VM Group Research Articles

A Proposal for a Simple Subclassification of Advanced Hepatocellular Carcinoma in Systemic Treatment.

This study focused on the presence or absence of vascular invasion and extrahepatic metastasis in hepatocellular carcinoma (HCC) and examined their impact on systemic treatment outcomes. We retrospectively analyzed 362 patients with unresectable HCC who received first-line systemic therapy. The prognostic evaluation was based on the presence of vascular invasion and extrahepatic metastasis at the time of treatment initiation. Patients with vascular invasion or extrahepatic metastasis (advanced group) had significantly worse outcomes than those without these features (intermediate group), with median survival times of 434 and 658 days, respectively. Further subdivision of the advanced group into three categories-patients with only extrahepatic metastasis (m group, n = 77), patients with only vascular invasion (v group, n = 78), and patients with both vascular invasion and extrahepatic metastasis (vm group, n = 52)-revealed that the m group had significantly better outcomes than those in the other two groups, with median survival times of 649, 323, and 187 days, respectively. A comparison of the clinical backgrounds among the three groups demonstrated that the m group had significantly better liver function at the time of treatment initiation than that in the other two groups. Multivariable analysis, including performance status, Child-Pugh score, and the use of immune checkpoint inhibitors as first-line therapy, identified the m group as an independent and significant prognostic factor (hazard ratio, 0.50). Unresectable HCC with extrahepatic metastasis and no vascular invasion represents a novel staging category for systemic treatment.

Comparison of different cementing techniques for cement penetration under tibial component in total knee arthroplasty: a retrospective observational study

PurposeThis study aimed to investigate the differences in cement penetration between cementing techniques in total knee arthroplasty (TKA).Materials and methodsWe retrospectively evaluated knee undergone TKA at our hospital for both preoperative and postoperative computed tomographic (CT) evaluations. Cementing was performed with hand mixing and hand packing (HM group) and with vacuum mixing and cement gun use (VM group). We measured the area under the tibial baseplate (sclerotic and nonsclerotic sides) and compared the mean and maximum depths of cement penetration at each area.ResultsOf the 44 knees evaluated, 20 and 24 knees were in the HM and VM groups, respectively. At the center of the sclerotic side, the mean penetration depths (2.0 ± 0.7 and 2.5 ± 0.7 mm, p = 0.02) and the maximum penetration depths (4.0 ± 0.9 and 5.0 ± 1.6 mm, p = 0.02) were significantly deeper in the VM group than in the HM group. The correlation between preoperative Hounsfield unit values and mean penetration were r = –0.617 (p < 0.01) and –0.373 (p = 0.01) in the HM and VM groups, respectively.ConclusionThe cementing technique of vacuum mixing and using a cement gun allowed for deeper cement penetration compared with the hand mixing and hand packing technique, even in bone sclerotic sites.

Sclerotherapy with intralesional bleomycin injection under guidance of multi-slice CT for retrobulbar orbital low-flow vascular lesions-single-center experience.

This study investigated the safety and efficacy of sclerotherapy with intralesional bleomycin injection (IBI) for retrobulbar orbital low-flow vascular lesions under multi-slice computed tomography (CT) guidance. Between January 2010 and September 2021, consecutive patients with retrobulbar orbital low-flow vascular lesions who underwent CT-guided IBI at a tertiary centre in Taiwan were enrolled. Their medical records and imaging data were retrospectively collected. This study enrolled 13 patients (7 male and 6 female patients; age range: 1-57 years; mean age: 25.9 years) with lymphatic malformation (LM, n = 4), venolymphatic malformation (n = 1), and venous malformation (VM, n = 8). The overall radiological response rate was 76.9% (10 of 13); the radiological response rate was 75.0% in the VM group (6 of 8) and 75.0% in the LM group (3 of 4). Moreover, 3 patients (23.1%) had minor complications and 1 (7.7%) had a major complication. The mean clinical and radiological follow-up was 8.3 months and no recurrence or progression was reported. CT-guided IBI is an effective and relatively safe minimally invasive treatment for retrobulbar orbital low-flow vascular lesions, with an overall radiological response rate of 76.9% in a mean of 1.5 sessions and a low complication rate. CT-guided sclerotherapy with IBI is a relatively safe, effective, and feasible alternative treatment option for retrobulbar orbital low-flow vascular lesions.

Development of Vibratory Microinjection System for Instantaneous Cell Membrane Piercing in Cytoplasmic Microinjection into Fertilized Eggs

To complete microinjection as quickly as possible, we have developed Vibratory Microinjection Systems (VMSs) that vibrate a micropipette in its longitudinal direction and can significantly reduce the time needed for pronuclear microinjection compared to ordinary (non-vibratory) microinjection. The longest breakdown of the time is the time required to pierce the cell membrane and the pronuclear membrane simultaneously. Because cytoplasmic microinjection, which pierces the cell membrane alone, is far more difficult and time-consuming than pronuclear microinjection, we next aimed to develop a VMS capable of penetrating the cell membrane instantly. In this new and latest version, two types of ultrasonic-wave vibrators were developed: the first for commercially available micropipettes (Femtotip) and the second for self-made micropipettes. The two vibrators differ only in their airtight structure, where the micropipettes connect to their respective vibrators: a female screw plus O-ring for the first vibrator (VMS6_1) and a silicone–-rubber tube for the second (VMS6_2). The tube-type joint used in VMS6_2 only slightly damped or amplified vibrations from the vibrator to the micropipette tip, propagating them much more accurately than the screw-type joint in VMS6_1. In addition, VMS6_2 significantly shortened the time taken to pierce the cell membrane of a fertilized egg: an average of 1.52 s (N = 410) vs. 3.62 s (N = 65) in VMS6_1. The VMS6_2 group achieved a piercing time of zero in 86.1% of the allocated eggs, while only 10.8% of the VMS6_1 group did. In each vibrator, we also compared vibratory microinjection (VM; N = 475) and ordinary microinjection (OM; N = 457), which uses injection pressure in place of vibration. None of the eggs in the OM group achieved the zero-second piercing time. Compared to the OM, the VM group showed a significantly shorter piercing time, 1.80 vs. 10.69 s on average, and a significantly better survival rate, 90.3 vs. 81.8% on average. VMS6_2 not only improved on the already demonstrated superiority of VM to OM but also enabled instantaneous piercing of the cell membrane.

A comparative analysis of Vamana and ShamanaChikitsa in prediabetes management: A randomized clinical trial

BackgroundPrediabetes is a condition before manifestation of diabetes. It is associated with biochemical change in body due to disturbances in food habits, sleep patterns and sedentary lifestyle. Conventional system of medicine has limitations, however Ayurvedic medicines can be effective for management of this condition. ObjectiveTo compare the efficacy of Vamana Karma (∼therapeutic emesis) followed by Darvyadi Kwatha (∼herbal decoction) with that of oral medication of Darvyadi Kwatha with lifestyle modification in reducing HbA1c of the prediabetic participants. MethodologyAfter approval of IEC and registration under clinical trial registry of India, 40 patients were registered in two groups suffering from prediabetes in the trial. The primary criteria were HBA1c, FBS & PPBS along with secondary criterias like Agnibala (∼strength of digestion and metabolism), Dehabala (physical strength) and Satvabala (mental strength) relief in signs & symptoms of Prameha and quality of life (SF-36 Score). ResultsStatistically significant results were observed in both the parameters: (primary & secondary) within the group [VM group (HbA1c (<0.001), FBS (<0.001) & PPBS (<0.001) and SM group (HbA1c (<0.001), FBS (<0.001) & PPBS (<0.001)] and between the group [HbA1c (P < 0.01), FBS (P < 0.01), SF-36 score (P < 0.001) as well. ConclusionThe present clinical study suggests that there is significant improvement between the groups. On comparision, it was found that treating prediabete.s Shodhana was more safe & effective than Shamana.

Comparing Efficacy of Standard Vs Modified Valsalva Maneuver in Terminating Paroxysmal Supraventricular Tachycardia

Aim: To know whether valsalva maneuver is more effective compared to modified valsalva in terminating paroxysmal supraventricular tachycardia or vice versa. Method: The study design was randomized controlled trial. This research was conducted in accident &amp; emergency department of Mayo hospital, Lahore. Duration of this study was nine months. Participants were divided in two groups, half were assigned in Standard VM group (Group A), and other half in Modified VM group (Group B). In both groups, assigned valsalva maneuver was repeated up to two times, only when paroxysmal supraventricular tachycardia did not revert to sinus rhythm on first time. In those patients, VM failed even after three attempts, antiarrhythmic medications were used. Primary outcome was defined on the basis of successful return of sinus rhythm after either by standard or modified valsalva maneuver. Results: Sixty two patients were included in this study, thirty one in each group. Out of thirty one patients in group A, two patients (3.2%) rhythm reverted to sinus, while in group B, seven patients (11.3%) rhythm reverted to sinus. The number of patients who needed rescue treatment was lower in group B -21 (77.4%) as compared to group A- 29(93.5%). Conclusion: The results of this study showed that modified VM was more effective in terminating PSVT as compared to standard VM. So, number of patients who required pharmacological cardioversion was lower in group B. Keywords: Supraventricular tachycardia (SVT), Standard valsalva maneuver (SVM), Modified valsalva maneuver (MVM)

RESPONSE OF FIBROBLASTS, MAST CELLS AND LIVER COLLAGEN ON FORMATION OF EXPERIMENTAL AMYLOIDOSIS

The aim of the study was to quantify the response of fibroblasts, mast cells and liver collagen to formation of experimental amyloidosis. Material and methods. All mice were kept on a standard vivarium diet. Experimental mice underwent formation of amyloidosis by subcutaneous administration of soy cream substitute. Intact mice (IG – 3 specimen) and the internal control group for amyloidosis development (KM – 3 specimen) received water in a free access mode. For mice of the second (VM – 3) and third groups (VFM – 3), water was replaced with dry red grape wine "Cabernet Sauvignon" (Crimea) with an ethyl alcohol content of 10–12°, sugar – 5–10 mg/dm³ against the background of amyloidosis. In addition, fructose 5 g/100 ml of wine was added to the wine of VFM group. To assess the relative area of amyloid-free collagen fibers, dewaxed liver sections were stained using the tricolor technique developed by V.A. Kozlov et al. (2017), to assess the relative area of amyloid deposits and to count fibroblasts (FB) – staining with hematoxylin and Congo red, to identify mast cells (TC) and to assess their functionality – Unna's method. The functional state of mast cells was assessed by the degranulation index (ID) and the sulfatation index (IC) which we proposed earlier. The obtained numerical data were used to calculate a new statistical value – the TC/FB index. The data are presented in the form of mean values and median values indicating the percentiles 10 and 90. Differences of the groups were determined using z‑test. Differences in median values were determined using F-test. Results and their discussion. Liver sections of intact mice corresponded to the histological norm. The relative area of amyloid in the liver sections in CM group was 15.2±2.26%, VM group – 1.9±2.1 and VMF group – 2.5±2.9% (p= 0.0000). The relative area of amyloid–free collagen fibers in IG was 0.50±0.18%, in KM is 0.11±0.03 (p = 0.0151), in VM is 0.51±0.16 and in VMF – 0.69±0.18%. ID in IG – 0.38±0.19, KM – 0.39±0.2, VM – 0.55±0.09, VMF – 1.03±0.19 (p = 0.0065 to IG). IS in IG – 0.57±0.19, KM – 0.38±0.2, VM – 0.54±0.09, VMF – 1.23±0.17 (p = 0.0051 to IG). The median values of TC number in IG were 0.8 (0.5¸1.3), KM – 0.4 (0.3¸0.5), VM – 3.0 (2.0¸3.7), VMF – 2.0 (1.3¸3.0), to IG p &lt; 0.05 in all cases. The median values of the FB number in IG were 35.3 (29.9¸39.9), KM – 40.1 (26.1¸55.4), VM – 28.6 (20.3¸33.7), to IG p &lt; 0.05 in all cases, VMF – 51.3 (46.2¸55.4), p &gt; 0.5. The median values of the TC/FB index in IG were 0.022 (0.013¸0.038), KM – 0.009 (0.007¸0.012), p = 0.0000, VM – 0.11 (0.063¸0.167), p = 0.0012, VMF – 0.037 (0.024¸0.06). Conclusions. When forming experimental amyloidosis in the liver of mice, there is a decrease in the number of TC with a parallel increase in the number of FB per field of vision. Substitution of water in the diet of mice by dry red grape wine inhibits the development of changes characteristic of experimental amyloidosis induced by soy cream substitute. A new statistical value – the TC/FB index reflects both the severity of amyloid liver damage and the effectiveness of preventive measures in the form of substituting water by wine.

Three-muscle surgery for large-angle esotropia in chronic sixth nerve palsy: comparison of two approaches

AimsTo report the effect of two three-muscle surgeries, inferior rectus belly transposition plus augmented superior rectus transposition plus medial rectus recession (ISM) and modified vertical rectus belly transposition plus medial...

Melatonin promotes in vitro maturation of vitrified-warmed mouse GV oocytes potentially by modulating MAD2 protein expression of SAC component through MTRs

Previous studies have shown that melatonin (MT) can ameliorate vitrification-inflicted damage in mouse germinal vesicle (GV) oocytes, however, the key mechanistic basis of this improvement still remains poorly understood. This study was conducted to investigate whether MT can improve in vitro developmental potential of vitrified-warmed GV oocytes through its receptors. The fresh oocytes were randomly divided into four groups: untreated (control group, F), vitrified by open-pulled straw method (vitrification group, V), vitrification group with 100 nmol/L MT supplementation (vitrification + MT group, VM), and with 100 nmol/L MT plus 100 nmol/L luzindole administration (vitrification + MT + luzindole group, VML) or with 50 nmol/L ramelteon addition (vitrification + ramelteon group; VR). After warming, oocytes were cultured in vitro, and MT receptors (MTRs), MAD2 (mitotic arrest deficient 2), Securin and CyclinB1 protein levels and spindle morphology were evaluated. The ratio of oocytes developed to the metaphase I (MI) and metaphase II (MII) stages was also assessed. The results showed that after vitrification-warming, the in vitro maturation rate of GV oocytes was significantly lower compared to the control (F) group. Vitrification also significantly impaired the spindle morphology, decreased the protein level of MTRs and Securin, and decreased MAD2 levels in MI oocytes. However, when MT or ramelteon (MTRs agonist) were added (group wise) to warming and maturation media, the maturation rate of GV oocytes was significantly increased, the normal proportion of the spindle morphology increased, and the expression level of MAD2 increased in their resulting MI oocytes compared to the vitrification group. However, following addition of both MT and ramelteon, the maturation rate of GV oocyte showed no significant difference between VML and vitrification groups. The spindle morphology and MAD2 levels in MI oocytes were comparable to the vitrification group but differed significantly from the VM group. Taken together, finding of the present study shows that MT (100 nmol/L) can ameliorate the in vitro maturation of vitrified-warmed mouse GV oocytes, potentially by improving the spindle morphology, modulating MAD2 protein level and promoting the development of MI stage oocytes through MTRs.

The Effect of Virtual Reality Technology on the Imagery Skills and Performance of Target-Based Sports Athletes

The aim of this study is the examination of the effect of virtual reality based imagery (VRBI) training programs on the shot performance and imagery skills of athletes and, and to conduct a comparison with Visual Motor Behavior Rehearsal and Video Modeling (VMBR + VM). In the research, mixed research method and sequential explanatory design were used. In the quantitative dimension of the study the semi-experimental model was used, and in the qualitative dimension the case study design was adopted. The research participants were selected from athletes who were involved in our target sports: curling (n = 14), bowling (n = 13), and archery (n = 7). All participants were randomly assigned to VMBR + VM (n = 11), VRBI (n = 12), and Control (n = 11) groups through the “Research Randomizer” program. The quantitative data of the study was: the weekly shot performance scores of the athletes and the data obtained from the “Movement Imagery Questionnaire-Revised.” The qualitative data was obtained from the data collected from the semi-structured interview guide, which was developed by researchers and field experts. According to the results obtained from the study, there were statistically significant differences between the groups in terms of shot performance and imagery skills. VRBI training athletes showed more improvement in the 4-week period than the athletes in the VMBR + VM group, in terms of both shot performance and imagery skills. In addition, the VRBI group adapted to the imagery training earlier than the VMBR + VM group. As a result, it was seen that they showed faster development in shot performances. From these findings, it can be said that VRBI program is more efficient in terms of shot performance and imagery skills than VMBR + VM, which is the most used imaging training model.

Effects of oocyte vitrification on the behaviors and physiological indexes of aged first filial generation mice

To evaluate the long-term effects of oocyte cryopreservation on the health of the first filial generation (F1), we used B6D2F1 mice for oocyte collection, in vitro fertilization, and breeding. The female F1 mice born from the offspring of fresh mature oocytes (control group) and from the offspring of vitrified oocytes with traditional vitrification medium (VM group) and new improved vitrification medium (2P10E7D group) were maintained until 14–15 months of age for behavioral tests and 16–17 months of age for physiological analyses. Behavioral indexes, including anxiety-like status, discrimination ability, learning and memory ability, were investigated. Physiological indexes including body weight, body fat, heart rate, blood pressure, and blood lipids were also analyzed. In our results, the behavioral indexes, body weight, body fat, heart rate, blood pressure, total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL) did not show significant differences among the three groups. However, the triglyceride (TG) level of the VM group was higher than that of the 2P10E7D group. Moreover, compared with the control group, both the VM group and the 2P10E7D group showed greatly increased diastolic blood pressure. This study is the first to report that oocyte vitrification might affect metabolic physiological indexes via transgenerational inheritance rather than behaviors related to anxiety-like status and cognitive ability. Furthermore, different vitrification media might have differential transgenerational effects.

Vildagliptin Versus α-Glucosidase Inhibitor as Add-On to Metformin for Type 2 Diabetes: Subgroup Analysis of the China Prospective Diabetes Study.

IntroductionThe effect of dipeptidyl peptidase-4 (DDP-4) inhibitors versus α-glucosidase inhibitors (AGIs) on the treatment of type 2 diabetes mellitus (T2DM) in a real-world setting is unknown. The aim of this real-world study was to compare the glucose-lowering effect and tolerability of vildagliptin as add-on to metformin monotherapy (VM) and AGI as add-on to metformin monotherapy (AM) in Chinese patients with T2DM.MethodsThis was a subgroup analysis of the China Prospective Diabetes Study, a post-marketing, prospective, observational, real-world study conducted at 52 centers in China. T2DM patients with inadequate glycemic control on metformin monotherapy who received VM or AM were included. The composite primary endpoint was glycemic control (hemoglobin A1c [HbA1c] < 7%) after 12 months in the absence of tolerability events (hypoglycemia, weight gain ≥ 3%, or gastrointestinal events leading to treatment discontinuation). Propensity score matching (PSM) was used to balance the two groups.ResultsThe success rates of the composite endpoint were higher in the VM group (n = 604/159 before/after PSM) than in the AM group (n = 159/157 before/after PSM), but the difference was not statistically significant (before PSM: 53.0 vs. 46.5%, P = 0.148; after PSM: 56.7 vs. 45.9%, P = 0.055). The glycemic control rate and HbA1c reduction were similar between groups at 3, 6, and 12 months. Compared with the AM group, the VM group had lower risks of any tolerability event (relative risk [RR] 0.53, 95% confidence interval [CI] 0.33–0.83, P = 0.006), of any adverse event (AE) (RR 0.64, 95% CI 0.41–1.00, P = 0.049), and of any serious AE (RR 0.45, 95% CI 0.25–0.81, P = 0.007).ConclusionThe results of this real-world study suggest that vildagliptin as add-on to metformin monotherapy had a similar glucose-lowering effect to AGI as add-on to metformin monotherapy, but with better safety.Electronic Supplementary MaterialThe online version of this article (10.1007/s13300-019-00742-8) contains supplementary material, which is available to authorized users.

The assessment of the biometric parameters with fetal MR imaging in fetuses with mild-isolated ventriculomegaly

Objective: To evaluate the biometric parameters of fetal brain in mild-isolated ventriculomegaly (VM) by using fetal brain magnetic resonance (MR) imaging.Materials and methods: In this retrospective study, we reviewed the fetal brain biometry in 36 fetuses with mild-isolated VM and 34 fetuses who had no central nervous system abnormality by using MR imaging. All of the images were interpreted by two radiologists. The evaluated parameters of both groups were tegmento-vermian angle, anteroposterior and superoinferior diameter of vermis, length of the corpus callosum, fronto-occipital diameter, laterolateral diameter of the cerebellum, cerebral and calvarial biparietal diameter, width of interhemispheric distance, third ventricle, and cisterna magna. Results: The mean gestational age was not significantly different between the normal group and mild-isolated VM group 24.73 (SD ± 0.60) and 24.52 (SD ± 0.64), respectively (p=0.595). No statistically significant difference was found in biometric parameters between the groups (p &amp;gt; 0.05). The anteroposterior and superoinferior diameter of the vermis, length of the corpus callosum, fronto-occipital diameter, cerebellar laterolateral diameter, cerebral and calvarial biparietal diameter increased and tegmento-vermian angle decreased with gestational age. Interhemispheric distance and third ventricle diameter were stable in both groups, and the width of cisterna magna also was stable in the normal group, while tended to be increased in the mild-isolated VM group. Conclusion: Intracranial anatomy should be evaluated carefully in fetuses with VM to rule out associated abnormalities although no differences in biometric values between normal and isolated VM groups in our study. Further studies are required to reach more accurate results.

Behaviour outcomes in children with epilepsy 1 year after surgical resection of the ventromedial prefrontal cortex

Early damage to the ventromedial prefrontal cortex (VM) has been associated with impaired behavioural functioning in children without epilepsy, yet behaviour in children with epilepsy and VM lesions has not been investigated. The primary aim of this study was to examine behavioural outcomes in children with epilepsy emanating from the VM preoperatively and one year after epilepsy surgery compared to the general population and matched epilepsy controls. Behavioural outcomes were defined as comprising both problems and competencies (i.e. social, school and co-curricular performance). A secondary aim was to examine whether seizure outcome, number of antiepileptic drugs (AEDs), or age at surgery related to behavioural outcomes. Ratings on the Child Behavior Checklist were examined preoperatively and 1 year after surgery for 20 children with epilepsy who had undergone surgical resection of the VM (N = 10) or temporal lobe (TL, N = 10). VM and TL groups were comparable on Full Scale IQ (40–101), age of seizure onset (0.5–9.0 years), age at surgery (3.1–16.9 years), seizure laterality (5 left in each group), age at assessments, sex (3 female in VM group, 2 female in TL group) and seizure outcome (7 seizure free in VM group, 6 seizure free in TL group). The VM group had significantly elevated behaviour problems (i.e. withdrawn, thought, social and attention problems) and reduced competencies (i.e. social and school) compared to the general population before and after surgery. VM and TL cases did not differ on any behaviour problem scales pre or postoperatively and neither group showed significant change in functioning over time; however, VM patients had significantly lower total competence than TL patients postoperatively. A significant seizure outcome × time interaction was observed: children who were seizure free following surgery (collapsed across surgical site) showed an improvement in total behaviour problems and aggression at 1 year follow-up, whereas children with ongoing seizures showed a deterioration in these domains. In conclusion, VM lesions in children with epilepsy are associated with behavioural problems but their profile does not differ from that of children with temporal lobe epilepsy. These results are consistent with the concept that seizures arise from epileptogenic networks that may affect multiple cortical areas, even when onset is in a focal site.

Alginate-coated chitosan microparticles encapsulating an oral plasmid-cured live Salmonella enterica serovar Gallinarum vaccine cause a higher expression of interferon-gamma in chickens compared to the parenteral live vaccine

ABSTRACTSalmonella enterica serovar Gallinarum causes a disease in chickens known as fowl typhoid. Interferon-gamma (IFN-γ) has been shown to be crucial in eliminating salmonellosis infection because of its strong association with T-cell responses. This study was undertaken to compare the expression of IFN-γ in chickens generated by different vaccine formulations. Eighty one-day-old Lohmann layer chicks were divided into four groups of 20 birds each for the experiment. This comprised an unvaccinated negative control group (NEG), a group vaccinated with the live 9R vaccine by the injection route (SC), a group vaccinated with alginate-coated chitosan microparticles encapsulating live plasmid-cured S. Gallinarum strain 9 (PC) by the oral route, and a group vaccinated with a weak attenuated live S. Gallinarum strain 9 encapsulated in alginate-coated chitosan microparticles (VM) given orally. Vaccinations were done at 10 and 14 weeks of age followed by challenge at 16 weeks of age. IgG was measured using ELISA. qRT-PCR was used to compare the mRNA fold expression of IFN-γ in the PC, VM and SC groups using the unvaccinated/unchallenged group as the control. There were significant differences in the IgG levels between each vaccinated group and the unvaccinated group (P < 0.05) after booster vaccination and post-challenge. There was 100% protection of the birds in SC and VM groups, 80% protection in PC group and 0% protection in the NEG group. Using 2−ΔΔCT calculation, IFN-γ was more highly expressed in the PC group than in the SC group or VM group. In conclusion, the IFN-γ was more highly expressed in the PC group (though not significantly higher) compared to the SC and VM groups and this could be attributed to the alginate-coated chitosan microparticles which acted as an adjuvant.

Pain inhibition through transplantation of fetal neuronal progenitors into the injured spinal cord in rats.

Neuropathic pain after spinal cord injury (SCI) is a complex condition that responds poorly to usual treatments. Cell transplantation represents a promising therapy; nevertheless, the ideal cell type in terms of neurogenic potential and effectiveness against pain remains largely controversial. Here, we evaluated the ability of fetal neural stem cells (fNSC) to relieve chronic pain and, secondarily, their effects on motor recovery. Adult Wistar rats with traumatic SCI were treated, 10 days after injury, with intra-spinal injections of culture medium (sham) or fNSCs extracted from telencephalic vesicles (TV group) or the ventral medulla (VM group) of E/14 embryos. Sensory (von Frey filaments and hot plate) and motor (the Basso, Beattie, Bresnahan locomotor rating scale and inclined plane test) assessments were performed during 8 weeks. Thereafter, spinal cords were processed for immunofluorescence and transplanted cells were quantified by stereology. The results showed improvement of thermal hyperalgesia in the TV and VM groups at 4 and 5 weeks after transplantation, respectively. Moreover, mechanical allodynia improved in both the TV and VM groups at 8 weeks. No significant motor recovery was observed in the TV or VM groups compared with sham. Stereological analyses showed that ~70% of TV and VM cells differentiated into NeuN+ neurons, with a high proportion of enkephalinergic and GABAergic cells in the TV group and enkephalinergic and serotoninergic cells in the VM group. Our study suggests that neuronal precursors from TV and VM, once implanted into the injured spinal cord, maturate into different neuronal subtypes, mainly GABAergic, serotoninergic, and enkephalinergic, and all subtypes alleviate pain, despite no significant motor recovery. The study was approved by the Animal Ethics Committee of the Medical School of the University of São Paulo (protocol number 033/14) on March 4, 2016.

Long-term feeding with high plant protein based diets in gilthead seabream (Sparus aurata, L.) leads to changes in the inflammatory and immune related gene expression at intestinal level

BackgroundIn order to ensure sustainability of aquaculture production of carnivourous fish species such as the gilthead seabream (Sparus aurata, L.), the impact of the inclusion of alternative protein sources to fishmeal, including plants, has been assessed. With the aim of evaluating long-term effects of vegetable diets on growth and intestinal status of the on-growing gilthead seabream (initial weight = 129 g), three experimental diets were tested: a strict plant protein-based diet (VM), a fishmeal based diet (FM) and a plant protein-based diet with 15% of marine ingredients (squid and krill meal) alternative to fishmeal (VM+). Intestines were sampled after 154 days. Besides studying growth parameters and survival, the gene expression related to inflammatory response, immune system, epithelia integrity and digestive process was analysed in the foregut and hindgut sections, as well as different histological parameters in the foregut.ResultsThere were no differences in growth performance (p = 0.2703) and feed utilization (p = 0.1536), although a greater fish mortality was recorded in the VM group (p = 0.0141). In addition, this group reported a lower expression in genes related to pro-inflammatory response, as Interleukine-1β (il1β, p = 0.0415), Interleukine-6 (il6, p = 0.0347) and cyclooxigenase-2 (cox2, p = 0.0014), immune-related genes as immunoglobulin M (igm, p = 0.0002) or bacterial defence genes as alkaline phosphatase (alp, p = 0.0069). In contrast, the VM+ group yielded similar survival rate to FM (p = 0.0141) and the gene expression patterns indicated a greater induction of the inflammatory and immune markers (il1β, cox2 and igm). However, major histological changes in gut were not detected.ConclusionsUsing plants as the unique source of protein on a long term basis, replacing fishmeal in aqua feeds for gilthead seabream, may have been the reason of a decrease in the level of different pro-inflammatory mediators (il1 β, il6 and cox2) and immune-related molecules (igm and alp), which reflects a possible lack of local immune response at the intestinal mucosa, explaining the higher mortality observed. Krill and squid meal inclusion in vegetable diets, even at low concentrations, provided an improvement in nutrition and survival parameters compared to strictly plant protein based diets as VM, maybe explained by the maintenance of an effective immune response throughout the assay.

Comparison of the efficacy of vocal training and vocal microsurgery in patients with early vocal fold polyp

IntroductionVocal fold polyp is a benign proliferative disease in the superficial lamina propria of the vocal fold, and vocal microsurgery can improve the voice quality of patients with vocal fold polyp. In preliminary studies, we found that vocal training could improve the vocal quality of patients with early vocal fold polyp. ObjectiveThis study aimed to compare the efficacies of vocal training and vocal microsurgery in patients with early vocal fold polyp. MethodsA total of 38 patients with early vocal fold polyp underwent 3 months of vocal training (VT group); another 31 patients with early vocal fold polyp underwent vocal microsurgery (VM group). All subjects were assessed using laryngostroboscopy, voice handicap index, and dysphonia severity index, and the efficacies of vocal training and vocal microsurgery were compared. ResultsThe cure rates of vocal training and vocal microsurgery were 31.6% (12/38) and 100% (31/31), respectively. The intragroup paired-sample t-test showed that the post treatment vocal handicap index, maximum phonation time, highest frequency (F0-high), lowest intensity (I-low), and dysphonia severity index in both the VT and VM groups were better than those before treatment, except for the jitter value. The intergroup independent-sample t-test revealed that the emotional values of vocal handicap index (t=−2.22, p=0.03), maximum phonation time (t=2.54, p=0.013), jitter (t=−2.11, p=0.03), and dysphonia severity index (t=3.24, p=0.002) in the VT group were better than those in the VM group. ConclusionsBoth, vocal training and vocal microsurgery could improve the voice quality of patients with early vocal fold polyp, and these methods present different advantages.

Light transmittance of CAD/CAM ceramics with different shades and thicknesses and microhardness of the underlying light-cured resin cement

ObjectivesThe aim of this in vitro study was to evaluate the effects of the thickness and shade of 3 types of computer-aided design/computer-aided manufacturing (CAD/CAM) materials.Materials and MethodsA total of 120 specimens of 2 shades (A1 and A3) and 2 thicknesses (1 and 2 mm) were fabricated using VITA Mark II (VM; VITA Zahnfabrik), IPS e.max CAD (IE; IvoclarVivadent), and VITA Suprinity (VS; VITA Zahnfabrik) (n = 10 per subgroup). The amount of light transmission through the ceramic specimens was measured by a radiometer (Optilux, Kerr). Light-cured resin cement samples (Choice 2, Bisco) were fabricated in a Teflon mold and activated through the various ceramics with different shades and thicknesses using an LED unit (Bluephase, IvoclarVivadent). In the control group, the resin cement sample was directly light-cured without any ceramic. Vickers microhardness indentations were made on the resin surfaces (KoopaPazhoohesh) after 24 hours of dark storage in a 37°C incubator. Data were analyzed using analysis of variance followed by the Tukey post hoc test (α = 0.05).ResultsCeramic thickness and shade had significant effects on light transmission and the microhardness of all specimens (p < 0.05). The mean values of light transmittance and microhardness of the resin cement in the VM group were significantly higher than those observed in the IE and VS groups. The lowest microhardness was observed in the VS group, due to the lowest level of light transmission (p < 0.05).ConclusionGreater thickness and darker shades of the 3 types of CAD/CAM ceramics significantly decreased the microhardness of the underlying resin cement.

Comparison of Morcellation Techniques at the Time of Laparoscopic Hysterectomy and Myomectomy

Study ObjectiveTo compare perioperative outcomes associated with the use of 3 techniques for tissue removal at the time of laparoscopic hysterectomy and myomectomy. DesignA retrospective cohort study (Canadian Task Force classification II-2). SettingAn academic hospital in Boston, MA. PatientsWomen who underwent a laparoscopic or robot-assisted laparoscopic hysterectomy or myomectomy involving tissue morcellation in 2014. InterventionsOne of 3 morcellation techniques: electronic power morcellation (PM), manual vaginal morcellation via the vagina (VM), or manual morcellation via minilaparotomy (ML). Measurements and Main ResultsOf the 297 cases included in this study (137 myomectomies, 62 total laparoscopic hysterectomies, and 98 laparoscopic supracervical hysterectomies), 96% of the cases were performed by fellowship-trained surgeons using conventional laparoscopy. Containment bags were used at the time of tissue extraction in 77% of the cases. Baseline characteristics and perioperative outcomes were similar in all groups. In hysterectomy cases, the average specimen size was largest in the ML group (591 ± 419 g in the ML group compared with 368 ± 293 g in the PM group and 449 ± 175 g in the VM group, p = .0009). After multivariate regression, no significant difference was found in blood loss, length of stay, or complications. The operative time was shorter in the PM group compared with the ML group by 16 minutes (mean = 140 minutes [95% confidence interval, 130–149 minutes] compared with 156 [95% confidence interval, 146–167], p = .02); this association remained significant once additionally adjusting for the use or nonuse of containment bags (p = .05). ConclusionWe did not detect a significant difference between the 3 morcellation techniques when comparing the perioperative complications although the longest operative times were noted for the minilaparotomy approach. All 3 morcellation techniques represent viable options for tissue extraction at the time of minimally invasive surgery.