Subgroups IIIA Research Articles

The Possible Therapeutic Role of MSC Derived Exosomes Extracted from Myocardial Infarction versus Healthy Rat Models in the Heart with Surgically Occluded Right Anterior Coronary Artery in Rats A Histological Study

Abstract Introduction Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary arteries of the heart, causing damage to the heart Muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes. MI may cause heart failure, an irregular heartbeat, cardiogenic Shock or cardiac arrest. Aim: this study is designed to compare between the therapeutic role of autologous exosomes versus homologous exosomes on surgically induced myocardial infarction model in adult male albino rats. Material and Methods Fifty adult male albino rats weighing 150–250 gm were included with age from 8 to 11 old months in the study. In addition, ten rats weighing 150 gm with age from 7 to 8 old weeks were used for adipose derived exosomes preparation. The rats were divided into the following three groups: Group I: control group, Group II: myocardial infarction group; rats were subjected to right (RACO Technique), Group III: rats were subjected to permanent RACO technique as in group II then rats were further subdivided into two subgroups; Subgroup IIIa received autologous exosomes in tail vein on the 2nd day of the experiment and Subgroup IIIb received homologous exosomes in tail vein on the 2nd day of the experiment. Results Group II showed disruption of cardiomyoctes which appeared deeply acidophilic and darkly stained nuclei with loss of the intercalated discs and muscle striations. Immunohistochemical stain revealed a significantly increased reaction to iNOS antibodies, caspase-3 antibodies, anti -PCNA and positive anti-VEGF in comparison to control group. Group III; including subgroups IIIa and IIIb; showed preservation of the myocardium integrity. However, subgroup IIIa revealed significant increase in anti-VEGF and decrease in iNOS antibodies as compared to subgroup IIIb. Conclusion Both exosomes from healthy rats and exosomes from rats with MI showed therapeutic and anti-inflammatory effects in surgically induced MI. These effects were more prominent in exosomes from rats with MI than healthy rats as detected by microscopic, morphometric, and statistical studies.

Внутрішньовенна інфузія лідокаїну для попередження хронічного післяопераційного болю в дітей після різних видів оперативних втручань

Chronic postoperative pain is a serious postoperative complication. Inadequate pain management in the early postoperative period can contribute to the development of hyperalgesia. Aim - to evaluate the effectiveness of intravenous infusion of lidocaine in the prevention of chronic postoperative pain after various types of surgical intervention in children and adolescents. Materials and methods. 150 children who underwent under general multicomponent anesthesia surgical interventions due to traumatic pathology (I group, n=40), abdominal (II group, n=48) and urological (III group, n=62) surgical interventions were examined. Each of these groups was divided into two subgroups: in the subgroups Ib (n=17), IIb (n=19) and IIIb (n=24) children received intravenous lidocaine (according to the instructions) as a component of multimodal analgesia in the perioperative period, in the control subgroups Ia (n=23), IIa (n=29) and IIIa (n=38) children did not receive lidocaine. The presence of chronic postoperative pain 6 and 12 months after the operation, its frequency, localization, intensity according, the impact on the child’s daily activity were analyzed. Data analysis was performed using the statistical package «SPSS 20» (SPSS Inc.) version 21.0.0. Results. Perioperative use of intravenous lidocaine infusion inpediatric patients was associated with a lower incidence of chronic pain 6 and 12 months after trauma surgery (odds ratio (OR): 5.13; 95% confidence interval (95% CI): 1.13-23.3 and OR: 4.24; 95% CI: 1.01-93.48, respectively) and after abdominal surgery (OR: 5.19; 95% CI: 1.02-26.94), as well as a higher level of functional activity after trauma (OR: 5.52; 95% CI: 1.08-28.2; p=0.028) and abdominal surgery (OR: 8.1; 95% CI: 1.01-70.36; p=0.032), but not after urological operations. Conclusions. This study demonstrated the efficacy of intravenous infusion of lidocaine to prevent of chronic pain after trauma and abdominal surgery in pediatric patients. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Effect of orlistat versus lipo-6 black on the testis of adult obese albino rats: histological and histomorphometric study

Background Obesity is a health problem with increasing incidence. Excess fat is the most common factor that contributes to its pathogenesis. Aim To evaluate the effect of obesity on the testis of male rats and compare the possible ameliorative effect of orlistat versus lipo-6. Materials and methods Fifty-six adult male rats were used. The control group ‘eight rats’ received a standard diet (SD) with no treatment for 90 days. The experimental group ‘48 rats’ received high-fat diet (HFD) for 60 days for obesity induction. Obese rats were subdivided into three groups (each group a and b). IIa received SD and IIb received HFD. IIIa received SD+orlistat and IIIb received HFD+orlistat. IVa received SD+lipo-6. IVb received HFD+lipo 6. The drugs were used for 30 days. Testicular specimens were subjected to histological, histomorphometrical, and immunohistochemical examinations. Data on obesity index, testis weight, abdominal circumference sperm percentage, and histomorphometry were analyzed statistically. Results Subgroups IIIa and IVa showed restoration of the structural integrity of the seminiferous tubules with the normal distribution of collagen fibers. Sections of subgroup IIIa showed negative caspase-3 immunostaining near the control group. Lee obesity index and percentage of abnormal sperm were close to control. Conclusion Orlistat and lipo-6 with diet adjustment reduced the severity of testicular damage induced by obesity.

Histological study of the effect of curcumin on indomethacin-induced ileitis in adult male albino rats

Background Ileitis induced by indomethacin represents a well-standardized model in the study of acute and chronic inflammation of the intestine. Curcumin is an orange-yellow component of the herb turmeric. It has potent anti-inflammatory, antioxidant, antimicrobial, and anticancer effects. Aim This work was performed to show the effect of curcumin on indomethacin-induced ileitis in rats using H&E stain. Materials and methods Thirty-six mature male albino rats (160–200 g) were used in this study. They were separated into four formain groups; control group: 8 rats, group I: 8 rats that received oral aqueous suspension of curcumin 100 mg/kg daily; group II: 10 rats included subgroups (IIA & IIB): ileitis was induced by subcutaneous injection of two doses of indomethacin; each dose was 7.5 mg/kg separated by 24 hours, the rats were then killed on the 3rd and the 18th day, respectively, and group III: 10 rats included subgroups (IIIA& IIIB): the ileitis group was treated with an oral aqueous suspension of curcumin 100 mg/kg daily and then the rats were killed on the 3rd and 18th day respectively. Results Subgroups IIA and IIB revealed sloughing of surface epithelium in the lumen of the intestine, ulceration, a significant decrease of villus height at H&E sections, and inflammatory cellular infiltration. Subgroups IIIA and IIIB showed marked improvement in the pathological changes of induced ileitis. Conclusion Curcumin could decrease ileitis induced by indomethacin in rats. So, it could be useful for the treatment of intestinal injury.

Antibacterial Efficacy of Irrigants with Varying Osmolarity on E. faecalis Biofilm: An In Vitro Study.

To evaluate the role of the addition of different concentrations of sodium chloride salt to conventional intracanal irrigants to vary their osmotic values and thereby compare their antibacterial efficacy. In an active attachment biofilm model, Enterococcus faecalis (ATCC 29212) biofilms were grown. Sodium chloride salts were added to 100 mL of distilled water to make 6M (hyperosmotic), 0.5M, and 0.25M (hypoosmotic) sodium chloride solutions, respectively. The experimental groups were divided into three groups: Group I: 5.25% sodium hypochlorite, group II: 2% chlorhexidine, and group III: 2% povidone iodine, and four subgroups within these three groups, such as subgroup A (without salt solution), subgroup B (with 6M of hyperosmotic salt solution), subgroup C (with 0.5M of hypoosmotic salt solution), and subgroup D (with 0.25M of hypoosmotic salt solution), respectively. Biofilms were treated with all the subgroups for a contact time of 15 min. A crystal violet assay was done to estimate the bacterial cell biomass. The results revealed that subgroups IIIB, IB, and IID, ID had a statistical reduction in bacterial biomass at p < 0.05. There were no significant differences between subgroups IC, IIC, and IIIC and subgroups IA, IIA, and IIIA. The antibacterial efficacy of all three irrigants was significantly affected by varying the osmolarities. The results prove that the hyperosmotic and hypoosmotic salt solutions, along with irrigants, have enhanced antibacterial efficacy on E. faecalis biofilm due to its ability to vary the turgor pressure of cell wall, as well as the inherent properties of the irrigants such as hypochlorous acid formation, ionic interaction, and free radical interactions.

Ecophysiology and genomics of the brackish water adapted SAR11 subclade IIIa

The Order Pelagibacterales (SAR11) is the most abundant group of heterotrophic bacterioplankton in global oceans and comprises multiple subclades with unique spatiotemporal distributions. Subclade IIIa is the primary SAR11 group in brackish waters and shares a common ancestor with the dominant freshwater IIIb (LD12) subclade. Despite its dominance in brackish environments, subclade IIIa lacks systematic genomic or ecological studies. Here, we combine closed genomes from new IIIa isolates, new IIIa MAGS from San Francisco Bay (SFB), and 460 highly complete publicly available SAR11 genomes for the most comprehensive pangenomic study of subclade IIIa to date. Subclade IIIa represents a taxonomic family containing three genera (denoted as subgroups IIIa.1, IIIa.2, and IIIa.3) that had distinct ecological distributions related to salinity. The expansion of taxon selection within subclade IIIa also established previously noted metabolic differentiation in subclade IIIa compared to other SAR11 subclades such as glycine/serine prototrophy, mosaic glyoxylate shunt presence, and polyhydroxyalkanoate synthesis potential. Our analysis further shows metabolic flexibility among subgroups within IIIa. Additionally, we find that subclade IIIa.3 bridges the marine and freshwater clades based on its potential for compatible solute transport, iron utilization, and bicarbonate management potential. Pure culture experimentation validated differential salinity ranges in IIIa.1 and IIIa.3 and provided detailed IIIa cell size and volume data. This study is an important step forward for understanding the genomic, ecological, and physiological differentiation of subclade IIIa and the overall evolutionary history of SAR11.

Comparative Study on the Effect of Adipose tissue derived Mesenchymal Stem Cells versus Metformin on Age-related Structural Changes of the Cerebellum in Albino Rat

Abstract Introduction Aging is a normal physiological process that affects all organs in the body including the cerebellum. Metformin is an anti-diabetic drug that is used in some age-related diseases. Regenerative medicine using adipose tissue derived mesenchymal stem cells (ADMSCs) is an emerging promising strategy. Aim to compare between the role of ADMSCs and metformin on the age-related structural changes of the cerebellum in female albino rats. Materials and methods Fifty-five female rats of different ages (4, 12 and 24 months) were included in this study. They were divided into three groups according to their ages: Group I (Adult rats), Group II (Old rats) and Group III (Senile rats). Group II and Group III were subdivided into three subgroups, Subgroup a: rats were left without treatment, Subgroup b: rats were given a single dose of 1X106 ADMSCs via tail vein. Subgroup c: Rats received300 mg/kg metformin/day orally. Rats were sacrificed after four weeks. The cerebellum was collected and processed for H&amp;E, Toluidine blue and immuno-histochemical reaction using glial fibrillary acidic protein (GFAP). Results Histological examination of the cerebellum of the subgroups IIa and IIIa revealed age-related structural changes in comparison to group I. Purkinje cells appeared distorted with irregular outline. Some Purkinje cells were seen shrunken while others appeared ballooned. Focal loss of Purkinje cells was also noticed. Granular layer contained small widely separated granule cells. GFAP reaction revealed an apparent decrease in number of astrocytes and their processes. The structural changes were more obvious in subgroup IIIa. In ADMSCs treated subgroups (IIbandIIIb); more noticeable improvement of these changes was noticed compared to the corresponding metformin treated subgroups (IIc and IIIc). Conclusion ADMSCs was more effective than metformin in preventing some age-related structural changes of the cerebellum.

Efficiency evaluation of the improved treatment and prevention complex in pregnant women after assisted reproductive technologies

Study objective: to determine the role and effectiveness of the proposed therapeutic and preventive complex and psychoemotional correction of hormonal disorders in the pregnancy dynamics after assisted reproductive technologies (ART) to improve the antenatal observation and prevention of obstetric and perinatal complications.Materials and methods. The study included 299 pregnant women: the main group included 249 women whose pregnancy occurred as an ART result; the control group included 50 pregnant women with spontaneous pregnancy. Therapeutic and prophylactic complex for pregnant women after ART included: micronized progesterone, magnesium oxide, folic acid, L-arginine aspartate, ω3-polyunsaturated fatty acids and long-term psychological correction on the eve of the ART program, at 8–10, 16–18 and 28–30 weeks of pregnancy. Results. There was a significant increase in the β-chorionic gonadotropin (β-hCG) level in women of the study groups in the first trimester of pregnancy against the background of the proposed treatment. Mean β-HCG value at 7–8 weeks of gestation in the subgroup IA exceeded the subgroup IB by 37% (p &lt;0.05), in subgroup IIA it exceeded the subgroup IIB by 33% (p &lt;0.05). The mean β-hCG value in subgroups IIIA and IIIB did not have a significant difference in the dynamics of the first trimester compared with the control group and among themselves (p &gt;0.05).Mean progesterone value at 7–8 weeks of gestation in subgroup IA increased by 38% in comparison with pregnant women who received the conventional treatment complex (p &lt;0.05), in subgroup IIA it was 73% higher than in subgroup IIB (p &lt;0.05). There was no significant difference in the progesterone level in subgroups IIIA and IIIB in the dynamics of the first trimester.The average cortisol value at 23–24 weeks of pregnancy in subgroup IA decreased by 42% (p &lt;0.05), in pregnant women with endocrine infertility against the background of the proposed treatment complex it was 62% less than in subgroup IIB (p &lt;0.05). The average cortisol level in women with a male factor of infertility was 63% lower than in subgroup IIIB against the background of the proposed complex (p &lt;0.05).Conclusion. Advanced therapy with micronized progesterone in combination with magnesium saturation, L-arginine aspartate, folic acid, ω-3 polyunsaturated fatty acids, as well as long-term psychoemotional correction is appropriate and effective compared to conventional therapy for pregnant women.

ANALYSIS OF THE EFFICIENCY OF COMPLEX TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS ACCORDING TO THE CHANGES IN THE ACTIVITY OF BLOOD SERUM ENZYMES

ANALYSIS OF THE EFFICIENCY OF COMPLEX TREATMENT OF PATIENTS WITH GENERALIZED PERIODONTITIS ACCORDING TO THE CHANGES IN THE ACTIVITY OF BLOOD SERUM ENZYMES

Effect of Tadalafil on Apoptosis and Proliferation in Urinary Bladder Mucosa after Chemically Induced Haemorrhagic Cystitis; A Histological and Immunohistochemical Study

Introduction: Haemorrhagic cystitis (HC) can be chemically induced by cyclophosphamide (CYP) injection; it is mainly used as an immunosuppressive and antineoplastic drug. Tadalafil (TAD) a phosphodiesterase type-5 inhibitor has vasodilator, anti-inflammatory and anti-apoptotic effects. It is mainly used for the treatment of erectile dysfunction and pulmonary arterial hypertension.Aim of the work: This work aimed to verify the effect of tadalafil on apoptosis and proliferation on the injured bladder mucosa after chemically induced HC. Material and Methods: Thirty-six adult male albino rats were randomly divided into four groups; group I was the control group, group II was TAD-treated group, group III was CYP-treated group and group IV was TAD-CYP treated group. Groups III and IV were subdivided into two subgroups (a and b), subgroups IIIa and IVa were euthanized after one day while subgroups IIIb and IVb were euthanized after 10 days. Urinary bladder specimens were processed for light and electron microscopic examination and immunohistochemical analysis of caspase-3 and Ki-67. Results: Subgroup IIIa revealed haemorrhage and decrease of urothelium thickness with presence of denuded areas. Subgroup IIIb showed restoration of urothelium with focal denuded areas. Both subgroups showed a significant increase in apoptotic index while subgroup IIIb showed a significant increase in proliferative index. Subgroup IVa revealed a significant decrease in apoptosis associated with a significant increase in proliferation, thereby limiting cellular loss. Subgroup IVb; showed a significant decrease in both apoptosis and proliferation indicated prevention of the developed hyperplasia of the urothelium. By transmission electron microscopy, the terminal differentiation of superficial cells of group IV was expressed by presence of an angular contour.Conclusion: TAD-CYP co-treatment provides a positive impact on the apoptosis, proliferation, and the histological changes of HC on urinary bladder mucosa. Therefore, further studies are required to elucidate the protective effect of TAD on CYP-induced HC.

ЗАВИСИМОСТЬ КОЭФФИЦИЕНТА КВАЗИУПРУГОЙ СИЛЫ И СРЕДНЕКВАДРАТИЧНОЙ АМПЛИТУДЫ ТЕПЛОВЫХ КОЛЕБАНИЙ АТОМОВ В D – ЭЛЕМЕНТАХ ОТ АТОМНОГО НОМЕРА В ГРУППАХ ПЕРИОДИЧЕСКОЙ СИСТЕМЫ МЕНДЕЛЕЕВА

The discovered regularities are explained by the configurationally model of the electronic structure of matter as follows: in subgroups IIIa – VIIIa of groups of the periodic table in the series Ti → Ni, the orbital of d - electrons form, together with the of s-electrons orbital, hybrid orbital, the degree of intersection of which increases with an increase in the ordinal number of elements and, accordingly, the interatomic force of interaction increases. In the copper subgroup, the bond strength is largely provided by s - electrons. A decrease in the energy stability of s - electrons in the transition from Cu (copper) to gold due to an increase in the distance of s - electrons from the nucleus and the degree of screening of the nuclear charge by internal electrons leads to a decrease in the interatomic force of interaction. In metals of the zinc subgroup d10 - the valence electrons in the condensed state is violated due to the excitation of s2 - configurations with the formation of a high concentration of ant bonding unlocalized electrons, the degree of loosening of which increases with an increase in the ordinal number of the element in this subgroup. This leads to a weakening of the force of interaction of atoms with an increase in the principal quantum number of s-electrons.

Эффективность элиминации вируса папилломы человека при лечении патологии шейки матки

Study Objective: To assess the efficacy of antiviral medications, using the apoptotic markers caspase-3 and caspase-9, in the treatment of cervical disorders accompanied by papillomavirus infection. Study Design: This was a prospective study. Materials and Methods: One hundred and seventy women with a positive human papillomavirus (HPV) test, aged 18 to 45, participated in the study. Group I consisted of 60 women with histologically confirmed cervical leukoplakia; Group II was made up of 55 patients with cervical intraepithelial neoplasia (CIN) I; and Group III comprised 55 women with CIN II. The control group consisted of 40 healthy women. All participants underwent a standard examination and had measurements taken for levels of caspase-1, caspase-3, and caspase-9, which were used to assess changes in their apoptotic programs. During the study, the patients with HPV were divided into subgroups. In the cervical leukoplakia group, 34 women (subgroup Ia) were only monitored and 26 women (subgroup Ib) received antiviral treatment. Similarly, in the CIN I group, 27 patients (subgroup IIa) were only monitored and 28 women (subgroup IIb) received antiviral drugs. In the CIN II group, all patients underwent excision of their lesions. According to the study design, 28 women who had undergone excision had monitoring alone (subgroup IIIa) and for 27 participants the surgical treatment was combined with an antiviral medication (subgroup IIIb). The efficacy of the treatment regimens was assessed three and six later by cytology and colposcopy data and levels of caspase-3 and caspase-9. Treatment efficacy was assessed chiefly by the presence or absence of HPV or reduction in viral load below significant levels. Study Results: After three and six months, viral load reduction in all subgroups of women who received antiviral treatment was greater and more of these women had a negative HPV test (after three and six months the overall efficacy was 11.7% vs. 30.7% and 20.5% vs. 42.3% in subgroups Ia and Ib, respectively; 7.4% vs. 21.4% and 22.2% vs. 35.7% in subgroups IIa and IIb, respectively; and 75% vs. 85.2% and 64.2% vs. 92.6% in subgroups IIIa and IIIb, respectively). Caspase-3 and caspase-9 levels decreased in both the subgroups that had monitoring alone and the subgroups that received combination treatment, but in the latter case they were closer to the control group’s levels. Correlation analysis revealed a strong direct relationship between clinically significant viral load and caspase-3 levels (rху = 0.79) and a moderate direct relationship between caspase-9 levels and high viral load (rху = 0.58). Conclusion: The proposed comprehensive approach, including antiviral therapy, to the treatment of HPV-associated cervical disorders such as leukoplakia, CIN I and CIN II, has higher clinical efficacy than monitoring over time alone or only the excision of lesions (in patients with CIN II). This is because of its effects on the system of natural killers and stimulation of the ability of cytotoxic lymphocytes to identify and destroy defective cells. Keywords: human papillomavirus, apoptosis, caspases, dysplasia, leukoplakia.

Pathogenetic substantiation of advantages and duration of phytoselective therapy of the menstrual cycle disorders

One of the urgent modern problems is determining the optimal medicine for treatment of menstrual irregularities and duration of therapy.Objective of the study was to determine the optimal treatment period of menstrual irregularities with TazalokTM, as well as the comparative effectiveness of the therapy results with a derivative drug of Vitex agnus-castus.Design: a comparative study.Materials and methods. Analysis of retrospective data and dynamic observation of 120 patients 23–37 years old with menstrual irregularities who received monotherapy with TazalokTM and Vitex agnus castus was carried out. 60 patients received drugs for 3 months (group I TazalokTM and group II Vitex agnus-castus), and 60 patients for 6 months(group III TazalokTM and group IV Vitex agnus-castus). Groups are divided into subgroups depending on the menstruation nature: A – heavy, B – meager menstruation. All patients underwent a hormonal examination after 6 months (the results of the previous three-month therapy were considered initial), sonographic study, and dynamics of the pain syndrome were assessed according to the visual analogue scale.Study results. Subgroups IIIA and IIIB (TazalokTM for 6 months) showed the best clinical results and data from hormonal tests, sonography of the pelvic organs, mammary glands, thyroid gland; elimination of pain. An increase in progesterone levels, normalization of estradiol levels, follicle-stimulating hormone, and luteinizing hormone has been observed. Normalization of thyroid function was found in patients taking TazalokTM. Groups IVA and IVB (Vitex agnus-castus for 6 months) showed mainly a decrease in prolactin levels, normalization of mammary echography. The advantage of TazalokTM using also consisted in cortisol normalizing, one of the main pathogenetic factors for menstrual irregularities. Conclusion. TazalokTM is the drug of choice for monotherapy of menstrual irregularities, demonstrates the advantages of hormonal and clinical correction of pathological conditions in relation to Vitex agnus-castus; the 6 months treatment period should be considered optimal.

EFFECT OF THERMOCYCLING ON REPAIRED ZIRCONIA CERAMIC RESTORATIONS USING DIFFERENT BONDING AGENTS

Statement of the Problem: The clinical success of zirconia intra-oral repair depends on the strength of the bond between the zirconia core and veneering composite. Purpose: In the present study, the effect of aging on the shear bond strength of zirconia ceramic and nanohybrid composite resin as a repair material was evaluated using different bonding agents. Materials and Method: Fifty six plates of zirconia ceramic (10mm×2mm) were prepared by CAD/CAM. All discs were air-abraded using 50μm Al2O3 particles at 2 bar pressure for 10 s, then divided into two equal groups A and B (n= 28) according to exposure to thermocycling. Each group was subdivided into four equal subgroups (n=7) according to the used bonding agent, as follows: control subgroup I, treated with Z-prime plus; subgroup II, All- Bond Universal; subgroup III, optibond; and subgroup IV, Voco-Futura bond. Surface roughness of all specimens (n=56) were evaluated immediately after bonding application using contact surf-test (Mitutoyo SJ 201, Japan). The composite resin (Ceram X nanohybrid) were then bonded and cured to each zirconia plate. The shear bond strength test was performed to group A with a universal testing machine at a crosshead speed of 1mm/ min before thermocycling. Specimens of group B were thermocycled 1000 times in water between 5˚C and 55˚C, then the shear bond strength test was performed. Bond strength values (MPa) were calculated and analyzed with a two-way ANOVA. The failure mode of each specimen was evaluated under a stereomicroscope. Results: The mean shear bond strengths before thermocycling were 13.22, 13.03, 7.02, and 6.69 (MPa) in subgroups IA, IIA, IIIA and IVA, respectively. After exposure to thermocycling the mean shear bond strengths were 13.47, 11.48, 0.00 and 0.00 (MPa) in subgroups IB, IIB, IIIB and IVB, respectively. The results showed that the shear bond strength were significantly higher in subgroups I and II than subgroups III and IV (p< 0.05). Chemical pre-treatment of zirconia with Z- Prime Plus revealed significant higher bond strength than the Optibond (subgroup III) and Voco bond (subgroup IV) before and after aging conditions. Conclusion: Treatment with both Z-prime and All- Bond Universal resulted in higher bond strength values compared to the Optibond and Voco Futurabond. The use of Z-Prime Plus treatment in combination with air-abrasion procedure resulted in the highest bond strength value that is stable on aging

Improving the Power of the American Society of Anesthesiology Classification System to Risk Stratify Vascular Surgery Patients Based on National Surgical Quality Improvement Project–Defined Functional Status

Recently published reports have shown that the American Society of Anesthesiology (ASA) classification system has limited applicability in vascular surgery patients. Most patients undergoing vascular procedures are designated as ASA class III, limiting discrimination in preoperative risk assessment. The 2006 National Surgical Quality Improvement Project (NSQIP), containing over 170,000 surgical cases, demonstrated that functional status is an important predictor of mortality. We propose that dividing ASA class III into 2 subgroups, based on NSQIP-defined functional status, improves the predictive value of the ASA scheme. The 2006 NSQIP database was queried for ASA class III patients undergoing vascular surgery procedures. Patients were divided into groups IIIA and IIIB based on independent or dependent (partial or complete) functional status, respectively. Difference in 30-day survival between subgroups was evaluated using Kaplan-Meier and logistic regression analyses. Differences in postoperative morbidity and length of stay were compared using the unpaired t-test. ASA class III patients having undergone vascular surgery procedures numbered 11,555 (68%). Of those 9,913 (85.7%) patients were independent (IIIA), and 1,642 (14.3%) were dependent (IIIB). Mean 30-day mortality was 1.3% in subgroup IIIA, and 6.5% in IIIB (logrank P<0.001, χ2, 137.8). Mean lengths of stay between subgroups IIIA and IIIB were 5.4 and 13.2days (P<0.001). The risk of NSQIP-defined postoperative complications was 0.16 in IIIA and 0.32 in IIIB (P<0.001). A 5-fold difference in mortality was observed between patients who were functionally independent and dependent. A significant increase in length of stay and incidence of postoperative complications was also observed in subgroup IIIB. Subdividing ASA class III vascular surgery patients markedly improves the value of the ASA classification system. Given the "high-risk" nature of patients with vascular disease, the addition of functional status to the preoperative assessment will assist in predicting outcomes in this patient population.

Histological comparative study between endogenous and therapeutic stem cells in adriamycin-induced renal cortical toxicity in male rats

Background Renal toxicity resulting from kidney injury poses an important problem to public health. Exogenous and endogenous stem cells (SCs) derived from various tissues hold great promise for regeneration. Aim The aim of this study was to assess and compare the effect of both endogenous and therapeutic SCs in rat model of adriamycin (ADR)-induced renal cortical toxicity. Materials and methods Twenty-four adult male albino rats were divided into three groups: the control group, the ADR group, and the SC therapy group. The ADR group received single intraperitoneal injection of 5 mg/kg ADR; this group was subdivided into subgroups IIa and IIb, and the rats were sacrificed at 2 and 4 weeks following the expected confirmed renal cortical injury, respectively. The SC therapy group received ADR and was injected with 0.5 ml of human umbilical cord blood SCs in the tail vein. The SC therapy group was subdivided into subgroups IIIa and IIIb that were sacrificed at 2 and 4 weeks following SC therapy, respectively. Kidney sections were stained with H&E, Prussian blue stain, and CD105 immunostaining. Morphometric study and statistical analysis were performed. Results A significant decrease in the mean glomerular area was found in subgroup IIb compared with control and other subgroups. A significant increase in the mean area of vacuolated cells with dark nuclei was found in subgroups IIa and IIb compared with other subgroups. A significant increase in the mean area of CD105+ cells was detected in subgroup IIIa and IIIb compared with other subgroups. Conclusion Endogenous SCs need to be activated by exogenous administration of SCs for more rapid improvement to attain normal function as early as possible.

Preliminary Suggestion about Staging of Anorectal Malignant Melanoma May Be Used to Predict Prognosis.

PurposeAnorectal malignant melanomas (AMM) are rare and have poor survival. The study aims to evaluate the clinicopathologic characteristics and outcomes of patients with AMM, and to devise a staging system predictive of survival outcome.Materials and MethodsThis was a retrospective study of 28 patients diagnosed with, and treated for AMM. Patients classified by clinical staging of mucosal melanoma (MM) were reclassified via rectal and anal TNM staging. Survival outcomes were compared among patients grouped by the three different staging systems.ResultsThe three staging systems were equated with similar figures for 5-year overall survival (OS) and 5-year disease-free survival (DFS) of patients diagnosed with stage I disease. Patients (n=19) diagnosed with MM stage II disease were reclassified by rectal TNM staging into three subgroups: IIIA, IIIB, and IIIC. For these patients, both 5-year OS and 5-year DFS differed significantly between the subgroups IIIA and IIIC (OS: IIIA vs. IIIC, 66.7% vs. 0%, p=0.002; DFS: IIIA vs. IIIC, 51.4% vs. 0%, p < 0.001).ConclusionThe accuracy of prognosis in patients diagnosed with AMM and lymph node metastasis has improved by using rectal TNM staging, which includes information regarding the number of lymph node metastases.

Comparative Study of the Possible Hepatoprotective Effect of Each of N-acetylcysteine, Coenzyme Q10 and Aloe Vera Gel in Acute Acetaminophen Induced Hepatotoxicity in Albino Rats. (Histological and Biochemical Study)

Introduction: Although acetaminophen is a widely used analgesic antipyretic, its toxicity is one of the most common causes of acute liver failure worldwide. N-acetyl cysteine (NAC) is the standard antidote for acute acetaminophen toxicity. Both coenzyme Q10 (CoQ10) and Aloe vera have antioxidant and anti-inflammatory effects so they are used in wide varieties of medical applications Objective: The aim of this work was to compare the possible hepatoprotective effects of NAC, CoQ10 and Aloe vera gel in acute acetaminophen induced hepatotoxicity in albino rats. Materials &Methods: Sixty male albino rats were divided into 3 groups, group I (control group) was further subdivided into 4 equal subgroups Ia, Ib, Ic and Id (n=5) receiving tap water, NAC (450mg/kg) as a single oral dose, CoQ1010mg/kg as a single i.p injection, Aloe vera (500mg/kg) as a single oral dose respectively. GroupII (n=10) received acetaminophen (700mg/kg) as a single oral dose. Group III was further subdivided into 3 subgroups IIIa, IIIb and IIIc (n=10), each received the same dose of acetaminophen as group II followed 1 hour later by NAC, CoQ10 or Aloe vera gel respectively in the same doses as group I. After 24 hours the rats were sacrificed under anesthesia and blood samples were collected for estimation of serum aspartate transaminase (AST) (Aspartate transaminase AST) and alanine transaminase (ALT) (Alanine transaminase ALT) levels. Liver homogenates were used for estimation of malondialdehyde (MDA), superoxide dismutase (SOD) and reduced glutathione (GSH). Liver specimens were harvested from all rats at the end of the experiment for histological examination by the light and electron microscopes. Results: Acetaminophen induced hepatotoxicity, as it significantly elevated AST, ALT and MDA and depleted liver GSH and SOD. NAC, CO Q10 and Aloe vera gel had hepatoprotective effects as they reversed these effects. Histologically, group Ib, Ic and Id revealed almost the control pattern of liver similar to group Ia. Group II liver sections showed loss of normal hepatocellular architecture with cellular infiltration and dilated congested blood vessels. Most of the hepatocytes appeared swollen with cytoplasmic vacuolation. Dark shrunken nuclei were encountered. Ultrastructurally, dense mitochondria, dilated profiles of rER and numerous lipid droplets were revealed. Many apoptotic bodies were further encountered. Both group IIIa and IIIc revealed almost the control pattern of the liver except for few areas of cellular infiltration and vascular dilatation and congestion in group IIIa. Group IIIb showed considerable improvement with persistent focal areas of hepatic affection. Conclusion: This study showed that NAC, CoQ10 and Aloe vera have significant hepatoprotective effects in acetaminophen induced hepatotoxicity, best seen with NAC and Aloe vera gel and less with CoQ10. Recommendations: Further study is recommended to explore the possible hepatoprotective effects of coenzyme Q10 and Aloe vera in chronic acetaminophen as well as other toxins induced hepatotoxicity.

Functional capacity as a significant independent predictor of postoperative mortality for octogenarian ASA-III patients.

The American Society of Anesthesiology's (ASA) 6-point physical status classification remains one of the most significant predictors of perioperative morbidity and mortality and is the most widely used risk stratification tool worldwide. Its utility is significantly limited for octogenarians, however, as the majority of these patients are classified as ASA-III. Thus, for patients aged 80 or older, we hypothesized that incorporating patients' functional status, defined by the ability to perform activities of daily living independently, would improve perioperative risk stratification. All data were extracted from the Veterans Affairs Surgical Quality Improvement Program, a perioperative prospectively maintained computerized database. ASA-III patients were reclassified into subgroups IIIA or IIIB, with IIIA representing functionally independent patients and IIIB representing partially or fully dependent patients. Functional status was self-reported during preoperative assessments. In this database, mortality data (primary outcome) was reliably available for all patients for the duration of the 96-month follow-up period, as were other perioperative patient data. Seven hundred and fifty-nine (72.4%) patients were classified as ASA-IIIA, and 290 (27.6%) patients were ASA-IIIB. Thirty-day and long-term survival was significantly better in the ASA-IIIA group, irrespective of type of surgery (hazard ratio 1.87, confidence interval 1.55-2.25, p < .001). ASA-IIIB hazard ratios for mortality were greatest for orthopedic and vascular surgery patients, but a significant divergence in survival between ASA-IIIA and IIIB patients was observed in all surgical specialties. As evidenced by Kaplan-Meier and multivariate analyses, functional capacity was a significant independent predictor of mortality for ASA-III patients older than 80 years of age.

SNaPBcen : a Novel and Practical Tool for Genotyping Burkholderia cenocepacia

Burkholderia cenocepacia is the most prevalent and feared member of the Burkholderia cepacia complex in lung infections of cystic fibrosis (CF). Genotyping and monitoring of long-term colonization are critical at clinical units; however, the differentiation of specific lineages performed by multilocus sequence typing (MLST) is still limited to a small number of isolates due to the high cost and time-consuming procedure. The aim of this study was to optimize a protocol (the SNaPBcen assay) for extensive bacterial population studies. The strategy used for the SNaPBcen assay is based on targeting single nucleotide polymorphisms (SNPs) located in MLST genes instead of sequencing full MLST sequences. Nonpolymorphic and redundant MLST positions were eliminated, and a set of 24 polymorphisms included in the SNaPBcen assay ensures a high-resolution genomic characterization. These polymorphisms were identified based on the comparative analysis of 137 B. cenocepacia MLST profiles available online (http://pubmlst.org/bcc/). The group of 81 clinical isolates of B. cenocepacia examined in this study using the SNaPBcen assay revealed 51 distinct profiles, and a final discriminatory power of 0.9997 compared with MLST was determined. The SNaPBcen assay was able to reveal isolates with microvariations and the presence of multiple clonal variants in patients chronically colonized with B. cenocepacia. Main phylogenetic subgroups IIIA, IIIB, and IIIC of B. cenocepacia could be separated by the Gl94R polymorphism included in the panel. The SNaPBcen assay proved to be a rapid and robust alternative to the standard MLST for B. cenocepacia, allowing the simultaneous analysis of multiple polymorphisms following amplification and mini-sequencing reactions.