M1 Group Research Articles

Relationship between Variation of Pre-ablation Stimulated Thyroglobulin and Distant Metastasis in Patients with Differentiated Thyroid Cancer.

To investigate the relationship between the dynamic variation of pre-ablation stimulated thyroglobulin(sTg)and distant metastasis in patietns with differentiated thyroid cancer(DTC). DTC patients after total or near total thyroidectomy were divided into two groups as M1 group(n=38)and M0 group(n=130)according to the presence of distant metastases or not. Clinical data including pre-ablation sTg and the corresponding thyrotropin(TSH)values were dynamically measured. The pre-ablation sTg and corresponding TSH collected at the first time were defined as Tg1 and TSH1,while as Tg2 and TSH2 at the last time. χ(2) test was used to compare the variation tendency of sTg between these two groups. Tg1,Tg2,pre-ablation sTg variation(∆Tg),and ∆Tg/∆TSH ratio between M0 and M1 were compared by Mann-Whitney rank-sum test. The receiver operating characteristic(ROC)curves and diagnostic critical point(DCP)were employed to evaluate the predictive values of the above indicators. Both Tg1 and Tg2 of M1 were significantly higher than those of M0(the Mann-Whitney rank-sum test:Tg1 P<0.001,Tg2 P<0.001). The corresponding areas under the ROC curve(AUC)to differentiate the two groups were 0.921 and 0.942,respectively. The cut-off value of Tg2,which was more accurate in predicting distant metastasis,was 24.3 ng/ml with a sensitivity of 92.11% and a specificity of 83.85%. Both ∆Tg and ∆Tg/∆TSH between these two groups were significantly different(the Mann-Whitney rank-sum test:∆Tg P=0.002,∆Tg/∆TSH P<0.001). ∆Tg/∆TSH worked better than Tg2 in predicting distant metastasis with both higher accuracy(87.50%)and higher specificity(86.92%). Dynamically tracing pre-ablation sTg may improve the accuracy and specificity of distant metastases prediction in DTC patients. ∆Tg/∆TSH,which means the ratio of sTg variation to TSH variation,may be a useful diagnostic marker for predicting distant metastases in DTC.

Postoperative stimulated thyroglobulin level and recurrence risk stratification in differentiated thyroid cancer.

Background:Postoperative preablative stimulated thyroglobulin (ps-Tg) has been evaluated in predicting prognosis and success of ablation regarding differentiated thyroid cancer (DTC); however, its relationship with recurrence risk and radioiodine decision-making remains uncertain, especially in Chinese DTC patients. We aimed to evaluate the association between ps-Tg and recurrence risk stratification in DTC, to provide incremental values for ps-Tg in postoperative assessment and radioiodine management.Methods:Seven hundred and seven patients with DTC were included; low-risk (L; n = 90), intermediate-risk (I; n = 283), and high-risk (H; n = 334, 117 with distant metastasis [M1]) patients were divided according to recurrence risk stratification. The M1 group was further analyzed regarding evidence of metastasis. Cut-off values of ps-Tg were obtained using receiver operating characteristic analysis.Results:Patients with more advanced disease at initial risk stratification were more likely to have higher ps-Tg levels (I vs. L: P < 0.05; H vs. I: P < 0.001; H vs. L: P < 0.001). The corresponding cut-off value of ps-Tg for distinguishing sensitivity and specificity in each of the two groups was 2.95 ng/ml (I vs. L: 61.5%, 63.3%), 29.5 ng/ml (H vs. I: 41.9%, 92.6%), 47.1 ng/ml (M1 vs. M0 in the H group: 79.5%, 88.9%) and 47.1 ng/ml (M1 vs. M0 in all patients: 79.5%, 93.7%). With the cut-off value at 47.1 ng/ml, ps-Tg was the only factor that could be used to identify distant metastases, and consequently if measured before radioiodine therapy would prevent 10.26% of patients with M1 from undertreatment.Conclusions:Ps-Tg, as an ongoing reassessment marker, favors differential recurrence risk grading and provides incremental values for radioiodine treatment decision-making.

Importance of excision repair cross-complementation group 1 and ribonucleotide reductase M1 as prognostic biomarkers in malignant pleural mesothelioma treated with platinum-based induction chemotherapy followed by surgery

Survival and response to platinum-based induction chemotherapy are heterogeneous among patients with malignant pleural mesothelioma. The aim of the present study was to assess the prognostic role of DNA repair markers, such as excision repair cross-complementation group 1 and ribonucleotide reductase M1, in multimodally treated patients with malignant pleural mesothelioma. Tumor tissue of a malignant pleural mesothelioma cohort (n = 107) treated with platinum/gemcitabine (n = 46) or platinum/pemetrexed (n = 61) induction chemotherapy followed by extrapleural pneumonectomy was assembled on a tissue microarray. Immunohistochemical expression of excision repair cross-complementation group 1 (nuclear) and ribonucleotide reductase M1 (nuclear and cytoplasmic) was assessed for its prognostic impact (association with overall survival or freedom from recurrence). Patients with high nuclear ribonucleotide reductase M1 expression before chemotherapy showed significantly longer freedom from recurrence (P = .03). When specifically analyzed in the subgroup of patients receiving platinum/gemcitabine followed by extrapleural pneumonectomy, high nuclear ribonucleotide reductase M1 was associated with prolonged freedom from recurrence (P = .03) and overall survival (P = .02). Low excision repair cross-complementation group 1 expression in prechemotherapy tumor tissues was associated with significantly longer freedom from recurrence (P = .04). Nuclear ribonucleotide reductase M1 and excision repair cross-complementation group 1 were independent prognosticators of freedom from recurrence in addition to pT stage in multivariate analysis. In the present study, nuclear ribonucleotide reductase M1 and excision repair cross-complementation group 1 expression were identified as independent prognosticators for freedom from recurrence of malignant pleural mesothelioma in patients undergoing induction chemotherapy followed by extrapleural pneumonectomy.

Natural variant of collagen-like protein a in serotype M3 group a Streptococcus increases adherence and decreases invasive potential.

Group A Streptococcus (GAS) predominantly exists as a colonizer of the human oropharynx that occasionally breaches epithelial barriers to cause invasive diseases. Despite the frequency of GAS carriage, few investigations into the contributory molecular mechanisms exist. To this end, we identified a naturally occurring polymorphism in the gene encoding the streptococcal collagen-like protein A (SclA) in GAS carrier strains. All previously sequenced invasive serotype M3 GAS possess a premature stop codon in the sclA gene truncating the protein. The carrier polymorphism is predicted to restore SclA function and was infrequently identified by targeted DNA sequencing in invasive strains of the same serotype. We demonstrate that a strain with the carrier sclA allele expressed a full-length SclA protein, while the strain with the invasive sclA allele expressed a truncated variant. An isoallelic mutant invasive strain with the carrier sclA allele exhibited decreased virulence in a mouse model of invasive disease and decreased multiplication in human blood. Further, the isoallelic invasive strain with the carrier sclA allele persisted in the mouse nasopharynx and had increased adherence to cultured epithelial cells. Repair of the premature stop codon in the invasive sclA allele restored the ability to bind the extracellular matrix proteins laminin and cellular fibronectin. These data demonstrate that a mutation in GAS carrier strains increases adherence and decreases virulence and suggest selection against increased adherence in GAS invasive isolates.

Cell proliferation and invasion in microRNA-143 and microRNA-29a transfected bladder cancer cells and its relationship of ras association domain family 1A methylation

Objective To evaluate the relationship among bladder cancer cell proliferation and invasion,microRNA-143 and 29a,and ras association domain family 1A (RASSF1A) methylation.Methods MiR-143 and miR-29a mimics were transfected to T24 cell lines.Transfection efficiency was confirmed by reverse transcription polymerase chain reaction (RT-PCR).All cell lines were divided into four groups:WT group (wild T24 cell lines without any treatment),NC group (transfected by negative control mimics),M1 group (transfected by miR-143 mimics) and M2 group (transfected by miR-29a mimics).Apoptosis rates,cell cycle,cell invasive inhibitor rates,RASSF1 A gene expression and methylation were detected.Results Transfection was successful confirmed by RT-PCR.Apoptosis rates of WT,NC,M1 and M2 group were 2.5％,3.4％,12.4％ and 13.3％ respectively.S-phase cells in M1 and M2 group increased significantly.Cell invasive inhibitor rates of NC,M1 and M2 group were 2.0％,16.5％ and 13.2％ respectively which showed the rates in M1 and M2 group were higher than NC group (P ＜0.05).RASSF1A gene expression was upgraded in M2 group and no changes were found in M1 group.What's more,MSP results showed that RASSF1 A gene was partial methylated in M2 group while it was completely methylated in other groups.Conclusion T24 bladder cancer cell proliferation and invasion decreased after miR-143 and miR-29a transfected.miR-29a transfection may inhibit RASSF1 A gene methylation and lead to gene expression uploaded. Key words: MicroRNA; Bladder cancer; Ras association domain family 1A; Methylation; Transfection

Audiologic presentation of enlargement of the vestibular aqueduct according to the SLC26A4 genotypes.

To determine the distribution of the number and types of mutant alleles of SLC26A4 and their correlations with hearing phenotypes in Korean bilateral enlargement of vestibular aqueduct (EVA) patients. Prospective cohort study. To determine the number and type of mutant alleles, Sanger sequencing of coding region of SLC26A4 was performed for 56 patients with bilateral EVA who were consecutively recruited. Their correlations with hearing phenotypes were analyzed based on 0.5-, 1-, 2-, and 3-kHz air conduction averages of pure-tone audiometry. Most patients with bilateral EVA (83.9%) carried two mutant alleles of SLC26A4 (M2), and all others (16.1%) had only one detectable mutant allele of SLC26A4 (M1) in the Korean population. There were no cases with zero mutations. p.H723R/p.H723R was the most frequently observed mutant allelic pair (34%), followed by p.H723R/c.919-2A>G (20%). There was no significant difference in hearing threshold, progression, or fluctuation of hearing level between the M1 and M2 groups. However, focusing on the type of mutations exclusively in the M2 group, cases with p.H723R/c.919-2A>G were associated with more frequent progression of hearing loss during the follow-up period. The cases with p.H723R/c.919-2A>G tended to show slightly better hearing than p.H723R homozygotes, although the difference was not statistically significant. There appears to be a different genotype-auditory phenotype correlation among ethnicities. Our data suggest that the auditory phenotype of Korean bilateral EVA patients is more strongly correlated with the type rather than the number of mutations in SLC26A4. NA.

Melanocortin 4 Receptor Is Involved in the Development of Morphine Tolerance

Background: Prolonged morphine treatment usually results in the development of analgesic tolerance. Melanocortin 4 receptor (MC4R) is involved in the development of morphine tolerance. The aim of this study was to examine the effects of an MC4R antagonist, HS014, on MC4R-mediated hyperalgesia and on microglia and cytokine expression in the spinal cord of rat during morphine tolerance.Methods: Thirty rats were assigned randomly to the N group, M group, HM group, NM group and HN group (N=6 in each group). Rats received 5-day treatment with saline (N group) or morphine (M group). Rats were given an intrathecal injection (i.t.) of HS014 (HM group) or saline (NM group) at 15 minutes prior to the morphine challenge. In the HN group, rats were injected with HS014 at 15 minutes prior to the saline. To observe the effect of HS014 on the development of morphine tolerance, morphine-tolerant rats were assigned to M1 group, M2 group, M3 group and N group on day 6 (N=6 in each group). The morphine-tolerant rats in M1 group, M2 group and M3 group received morphine (10 mg/kg, i.p.), HS014 (5 μg, i.t.) and HS014 (5 μg, i.t.) followed 15 minutes later by injection of morphine (10 mg/kg, i.p.), respectively. Control rats (N group, N=6) were injected with saline under identical conditions.Results: Morphine treatment (10 mg/kg, i.p. twice daily) over 5 days induced tolerance as reflected by a significant reduction of withdrawal latency from 29.67 ± 1.81 s to 8.67 ± 1.70 seconds in the hot-plate test. Repeated HS014 injection prior to morphine administration inhibited the development of morphine tolerance. Furthermore, a single administration of HS014 restored morphine analgesic potency in morphine-tolerant rats. Immunohistochemical staining showed that the administration of HS014 during the induction of morphine tolerance inhibited the activation of microglia, reduced the expression of proinflammatory cytokines, such as interleukin (IL)-1, IL-6 and tumor necrosis factor (TNF)-α, and increased the expression of anti-inflammatory cytokines (IL-10) at the L5 lumbar spinal cord.Conclusions: HS014 attenuates the development of antinociceptive tolerance following chronic administration of morphine by inhibiting microglial activation and reducing the expression of IL-1, IL-6 and TNF-α. Citation: Hong-Mei Xu, Ze-Jun Niu, Hai-Chen Chu, Xue-Feng Zhang. Melanocortin 4 receptor is involved in the development of morphine tolerance. J Anesth Perioper Med 2014; 1: 90-6. doi: 10.24015/JAPM.2014.0014This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

P-017 M2 Occlusions as a Target for Endovascular Therapy: Comprehensive Analysis of Diffusion/Perfusion MRI, Angiography, and Clinical Outcomes

IntroductionThe ideal population of patients for endovascular reperfusion therapy (ERT) in acute ischemic stroke (AIS) remains undefined. Recent trials have moved towards including only patients with proximal (ICA or M1)...

Dietary methionine supplementation alters the expression of genes involved in methionine metabolism in salmonids

The objective of the present study was to investigate the effect of dietary methionine (Met) concentration and alternating feeding strategies in methionine delivery, on the mRNA transcript levels of genes involved in Met resynthesis (betaine-homocysteine methyltransferase, BHMT; S-adenosylhomocysteine hydrolase, SAHH) and net Met loss (taurine synthesis) (cystathionine beta-synthase, CBS) in Atlantic salmon (Salmo salar) liver. Salmon alevins (265 ± 3 mg) were distributed into 24 tanks (50 fish per tank; 3 replicates). The experimental diets were supplemented with l-methionine at 0, 1.9, 5.8, and 17.4 g/kg (M0, M1/3, M1, and M3, respectively). The M3 diet without glycine was prepared to examine Met toxicity (M3-G). These diets were provided via “mono-feeding strategy,” meaning fish were fed a designated single diet. This experiment also included alternative feeding groups with “duo-feeding” strategy: AF1 (fish fed M0 for 2 days followed by M1 for 1 day), AF2 (fish fed M0 for 2 days followed by M3 for 1 day), and AF3 (fish fed two meals of M0 followed by one meal of M3). Salmon fed M0 diet had smaller weight compared to all other groups. There was no effect of alternative feeding on the growth except with the M0 group. The highest expression of CBS gene was found in the M0, M1/3, and AF-1 groups compared to the M3 and M3-G groups. The expression of CBS gene in the M1 group was lower compared to the AF-1 group. The expression of SAHH gene was the highest in the M3 group compared to the M1, M1/3, and AF-3 groups. The highest expression of BHMT gene was found in the M0, M1/3, and AF-1 groups, indicating enhanced re-methylation of homocysteine by betaine to Met. The lowest BHMT expression in M1, M3, M3-G, AF-2, and AF-3 groups compared to other treatments can be indicative of downregulation of remethylation in the liver. The alternate provision of methionine in a form of combination of low and high methionine containing diets seemed to support its efficient utilization in the salmon liver.

Low-dose cisplatin administration to septic mice improves bacterial clearance and programs peritoneal macrophage polarization to M1 phenotype.

Sepsis is a systemic inflammatory response to infection, and early responses of macrophages are vital in controlling the infected microorganisms. We used a cecal ligation and puncture (CLP) model of sepsis to determine the role of cisplatin (0.1, 0.5 and 1 mg kg(-1)) with respect to peritoneal macrophages, controlling peritoneal/blood bacterial infection, and systemic inflammation. We found that mice which received low-dose (0.1 and 0.5 mg kg(-1)) i.p. cisplatin had lower mortality rate and improved clinical scores compared with mice in normal saline-treated group, and the level of IL-6 and TNF-α was significantly reduced after cisplatin administration in peritoneal fluid of mice underwent CLP. Although cisplatin had no directly bactericidal ability, the numbers of bacteria in peritoneal and blood were significantly reduced at 24 and 72 h after the onset of CLP. Besides, in vivo phagocytosis and killing assay showed that the ability of macrophage derived from peritoneum was significantly increased with cisplatin treatment (5, 10, and 15 μM) for both gram-positive (Enterococcus faecalis) and gram-negative (Escherichia coli) bacteria. This was associated with the macrophage phenotype polarization from CD11b(+) F4/80(high) CD206(-) to CD11b(+) F4/80(low) CD206(-) M1 group. These findings underscore the importance of low-dose cisplatin in the treatment of sepsis.

Oral toxicity evaluation of kefir-isolated Lactobacillus kefiranofaciens M1 in Sprague–Dawley rats

Lactobacilli kefiranofaciens M1 has shown novel immunomodulation and anti-allergy probiotic attributes in cell and animal models. An acute oral toxicity assessment of L. kefiranofaciens M1 was evaluated in Sprague–Dawley rats. The rats were randomly assigned to four groups (12 rats/sex/group): the low dose group was orally gavaged with L. kefiranofaciens M1 at 3.0×108cfu/kg bw while the medium dose and high dose groups received 9.0×109cfu/kg bw and 1.8×1010cfu/kg bw, respectively, for 28days. The control group received phosphate buffer saline. The body weights were measured weekly while blood samples were collected for haematology and serum biochemistry tests. Histopathology of the organs (heart, liver, kidney, adrenal glands, spleen, ovary, testis), and urinalysis were conducted on study termination. The body weight gain of the L. kefiranofaciens M1 and control groups were comparable during the administration period. Overall, L. kefiranofaciens M1 did not induce adverse effects on haematology, serum biochemistry, and urinalysis parameters. Gross and microscopic histopathology of the organs revealed no toxicity effect of L. kefiranofaciens M1. In conclusion, 1.8×1010cfu/kg bw of L. kefiranofaciens M1 was considered as the no-observed-adverse-effect-level (NOAEL), which was the highest dose tested in the present study.

Expression of ribonucleoside reductase subunit M1, but not excision repair cross-complementation group 1, is predictive in muscle-invasive bladder cancer treated with chemotherapy and radiation.

The aim of this study was to determine the prognostic and predictive values of ribonucleoside reductase subunit M1 (RRM1) and excision repair cross-complementation group 1 (ERCC1) expression in patients with muscle-invasive bladder cancer treated with chemoradiotherapy. The expression of RRM1 and ERCC1 in pretreatment tumor samples of retrospectively identified patients was determined by immunohistochemical analysis. A total of 39 patients were included in this study; 49% were treated with neoadjuvant chemotherapy and 67% with concomitant chemoradiotherapy; 56% were treated with gemcitabine-based and 51% with platinum-based chemoradiotherapy. The median follow-up was 19 months (interquartile range, 11-50 months). Based on the immunohistochemical analysis, 44 and 32% of the tumors exhibited increased expression of RRM1 and ERCC1, respectively. The complete response (CR) and local recurrence rates following chemoradiotherapy were 79 and 21%, respectively. A low expression of RRM1 was associated with a higher rate of CR to chemoradiotherapy (95 vs. 57%, P=0.012); however, there was no such association with low ERCC1 expression (67 vs. 84%, P=0.39). RRM1 expression predicted an improved CR in patients treated with gemcitabine-based chemoradiotherapy (57 vs. 100%, P=0.036), but not in those treated with other agents (56 vs. 88%, P=0.29). ERCC1 expression was not found to be correlated with CR (67 vs. 84%, P=0.39), even when restricted to patients treated with platinum agents (71 vs. 75%, P=1.0). In the univariate analysis, RRM1 expression, but not ERCC1 expression, was identified as a prognostic marker for worse cancer-specific survival in all the patients and in those treated with gemcitabine-based regimens. No independent prognostic factor was identified in the multivariate model, which included tumor stage, vascular invasion, hydronephrosis and RRM1 status. Although these findings require further validation, they suggest that RRM1 may be a beneficial stratification variable for the selection of chemotherapy regimens for chemoradiotherapy, with patients with low RRM1 expression being considered suitable for gemcitabine treatment.

Natural Disruption of Two Regulatory Networks in Serotype M3 Group A Streptococcus Isolates Contributes to the Virulence Factor Profile of This Hypervirulent Serotype

Despite the public health challenges associated with the emergence of new pathogenic bacterial strains and/or serotypes, there is a dearth of information regarding the molecular mechanisms that drive this variation. Here, we began to address the mechanisms behind serotype-specific variation between serotype M1 and M3 strains of the human pathogen Streptococcus pyogenes (the group A Streptococcus [GAS]). Spatially diverse contemporary clinical serotype M3 isolates were discovered to contain identical inactivating mutations within genes encoding two regulatory systems that control the expression of important virulence factors, including the thrombolytic agent streptokinase, the protease inhibitor-binding protein-G-related α2-macroglobulin-binding (GRAB) protein, and the antiphagocytic hyaluronic acid capsule. Subsequent analysis of a larger collection of isolates determined that M3 GAS, since at least the 1920s, has harbored a 4-bp deletion in the fasC gene of the fasBCAX regulatory system and an inactivating polymorphism in the rivR regulator-encoding gene. The fasC and rivR mutations in M3 isolates directly affect the virulence factor profile of M3 GAS, as evident by a reduction in streptokinase expression and an enhancement of GRAB expression. Complementation of the fasC mutation in M3 GAS significantly enhanced levels of the small regulatory RNA FasX, which in turn enhanced streptokinase expression. Complementation of the rivR mutation in M3 GAS restored the regulation of grab mRNA abundance but did not alter capsule mRNA levels. While important, the fasC and rivR mutations do not provide a full explanation for why serotype M3 strains are associated with unusually severe invasive infections; thus, further investigation is warranted.

Clinical Experience With a Novel Glaucoma Drainage Implant

To retrospectively evaluate the safety and efficacy of an Ahmed glaucoma valve (AGV) modified with a polyethylene shell (M4) to reduce the fibrotic reaction around the drainage plate compared with the S2 and FP7 models in patients with glaucoma. The medical records of patients who underwent implantation of the AGV FP7, S2, and M4 were reviewed. The primary outcome measure was cumulative probability of success, defined as an intraocular pressure (IOP) between 5 and 18 mm Hg and >20% reduction of IOP without loss of light perception, need for additional IOP-lowering surgical procedures, or removal of AGV. Seventy-six, 38, and 40 eyes received the FP7, S2, and M4 with a mean follow-up time of 578±157, 662±186, and 504±158 days, respectively. The mean IOP was reduced from 31.0±10.6 to 13.9±5.5 mm Hg in the FP7 group, 33.5±12.1 to 15.8±8.1 mm Hg in the S2 group, and 27.0±12.0 to 15.0±4.0 mm Hg in the M4 group at 1 year (P=0.31). At 1 year, the cumulative probability of success was 70%, 66%, and 80% and at 18 months, 61%, 53%, and 52% in the FP7, S2, and M4 groups, respectively (P=0.99). Complications were similar among groups. No significant difference was observed between the AGV M4, FP7, and S2 at 1 year. Additional follow-up is required to determine its long-term safety profile and efficacy.

Immunophenotyping characteristics of AML and their correlation with the curative effects

This study was aimed to explore the immunophenotyping characteristics of acute myeloid leukemia (AML) and their correlation with the curative efficacy. The bone marrow or blood samples were collected from 516 patients with newly diagnosed AML, and their immunophenotypes were analyzed by flow cytometry. The results showed that (1) In 516 cases, the ratios of myeloid antigen expression were higher, as follows: MPO 95.0%, CD33 93.0%, CD13 88.8%, CD117 69.4%; and the expressions of CD14, CD15, CD64 and CD71 were lower, meanwhile 145 cases were accompanied with lymphocyte antigen expression, the ratios were as follows: CD7 21.5%, CD19 6.0%, CD2 0.78%, CD10 0.58% and CD20 0.58%; the positive expression rate of CD71 in M6 was 100%, and that of CD64 in M5 was the highest (30.2%); the overall positive rate of CD34 was 57.8%. (2) After first chemotherapy, the complete remission (CR) rate was 64.7%, CR rate of CD34(+) patients was lower than that of CD34(-) in M3 group (P = 0.019). The CR rate of CD34(+) patients was significantly lower than that of CD34(-) in non-M3 group (P = 0.002). The CR rate of CD19(+) patients was higher than CD19(-) (P = 0.028); the CR rate of CD7(+) patients was significantly lower than that of CD7(-) (P = 0.002); the CR rate of CD71(+) patients was lower than that of CD71(-) (P = 0.013); the CR rate of MPO(+) patients was higher than that of MPO(-) (P = 0.015). Between the CR rate of CD11b, CD13, CD33-positive and-negative group, the difference was not statistically significant (P > 0.05). It is concluded that the phenotype is a prerequisite for the diagnosis of AML, and can help to guide the clinical typing, selection of treatment protocols and evaluation of prognosis.

Difference in the Effect of Outpatient Pulmonary Rehabilitation Due to Variation in the Intervention Frequency: Intervention Centering on Home-based Exercise

[Purpose] The purpose of this study was to investigate differences in effects caused by variation in the intervention frequency of outpatient pulmonary rehabilitation, in terms of the pulmonary function, lower-limb muscle strength, exercise tolerance, and quality of life (QOL). [Subjects and Methods] A total of 36 patients with mild to severe chronic obstructive pulmonary disease (COPD) were studied. These patients were all men over the age of 40 who did not require assistance for activities of daily living (ADL). Groups undergoing intervention once a month (M1 group) and once a week (W1 group) were compared in terms of the effects of outpatient pulmonary rehabilitation for a period of 12 weeks. Intervention during this time included supervised and home-based exercise. [Results] Comparison of before and after intervention revealed that the rate of change in the W1 group was significantly higher than that in the M1 group in terms of the QOL, lower-extremity muscle strength, and 6-minute walking distance. [Conclusion] Outpatient pulmonary rehabilitation programs yielded greater improvements in the W1 group than in the M1 group in terms of the QOL and exercise tolerance.

Identificação e caracterização de espécies de Colletotrichum associadas à antracnose de anonáceas no estado de Alagoas

No Brasil, Colletotrichum gloeosporioides é a única espécie associada à antracnose de anonáceas. Contudo, apenas características morfológicas têm sido utilizadas na identificação. Assim, o objetivo do trabalho foi identificar e caracterizar espécies de Colletotrichum que causam a antracnose nas culturas da pinha e da graviola no Estado de Alagoas. Cinquenta e um isolados, obtidos de folhas de pinheira e gravioleira com sintomas típicos da doença, foram coletados em Maceió, Palmeira dos Índios e União dos Palmares. Os isolados foram inoculados em folhas destacadas de ambas as culturas e caracterizados morfologicamente através da morfometria de conídios e apressórios, e molecularmente por meio do sequenciamento da região ITS. Verificou-se que todos os isolados foram patogênicos a ambas as espécies. Na caracterização morfológica, os isolados foram agrupados em três grupos: M1, M2 e M3. O grupo M1 foi formado por 32 isolados com características relacionadas a C. gloeosporioides. No grupo M2, constituído de 15 isolados, predominaram características de C. boninense, enquanto, no grupo M3, composto por quatro isolados, as características foram típicas de C. fragariae. A análise filogenética, da mesma forma, também resultou em três grupos (F1, F2 e F3), os quais, de modo geral, estiveram em concordância com os dados da morfologia. O grupo filogenético F1 concentrou os isolados do grupo morfológico M1 e sequências de referências de C. gloeosporioides e C. fragariae. O grupo F2, que agrupou as sequências de C. boninense, concentrou os isolados do grupo morfológico M2. Finalmente, o grupo F3 incluiu sequências de C. magna e outros quatro isolados desse estudo. Assim, foi possível comprovar que quatro espécies de Colletotrichum são responsáveis pela antracnose em pinheira e gravioleira em Alagoas: C. gloeosporioides, C. boninense, C. fragariae e C. magna.

Leakage of Phosphatases and Fertility of Buck Semen Cryopreserved under Different Freezing Modes

Present study was conducted on 160 ejaculates collected at weekly interval by artificial vagina method from 13 adult Sirohi bucks. Pooled ejaculates were diluted with Tris-egg yolk-citric acid-fructose-glycerol extender (1:4), filled and sealed in straws. Few straws of diluted semen were thawed (40° C/15 seconds) and assessed for acid and alkaline phosphatases (ACP and AKP) in seminal plasma of diluted semen (Control Group). Remaining semen straws were randomly grouped to constitute freezing mode groups (M1, M2, M2, and M4) and processed further for cryo-preservation of semen. Accordingly diluted semen straws were cooled @-4° C/minute from 25° C up to 5° C thereafter equilibrated for 2 hours and frozen up to -160° C @ 15, 20, 25 and 300 C/minute for M1, M2, M3 and M4 groups respectively. These frozen straws were hold at this temperature for 2 minutes then stored separately in LN2. After 7 days of storage, straws from each freezing mode group were thawed and assessed for ACP and AKP in seminal plasma. In vivo fertility trials were also conducted with straws of control (fresh diluted semen) as well as freezing mode groups (frozen at different freezing rates). Least square analysis of variance for the data obtained revealed highly significant (P ≤ 0.01) rise in the seminal plasma ACP and AKP enzyme levels in frozen thawed semen as compared to that in fresh diluted semen. The Values of ACP and AKP also differed significantly (P ≤ 0.05) among all the freezing mode groups wherein lowest values of ACP were observed in M3 group followed by M4, M2 and M1 groups in increasing order whereas, lowest values of AKP were observed in M3 followed by M2, M4 and M1 groups in increasing order. Highest fertility rates were observed with semen from M3 followed by M2, M4 and M1 groups. On the basis of enzyme leakage and in-vivo fertility trials, the optimum freezing rate for cryopreservation protocol was arrived at 25° C/minute.DOI: http://dx.doi.org/10.3126/ijasbt.v1i4.8913 Int J Appl Sci Biotechnol, Vol. 1(4): 202-207

The Influence of the Length of the First Metatarsal on the Risk of Reulceration in the Feet of Patients With Diabetes

Our aim was to identify the optimal diagnostic cutoff point on the scale of protrusion measurements of the first metatarsal (M1) to predict the probability of reulceration after metatarsal head resection in patients with diabetes mellitus. We conducted a prospective study of patients with diabetes who underwent resection of at least 1 metatarsal head in our department. After surgery, we measured the difference in length (protrusion) between the M1 and the longest of the 4 lesser metatarsals by radiographic view. The patients were divided into those in whom the M1 was the longest of the 5 metatarsals (group 1) and patients in whom at least one of the lesser metatarsals was longer than the M1 (group 2). They were followed-up for 12 months and were assessed for reulceration. Ninety-one patients were included in the present study: 43 (47%) in group 1 and 48 (53%) in group 2. In group 1, the longer the protrusion of M1 was, the higher the probability for reulceration (P < .001, 95% confidence interval = 0.813-0.997). In group 2, the shorter the protrusion of M1, the higher the probability for reulceration (P = .002, 95% confidence interval = 0.628-0.905). The optimal cutoff point for group 1 was 11 mm (sensitivity = 84.6%, specificity = 86.7%) for the probability of reulceration. In group 2, it was -7 mm (sensitivity = 81.8%, specificity = 65.4%). These results suggest that M1 protrusion is an optimum prognostic indicator for reulceration and could be recommended for detecting patients at risk of reulceration after surgery.

Epithelioid Sarcoma: Need for a Multimodal Approach to Maximize the Chances of Curative Conservative Treatment

This study was designed to evaluate the impact of multimodal management on a series of epithelioid sarcoma (ES) patients treated with curative intent. Data were collected on 69 consecutive patients treated from 1982 to 2012. Univariate and multivariate analyses were performed for tumor control and overall survival (OS). In total, 54 (78 %) patients had localized ES (M0 group). In the M0 group, 85 % of patients received multimodal management (surgery n = 50, radiotherapy n = 37, chemotherapy n = 30). Among 42 patients with limb ES, 9 (21 %) underwent amputation, and isolated limb perfusion (ILP) was required in 17 (40.5 %) to allow conservative management. Among the 45 patients who underwent conservative surgery, flap reconstructions were required in 13 (28.8 %). The median follow-up was 5.7 years. The 5-year actuarial OS rates were 54, 62, and 24 % in the entire group and the M0 and M1 groups, respectively. In the M0 group, the 5-year actuarial distant control, local control (LC), and locoregional control rates were 67, 75, and 66 %, respectively. Prognostic factors for poor OS in the multivariate analysis were tumors that were deep to the fascia (p = 0.04) and grade 3 (p = 0.005). In the univariate analysis, age <30 years (p = 0.04), the T2 stage (p = 0.04), and mass presentation (p = 0.03) correlated with decreased LC, whereas patients who underwent ILP had a significantly higher LC rate (hazard ratio 3; 95 % confidence interval 0.9-9.4; p = 0.05). Multimodal management including ILP and flap reconstruction is necessary to achieve optimal conservative LC. High rates of metastasis and lymphatic spread require innovative systemic treatments.