Anal PAP, HPV tests and magnifying chromoendoscopy with biopsies in the diagnosis of anal intraephitelial neoplasia / Papanicolau anal, testes de HPV e cromoendoscopia de ampliação com biópsias no diagnóstico de neoplasia intraepitelial anal

Abstract Introduction: Anal intraepithelial neoplasia (AIN) is the most likely precursor of squamous cells cancer which represents 90% of anal cancers. The use of biomolecular tests as a screening method has been extended by gynecology. Given the similarities that exist between the HPV disease in the lower genital tract and anorectal sectors, it is expected that HPV tests can provide information for the diagnosis, treatment and follow-up for AIN-affected patients. Objectives: Comparing the performance of anal cytology, PAP and HPV tests (Hybrid Capture and Papillocheck) against the histology of the diagnosis of low- and high-grade AIN in risk groups. Material and methods: A cross-sectional study was carried out to evaluate diagnostic methods for low- and high-grade AIN in 73 patients. Samples for anal PAP, Papillocheck and Hybrid Capture were taken from all patients who then, regardless of the results, underwent magnifying chromoendoscopy (MCE) along with biopsy. Diagnostic test performances and their 95% confidence intervals (CI: 95%) were calculated as well as the likelihood ratio for each test. Results: Of the 73 patients, 49 (67%) were women. The average age of the patients was 38 years. In 38 patients (52%), the histology was positive with 10 (14%) grade II AIN or higher. There were no statistically significant differences in sensitivity nor in specificity for low- and high-grade AINs between any of the tests. Conclusion: Anal PAP, the Hybrid Capture test (HC2, Qiagen) and PapilloCheck (Greiner Bio One) were highly sensitive but not specific for low- and high-grade AINs. Therefore, a biopsy should be conducted against a positive result of any of the tests to confirm AIN and the degree of dysplasia. The screening method selection depend on the availability but also costs of the test should be considered, since all the diagnostic tests have similar performance.

Resumo Introdução: A neoplasia intraepitelial anal é o precursor mais provável do câncer de células escamosas, que representa 90% dos tumores anais. O uso de exames biomoleculares como método de triagem foi ampliado pela ginecologia. Considerando-se as semelhanças entre as apresentações de HPV no trato genital inferior e anorretal, espera-se que os exames de HPV possam fornecer informações para o diagnóstico, tratamento e acompanhamento dos pacientes com neoplasia intraepitelial anal. Objetivo: Comparar o desempenho da citologia anal, Papanicolau, exames para HPV (teste de captura híbrida e Papillocheck) e histologia no diagnóstico de neoplasia intraepitelial anal de baixo e alto grau em grupos de risco. Material e métodos: Foi realizado um estudo transversal para avaliar métodos de diagnóstico de neoplasia intraepitelial anal de baixo e alto grau em 73 pacientes. Amostras para Papanicolau anal, Papillocheck e captura híbrida foram coletadas de todos os pacientes; independentemente dos resultados desses exames, todos foram submetidos a cromoendoscopia de ampliação (CEA) e biópsia. O desempenho dos exames e seus intervalos de confiança de 95% (95% CI) foram calculados, bem como a razão de verossimilhança para cada teste. Resultados: Dos 73 pacientes, 49 (67%) eram mulheres. A idade média dos pacientes foi de 38 anos. A histologia foi positiva em 38 pacientes (52%), dos quais dez (14%) apresentaram neoplasia intraepitelial anal grau II ou superior. Não foram observadas diferenças estatisticamente significativas na sensibilidade ou especificidade para as neoplasias intraepiteliais anal de baixo e alto grau entre qualquer um dos exames. Conclusão: O Papanicolau anal, o teste de captura híbrida (HC2, Qiagen) e o Papillocheck (Greiner Bio One) foram altamente sensíveis, mas não específicos para neoplasia intraepitelial anal de baixo e alto grau. Portanto, uma biópsia deve ser realizada após um resultado positivo em qualquer um dos testes para confirmar o diagnóstico de neoplasia intraepitelial anal e seu grau. A seleção do método de triagem depende da disponibilidade, mas os custos devem ser considerados, uma vez que todos os testes apresentam desempenho semelhante.

Improvement in affinity and thermostability of a fully human antibody against interleukin-17A by yeast-display technology and CDR grafting

Monoclonal antibodies (mAbs) are widely used in many fields due to their high specificity and ability to recognize a broad range of antigens. IL-17A can induce a rapid inflammatory response both alone and synergistically with other proinflammatory cytokines. Accumulating evidence suggests that therapeutic intervention of IL-17A signaling offers an attractive treatment option for autoimmune diseases and cancer. Here, we present a combinatorial approach for optimizing the affinity and thermostability of a novel anti-hIL-17A antibody. From a large naïve phage-displayed library, we isolated the anti-IL-17A mAb 7H9 that can neutralize the effects of recombinant human IL-17A. However, the modest neutralization potency and poor thermostability limit its therapeutic applications. affinity optimization was then used to generate 8D3 by using yeast-displayed random mutagenesis libraries. This resulted in four key amino acid changes and provided an approximately 15-fold potency increase in a cell-based neutralization assay. Complementarity-determining regions (CDRs) of 8D3 were further grafted onto the stable framework of the huFv 4D5 to improve thermostability. The resulting hybrid antibody 9NT/S has superior stabilization and affinities beyond its original antibody. Human fibrosarcoma cell-based assays and analyses in mice indicated that the anti-IL-17A antibody 9NT/S efficiently inhibited the secretion of IL-17A-induced proinflammatory cytokines. Therefore, this lead anti-IL-17A mAb might be used as a potential best-in-class candidate for treating IL-17A related diseases.

Research Progress of the Relationship between the Expression of TAR DNA-bind-ing Domain Protein 43 and Brain Injury / 法医学杂志

T A R D N A-binding dom ain protein 43 (T D P-43) is a highly conserved and w idely expressed nuclear protein. N ow adays, the expression of T D P-43 can be found in m ost neurodegenerative diseases such as A lzheim er's disease, w hich m akes it becom e a neurodegenerative disease associated m arker pro-tein. From the current research status at hom eland and abroad, and around the relationship betw een the expression of T D P-43 and brain injury, this article em phatically probes into the specific expression and function of T D P-43 in acute and chronic brain injury based on the know ledge of its biological charac-teristics, w hich aim s to explore the feasibility for determ ining the cause of death and the injury and dis-ability situations by T D P-43 in forensic pathology.

Una opción para restaurar la musculatura intrínseca cubital cuando el nervio interóseo anterior no se encuentra disponible / An option to restore ulnar intrinsic muscles when the anterior interosseus nerve is not available

Resumen: Antecedentes: Las lesiones de nervio periférico, principalmente las traumáticas, tienen efectos devastadores para la función. Tradicionalmente las opciones eran en forma temprana el injerto nervioso y en forma tardía la transferencia tendinosa. Durante los últimos años se han venido realizando transferencias nerviosas cuando la lesión es temprana y la placa motora aún es viable. Los resultados en su mayoría son superiores a los injertos nerviosos y a las transferencias tendinosas. Métodos y resultados: Se presenta el caso de una paciente que sufrió lesión de nervio mediano y cubital en el antebrazo y se utilizaron las ramas redundantes de los músculos extensor carpi ulnaris y extensor digiti quinti. Los resultados fueron buenos a los cuatro años. Conclusión: Cuando existe un déficit de la musculatura intrínseca cubital de la mano, el donador favorito es la rama terminal del nervio interóseo anterior. Cuando éste no se encuentra, debemos tener opciones para restaurar esta función.

Abstract: Background: The peripheral nerve injuries are devastating for the patient; the classic reconstructive options are the Nerve Graft and Tendon Transfers. Lately the Nerve Transfers are being used more and more broadly. They are an excellent option on early injuries and when the motor plate is still alive. The advantages are numerous, because the functional recovery is much better. Methods and results: We report the case of a patient who sustained and injury on the median and ulnar nerve, so the EDQ and ECU branches were used to restore the Ulnar Intrinsic Function. The 4-year follow-up showed good results. Conclusion: The ulnar intrinsic innervations provide dexterity; fine motor function and pinch, which is essential for a functioning hand. The most popular donor to restore the function of the motor branch of the ulnar nerve is the anterior interosseous nerve. When this is unavailable the use of the redundant branches of the EDQ and ECU must be considered.

Caracterización de la niñez menor de 2 años, beneficiaria de la estrategia de AIN-C, Municipio de Curarén, área sur de Francisco Morazán, Honduras, febrero 2016

OBJETIVO: Caracterizar a la niñez menor de 2 años, integrados a la estrategia de AIN-C delproyecto descentralizado ChildFund en el municipio de Curaren, del área sur de Francisco Morazán, Honduras, Febrero 2016. Problema: Cómo se caracteriza la niñez menor de 2 años, integrada en la estrategia de AIN-Cdel proyecto descentralizado Child Fund en el municipio de Curaren, del área sur de Francisco Morazán, Honduras, febrero2016. MÉTODO: Se tomó una muestra de 134 niños beneficiarios de la estrategia de AIN-C, en elmunicipio de Curaren; a los cuales se les tomo talla y peso durante la visita de seguimiento enel mes de febrero, para realizar la valoración de desnutrición aguda, crónica y global, setomaron muestras de exámenes de laboratorio para detección de anemia 73 muestras y 56para detección de parasitismo intestinal y también se interrogó sobre el patrón alimentario,todo la información se procesó en una base de datos; la cual se analizó por el programa deEpiInfo 7. RESULTADOS: De los 134 niños 74(55%) mujeres y 60(45%) hombres. Índice antropométricoP/L-T: normal un 90%, 8% sobrepeso y 3% Emaciado. Índice antropométrico L-T/E: normal81%, baja talla 13%, baja talla severa 4.5% y muy alto para la edad 1.5%.Indice antropométrico P/E: 96% crecimiento adecuado y 4% crecimiento inadecuado. El 96% y 86%de la muestras de Hemoglobina (Hb)y heces fecales estaban en valores normales,respectivamente. En el patrón alimentario, el 84% de los niños recibió lactancia materna exclusiva y el 81% inicio su ablactación a los 6 meses. CONCLUSIÓN: Se realizó la clasificación de en base al índice antropométrico peso para la talla, talla para la edad y peso para la edad; en las tres mediciones la mayoría de los niños se encuentran dentro de los límites de referencia normal de acuerdo a las gráficas y concrecimiento adecuado; siendo la desnutrición global en donde salen mejor evaluados y la desnutrición crónica donde hay más problemas con los niños.

Incidental findings of Cysticercus tenuicollis metacestodes in five oryx species

Objective: To determine the prevalence of Cysticercus tenuicollis (C. tenuicollis) metacestodes in five oryx species kept in Al Ain Zoo animal collection. Methods: This study was based on a retrospective analysis of post-mortem records covering a four year period (July 2010 to July 2014). Results: A total of 213 individual animals were recorded dead during the four year period (July 2010 to July 2014). Out of this, 12 (5.6%) were recorded with C. tenuicollis. More females (8) than males (4) were recorded to have C. tenuicollis, although this was not statistically significant (P = 0.373. 7). Conclusions: This study shows that, Arabian oryx, beisa oryx, fringe-eared oryx, gemsbok and scimitar-horned oryx are susceptible to C. tenuicollis. Based on the epidemiology and the life cycle of this parasite, it is possible that these captive animals ingested the parasite through contaminated feed which could have happened in the pasture land or stray dogs and wild canidae (e.g. fox) visited the zoo contaminating the oryx feed. Stray dogs and wild canidae should be prevented from visiting pasture land and a captive animal facility.

Incidental findings of Cysticercus tenuicollis metacestodes in five oryx species

Objective: To determine the prevalence of Cysticercus tenuicollis (C. tenuicollis) met-acestodes in five oryx species kept in Al Ain Zoo animal collection. Methods: This study was based on a retrospective analysis of post-mortem records covering a four year period (July 2010 to July 2014). Results: A total of 213 individual animals were recorded dead during the four year period (July 2010 to July 2014). Out of this, 12 (5.6%) were recorded with C. tenuicollis. More females (8) than males (4) were recorded to have C. tenuicollis, although this was not statistically significant (P = 0.3737). Conclusions: This study shows that, Arabian oryx, beisa oryx, fringe-eared oryx, gemsbok and scimitar-horned oryx are susceptible to C. tenuicollis. Based on the epidemiology and the life cycle of this parasite, it is possible that these captive animals ingested the parasite through contaminated feed which could have happened in the pasture land or stray dogs and wild canidae (e.g. fox) visited the zoo contaminating the oryx feed. Stray dogs and wild canidae should be prevented from visiting pasture land and a captive animal facility.

Remoción de terceros molares mandibulares con asistencia endoscópica: nota técnica de un nuevo procedimiento quirúrgico para prevenir lesiones del NAI y formación de defectos óseos / Removal of mandibular third molars with endoscopic approach. Technical note of a new surgical procedure to avoid IAN damage and bone defect formation

La variada posición anatómica de los terceros molares mandibulares presenta importantes desafíos asociados a su profundidad y grado de inclinación. Las complicaciones más habituales del procedimiento quirúrgico convencional de extracción se relacionan con la extensa osteotomía y poca visualización del sitio quirúrgico, que pueden generar consecuencias post-quirúrgicas como inflamación, dolor, trismus, lesiones reversibles e irreversibles del nervio alveolar inferior (NAI) o nervio lingual, riesgo de fractura y formación de defectos periodontales del segundo molar. La implementación de soportes rígidos en la óptica endoscópica ha permitido utilizar esta tecnología para realizar abordajes mínimamente invasivos para remover terceros molares mediante accesos flapless con una mínima osteotomía de la zona oclusal, conservando la pared bucal y lingual a través de la visualización directa y magnificada del sitio quirúrgico, adaptable a los movimientos del paciente durante la intervención. En este reporte se presenta un nuevo procedimiento quirúrgico mínimamente invasivo a través de asistencia endoscópica para la conservación ósea en la remoción de terceros molares mandibulares con riesgo de lesión del nervio alveolar inferior.

Anatomic variability of the position of mandibular third molars represents significant challenges associated with its depth and angulation. The most common complications of conventional surgical procedure are related to extensive osteotomy and poor visualization, which can cause postsurgical effects such as inflammation, pain, trismus, reversible and irreversible lesions of the inferior alveolar nerve (IAN) or lingual nerve, fracture risk and formation of a deep periodontal defect on the distal aspect of the second molar. The implementation of rigid endoscopy in optics has allowed to use this technology via a minimally invasive approach to remove third molars by a minimally occlusal flapless ostectomy, preserving the buccal and lingual walls through direct and magnified visualization of the surgical site, adaptable to the patient’s movements during the surgery. In this report, we present a new and minimally invasive procedure through endoscopic assistance for bone conservation in the removal of third molars at risk of inferior alveolar nerve injury.

Effect of Cyclosporin A and Tetrandrine on rhodamine 123 accumulationin in bovine brain capillary endothelial cells / 中国药理学通报

Aim To study the effect of cyclosporin A and tetrand ri ne on P-glycoprotein (P-gp)of bovine brain capillary endothelial cell. M ethods The fluorescent dye, rhodamine-123 (Rh-123) was used to evaluate t he functional activity of the P-glycoprotein (P-gp) efflux transport system in primary cultured bovine brain capillary endothelial cell (BCEC) monolayer. Results Rhodamine-123 accumulation was increased significantly in monola yer treated with the P-gp modifying agent, cyclosporin A and tetrandrine. Conclusion The observation suggests that this Rh-123 method is sens itive, stable to evaluate the function of P-gp of blood-brain barrier (BBB). R h-123 accumulation is also increased by tetrandrine in dose-dependent manner.

Patient-Controlled Epidural Analgesia during Labor and Delivery / 대한마취과학회지

BACKGROUND: Epidural administration of dilute solution of local anesthetic and lipid-soluble opioid provides the best pain relief during labor and delivery. The purpose of this study was to evaluate the safety, efficacy and patient satisfaction of patient-controlled epidural analgesia compared with continuous infusion epidural analgesia. METHODS: Forty healthy full-term parturients who requested epidural analgesia were assigned randomly to either patient-controlled epidural analgesia (PCEA) group or continuous infusion epidural analgesia (CIEA) group. All parturients received proper dose of 0.25% bupivacaine with 0.0008% fentanyl to block T10 sensory level. PCEA was programmed as followings; no background infusion, a 4 ml bolus dose and 15min lock-out interval using 0.0625% bupivacaine with 0.0002% fentanyl. CIEA was started with the same solution at 12ml/hr constantly. RESULTS: Hourly requirement of 0.0625% bupivacaine (mean+/-SD 7.1+/-5.8 ml/hr, median 7.6 ml/hr in PCEA group and mean+/-SD 13.2+/-2.9 ml/hr, median 12 ml/hr in CIEA group) during labor was significantly reduced in PCEA group (p<0.05). Maternal satisfaction, obstetric and neonatal parameters were shown no statistically significant difference. Incidences of postpartum complications such as gait disturbance, urinary difficulty, pruritus, nausea and vomiting were rare in both groups. CONCLUSIONS: Patient-controlled epidural analgesia is safe and effective and has 37% sparing effect of bupivacaine dosage used per hour compared with continuous infusion epidural analgesia.