously shown that KRN5500, a derivative of the antibiotic spicamycin, produces a prolonged (7-day), and significant reduction in neuropathic pain, but not nociceptive pain. Herein, we provide further evidence for the efficacy of this drug in inhibiting pain after IV injection in a spared nerve injury model of neuropathic pain. A single IV dose of the drug produces an increase in pain thresholds to punctuate mechanical stimuli and to cold stimuli over a period of 7 days, whereas IV injection of the vehicle is without any effect. No change in pain threshold was observed in the contralateral foot. In addition, a significant antiallodynic effect to mechanical stimuli was observed at 1, 2, 4, and 6 wk. The drug may be a potential candidate for cancer-related neuropathic pain as well as a marker for discovery of effective analgesics for neuropathic pain.

IMPLICATIONS

We examined the effect of a novel drug (KRN5500) on nerve damage pain. After the successful effects of this drug in a single human, we have shown that the drug infused as a single application at different doses in a rat model of nerve damage pain produces pain relief in this model for many weeks.

Recognition of DNA-arginine photoadduct by anti-DNA autoantibodies in systemic lupus erythematosus

BACKGROUND & OBJECTIVES

Studies have been carried out to synthesize and characterize the photoconjugate between positively charged amino acid, arginine and DNA fragments and their role in the induction of anti-DNA antibodies.

METHODS

Calf thymus DNA fragments of about 200 base pairs (bp) were covalently crosslinked with arginine under UV light. The amino acid was found to be covalently photoconjugated to DNA and resulted in the formation of a crosslink. The photoadduct was characterized by various physicochemical methods.

RESULTS

Photoaddition of arginine to 200 bp DNA rendered the nucleic acid conformer thermodynamically more stable than the native form. After systematic characterization of the photoadduct, it was used as an antigen for the generation of antibodies in experimental animals. The photoadducts were found to be immunogenic in rabbits, inducing high titre antibodies. The DNA-arginine photoadduct showed higher binding with SLE sera known to have high level of anti-DNA antibodies.

INTERPRETATION & CONCLUSION

Naturally occurring anti-DNA autoantibodies were found to recognize DNA-arginine photoadduct. The recognition of DNA-arginine photoadduct by anti-DNA autoantibodies points to the role of modified DNA in the induction of anti-DNA antibodies in autoimmune disorders.

Introducing music as a means of habilitation for children with cochlear implants

OBJECTIVE

To investigate the feasibility, methods and the primary results of utilizing music as a means of habilitation of children with cochlear implant.

STUDY DESIGN

A habilitation program based on music training is developed. The results are presented as a case-series.

METHODS

Music Training Program is introduced as a new habilitation program. Methods of training (based on Orff method) and measuring the outcomes are introduced in this paper. Effects of this program on other habilitation programs and overall hearing related skills of children were also investigated by open questioning of the parents and the habilitation staff.

RESULTS

Twenty-three children, (age: 2.5-12.5 years) were selected. All children showed appreciable progress in playing a musical instrument. The effects on other habilitation processes were significant and all parents expressed their satisfaction with the program, as they perceived its benefits.

DISCUSSION

The necessity of adding Music Training Program to the routine habilitation may be summarized as follows: Music is a feature of sound, which should be mastered. The psychological effects of being able to accomplish a hearing-related task can add to the self-esteem of children and help prevent and reduce anxiety. Music is a habilitation method: Introducing new concepts of sound, like temporal and frequency-related characteristics, is a crucial part of the habilitation of a child with cochlear implant. Practising new concepts needs motivation, too. We emphasize on using all means of rehabilitation and encourage teaching music to cochlear implant children between 4 and 5 years of age having approximately 4 months of experience with cochlear implant.

The effects of KRN5500, a spicamycin derivative, on neuropathic and nociceptive pain models in rats

We studied the effects of a spicamycin derivative, KRN5500, on two animal models of neuropathic pain (Chung and Bennett models) and a nociceptive pain model by using Complete Freund's adjuvant. After the establishment of mechanical allodynia by using the previously mentioned models, a single intraperitoneal injection of KRN5500 produced significant attenuation of mechanical allodynia in both neuropathic pain models. However, this effect was not observed in rats that had a nociceptive injury (Complete Freund's adjuvant). Furthermore, this experimental drug did not alter the mechanical pain threshold (by using von Frey filament test) on normal, uninjured rats. We have demonstrated that KRN5500 may have value in the treatment of neuropathic pain.

Lack of pre-emptive analgesic effects of local anaesthetics on neuropathic pain

We investigated the significance of pre-emptive analgesia using a well-known model of neuropathic pain in rats. Lignocaine, bupivacaine or saline was applied locally to the left L5-L6 spinal nerve before or 4 days after nerve injury. Mechanical allodynia was then evaluated before and after injury. Pre- and post-injury treatment with local anaesthetics both resulted in a two- to threefold increase in the pain threshold, as manifested by a significant increase in von Frey measurements. However, this effect lasted only 24 h. Our study in rats questions the beneficial effect of a single dose of local anaesthetic as pre-emptive analgesia.

Role of ROS modified human DNA in the pathogenesis and etiology of cancer

The effect of hydroxyl radical, generated by ultraviolet (UV) irradiation of hydrogen peroxide, on human placental DNA was monitored by UV spectroscopy, melting temperature studies, S1 nuclease digestibility and hydroxyapatite column chromatography. Immunological data indicated that reactive oxygen species (ROS) modified human DNA induced high titer antibodies. In ELISA, serum antibodies from various cancer patients showed a higher recognition of ROS-human DNA as compared to native DNA. Retarded mobility of the immune complex formed between IgG, isolated from cancer sera, and ROS-human DNA provided convincing evidence for antigen-antibody interaction. Oxidative lesions in DNA of cancer patients were probed using anti-ROS-human DNA IgG. DNA from cancer patients were found to inhibit anti-ROS-human DNA IgG activity in the range of 40% to 57%. These binding results indicate the presence of oxidative lesions in the cancer patient's genome.