RV144 vaccine imprinting constrained HIV-1 evolution following breakthrough infection

The scale of the HIV-1 epidemic underscores the need for a vaccine. The multitude of circulating HIV-1 strains together with HIV-1’s high evolvability hints that HIV-1 could adapt to a future vaccine. Here, we wanted to investigate the effect of vaccination on the evolution of the virus post-breakthrough infection. We analyzed 2,635 HIV-1 env sequences sampled up to a year post-diagnosis from 110 vaccine and placebo participants who became infected in the RV144 vaccine efficacy trial. We showed that the Env signature sites that were previously identified to distinguish vaccine and placebo participants were maintained over time. In addition, fewer sites were under diversifying selection in the vaccine group than in the placebo group. These results indicate that HIV-1 would possibly adapt to a vaccine upon its roll-out.

Diffusion MR imaging acquisition and analytics for microstructural delineation in preclinical models of TBI

Significant progress has been made toward improving both the acquisition of clinical diffusion-weighted imaging (DWI) data and its analysis in the uninjured brain, through various techniques including a large number of model-based solutions that have been proposed to fit for multiple tissue compartments, and multiple fibers per voxel. While some of these techniques have been applied to clinical traumatic brain injury (TBI) research, the majority of these technological enhancements have yet to be fully implemented in the preclinical arena of TBI animal model-based research. In this review, we describe the requirement for preclinical, MRI-based efforts to provide systematic confirmation of the applicability of some of these models as indicators of tissue pathology within the injured brain. We review how current DWI techniques are currently being used in animal TBI models, and describe how both acquisition and analytic techniques could be extended to leverage the progress made in clinical work. Finally, we highlight remaining gaps in the preclinical pipeline from data acquisition to final analysis that currently have no real, preclinical-based correlate.

Diagnosis and First-Line Treatment of Patients with Lung Cancer in Italian General Hospitals

The quality of diagnostic and therapeutic care was examined in a series of 380 consecutive newly diagnosed cases of primary lung cancer seen in 20 Italian general hospitals between January and June 1987. At diagnosis most patients (78%) had one or more symptoms related to the tumor, and in an additional 9 % symptoms were related to the presence of distant metastases. The median diagnostic time lag between first symptoms and final diagnosis was 50 days with a significantly longer delay in patients first seen by their general practitioner compared with those who sought first care in hospital outpatient departments. The diagnostic process was satisfactorily carried out in fewer than two-thirds of the patients leading to complete ascertainment of disease stage and histology in 58% cases with significantly better performance in more specialized institutions. Analysis of the first-line treatment profile indicated a rather aggressive therapeutic attitude In the case of patients with non-small cell lung cancer – 28% of them had chemotherapy despite the lack of any proof of efficacy in controlled clinical trials – and a failure to identify among the patients with small cell disease those amenable to more aggressive treatment. The lack of progress in the treatment of lung cancer over the last decades seems to have resulted in widely varying practice patterns where a mixture of aggressive and laissez-faire attitudes does not take into account that in the absence of effective therapies a more conservative attitude would at least have some advantage in terms of quality of remaining life for many patients.

Adhesion and growth of osteoblast-like cells on laser-engineered porous titanium surface: expression and localization of N-cadherin and beta-catenin

Response of different types of cells on biomaterials is crucial for the applications of tissue engineering and regenerative medicine. It is recognized that cell behaviour depends largely on material surface characteristics. The purpose of this study was to define the biologic response of MG63 cells to the innovative patented surface SYNTHEGRA. MG63 morphology and distribution on the three different titanium disk surfaces (sandblasted, smooth, and laser-treated) were evaluated by microscopy analysis after staining with hematoxylin and eosin. Cell adhesion was determined by crystal violet assay at 48 h while proliferation and cytotoxicity were performed by MTT assay at 24, 48, 72 and 240 h. The expression and localization of N-cadherin and beta-catenin were studied by immunofluorescence and confocal microscopy. At 48 h the adhesion was similar in all titanium surfaces, no difference in cell viability were observed in all titanium disks when compared with controls, while the cell growth on laser-treated disks was significantly higher at 240 h than at 24 and 72 h. Morphological analysis show that cells are aligned along the grooves and inside the cavities. beta-catenin signal appeared more diffuse and localized underneath the cell membrane, while N-cadherin signal was fainter in cells grown on SYNTHEGRA surface. This work put into evidence the performance of newly designed laser-micromachined surface for adhesion, growth and distribution of human osteoblast-like cells. SYNTHEGRA surface inducing modification of N-cadherin and beta-catenin expression and localization, are suggestive of cells undergoing differentiation towards osteocytes and could be particularly suited for immediate load implant procedures.

Long-term Treatment With Pravastatin Alone and in Combination With Gemfibrozil in Familial Type IIB Hyperlipoproteinemia or Combined Hyperlipidemia

BACKGROUND: Pravastatin inhibits 3-hydroxy-3-methylglutaryl-coenzyme A reductase. It prevents mevalonate synthesis, reducing endogenous cholesterol production, and reduces cholesterol content in the liver, thus resulting in a down-regulation of low-density lipoprotein receptor production. Gemfibrozil reduces very low-density lipoprotein production and low-density lipoprotein-cholesterol level and increases very low-density lipoprotein catabolism. Therefore, it was suggested that combination therapy with both drugs could effect greater reduction of cholesterol levels as compared to pravastatin alone. The present study was carried out to evaluate the efficacy and safety of pravastatin as a monotherapy or in combination with gemfibrozil in the treatment of patients with familial type IIb hyperlipoproteinemia or familial combined hyperlipidemia. METHODS AND RESULTS: Forty-one patients were included in the study. All patients initially followed 6 weeks of hypolipidemic diet; subsequently they were randomized and received either 20 mg once daily of pravastatin alone (n = 13) or 20 mg of pravastatin together with 600 mg of gemfibrozil twice daily (n = 14). As a control, 14 patients were treated with diet only. The treatment lasted 24 months and clinical evaluation and laboratory tests were done at given time points. Both groups of treated patients showed an early reduction (3 months) of total (about 30% P <.01 vs controls), low-density lipoprotein (about 35%, P <.01 vs controls) and very low-density lipoprotein cholesterol levels (about 18%, P = NS). In contrast, high-density lipoprotein cholesterol levels increased significantly in patients treated with pravastatin and gemfibrozil (about 20%, P <.05 vs controls). Pravastatin treatment alone reduced the level of serum triglycerides as efficiently as in combination with gemfibrozil. Data showed a sustained normalization of lipid profile until 24 months. However, this effect was achieved in patients that had rather low levels of triglycerides. During the treatment we did not observe any difference in the incidence of possible drug-related side effects. Severe myopathy or rhabdomyolysis was not observed at the doses of the drugs used in our study. CONCLUSIONS: Therapy with pravastatin and in combination with gemfibrozil resulted in significant and sustained normalization of lipid profile in high-risk patients with familial type IIb hyperlipoproteinemia or familial combined hyperlipidemia.

Osteoid osteoma of the clavicle

We describe a case of osteoid osteoma of the clavicle in an Olympic free-style wrestler who presented to us with persistent and increasingly elevated pain in his right shoulder. Originally a persistent injury was considered to be causing the pain, however, the correct diagnosis was made three months after the onset of the symptoms. Even in sportsman where muscle pain is commonplace, non-traumatic conditions should be considered in the presence of persistent and increasingly elevated pain that is not relieved by rest and physiotherapy.

[Evaluation of the therapeutic efficacy of pravastatin in monothereapy and in association with gemfibrozil in hypercholesterolemia associated with moderate hyperglyceridemia]

Pravastatin is a new drug that inhibits 3-hydroxy-3-methylglutaryl-coenzyme A reductase, the key enzyme in cholesterol synthesis. It prevents mevalonate synthesis, thus reducing cholesterol. Pravastatin also stimulates the expression of LDL receptors, leading to an activation of this specific pathway of LDL catabolism. Gemfibrozil is a fibrate drug. Although the mechanism of hypolipidemic action of fibrates is not conclusively elucidated, it seems to involve reduction of LDL cholesterol secondary to decreased VLDL production and increased VLDL catabolism. Therefore, it might be hypothesized that combination therapy with both agents could afford greater reduction of cholesterol levels as compared to pravastatin alone. This study compared the efficacy and safety of pravastatin in monotherapy or in combination with gemfibrozil in the treatment of primary hypercholesterolemia with moderate hypertriglyceridemia. Thirty-eight subjects (aged 57 +/- 15 years, 25 M and 13 F) with baseline cholesterol levels > 220 mg/dl, were included in the study. Serum triglyceride levels were greater than 170 mg/dl and lower than 250 mg/dl. All patients initially followed 4 weeks of hypolipidemic diet. The patients were there assigned to receive either 20 mg once a day of pravastatin alone (n 13) or 20 mg of pravastatin in association with 600 mg of gemfibrozil daily (n 11). Fourteen additional patient, treated with diet only, served as a control group. The treatment plan provided 18 months of active treatment with clinical and laboratory controls every month. Both groups of treated patients showed a reduction of total and LDL-cholesterol levels. The HDL-cholesterol levels increased significantly both with pravastatin and with gemfibrozil.(ABSTRACT TRUNCATED AT 250 WORDS)

One case of rotational subluxation of the carpal scaphoid

The authors describe one case of perilunate dislocation. After reduction of the dislocation, there was a residual rotational subluxation of the scaphoid due to dorsal tearing of the scapho-triquetral and radio-scaphoid ligaments. The subluxation results in post-traumatic dorsal instability of the carpus. The authors report their clinical experience and conclude that clinical and radiographic diagnosis is not always easy and treatment, which is always surgical, must aim at joint stabilization and ligament reconstruction.

Paradoxical effects of cardiac arrest by multidose potassium cardioplegia on myocardial lysosome integrity and phospholipid content

Multidose potassium cardioplegia is known to result in greater preservation of myocardial ATP content and better recovery of function as compared to cardiac arrest induced by aortic clamping. The present study was undertaken to assess the effects of this procedure on biochemical markers of tissue damage. Rat hearts undergoing either multidose cardioplegia or ischemic cardiac arrest were maintained at 18 degrees C for 1 or 2 hr and processed without reperfusion. Control hearts were processed at time zero. The activity of two lysosomal enzymes (beta-glucuronidase and acid phosphatase), as well as membrane phospholipid content, was measured in cardiac homogenates. One hour of arrest by either technique did not induce significant changes in these parameters. Two hours of arrest affected lysosomal integrity, as indicated by release of lysosomal enzymes into the cytosol. Soluble acid phosphatase activity averaged 44.7 +/- 1.3 mU/mg of protein in the hearts processed after 2 hr of cardioplegic arrest, and was significantly higher than that of control hearts (12.3 +/- 3.8 mU/mg of protein; P less than 0.01) and that of hearts subjected to 2 hr of ischemic arrest (29.2 +/- 4.5 mU/mg of protein; P less than 0.01 vs cardioplegic arrest; P less than 0.01 vs controls). Phospholipid content in hearts subjected to 2 hr of cardioplegic arrest was lower than in controls (0.49 +/- 0.06 micrograms Pi/mg of protein vs 0.76 +/- 0.03 micrograms Pi/mg of protein; P less than 0.01). In conclusion, 2 hr of hypothermic cardiac arrest was associated with biochemical indices of tissue damage.(ABSTRACT TRUNCATED AT 250 WORDS)

[The Japanese community in Argentina]

"Based on original survey data and census materials, the authors estimate the Japanese community in Argentina comprises about 10,000 native Japanese and some 40,000 ethnic Japanese born in Argentina. A complete picture is given of this community, including its evolution since the early arrivals around 1900. Data cover several aspects: demographic traits, socio-economic origin of immigrants, present employment structure, education, level of living, degree of acculturation in Argentina, intensity of connections with Japan, membership and participation in community organisations." (SUMMARY IN ENG)