PK Group Research Articles

A Network of Circular RNA and MicroRNA Sequencing Provides Insights into Pigment Deposition of Changshun Blue Eggshell Chickens.

Eggshell color plays important biological roles and attracts the attention of both egg retailers and researchers. However, whether non-coding RNAs are involved in pigment deposition among different eggshell colors remains unknown. In this study, RNA sequencing was used to analyse the uterine gland transcriptome (CircRNA and miRNA) of Changshun chicken blue-shell hens producing four different eggshell color eggs including dark blue PK(DB) and light blue (LB), dark brown and greenish (between blue and pink, DP) and pink (p). We found that miR-192-x, targeting SLC16a7, was expressed in DB, DP, and LB groups compared with the PK group, which indicates that miR-192-x may play a role in the blue eggshell color. KEGG and GO analyses showed that the "metabolic pathways" with targeted genes such BLVRA and HMOX1 were detected in dark and light blue color eggshell chickens, which confirms the different ratios of biliverdin and HO-1 involved in the deposition of blue color. As annotated by connectivity analysis, RASGRF1 and RASGRF2, belonging to the RASGRF family, are involved in the Ras signaling pathway, which plays an important role in cell growth, differentiation, metastasis and apoptosis. Our findings enrich the database of circRNA, miRNAs and genes for chicken uterine tissue, which will be useful in accelerating molecular selection for blue eggshell color layers.

Comparison of remifentanil and esketamine in combination with propofol for patient sedation during fiberoptic bronchoscopy

BackgroundIdeal sedation and analgesia strategies for fiberoptic bronchoscopy have not been found. At present, propofol based sedation strategy still has some defects, such as respiratory depression and blood pressure drop. It is difficult to meet the requirements of safety and effectiveness at the same time. The aim of this study was to compare the clinical efficacy of propofol/remifentanil with propofol/esketamine for patient sedation during fiberoptic bronchoscopy.MethodPatients undergoing fiberoptic bronchoscopy were randomly assigned to propofol/ remifentanil (PR group; n = 42) or propofol/esketamine (PK group; n = 42) for sedation and analgesia. The primary outcome was the rate of transient hypoxia (oxygen saturation (SpO2) < 95%). The secondary outcomes are the intraoperative hemodynamics, including the changes in blood pressure, heart rate, the incidence of adverse reactions, the total amount of propofol usage were recorded, and the satisfaction level of patients and bronchoscopists.ResultsAfter sedation, the arterial pressure and heart rate of patients in the PK group were stable without significant decrease. Decreases in diastolic blood pressure, mean arterial pressure, and heart rate were observed in patients in the PR group (P < 0.05), although it was not of clinical relevance. The dosage of propofol in the PR group was significantly higher than that in the PK group (144 ± 38 mg vs. 125 ± 35 mg, P = 0.012). Patients in the PR group showed more transient hypoxia (SpO2 < 95%) during surgery (7 vs. 0, 0% versus 16.6%, P = 0.018), more intraoperative choking (28 vs. 7, P < 0.01), postoperative vomiting (22 vs. 13, P = 0.076) and vertigo (15 vs. 13, P = 0.003). Bronchoscopists in the PK group showed more satisfaction.ConclusionCompared with remifentanil, the combination of esketamine with propofol in fiberoptic bronchoscopy leaded to more stable intraoperative hemodynamics, lower dosage of propofol, lower transient hypoxia rate, fewer incidence of adverse events, and greater bronchoscopists satisfaction.

Comparison of repeat penetrating keratoplasty, DSAEK and DMEK for the management of endothelial failure of previous PK

PurposeTo compare the clinical outcomes of repeat PK, DSAEK-on-PK or DMEK-on-PK for the management of endothelial failure of previous penetrating keratoplasty.DesignRetrospective, interventional consecutive case series.Participants104 consecutive eyes of 100 patients requiring a second keratoplasty for endothelial failure of their primary penetrating keratoplasty performed between September 2016 and December 2020.InterventionRepeat keratoplasty.Main outcome measuresSurvival and visual acuity at 12 and 24 months, rebubbling rate and complications.ResultsRepeat PK was performed in 61/104 eyes (58.7%), DSAEK-on-PK was performed in 21/104 eyes (20.2%) and DMEK-on-PK was performed in 22/104 eyes (21.2%). Failure rates in the first 12 and 24 months were 6.6% and 20.6% for repeat PKs compared to 19% and 30.6% for DSAEK and 36.4% and 41.3% for DMEK. For those grafts surviving 12 months, the chances of surviving to 24 months were greatest for DMEK-on-PK at 92% vs 85% each for redo PK and DSAEK-on-PK. Visual acuity at one year was logMAR 0.53 ± 0.51 in the redo PK group, 0.25 ± 0.17 for DSAEK-on-PK and 0.30 ± 0.38 for DMEK-on-PK. 24-month outcomes were 0.34 ± 0.28, 0.08 ± 0.16, and 0.36 ± 0.36 respectively.ConclusionsDMEK-on-PK has a greater failure rate in the first 12 months than DSAEK-on-PK which has a greater failure rate than redo PK. However, the 2-year survival rates in our series for those already surviving 12 months were greatest for DMEK-on-PK. There was no significant difference in visual acuity at 12 or 24 months. Careful patient selection is needed by experienced surgeons to determine which procedure to offer to patients.

Evaluation of Mechanical Behavior of CAD/CAM Polymers for Long-term Interim Restoration Following Artificial Aging.

Mechanical properties are crucial parameters for the clinical performance of longterm CAD/CAM interim restorations. This study aimed to evaluate and compare fracture toughness (FT), flexural strength (FS), flexural modulus (FM), microhardness (H), and the brittle index (BI) of three different long-term interim restorative materials after simulated ageing. CAD-Temp; VCT, Everest C-Temp; CT, and PEEK; PK were the materials used. Specimens were divided into subgroup A (control group) with no thermocycling, and subgroup B subjected to 5000 thermocycles between 5 and 55 °C for 30 seconds. FS, FM, FT, H, microstructure, and the brittle index were evaluated. The data was examined using two-way ANOVA and Tukey's test for post-hoc comparisons. In the VCT group, FS, FT, and H were significantly reduced (p ⟨0.05) after thermocycling. In the PK group, no statistically significant differences (p ⟩0.05) were detected between the aged and non-aged groups. As for the CT group, the tested properties were significantly reduced (p ⟨0.05) after simulated aging condition. The PK group recorded appropriate mechanical behavior both before and after simulating aging, in addition to its better machinability than other materials. The CT group had better mechanical properties before and after ageing, despite the significant reduction in mechanical properties after aging.

Microinjury-Induced Tumor Necrosis Factor-α Surge Stimulates Hair Regeneration in Mice

Introduction: Tumor necrosis factor (TNF)-α released after follicular injury such as that caused by plucking plays a role in the activation of hair regeneration. Microneedle (MN) treatment is applied to the scalp to increase permeability and facilitate the delivery of any number of compounds. Because the MN treatment causes injury to the epidermis, albeit minor, we reasoned that this treatment would lead to a temporary TNF-α surge and thereby promote hair regeneration. Methods: To investigate the effects of MN-treatment-induced microinjury and TNF-α on hair growth, we used C57BL/6N mice which were divided into six experimental groups: three groups of 1) negative control (NC), 2) plucking positive control (PK), and 3) MN therapy system (MTS) mice; and three groups identical to above were treated with a TNF-α blocker for 3 weeks: 4) NCB, 5) PKB, and 6) MTSB group. Results: After injury, TNF-α surge occurred on day 3 in the PK group and on day 6 in the MTS group. Wnt proteins and VEGF expression were markedly increased in the PK group on day 3 and on day 6 in the MTS group compared to the NC group. Following wound healing, only MTS and PK groups displayed thickened epidermis and longer HF length. Within the 2 weeks following treatment, the rate of hair growth was much slower in the injured mice treated with the TNF-α blocker. Conclusion: Our findings indicate that microinjury stimulates the wound-healing mechanism via TNF-α/Wnt/VEGF surge to induce hair growth, and that blocking TNF-α inhibits this growth process.

A Comparison Between Modified Unilateral Extrapedicular and Bilateral Transpedicular Percutaneous Kyphoplasty in the Treatment of Lumbar Osteoporotic Vertebral Compression Fracture

Few researchers have verified the clinical efficacy and safety of the modified unilateral extrapedicular approach (mUEP) applied to the percutaneous kyphoplasty (PKP) in comparative studies with other puncture techniques. Compared with the bilateral transpedicular approach (BTP), whether mUEP PKP is a preferred treatment for lumbar osteoporotic vertebral compression fracture (OVCF) remains unclear. Patients treated by PKP for single-level lumbar OVCF in our institution from September 2019 to December 2020 were retrospectively enrolled. Patients were grouped according to the puncture techniques. Clinical and radiologic outcomes were evaluated preoperatively, postoperatively, and at follow-up. The clinical evaluation was performed by using visual analog scale for pain relief and Oswestry Disability Index for health status. Radiologic measurements contained anterior vertebral height, kyphotic angle, and bone cement distribution. In total, 76 patients with a mean follow-up duration of 16.6 months were enrolled, including 34 patients in the mUEP PK group and 42 patients in the BTP PKP group. In the mUEP group, operation time, fluoroscopy times, and injected cement volume were significantly less than that in the BTP group (P < 0.01). Both visual analog scale and Oswestry Disability Index scores of all patients decreased significantly after surgery (P < 0.01), with no significant differences between the 2 groups at each follow-up. Both mUEP PKP and BTP PKP showed significant anterior height restoration and kyphotic angle correction (P < 0.01), with no significant differences between the 2 groups at each follow-up. Meanwhile, the mUEP PKP reduced the incidence of intraspinal cement leakage (P < 0.05), and no facet joint violation was found in mUEP PKP. mUEP PKP could be clinically and radiographically equivalent to BTP PKP. However, it has advantages in reducing operation time and fluoroscopy times, lowering the risk of intraspinal cement leakage, and preventing the presence of facet joint violation. Compared with BTP PKP, the mUEP PKP seems to be an effective and alternative puncture technique for the treatment of lumbar OVCF after appropriate patient selection.

Potential Probiotic Acceptability of a Novel Strain of Paenibacillus konkukensis SK 3146 and Its Dietary Effects on Growth Performance, Intestinal Microbiota, and Meat Quality in Broilers.

Simple SummaryThis study investigated the probiotic characteristics of Paenibacillus konkukensis and its dietary effects on growth performance, intestinal characteristics, intestinal microbiota, and meat quality in broilers. Through this study, P. konkukensis showed non-hemolytic activity, variable antibiotic susceptibility, and moderate acid and bile tolerance. Supplementary feeding of P. konkukensis as bacterial culture did not affect the growth performance parameters and meat quality, with positive effects on meat yield and intestinal microflora. Overall, dietary P. konkukensis may not have any adverse effects and might be considered as a probiotic feed additive in poultry.This study evaluates the in vitro probiotic characteristics of P. konkukensis sp. nov. SK-3146, which was isolated from animal feed, and its dietary effects on growth performance, intestinal characteristics, intestinal microbiota, and meat quality in broilers. In vitro experiments revealed that P. konkukensis was non-hemolytic with variable antibiotic susceptibility, and acid as well as bile tolerance. To assess the effect of P. konkukensis on broilers, a total of four hundred eighty 1-day-old Ross 308 broiler chicks were allocated to 3 treatment groups with 4 replicates of 40 birds each; the negative control group was fed a basal diet without any feed additives (NC), the positive control group was fed a basal diet containing 0.01% enramycin (PC), and the experimental group was fed a basal diet containing P. konkukensis bacterial culture (PK) at 104 CFU/g of the diet based on bacterial count. The experiment lasted for 35 days. Results indicated that there were no significant differences in any growth performance parameters among the dietary treatments (p > 0.05). In addition, the inclusion of P. konkukensis in the broilers’ diet did not affect meat cooking loss, color, and pH but increased the relative weight of breast meat (p < 0.05). The PK group showed heavier intestinal weight and shorter intestinal length than the NC group (p < 0.05). The ratio of the intestinal weight to length of jejunum was the highest in the PK group (p < 0.05). The PK group showed increased counts of Streptococcus thermophilus (p < 0.05) with no adverse effects of P. konkukensis on other intestinal microbiota in the jejunum. This study implies that P. konkukensis might have the potential to be applied as a probiotic feed additive in poultry.

Comparison of Glaucoma Therapy Escalation After Penetrating Keratoplasty to Descemet Stripping Automated Endothelial Keratoplasty for the Treatment of Pseudophakic Bullous Keratopathy: A Cohort Study.

The purpose of this study was to compare glaucoma therapy escalation (GTE), graft survival, vision, and glaucoma following penetrating keratoplasty (PK group) and Descemet stripping automated endothelial keratoplasty (DSAEK group) to treat pseudophakic bullous keratopathy (PBK). This cohort included cases of PBK managed with PK from 2009 to 2014. We compared the incidences and determinants of GTE, graft survival, and visual disability. P < 0.05 was statistically significant. There were 58 eyes in the PK group and 117 eyes in the DSAEK group. The incidence of GTE in the PK and DSAEK groups at the last follow-up was 34.2% (95% confidence interval [CI]: 19.5-48.9) and 46.6% (95% CI: 27.7-65.4), respectively. The risk of GTE was similar between the groups (relative risk [RR] = 1.36 [95% CI: 0.94-1.98], P = 0.12). GTE was significantly associated with graft survival in the PK group (RR = 3.25 [95% CI: 1.5-7.0], P < 0.001) and the DSAEK group (RR = 3.77 [95% CI: 2.6-5.6], P < 0.001). Glaucoma (P = 0.001) and previous keratoplasty (P < 0.001) were significant predictors for GTE. At the final follow-up visit, severe visual disability was not significantly different between the groups (RR = 0.9 [95% CI: 0.3-2.9], P = 0.88). There was a statistically significant improvement in vision after DSAEK (P < 0.001) but not after PK (P = 0.67). GTE was similar in eyes with PBK managed by PK or DSAEK. Glaucoma and previous keratoplasty were predictors of GTE post-keratoplasty. DSAEK gave better visual outcomes than PK for managing PBK.

In Vitro Effect of Denture Cleansers on the Color Stability of Polyetheretherketone and Other Denture Base Polymers

The aim of this in vitro study was to compare the long-term effect of overnight use of denture cleansers with different chemical compositions on the color stability of denture base polymers (DBPs). The four DBPs evaluated were PEEK (PK group), thermoinjection-molded polyamide (PA group), auto-polymerized polymethylmethacrylate (PMMA) (AP group), and heat-polymerized resin PMMA (HP group). The cleaning agents used were Corega tablet (CT), Protefix tablet (PT), and 0.5% sodium hypochlorite (NaOCl) solution (SH). Distilled water (DW) served as a control. Forty-eight disc-shaped specimens (10mm × 2mm) were prepared from each DBP and randomly immersed in the different storage media (n=12 in each group). Color measurements of the specimens before and after immersion in the denture cleansers were made using a spectrophotometer (VITA Easyshade V). The color changes were measured and recorded in L* a* b*. After 120 d, the CIEDE2000 formula was used to calculate color changes (∆E00). For analysis of the data, a multivariate analysis of variance was used (p&lt;0.05). The results of the statistical analysis revealed significant color change differences in the DBPs immersed in the various denture cleansers (p&lt;0.05). Groups PA and PK showed the highest values for all solutions. AP-SH showed the highest ∆E00 value in group AP, no significant difference was found between other solutions. In group HP, there was no statistically significant difference between the average ∆E00 values of all solutions. Long-term daily use of the denture cleansers affected the color stability of all the DBPs, although the level of color change was acceptable. Laboratory and clinical studies on the color stability of PEEK are needed to confirm the results of this study.

Outcomes of keratoplasty in a cohort of Indian patients with xeroderma pigmentosum.

Purpose:To evaluate the outcomes of keratoplasty for xeroderma pigmentosum (XP) performed at a tertiary eye care center.Methods:A retrospective review of medical records of those patients who were clinically diagnosed to have XP (54 eyes of 36 patients) and underwent keratoplasty; either deep anterior lamellar keratoplasty (DALK, four eyes), endothelial keratoplasty (EK, eight eyes), or penetrating keratoplasty (PK, 42 eyes) from 1994 to 2018.Results:The median age at surgery was 20.6 years (interquartile range [IQR], 14.6–27.6 years) and 20 (55.6%) were males. Graft failure occurred in 15 eyes (35.7%) in the PK group and two eyes (50%) in the DALK group; none failed in the EK group. The probability of graft survival in the PK group was 97.2% ± 2.7% at 1 year, 74.0% ± 8.0% at 2 years, and 54.8% ± 11.7% at 5 years. In the PK group, 13 eyes needed antiglaucoma medications, 11 eyes developed graft infiltrate, and 13 eyes needed secondary interventions (cataract surgery, excision biopsy, and tarsorrhaphy). In the EK group, three eyes needed secondary interventions (excision biopsy). Median postoperative endothelial cell density at the last follow-up in the PK group was 1214 cells/mm2 (IQR, 623–2277 cells/mm2).Conclusion:Despite the complexities of the ocular surface and adnexal issues in XP, keratoplasty had reasonably good outcomes. More than half of the PK grafts survived 5 years with no failures in the EK group. Regular follow-up and timely management of suture-related infections raised intraocular pressure, and suspicious ocular surface lesions, in addition to solar protection, are important for the success of keratoplasty in these eyes.

Ketamine- Propofol or Fentanyl- Propofol intravenous infusion a better combination for short surgical procedures in paediatric patients, a comparative study

Ketamine- Propofol or Fentanyl- Propofol intravenous infusion a better combination for short surgical procedures in paediatric patients, a comparative study - IJCA- Print ISSN No: - 2394-4781 Online ISSN No:- 2394-4994 Article DOI No:- 10.18231/2394-4994.2018.0072, Indian Journal of Clinical Anaesthesia-Indian J Clin A

CLINICAL AND RADIOLOGIC OUTCOMES OF TWO TYPES OF CAGES USED IN THE TREATMENT OF DEGENERATIVE LUMBAR DISEASES: NOVEL TITANIUM CAGES VERSUS PEEK CAGES

Purpose: This study reports the clinical effects of [Formula: see text]-shaped titanium cages (ReBorn Essence Z-Brace cages) and compares the clinical outcomes between [Formula: see text]-shaped titanium cages (ZTC group) and polyetheretherketone cages (PEEK cages, PK group) for the application in transforaminal lumbar interbody fusion (TLIF). Methods: A retrospective and case control study with six patients using PEEK cages and four patients using ZTC was conducted. All patients underwent TLIF and had a 3-month follow-up. The Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) were selected to assess the pain of low back and neurological status. The intervertebral disc height (DH) and segmental angle (SA) were also measured to estimate the radiological changes. At the 3-month follow-up, the fusion and subsidence rates were evaluated. Results: There was no significant difference between the two groups regarding the ODI and VAS scores. At the 3-month follow-up, the subsidence rates were 42% and 0% for the PK and ZTC groups, respectively; the bony fusion rates were 67% and 100% for the PK and ZTC groups, respectively. Conclusion: The study has indicated that both PEEK and [Formula: see text]-shaped titanium cages can be effective options used to treat degenerative disc disease (DDD). Moreover, the higher fusion and lower subsidence rates have revealed that [Formula: see text]-shaped titanium cages may be a better choice compared to PEEK cages for lumbar reconstruction after TLIF.

Improved hemostasis with plasma kinetic bipolar sealing device in the vaginal steps of laparoscopic-assisted vaginal hysterectomy

ObjectiveDuring the vaginal steps of laparoscopic-assisted vaginal hysterectomy (LAVH), excessive bleeding occurs if the vascular pedicles are not securely clamped. Accordingly, this study investigates if an advanced bipolar sealing device (PlasmaKinetics [PK] Sealer), compared to conventional sutures, could improve the efficacy and safety in the vaginal steps of LAVH. Material and methodsThe medical records of 101 women who underwent LAVH for a non-malignant condition between June 2014 and August 2017 were retrospectively reviewed. Among the women, 60 received LAVH using conventional sutures (control group), while 41 using the PK Sealer during vaginal steps (PK group). ResultsA 35% reduction (76.1 vs. 117.3 mL) in the blood loss was observed in the PK group. The natural logarithm (ln) of the blood loss was significantly lower in the PK group than in the control group (P = .045). The percentage of cases which achieved the minimal blood loss goal (<50 mL) was significantly higher in the PK group than in the control group (61 vs. 48%, P = .044). After adjusting for confounding factors, the PK group still exhibited a significantly lower ln intraoperative blood loss (OR -0.477, P = .002) than the control group. ConclusionThe PK bipolar sealing device provides a safe and effective alternative in reducing blood loss in the vaginal steps of LAVH.

Tissue Distribution of Menaquinone-7 and the Effect of α-Tocopherol Intake on Menaquinone-7 Concentration in Rats.

We have reported that vitamin E intake lowers phylloquinone (PK) concentration in extrahepatic tissues of rats. In this study, we aimed to clarify the characteristic of the distribution of menaquinone-7 (MK-7), a vitamin K contained in fermented foods, by comparison with other vitamin K distributions and to clarify the effect of vitamin E intake on MK-7 concentration in rats. Rats were fed a vitamin K-free diet (Free group), a diet containing 0.75 mg PK/kg (PK group), a 0.74 mg menaquinone-4 (MK-4)/kg diet (MK-4 group), a 1.08 mg MK-7/kg diet (MK-7 group), or a 0.29 mg menadione (MD)/kg diet (MD group) for 16 wk. MK-7 mainly accumulated in the liver, spleen, and adrenal gland of the MK-7 group, although PK accumulated in the serum and all tissues of the PK group. Conversely, MK-4 was present in all tissues of the PK, MK-4, MK-7, and MD groups. MK-4 concentration in the serum, liver, adipose tissue, and spleen was higher in the MK-4 group than in the other groups; however, MK-4 concentration in the kidney, testis, tibia, and brain was lower in the MK-4 group than in the PK, MK-7, and MD groups. Next, vitamin E- and K-deficient rats were orally administered MK-7 with or without α-tocopherol. α-Tocopherol did not affect MK-7 or MK-4 concentration in the serum and various tissues. These results suggested that MK-7 is particularly liable to accumulate in the liver, and MK-7 concentration is not affected by vitamin E intake.

Neuromuscular and electromechanical properties of ultra-power athletes: the traceurs.

Practising a power-type activity over years can shape the neuromuscular profile of athletes. This study aimed at comparing the neuromuscular profile of anon-trained group (NT, n = 10) to power athletes practising Parkour (= traceurs, group PK, n = 11), an activity consisting of jumping obstacles mostly in an urban landscape. Maximal isometric plantar flexion force (MVC) and rate of torque development (RTD) were evaluated, and neuromuscular function of triceps surae muscles was assessed and compared between groups through the analysis of evoked potentials from posterior tibial nerve stimulation. PK group exhibited higher MVC force (131.3 ± 8.7Nm) than NT (110.4 ± 9.6Nm, P = 0.03) and higher RTD (489.1 ± 93Nm/s) than NT (296.9 ± 81Nm/s). At a nervous level, this greater performance was related to a greater voluntary activation level (PK: 96.8 ± 3.6%; NT: 91.5 ± 7.7%; P = 0.02) and soleus V-wave amplitude (P = 0.03), and a lower antagonist co-activation (P = 0.02) and rest soleus spinal excitability (PK Hmax/Mmax: 0.32 ± 0.13; NT: 0.58 ± 0.17; P < 0.001). At a muscular level, PK group exhibited higher mechanical twitch amplitude (PK: 13.42 ± 3.52Nm; NT: 9.86 ± 4.38Nm; P = 0.03) and electromechanical efficiency (P = 0.04). The greater maximal force production capacity of traceurs compared to untrained was underlain by nervous factors, such as greater descending command and greater ability to modulate the spinal excitability, but also by muscular factors such as greater excitation-contraction coupling efficiency. The high eccentric loads that characterize Parkour training may have led traceurs to exhibit such neuromuscular profile.

Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCy.

In the era of precision medicine, the impact of personalized dosing of busulfan is not clear. We undertook a retrospective analysis of 78 patients with myeloid malignancies who received fludarabine and busulfan (FluBu4) with or without measuring Bu pharmacokinetics (Bu PK) and those who received busulfan with cyclophosphamide (BuCy). Fifty-five patients received FluBu4, of whom 21 had Bu PK measured, and 23 patients received BuCy. Total donor cell chimerism showed that the percentage of patients maintaining 100% donor chimerism on day 100 was 66.7%, 38.2%, and 73.9% in the FluBu4 with PK, FluBu4 with no PK, and BuCy, respectively (P = .001). Patients who had decreasing donor chimerism by day 100 were 23.8%, 52.9%, and 26.1% in the FluBu4 with PK, FluBu4 with no PK, and BuCy, respectively (P = .04). Bu PK group had fewer patients with less than 95% donor chimerism on day 30, which was not statistically significant, 5% (FluBu4 PK), 31% (FluBu4 with no PK), and 21% (BuCy) (P = .18). Survival distributions were not statistically significant (P = .11). Thus, personalized drug dosing can impact donor chimerism in myeloid malignancies. This will need to be examined in larger retrospective multicenter studies and prospective clinical trials.

Sedative and Analgesic Effects of Propofol-Fentanyl Versus Propofol-Ketamine During Endoscopic Retrograde Cholangiopancreatography: A Double-Blind Randomized Clinical Trial.

BackgroundEndoscopic retrograde cholangiopancreatography (ERCP) is a painful procedure that requires analgesia and sedation.ObjectivesIn this study, we compared the analgesic and sedative effects of propofol-ketamine versus propofol-fentanyl in patients undergoing ERCP.MethodsIn this clinical trial, 72 patients, aged 30 - 70 years old, who were candidates for ERCP were randomly divided into two groups. Before the start of ERCP, both groups received midazolam 0.5 - 1 mg. The intervention group (PK) received ketamine 0.5 mg/kg, and the control group (PF) received fentanyl 50 - 100 micrograms. All patients received propofol 0.5 mg/kg in a loading dose followed by 75 mcg/kg/minute in an infusion. The patients, the anesthesiologist, and the endoscopist were unaware of the medication regimen. Sedation and analgesia quality (based on a VAS), blood pressure, respiratory rate, heart rate, arterial oxygen saturation, recovery time (based on Aldrete scores), and endoscopist and patient satisfation were recorded.ResultsThe sedative effects were equal in the two groups (P > 0.05), but the analgesic effects were higher in the PF group than in the PK group (P < 0.05). The PK group had higher blood pressure levels in the eighth minute. Respiratory rate, heart rate, and arterial oxygen saturation showed no significant differences between the groups (P > 0.05). Endoscopist satisfaction, patient satisfaction, and recovery time showed no significant differences between the two groups (P > 0.05).ConclusionsThe results showed that the sedative effect of propofol-ketamine was equal to the propofol-fentanyl combination during ERCP. To prevent respiratory and hemodynamic complications during ERCP, the propofol-ketamine combination should be used in patients with underlying disease.

Multimodal Analgesia With Ketamine or Tramadol in Combination With Intravenous Paracetamol After Renal Surgery.

BackgroundOpioids are generally the preferred analgesic agents during the early postoperative period.ObjectivesThe present study was designed to assess and compare the multimodal analgesic effects of ketamine and tramadol in combination with intravenous acetaminophen after renal surgery.Patients and MethodsThis randomized, double-blinded, clinical trial was conducted on 80 consecutive patients undergoing various types of kidney surgeries in Sina hospital in Tehran in 2014 - 2016. After extubation, the patients were randomly assigned to receive intravenous paracetamol (1 gr) plus tramadol (0.7 mg/kg) (PT group) or paracetamol (1 gr) plus ketamine (0.5 mg/kg) (PK group) within ten minutes. Pain severity was assessed by the visual analog scale (VAS), and the level of agitation was assessed by the Ramsey sedation scale (RSS). Morphine consumption was assessed within the first six hours after drug injection, and hemodynamic parameters were assessed at 5, 10, and 20 minutes after infusion, at the time of transfer from recovery to the ward, and also at one and six hours after transfer to the ward.ResultsPostoperative pain scores were significantly lower in the PK group than in the PT group during all study time points. The mean dose of morphine needed at recovery in the PK group was lower compared with the PT group (0.47 ± 0.94 mg versus 1.50 ± 1.35 mg/P = 0.001). The level of agitation based on the RSS score was significantly lower in the PK group than in the PT group at 10 and 20 minutes after drug administration. The total postoperative complication rate in the PK group was lower than in the PT group (20% versus 53.3%, P = 0.007). In this regard, catheter bladder discomfort was more frequent in the PT group than in the PK group (43.3% versus 3.3%, P < 0.001).ConclusionsThe combination of intravenous paracetamol 1 gr and ketamine 0.5 mg/kg resulted in an overall reduction in pain scores, decreased postoperative analgesic requirements, and lower agitation score compared with intravenous paracetamol 1 gr and tramadol 0.7 mg/kg for patients undergoing renal surgery.

Outcomes of Repeat Keratoplasty for Failed Therapeutic Keratoplasty

To analyze clinical outcomes of repeat optical penetrating (PK) or endothelial keratoplasty (EK) after failed therapeutic keratoplasty (TPK). Retrospective consecutive, comparative, interventional case series. setting: LV Prasad Eye Institute, Hyderabad, India. Patients aged >18 years who underwent a repeat PK or EK following a failed TPK with a follow-up of at least 1 year were included. Patients with culture-negative ulcers, viral etiology, coexistent ocular surface disease, and multiple grafts were excluded from the study. PK or EK for failed TPK. Corrected distance visual acuity at 1 year follow-up. secondary outcome measure: Graft clarity. One hundred twelve eyes (67 PK, 45 EK) were included in the study. The PK group had a significantly higher number of cases with high-risk features prior to regraft. Improvement in visual acuity in each ofthe types of grafts was statistically significant (P<.01), but there was no difference between the 2 groups at 1 year postoperatively. A statistically significant proportion of grafts regained graft clarity after regrafting in the PK group (P < .01) but not in the EK group (P=.205) at 1 year postoperatively. Endothelial rejection rates were higher in the PK group. Subgroup analysis showed that eyes that had PK or EK for failed TPK conducted for Aspergillus keratitis showed better outcomes in terms of graft clarity. Kaplan-Maier (KM) survival analysis for graft clarity showed cumulative survival of 50% at 5 years. The survival using the KM curve was not statistically different between the 2 groups (P= .33). This study shows that visual rehabilitation with relatively good functional outcomes can be achieved by performing repeat PK or EK in patients after failed TPK.

Molecular characterization and genealogy of Carnation mottle virus Brazilian isolates from carnation

Carnation mottle virus (CarMV), associated with carnation plants showing or not symptoms, was identified by host range, serology and molecular analysis of the coat protein gene. Seven samples were assayed by biological and serological tests. Two of them, one from Sao Paulo (SP) and another from Minas Gerais (MG) states, Brazil, which presented higher absorbance values in DAS-ELISA, were selected for molecular studies. Foliar samples were submitted to total RNA extraction, RT-PCR with specific primers, and amplicons obtained were sequenced. Phylogenetic analyses were carried out using the PAUP program after determining the nucleotide substitution model. The identity percentages between Brazilian sequences were 99%. When sequences of CP carnation isolates from other countries were compared, the identity percentages ranged from 96-99%. CarMV isolates from SP and MG states are the first sequences obtained in Brazil, and analysis showed that they belong to the PK group and showed only two amino acids changes at positions 61 and 260. The virus presents a high genetic stability and it is readily mechanically transmitted from infected to healthy plants. This is the first report of CarMV in MG state, of CP nucleotide sequences from Brazilian CarMV isolates, as well as molecular phylogenetic analysis in Brazil.