Subgroups A1 Research Articles

Discussion on optimal duration of pegylated interferon α combined with ribavirin for chronic hepatitis C in HIV-infected patients

Objective: To investigate the optimal duration of pegylated-alpha interferon (Peg-INFα) combined with ribavirin (RBV) in treating chronic hepatitis C infection in human immunodeficiency virus (HIV)-infected patients. Methods: A multicenter prospective study was conducted. The study subjects were divided into two groups; HIV/HCV co-infections (Group A, n = 158) and control with HCV-monoinfections (Group B, n = 60). All recruited patients received standard Peg-INFα plus RBV therapy. Group A was divided into 3 subgroups according to CD4(+) cell counts: A1 subgroup, 79 cases, CD4(+) counts > 350 cells /μl, who received anti-HCV before combination antiretroviral therapy(cART); A2 subgroup, 45 cases, CD4(+) counts between 200 and 350 cells/μl, who did not start anti-HCV until they could tolerate cART well; A3 subgroup, 34 cases, CD4(+) counts < 200 cells /μl, cART was administered first, and anti-HCV therapy was started when CD4(+) counts > 200 cells/μl. The anti-HCV efficacy of two groups and 3 subgroups were compared. Statistical analysis for normal distribution and homogeneity of variance data was calculated by t-test and the counting data was analyzed by χ (2) test. The Mann-Whitney U test was used for non-normal data. A one-way analysis of variance (ANOVA) was used for the comparison of multiple groups, followed by SNK method. Multiple independent samples were used for non-parametric tests. Results: There was no significant difference in age and baseline HCV RNA levels between groups and subgroups (P > 0.05). By an intent-to-treat (ITT) analysis, in Group A, the ratio of complete early virological response (cEVR) rate was 75.3% (119/158), the ratio of end of treatment virological response (eTVR) rate was 68.4% (108/158), and the ratio of sustained virological response (SVR) rate was 48.7% (77/158); in Group B, the ratio of cEVR rate was 93.3% (56/60), the ratio of eTVR rate was 90.0% (54/60), and the ratio of SVR rate was 71.7% (43/60); The therapeutic index of Group A were lower than those of Group B (P≤0.05). By per-protocol (PP) analysis, the ratio of cEVR rate in Group A [75.2% (88/112)] was still lower than that in Group B [93.3% (56/60)], but no significant differences were found in the ratio of eTVR rate and SVR rate between 2 groups (P > 0.05). Comparing the efficacy of subgroups (A1, A2 and A3) by ITT analysis, the ratios of cEVR rate were respectively 78.5% (62/79), 75.6% (34/45) and 67.6% (23/34); the ratios of eTVR rate were respectively 68.4%(54/79), 80.0%(36/45)and 52.9%(18/34); and the ratios of SVR rate were respectively 41.8%(33/79), 64.4%(29/45)and 44.1%(15/34). The ratio of eTVR in subgroup A2 was obviously higher than that in subgroup A3 and the ratio of SVR in subgroup A2 was statistically higher than that of subgroup A1(P≤0.05). However, by PP analysis, no significant differences of the therapeutic indexes were found among the respective subgroups (P > 0.05). Conclusion: HIV-HCV co-infected patients would have better anti-HCV efficacy with Peg-INFα-2a plus RBV than HCV- monoinfected patients. The best time for initiating anti-HCV therapy in HIV-HCV co-infected patients is when CD4(+) counts 200 cells/ μl.

Adult Attention Deficit Hyperactivity Disorder : A Case Report

Background: Oseltamivir phosphate (OP) is preferred treatment for influenza with activity against influenza A and B. It is commonly recommended for the treatment and chemoprophylaxis in pregnancy and lactation. Serious neuropsychiatric adverse reactions were observed in patient treated with OP. Objective: This study aims to evaluate the effects of OP on prenatal and post-natal development of the albino rat cerebellar cortex. Material and methods: This study was carried out on 40 pregnant albino rats and 120 of their offspring of both sex, 3 from each mother. The pregnant rats were divided equally into 2 main groups A and B. Group A (control): it was subdivided equally into 2 subgroups A1 and A2. Group B (OP treated): it was subdivided equally into 2 subgroups B1 and B2. In group A, each rat mother was given 0.9 ml distilled water twice daily by oral gavage for successive 5 days. In group B, each rat mother was given 0.9 ml distilled water containing 1.35 mg OP twice daily by oral gavage for successive 5 days. Dosing started from the 15th to 19 th of pregnancy in subgroups A1 and B1 while it started from the 1st to 5th day after delivery in subgroups A2 and B2. Cerebelli were collected, on the 1st day of birth in subgroups A1 and B1, on the 7 th day of birth in subgroups A2 and B2, and on the 14 th day of birth in subgroups A1, A2, B1 and B2. The cerebelli of all subgroups were subjected to light microscopic study and the cerebelli of 14 days old offspring were subjected also, to transmission electron microscopic and morphometric studies and statistical analysis. Results: OP induced delayed development and neurotoxic effects on the cerebellar cortex of albino rat offspring whose mother dosed OP during pregnancy or during lactation. Conclusion: Oseltamivir phosphate induced pre and post-natal delayed development and neurotoxic insults on the cerebellar cortex of albino rat.

Abstract PD7-12: Molecular subtyping of male breast cancer by the International male breast cancer program (IMBC): EORTC 10085/TBCRC 0-29/BIG 2-07/NABCG/BOOG 2009-04

Abstract Introduction. Male breast cancer (male BC) is a rare disease for which disease management is extrapolated from females. IMBC, an international consortium, which previously reported on clinico-pathological aspects, now reports on molecular subgroups revealed by RNA sequencing and their relation to patient outcome. Methods. Tumor samples from the retrospective MALE BC registry diagnosed between 1990-2010 and with pathology and outcome data (relapse-free- (RFS) and overall survival (OS)) were included (n=699). To allow the discovery of prognostic features, we selected, stratified for known risk factors (TN stage, grade, age at diagnose and adjuvant endocrine treatment), from the cohort 152 cases with poor (RFS &amp;lt;= 4 yrs) and good outcome (RFS &amp;gt; 7yrs) evenly distributed. Here, we report RNA sequencing results of the first 73 cases, 38 with poor and 35 with good outcome. RNA sequencing reads were used to generate gene expression values and to report transcripts carrying driver mutations. Unsupervised clustering identified subgroups and within subgroups differentially expressed genes were identified. The reported prognostic male BC subgroups M1 and M2 (Johansson BCR 2012(14):R31) were also annotated. All identified subgroups were related to outcome using logistic regression (p-value using Wald test). Results. Unsupervised clustering revealed 2 main subgroups of which group 1 was enriched for expression of ER target genes, WNT3 and genes from amplicons known for female BC, e.g. 19p13 (CCNE1), 8q24 (MYC), and 11q13 (CCND1). The biology of the smaller group 2 was less defined but TGFβ2 expression was high as were various kallikreins (KLK) including interestingly KLK3 (prostate specific antigen). Other known amplified regions [(8p11 (FGFR1), 20q13 (ZNF217) and 12q15 (MDM2)] and mutated transcripts [PIK3CA (H1047R/L/Q; E542K, E545K, N345K; 16% of cases), TP53 and SF3B1 (K700E) (2% of cases)] were identified. Profound tumor infiltrate gene expression was present in 5% of cases and one third of cases expressed proliferation markers. Except for TP53, none of these latter characteristics were unevenly distributed among the 2 main subgroups. ER and AR were highly correlated, particularly in group 1. The two main groups could be further subdivided. Group 1 comprised 3 subgroups of which subgroup 1a expressed TFF1/3 and NAT1, well-known ER targets, while subgroups 1b and 1c expressed other ER targets,respectively BEX1 and PITX1. HOXC cluster expression differentiated subgroup 1b from 1a and 1c. None of these intrinsic subgroups were, however, related to RFS. The previously reported M2 subgroup, which largely segregated with subclusters 1a and 1b, was associated with a better RFS than the M1 subgroup (OR=2.9; 95%CI 1.1-7.5; p-value=0.03). Conclusions. 1) Intrinsic subtypes of male BC were revealed and their subgrouping is defined by ER associated subsets of genes. 2) The association of the reported M2 subgroup of male BC with longer RFS was validated; 3) Currently identified biological characteristics of male BC may improve future treatments. The full report on 152 cases including a comparison to female BC will be presented at the conference. This research was funded by Breast Cancer Research Foundation Citation Format: Martens JWM, Sieuwerts A, Ponchet C, Smid M, de Weerd V, Slaets L, Piper T, van Deurzen CHM, Schroder CP, Stangle C, Kloosterman W, van Leeuwen-Stok E, Nilsson C, Vermeij J, Peeters S, Goulioti T, Nowaczyk M, Aebi S, Rubio IT, Kelly C, Bayani J, Porter P, Murray M, Hudis C, Middleton L, Korde L, Ruddy K, Winer E, Bogler O, van den Weyngaert D, dal Lago L, Fraser J, Benstead K, van Asperen C, Linderholm B, Hedenfalk I, Tryfonidis K, Giordano S, Bartlett J, Cardoso F. Molecular subtyping of male breast cancer by the International male breast cancer program (IMBC): EORTC 10085/TBCRC 0-29/BIG 2-07/NABCG/BOOG 2009-04 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD7-12.

Frecuencia de subgrupos del antígeno A en donantes voluntarios de sangre

The presence of weak variants of blood type A represents a challenge in the practice of immunohematology for discrepancies in the time of the classification. It is common in blood banks to perform a forward and reverse typing for the purpose of confirming the blood type, but not all the people with a subgroup A2 have developed anti-A1 antibodies. We present a descriptive, observational and transversal study that establishes the proportion of subgroups of A antigen with the analysis of manual tube technique and monoclonal antibodies like anti-A, anti-A1 (Dolichus biflorus lectins extract) and anti-H. The analysis involved a total of 818 samples of voluntary blood donor, selected by random sampling, which were initially classified as 737 of Type A, and 81 as Type AB, with a confidence level of 95% (alpha error of 5% and 3% of precision). The present study evaluated the existence of the subgroups A1, A2, A1B, A2B, A intermediate and A intB. It is recommended the identification of subgroups in different types of blood in the laboratory and blood banks.

Особливості ліпідного обміну в жінок із гострим коронарним синдромом без підйому сегмента ST залежно від гормонального статусу

Introduction. The role of lipid metabolism disorders in the process of atherogenesis has long been established. It is known little about the effects of dyslipidemia on the development of coronary artery disease in women. There is a perception that the effect of endogenous estrogens during the fertile period of woman's life slows down the manifestation of atherosclerosis in women and before the onset of menopause, the incidence of CVD in women is lower. Hypercholesterolemia or atherogenic dyslipidemia is a particular danger in the development of CVD in women and the risk of macrovascular injury associated with it is due to the long asymptomatic course and significant prevalence in the female population.The aim of the study – toconduct a comparative analysis of lipid metabolism in women with acute coronary syndrome without ST segment elevation(STEMI) and practically healthy women, depending on the hormonal status.Materials and Methods. We examined 157 women aged 35–72 years (average age 56.54±0.87 years). Among them, 112 female patients with STEMI (group 1) aged 39 to 72 years (average age 58.52±0.99 years). The comparison group (group 2) were 45 practically healthy women aged 35 to 71 years (average age 52.58±1.58 years). The levels of female sex hormones were determined. The lipid metabolism indices in women were measured.Depending on the type of hormonal status, women of the 1 and 2 groups were divided into subgroups A and B consisted of 64 patients with STEMI, aged from 39–72 (middle age – 60.77±1.16), 2А – 26 practically healthy women 42–71 years (average age 58.64 ± 2.18 years) with hormonal signs of postmenopause: estradiol level &lt;80 pmol/l (21.79 pg/ml) and LH/FSH &lt;1 ratio index. The subgroup 1Bincluded 48 female patients with non STEMI at the age of 35 to 65 years (mean age 52.29±1.63), IIB-19 practically healthy individuals of the female population aged 35 to 58 years (middle age – 49.84±1.84years) with estradiol levels&gt; 80 pmol/l (21.79 pg/ml) and a ratio of LH/FSH&gt; 1.Resultsand Discussion. Almost all female patients of the IA subgroup had a level of total cholesterol level more than 4 mmol/l, which was 1.3 times significantly greater than that of IB subgroup (95.31±2.64% (IA) vs 75.00±6.25 % (IB)). The mean level of LDL cholesterol is significantly higher in women IA subgroups (4.50±0.21 mmol/l (IA) vs 3.44±0.24 mmol/l (IB)). In 73,43±5,52% of the IA subgroup, hypertriglyceridemia was detected, which was 1.6 times more likely to be registered (45.83±8.19%) than in patients with IB subgroups. The proportion of patients with lowered LDL cholesterol was almost 1.5 times lower in the IA subgroup (37.50±6.05% (IA) vs 52.08±7.21% (IB)). The mean HDL cholesterol level in the IB was significantly lower in comparison with the subgroup 1A (1.04±0.03 mmol/l (1B) versus 1.16±0.05 mmol/l (IA). Diabet (31.25±5.15 %), smoking (54.16±7.19 %) and occupationally hazardous labor (89.58±4.41 %) was significantly higher in patients of the subgroup 1B.Conclusions.In women with STEMI, regardless of the hormonal balance of female sex hormones, there is a greater prevalence and severity of dyslipidemia compared with healthy individuals. Estrogen deficiency in postmenopausal women with STEMI cause severe lipid and lipid metabolism disorders, which contributes to the development of acute coronary syndrome. Lower levels of HDL cholesterol in patients with estrogen retained estrogen compared to estrogen-deficient patients are due to higher prevalence of diabetes (31.25±5.15 %), smoking (54.16±7.19 %) and occupationally harmful work (89.58±4.41 %), along with the presence of traditional risk factors of STEMI in these women.

Molecular cloning and functional analysis of two novel polygalacturonase genes in Rhizoctonia solani

Two novel polygalacturonase (PG) genes, RsPG3 and RsPG4, were cloned from Rhizoctonia solani isolate YN-7, which is a member of anastomosis group (AG) subgroup 1A and causes rice sheath blight. The predicted protein product of RsPG3 contained 239 amino acid (aa) residues, with a molecular mass of 25.0 kD, whereas RsPG4 encoded a deduced protein of 345 aa residues, with a mass of 37.5 kD. Sequence alignment, phylogenetic analysis and gene ontology indicated that RsPG3 and RsPG4 had endo-PG and exo-PG activity, respectively. Recombinant RsPG3 and RsPG4 both exhibited PG activity that led to the destruction of rice sheaths and release of reducing sugars. Pathogenicity assays showed that the two PGs induced tissue necrosis in rice sheaths, indicating that both RsPG3 and RsPG4 are important virulence factors in the R. solani–rice interaction. Further studies are underway to more clearly define the role of these enzymes in rice cell wall degradation and their interaction with PG inhibitor proteins.

Indications for Ureteropyeloscopy in the Detection of Upper Urinary Tract Tumors

Objectives: Ureteropyeloscopy has recently become an essential technique in the diagnosis of upper urinary tract tumors. However, no consensus has been reached regarding its indications. In addition, it is accompanied by several limitations and potential adverse events such as dissemination of malignant cells, adhesion of the ureter to the surrounding tissue, ureteral stricture, and ureteral perforation. In order to determine when and what circumstances dictate the need for ureteropyeloscopy to detect upper urinary tract tumors, we investigated the indications for ureteropyeloscopy based on voided urine cytology and preoperative radiographic findings. Patients and Methods: In this retrospective study, we evaluated 92 patients (62 men and 30 women) with a mean age of 66.4 years (range, 15–87 years) who had undergone diagnostic ureteropyeloscopy at our institution for the past 10 years. All patients were divided into six subgroups based on voided urine cytology and preoperative radiographic findings: subgroups A1 (n = 18) and A2 (n = 2), positive cytology (positive catheter urine cytology/negative catheter urine cytology) and positive images; Subgroup B (n = 19), positive cytology and negative images; Subgroups C1 (n = 30) and C2 (n = 10), negative cytology and positive images (upper urinary tract carcinomas/other abnormal findings); Subgroup D (n = 13), negative cytology and negative images. Ureteropyeloscopic findings including histology were compared with urine cytology and radiographic findings. Results: Voided urine cytology exhibited 60.4% sensitivity and 77.3% specificity, while preoperative radiographic findings exhibited 70.8% sensitivity and 63.6% specificity. Carcinomas were detected in all patients in Subgroups A1 and A2. Carcinomas were also detected in 9 patients (47.4%) in Subgroup B, of whom 5 showed a history of bladder tumors. The remaining 10 patients all had a history of bladder cancer. In Subgroups C1, C2, and D, carcinomas were detected in 14 patients (46.7%), 1 patient (10%), and 4 patients (30.8%), respectively. These results suggested that ureteropyeloscopy should be recommended for patients with negative cytology. Three complications (pyelonephritis, renal failure, and urinary retention) were noted, but none of these was severe and all were cured within a few days. No malignant findings were obtained in any of the patients during follow-up after negative findings in ureteropyeloscopy. Conclusions: Ureteropyeloscopy is essential for detecting upper urinary tract carcinoma in patients with negative voided urine cytology and positive radiographic findings. In addition, ureteropyeloscopy seems to be used commonly among patients with positive urine cytology and negative radiographic findings, or those with bleeding from the ureteral orifice. However, unless conservative nephron-sparing treatment is considered, ureteropyeloscopy may be unnecessary for patients with positive urine cytology and positive radiographic findings.

Эффективность хронофармакотерапии у пациентов с хронической сердечной недостаточностью с сохраненной фракцией выброса и различной чувствительностью к соли

Included 130 patients with uncontrolled AH, type 2 diabetes and HFpEF (81 women and 49 men), median age - 59 (38-72) years. Patients were divided into 2 groups: saltsensitive (group 1) and salt-resistant (group 2), and then randomized to 2 subgroups depending on the treatment option: morning ramipril and indapamide retard, in the evening amlodipine (subgroup 1A and 2A) or in the evening ramipril, in the morning indapamide-retard and amlodipine (subgroup 1B and 2B). Initially and after 24 weeks of antihypertensive therapy, an echocardiographic study was carried out with an assessment of the main indicators of the structural and functional state of the left ventricular (LV) myocardium, a 6-minute walk test for determining the functional state of patients. After 24 weeks in all subgroups there was a reliable positive dynamics of echocardiographic indicators. In the group of salt-sensitive patients, the reception of the angiotensin converting enzyme inhibitor (ACE inhibitor) in the evening and thiazide diuretic (TD) + calcium antagonists (AC) in the morning provided a signifcantly more signifcant reduction in the majority of LV myocardial remodeling parameters compared with the administration of ACE inhibitor + TD in the morning and AK in the evening. In the case of salt-resistant patients, comparable positive changes in echocardiographic indicators were noted against the background of both dosing regimens during the day. Against the background of the treatment, irrespective of the salt sensitivity and dosing regimen, an unreliable and comparable increase in the distance of the 6-minute walk test was recorded during the day. In salt-sensitive patients with AH, type 2 diabetes and HFpEF, the use of ACE inhibitor before bedtime provided signifcantly more signifcant regression of the parameters of the structural and functional state of LV myocardium compared with the morning reception. In the group of salt-resistant patients, the efcacy of both dosing regimens during the day was comparable.

The possible therapeutic role of mesenchymal stem cells in amiodarone-induced lung injury in adult male albino rats

Background and aim Lung injury and even pulmonary fibrosis represent a known adverse effect of amiodarone. No effective treatment was reported for pulmonary fibrosis except lung transplantation. Stem cell therapy holds a great promise for the repair of injured tissues. Mesenchymal stem cells (MSCs) have the potential to present a new trend of treatment. This work aimed to study the effect of bone marrow-MSCs on amiodarone-induced lung injury in albino rats by histological methods. Materials and methods Forty-two adult male albino rats were used. Seven rats were used as a source of bone marrow-MSCs. Thirty-five rats were divided into the following groups: negative control group included seven rats that received no treatment; vehicle control group included seven rats that received polysorbate 80; amiodarone group included 14 rats that received daily oral amiodarone for 6 weeks and were subdivided into two equal subgroups as subgroup 3a (amiodarone administrated) and subgroup 3b (kept for 4 weeks after amiodarone stoppage); and stem cell-treated group included seven rats that received stem cells after amiodarone stoppage. Lung specimens were examined histologically. Results Amiodarone group showed disrupted lung architecture, collapsed alveoli, and significant increase in the thickness of interalveolar septa. Bronchioles showed thickened smooth muscle layer and obliterated lumens. Highly significant increase in area percent of collagen fibers was observed. In stem cell group, there was improvement of these histological changes. Conclusion MSCs can improve the deleterious effects associated with amiodarone-induced lung injury.

A survey of phenotype distribution of subgroup A2, blood groups MNS, P, and Kell in the Kazak nationality living in northern Xinjiang of China

The research was undertaken to study the phenotypic polymorphisms of the subgroup A2, blood groups MNS, P, and Kell in the Kazakh population in northern Xinjiang, China and establish data on rare blood group antigens in the Kazakh population, in order to provide references for clinical blood transfusion safety and prevention of hemolytic disease of the new born. In this study, 6,862 unrelated Kazakh individuals in northern Xinjiang were randomly selected, and their blood samples were collected for serological testing. The antigens of A, B, A1, M, N, P1 and K were detected by serological saline tube method, and the antigens of S, s, and k were detected by the microcolumn gel antiglobulin card method. The results were as follows: ① The detection rates of subgroup A2 in group A and group AB were 7.08% and 21.79%, respectively; ② The allele frequencies of the blood groups MNS, P and Kell were M=0.5668, N=0.4332, S=0.1860, s= 0.8140, P1=0.2848, P2=0.7152, K1=0.0096, K2=0.9904. The observed values and expected values of frequency distribution of genotypes were compared by χ² test, which conformed to the Hardy-Weinberg genetic law (P>0.05); ③ Fourteen cases of S^-s^- rare phenotype were detected in MNS blood group system, with a frequency of 1.16%; ④ The frequency of K antigen in the Kell blood group system was 1.92%. One case of rare KK homozygote was detected, with a frequency of 0.034%. Our study suggested that the distribution of gene frequency of subgroup A2, blood groups MNS, P and Kell in the Kazakh population in northern Xinjiang has its own characteristics, and their blood group MNS has unique genotypes. The positive rate of K antigen of blood group Kell in the Kazakh population was significantly higher than Chinese Han population.

Association of serum testosterone levels and testicular volume in adult patients.

A retrospective observational study was undertaken to gain new insight into the relationship between total testicular volume and levels of serum testosterone, luteinising hormone, follicle-stimulating hormone, prolactin and clinical variables. A total of 312 men with sexual dysfunction or infertility were divided into groups A and B (156 each) on the basis of basal plasma testosterone ≤5nmol/L of ≥12nmol/L respectively. Group A was subclassified in A1 (primary hypogonadism) and A2 (secondary hypogonadism). There were significant differences in total testicular volume between group A (15.33±11.94ml) and group B (36.74±6.9; p<.001) and also between subgroup A1 (11.07±8.49ml) and subgroup A2 (23.62±13.04ml; p<.001). Only 13.5% of patients in group B had a total testicular volume <30ml. Differences in all studied parameters were found between group A and group B. There were no variations when comparing age, body mass index and testosterone in groups A1 and A2 . The use of total testicular volume and body mass index together for predicting testosterone levels yields a sensitivity and specificity of 85.3% and 86.5% respectively. Logistic regression analysis, univariate and multivariate models, using the measurement of total testicular volume resulted in a high capacity to predict testosterone levels.

Draft Genome Sequence of Rhizoctonia solani Anastomosis Group 1 Subgroup 1A Strain 1802/KB Isolated from Rice.

ABSTRACTSheath blight, caused by Rhizoctonia solani anastomosis group 1 subgroup 1A (AG1-1A), is one of the most devastating rice diseases worldwide. Here, we report the draft genome sequence of R. solani AG1-1A strain 1802/KB isolated from a popular Malaysian rice variety. To the best of our knowledge, this is the second reported representative genome from AG1-1A.

Problematic issues of treatment of ovarian endometriomas in women of reproductive age

Introduction. The wide spread of endometriosis disease, difficulties in diagnosing and choosing the tactics of its treatment cause the existing problems of management of endometriosis. Absence of the onset of the period of stable remission, high frequency of recurrence of the disease make it possible to consider this problem actual in the group of patients of reproductive age, and especially among women with previously realized reproductive potential, since pregnancy is considered to be the important principle of treatment of endometriosis. The aim of the study was to study the effectiveness of various treatment regimens for endometriomas in patients with previously realized reproductive potential. Materials and M ethods. 44 women aged from 17 to 49 years were examined: the first group consisted of 25 healthy nonpregnant women, the second group included 19 women, with endometriomas receiving the traditional (subgroup 2a) and complex (subgroup 2b) treatment. Results. It was revealed that in patients receiving traditional therapy, in the end of the course of treatment, the initial activation of the humoral unit of the immune system was observed, which indicated the need for immunocorrection. In patients receiving complex therapy, normalization of the body's immune homeostasis, stabilization of the processes of apoptosis and proliferation, the main links in the etiopathogenesis of endometriosis were noted, which indicated an improvement in the effectiveness of the treatment. The control ultrasound in the dynamics in 1 and 3 months in patients who continued to receive complex therapy, revealed a decrease in the size of pathological formation and a pronounced antiproliferative effect on the hyperplastically altered endometrium, diagnosed before the start of treatment in 21.05% of patients. After 3 months of treatment, there was no need for an endometrial biopsy in this group of patients. Conclusions. With the use of a comprehensive approach to the treatment of endometriomas normalization of the body's immunodeficiency parameters, regression of the endometriomas and the absence of hyperplastic endometrial processes are noted, which allows to recommend this scheme for further use.

Retrospective Analysis of the Effect of Hering's Law on Outcomes of Surgical Correction of Ptosis.

IntroductionSeveral factors may influence aesthetic outcomes of ptosis surgery, especially in patients with asymmetrical ptosis. We retrospectively assessed the effect of Hering's law on surgical outcomes of patients with asymmetrical ptosis.MethodsPatients with mild to moderate asymmetrical ptosis (N = 300) who underwent advancement or plication of upper eyelid aponeurosis between January 2014 and July 2016 were enrolled. Fifty patients (group A) underwent surgery without taking into consideration the impact of Hering's law. Of these, 35 patients with unilateral ptosis (subgroup A1) underwent standard surgery on the contralateral side, whereas 15 patients with bilateral ptosis (subgroup A2) were first operated on the milder side followed by the more severely affected side.In 250 patients (group B), surgery was performed taking cognizance of the implications of Hering's law. These included 100 patients with unilateral ptosis (B1) and 150 with bilateral ptosis (B2). Difference in bilateral palpebral fissure symmetry by less than 0.5 mm was considered as satisfactory outcome.ResultsDuration of postoperative follow-up ranged from 3 to 24 months. Satisfactory outcomes were achieved over 60% of patients in group A (A1, 60.6%; A2, 66.67%) and in 96% of patients in group B (B1, 95%; B2, 96.67%). Patients with unsatisfactory outcomes underwent repair according to Hering's law after 3 months and obtained good results.ConclusionsApplication of Hering's law may improve outcomes of corrective surgery in patients with asymmetric ptosis.

Effect of intraperitoneal and incisional port site lidocaine on pain relief after gynecological laparoscopic surgery: A randomized controlled study

Abstract Objective To evaluate the role of Intraperitoneal and port site use of local anesthetic (Lidocaine HCl) in gynecological laparoscopy for postoperative pain relief. Study design A prospective randomized controlled study. Setting Aswan University Hospital-Egypt. Materials and methods We included patients undergoing laparoscopic surgery in the laparoscopy unit either diagnostic or operative. They were classified into two groups: group A (patients underwent diagnostic laparoscopy) and group B (patients underwent operative laparoscopy). Each group was randomized to two sub groups. subgroup 1 or 2; subgroup 1 (control) which comprised 18 patients who were given routine care for surgery and 50 ml normal saline intraperitoneal washing and subgroup 2 (study), which included 18 patients who were given routine care plus pre- and post-incisional subcutaneous injection of 2% lidocaine HCl (xylocaine) 1 ml at each portal site and 10 ml 2% intraperitoneal lidocaine (200 mg) in 50 ml normal saline. The primary outcome of the study is the difference in mean pain score postoperatively between groups. Results There was significant reduction of the pain 1, 2, 4 and 8 h post-operatively shown by visual analogue scale pain scores in subgroup B2 compared to subgroup B1 and in subgroup A2 compared to subgroup A1 (P-value = 0.000). There was no significant difference in the incidence of nausea, vomiting, shoulder tip pain between both groups. Also there was no significant difference regards time of resumption of intestinal peristalsis and operation duration between subgroups. Conclusions This study clearly depicts that incisional and intraperitoneal infiltration of lidocaine is an easy, safe, inexpensive, and noninvasive method that provides good analgesia during the early post-operative period and also provides early recovery from laparoscopic surgery.

Evaluation of Enamel Loss with Bonding and Debonding: A Study with Profile Projector

Introduction: Accidental detachment of brackets is a common problem in orthodontic bonding and removal of the residual resin certainly results in some amount of enamel loss. Aims: The present study was undertaken to measure and compare the amount of enamel loss with different prophylactic methods and to check which method results in the least amount of enamel loss. Materials and Methods: One hundred and twenty human premolars extracted for orthodontic treatment purpose were included in the study and divided into three groups of forty samples each: Group 1 (tungsten carbide bur), Group 2 (diamond bur), and Group 3 (soflex disc). The groups were further subdivided into subgroups (a and b) of twenty samples each for different etching times. The enamel loss was measured with profile projector. Results: The mean enamel loss for different subgroups was as follows - subgroup 1a tungsten carbide bur with etching time of 20 s = 69.06 μm and subgroup 1b tungsten carbide bur with etching time of 40 s = 70 μm, subgroup 2a diamond bur with etching time of 20 s = 76 μm and subgroup 2b diamond bur with etching time of 40 s = 76.12 μm, and subgroup 3a soflex disc with etching time of 20 s = 68.32 μm and subgroup 3b soflex disc with etching time of 40 s = 72.24 μm. Statistical Analysis: Analysis of variance showed a significant difference ( P t -test showed no significant difference in mean enamel loss between 20 and 40 s of etching time within groups. Conclusion: It is concluded that tungsten carbide bur resulted in the least amount of enamel loss and gouging and scarring is minimum when viewed with naked eye.

Gambaran Populasi Golongan Darah Subgroup A (A1, A2) di PMI Kulon Progo

Subgroup A1 and A2 are the most important in the blood group A. Subgroup A1 has the A antigen more than A2 subgroup, the A2 subgroup can cause misidentification of blood group due to poor A antigen and genetic variation possessed. Misidentification of the blood group will increase the risk of transfusion reactions. This research aims to describe the A1 and A2 subgroup population in Kulon Progo district. This study was conducted with a cross sectional sampling technique. The sample in this study were taken from donors of blood group A in Kulon Progo Red Cross. Identification of A1 and A2 subgroup is done by using lectin (Dolichos biflorus extract). The result of the examination of 53 samples showed that 96,2% was A1 subgroup and 3,8% was A2 subgroup.Key words : Subgroup A1, Subgroup A2, Population, Kulon Progo

A study on validity of C-reactive protein in deciding the duration of antibiotic therapy in suspected neonatal bacterial infection

Background: Neonatal septicemia is defined as generalized bacterial infection of newborns documented by positive blood culture in first four weeks of life. Objective of present study was to determine whether C-Reactive protein can be used as a parameter to identify the time point when antibiotic treatment can safely be discontinued in a defined major subgroup of neonates treated for suspected bacterial infection.Methods: A total of 50 neonates with birth weight more than 1500gms with suspected septicemia were enrolled in the prospective study. Serum CRP were determined 24-48 hours after the first dose of antibiotics. If CRP was less than 6mg/l, infants were considered unlikely to be infected and the antibiotic treatment was stopped. If CRP was more than 6mg/l, antibiotics were continued and CRP measured on alternative days in one subgroup (2a) and on seventh day in another subgroup (2b). CRP was the single decision criterion to stop the antibiotic therapy. Negative predictive value with respect to further treatment was determined.Results: Duration of antibiotic therapy could be reduced to less than seven days in 54% cases and &lt; 72 hours in 48% cases.Conclusions: Negative predictive value of serial CRP is 100% in deciding the duration of antibiotic therapy in suspected neonatal septicemia.

Genetic diversity of human metapneumovirus in hospitalized children with acute respiratory infections in Croatia.

Human metapneumovirus (HMPV) is recognized as a global and frequent cause of acute respiratory tract infections among people of all ages. The objectives of this study were molecular epidemiology and evolutionary analysis of HMPV strains which produced moderate and severe acute respiratory tract infections in children in Croatia during four consecutive seasons (2011-2014). A total of 117 HMPV-positive samples collected from hospitalized pediatric patients presenting with acute respiratory tract infections and tested by direct immunofluorescence assay were first analyzed by amplifying a part of the F gene. Sixteen samples were further analyzed based on complete F, G, and SH gene sequences. HMPV genome was identified in 92 of 117 samples (78%) and the circulation of multiple lineages of HMPV was confirmed. In 2011, 2012, and 2014, subgroups A2 and B2 co-circulated, while B1 gained prevalence in 2013 and 2014. The study established the presence of a novel subcluster A2c in Croatia. This subcluster has only recently been detected in East and Southeast Asia. This study provides new insights into epidemiology and genetic diversity of HMPV in this part of Europe.

EFFECT OF CONNECTOR SURFACE AREA AND TYPE OF CEMENT ON FRACTURE RESISTANCE OF FULL CONTOURED MONOLITHIC CAD CAM ZIRCONIA FIXED PARTIAL DENTURES

The aim of this study: was to investigate the influence of different connector surface areas on the fracture resistance of three and four units full contoured monolithic zirconia FPDs manufactured by CERCON machine and cemented by either zinc phosphate or resin cements. Materials and methods: Sixty full contoured monolithic zirconia FPDs cementd on resin casts were divided into two main groups (30 FPDs each) according to the number of units (three and four units FPDs), each group was subdivided into three subgroups according to connector surface area dimensions (10FPDs each). Subgroup A1: Surface area of each connector didn’t exceed 24 mm2. , Subgroup A2: Surface area of each connector was greater than 24 mm2 and less than 35 mm2 and Subgroup A3: Surface area of each connector was more than 35 mm2. Each subgroup was further randomly divided into two (5FPDs each). division C1 : FPDs were cemented using zinc phosphate cement and division C2 : FPDs were cemented using dual cured resin cement (Variolink N). the specimens were stored in deionized water in an incubator (QWJ500; Queue Systems Inc. USA) maintained at oral temperature (37°C) for and removed 24 hours before mechanical testing. Specimens were loaded in universal testing machine until failures were observed. The obtained data of fracture resistances were statistically analyzed. Results: showed that for all subgroups, by increasing the connector surface area a statistically significant increase in the fracture resistance was observed, whether using resin cement or zinc phosphate cements. For three units FPDs, using adhesive resin cement produced higher fracture resistance values than using zinc phosphate cements, that were statistically non-significant for subgroupsA1,A2 while it was statistically significant for subgroup A3. (at p-value < 0.05). For four units FPDs, using adhesive resin cement produced higher fracture resistance values than using zinc phosphate cements that were statistically non-significant for subgroup A1, while they were statistically significant for subgroups A2and A3. (at p-value < 0.05). using Zinc phosphate cements with three units FPDs produced statistically significant higher values than with four units FPDs Using resin cements with three units FPDs produced statistically significant higher values than with four units FPDsfor only subgroup A3. While the difference was not statistically significant for subgroup A1 and A2. conclusions: it was found that the fracture resistance of the full contoured three and four units FPDs made using monolithic zirconia is affected by the connector dimension , span length and the used cement. By increasing the connector surface area, the fracture resistance values increased significantly with both cements. Generally, For all tested subgroups, three units monolithic zirconia FPDs have higher fracture resistance values than four units FPDs. Using resin cement produced higher values of fracture resistance than using zinc phosphate cement.