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1.
Water Environ Res ; 94(8): e10777, 2022 Aug.
Article in English | MEDLINE | ID: mdl-36004674

ABSTRACT

Dual upflow reactive filtration by a slowly moving sand bed with continuously renewed, hydrous ferric oxide-coated sand is used for removing polluting substances and for meeting the ultralow 0.05 mg/l total phosphorus discharge permit limits at a 1.2 million liters per day (0.32 million gallons per day) water resource recovery facility in Plummer, Idaho, in the United States. A life cycle assessment (LCA) of this reactive filtration installation was carried out to assess the environmental hotspots in the system and analyze alternative system configurations with a focus on CO2 equivalent (CO2 e) global warming potential, freshwater and marine eutrophication, and mineral resource scarcity. "What if" scenarios with alternative inputs for the energy, metal salts, and air compressor optimization show trade-offs between the impact categories. Key results that show a comparative reduction of global warming potential include the use of Fe versus Al metal salts, the use of renewable energy, and the energy efficiency benefit of optimizing process inputs, such as compressor air pressure, to match operational demand. The LCA shows a 2 × 10-2  kg CO2 e footprint per cubic meter of water, with 47% from housing concrete, and an overall freshwater eutrophication impact reduced by 99% versus no treatment. The use of renewable hydropower energy at this site isolates construction concrete as a target for lowering the CO2 e footprint. PRACTITIONER POINTS: The main LCA eco-impact hotspots in this dual reactive filtration tertiary treatment are construction concrete and the ferric sulfate used. Iron salts show smaller impact in global warming, freshwater eutrophication, and mineral resource scarcity than "what if scenario" aluminum salts. The energy mix for this site is predominantly hydropower; other energy mix "what if" scenarios show larger impacts. Operational energy efficiency and thermodynamic analysis show that fine tuning the air compressor helps reduce carbon footprint and energy use. LCA shows a favorable 2 x 10-2 kg CO2e/m3 water impact with 99% reduction of freshwater eutrophication potential versus no treatment.


Subject(s)
Phosphorus , Wastewater , Carbon Dioxide , Ferric Compounds , Minerals , Salts , Sand , Wastewater/analysis , Water
2.
Sci Rep ; 11(1): 1734, 2021 01 18.
Article in English | MEDLINE | ID: mdl-33462273

ABSTRACT

In order to deal with the arising environmental issues across the globe at present nano particles with unique properties laid a benchmark in the name of nano catalysis. In this work the significance of calcination temperature on the thermal, electronic, structural and surface properties of a nano catalyst produced by sol-gel method using ultrasonic radiation against the disposal of toxic textile pollutants is studied in detail. The extract of tea leaves has been used as a bio-template during the synthesis to revise the crystallite size, surface area, optical absorption potential, and rate of agglomeration of nano sized grains by regulating their physico-chemical and surface properties. The influence of calcination in the transformation of single phased anatase titania to mixed phase anatase-rutile titania and the corresponding outcome in its photocatalytic activity employed in water treatment applications have been verified. The nano catalyst obtained is characterized by X-ray diffraction (XRD), Scanning electron microscopy (SEM), Transition electron microscopy (TEM), Fourier transform infrared spectroscopy (FT-IR), Thermo gravimetric analysis (TGA), Brunaueur Emmett Teller (BET) analysis, UV-Vis diffused reflectance spectroscopy (DRS-UV-Vis) etc. The mesoporosity of the particle was examined using Barrett Joyner Halenda (BJH) model. The enhanced photo catalytic efficiency (about 97.7%) of templated nano titania due to calcination is verified against Congo red, a textile dye under optimized conditions. The nano catalyst produced can be easily separated, recycled to support its economic feasibility.

4.
Sci Rep ; 10(1): 8053, 2020 05 15.
Article in English | MEDLINE | ID: mdl-32415285

ABSTRACT

Milk is globally consumed as a rich source of protein and calcium. A major protein component of milk is casein, with ß-casein having 2 major variants A1 and A2. Of these, A1 casein variant has been implicated as a potential etiological factor in several pathologies, but direct effect on lungs has not been studied. The objective of the present study was to evaluate the A1and A2 ß casein variants of cow milk as factors causing allergic airway disease in murine model. Mice fed with A1A1 milk exhibited increased airway hyperresponsiveness with increasing concentration of bronchoconstrictor (methacholine), which was not observed in mice fed with A2A2 milk. Significantly elevated levels of IL-4 and IL-5 were found in bronchoalveolar lavage and serum of A1A1 variant fed mice. Increased IgE and IgG levels along with increased infiltration of lymphocytes and eosinophils, leading to peribronchial inflammation was also observed in A1A1 variant fed mice, although, no goblet cell hyperplasia or airway remodeling was observed. In contrast, A2A2 milk fed mice presented phenotype matching the control group, while A1A2 milk fed group presented an intermediate phenotype. In summary, our results show that A1 form of cow milk has a proinflammatory effect on the lung resulting in phenotype closely matching with the typical allergic asthma phenotype.


Subject(s)
Animal Feed/adverse effects , Caseins/adverse effects , Caseins/genetics , Disease Susceptibility , Genetic Variation , Milk/adverse effects , Pneumonia/etiology , Animals , Biomarkers , Cattle , Cytokines/metabolism , Eosinophils/immunology , Eosinophils/metabolism , Genotype , Immunoglobulin E/immunology , Immunoglobulin G/immunology , Inflammation Mediators/metabolism , Male , Mice , Mice, Inbred BALB C , Pneumonia/metabolism , Pneumonia/pathology , Th2 Cells/immunology , Th2 Cells/metabolism
5.
Eur Rev Med Pharmacol Sci ; 24(6): 3422-3425, 2020 03.
Article in English | MEDLINE | ID: mdl-32271461

ABSTRACT

The COVID-19 (Coronavirus disease 2019) spreads primarily through droplets of saliva or discharge from the nose. COVID-19 is predominantly considered as an unavoidable pandemic, and scientists are very curious about how to provide the best protection to the public before a vaccine can be made available. There is an urge to manufacture a greater number of masks to prevent any aerosol with microbes. Hence, we aim to develop an efficient viral inactivation system by exploiting active compounds from naturally occurring medicinal plants and infusing them into nanofiber-based respiratory masks. Our strategy is to develop fibrous filtration with three-layered masks using the compounds from medicinal plants for viral deactivation. These masks will be beneficial not just to healthcare workers but common citizens as well. In the absence of vaccination, productive masks can be worn to prevent transmission of airborne pathogenic aerosols and control diseases.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Masks/virology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , COVID-19 , Humans , SARS-CoV-2
6.
Mymensingh Med J ; 29(1): 142-148, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31915350

ABSTRACT

Hypertension (HTN) is an important cause of cardiovascular mortality and the prevalence of hypertension is increasing particularly in middle- and low-income countries including Bangladesh. No data are available for the prevalence of hypertension among the government employees in Bangladesh. In this cross-sectional study, conducted from 30 October to 31 December 2016, 1219 government employees aging ≥18 years working in Rangpur city were evaluated for the presence of HTN and its risk factors. Socio-demographic and anthropometric data, data on the presence of various known risk factors of hypertension were collected. Hypertension was defined with systolic BP ≥140mmHg and/or diastolic BP ≥90mmHg or those getting treatment for hypertension. Statistical analysis was done by using SPSS version 23.0; odds of hypertension among subjects with risk factors were calculated and p ≤0.05 was considered to be statistically significant. The prevalence of hypertension was 38.3% among the study subjects. Significantly higher odds of having hypertension were observed in study subjects with the age groups of 35-49 (OR 2.12, 95% CI: 1.51-2.99, p<0.001) and ≥50 (OR: 4.96, 95% CI: 3.43-7.18, p<0.001) years than age group <35 years. Employees who were averagely satisfied and not satisfied for their jobs also had higher odds (OR: 1.38, 95% CI: 1.00-1.91, p=0.049 and OR: 1.48, 95% CI: 3.43-7.18, p=0.337) of having hypertension than fully satisfied ones. Having diabetes mellitus was found to increase the odds (OR 2.12, 95% CI: 1.51-2.99, p<0.001) of hypertension. Male gender, urban/suburban residence, not doing physical exercise, sedentary/light working habit, overweight/obesity also increased the odds of having hypertension though these were not statistically significant. There is a high burden of hypertension among the government employees in Rangpur city. Age, job satisfaction and diabetes were independent risk factors of hypertension.


Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus/epidemiology , Government Employees/statistics & numerical data , Hypertension/epidemiology , Obesity/epidemiology , Adult , Bangladesh/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Risk Factors , Sex Distribution , Suburban Population/statistics & numerical data , Urban Population/statistics & numerical data
7.
3 Biotech ; 8(10): 409, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30237956

ABSTRACT

The current work is focused on establishing therapeutic protocol using unconventional drugs of herbal origin and studying their mechanism of action at molecular level in the treatment of bovine sub-clinical mastitis. It explores the potential of different cytokines which can be used for diagnosis, prognosis and monitoring of bovine sub-clinical mastitis. Prosopis juliflora alkaloids was administered intramammarily in 24 sub-clinically affected quarters once a day for 5 consecutive days at the rate of 10 ml of 1% formulation. In 18 disease control quarters, sterile normal saline was infused. The bacterial cultural examination, somatic cell count (SCC) and cytokines (IL-1ß, IL-6, IL-8, IL-12, GM-CSF, IFN-γ, TNF-α) expression by real-time PCR were evaluated on day 7, 14, 21 and 28 post-last treatment from milk samples. Around 75.0% of treatment group quarters showed significant (p < 0.05) reduction in SCC on day 28 post-last treatment, whereas 94.4% control group quarters did not show any significant decline in SCC. 58.3% of treated quarters showed both bacteriological cure as well as significant (p < 0.05) reduction in SCC on day 28 post-last treatment. While, among control group quarters, 83.3% quarters not only remained bacteriological positive, they also did not show any significant decline in SCC. The in vitro antimicrobial activity of alkaloids of P. juliflora was evaluated. Lower concentrations of alkaloids (0.25% and 0.50%) dissolved in normal saline showed zone of inhibition against 12 out of 15 isolates, however higher concentration (1, 1.5, 2, 2.5 and 5%) showed zone of inhibition against all 15 bacterial isolates. The gene expression level of IL-1ß, IL-8 and IFN-γ cytokines exhibited significant difference between healthy and sub-clinically affected quarters highlighting the potential of these cytokines in the diagnosis of bovine sub-clinical mastitis. Down-regulation of IL-1, IL-6, IL-8 and IFN-γ cytokines in treated quarters can be explored for making the prognosis and monitoring post-treatment disease progression of bovine sub-clinical mastitis. The P. juliflora alkaloid demonstrated strong in vitro and in vivo antibacterial activity, along with causing immunomodulation by enhancing post-treatment gene expression of IL-1, IL-6 and IL-8 cytokines. Therefore, P. juliflora alkaloids hold a strong claim as an effective alternative herbal therapy in bovine sub-clinical mastitis.

8.
Opt Express ; 24(23): 26044-26054, 2016 Nov 14.
Article in English | MEDLINE | ID: mdl-27857343

ABSTRACT

The responsivity of room-temperature, semiconductor-based photodetectors consisting of resonant RF circuits coupled to microstrip buslines is investigated. The dependence of the photodetector response on the semiconductor material and RF circuit geometry is presented, as is the detector response as a function of the spatial position of the incident light. We demonstrate significant improvement in detector response by choice of photoconductive material, and for a given material, by positioning our optical signal to overlap with positions of RF field enhancement. Design of RF circuits with strong field enhancement are demonstrated to further improve detector response. The improved detector response demonstrated offers opportunities for applications in RF photonics, materials metrology, or single read-out multiplexed detector arrays.

9.
Food Policy ; 62: 28-40, 2016 Jul.
Article in English | MEDLINE | ID: mdl-27478297

ABSTRACT

Nearly half of the malnourished population of the world lives in South Asia, and agriculture is the main source of livelihood of the people in this region. Many review exercises have analysed the available evidences to understand the ways in which agriculture can be leveraged to enhance nutritional status; however, very few of them have employed a systematic approach ensuring internal and external validity. The present paper seeks to fill this gap for strengthening the policy recommendations. It demonstrates an association between agricultural interventions and nutritional outcomes; and it shows that the production of targeted nutrition-rich crops, homestead gardens, and diversification of the agricultural production system towards fruits and vegetables and aquaculture can potentially improve nutrient intake and nutritional outcomes. The empowerment of women and nutrition knowledge play a crucial role in establishing linkage between agriculture and nutritional outcomes.

10.
Semin Cutan Med Surg ; 35(2): 68-73, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27416311

ABSTRACT

Hormones and androgens play an important role in the pathogenesis of acne. Multiple hormonal modulators are now available for the treatment of acne. The efficacies and side effects of currently available hormonal agents are reviewed here including the use of oral contraceptives, spironolactone, flutamide, cyproterone acetate, finasteride, and cortexolone 17α-propionate. Hormonal therapies are an efficacious treatment option for acne among females. With the growing need to reduce antibiotic exposures, hormonal therapies should be more widely studied and incorporated into acne treatment strategies.


Subject(s)
Acne Vulgaris/drug therapy , Contraceptive Agents/therapeutic use , Dermatologic Agents/therapeutic use , Hormones/metabolism , Administration, Oral , Cortodoxone/analogs & derivatives , Cortodoxone/therapeutic use , Cyproterone Acetate/therapeutic use , Female , Finasteride/therapeutic use , Flutamide/therapeutic use , Hormones/therapeutic use , Humans , Male , Meta-Analysis as Topic , Mineralocorticoid Receptor Antagonists/therapeutic use , Propionates/therapeutic use , Spironolactone/therapeutic use , Treatment Outcome
11.
J Am Acad Dermatol ; 73(5): 856-63, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26386632

ABSTRACT

Skin is an important interface between the host and its environment. Inflammatory dermatoses often have disrupted skin barrier function, rendering patients more susceptible to allergenic triggers leading to an exaggerated immune response. The skin surface lipid film, an important component of the skin barrier, comprises a mixture of keratinocyte and sebaceous gland-derived lipids. Recent evidence demonstrated that defective keratinocyte lipid synthesis predisposes for the development of atopic dermatitis. However, the important role of sebaceous gland-derived lipids in skin inflammatory diseases may be underrecognized. This overview focuses on the importance of the contribution of sebaceous glands to barrier function. Sebaceous gland alteration may play a role in the pathogenesis of common skin diseases including acne vulgaris, atopic dermatitis, psoriasis, rosacea, and seborrheic dermatitis.


Subject(s)
Acne Vulgaris/etiology , Dermatitis, Atopic/etiology , Lipids/analysis , Sebaceous Glands/metabolism , Sebum/chemistry , Skin Physiological Phenomena , Acne Vulgaris/drug therapy , Dermatitis, Atopic/pathology , Dermatitis, Seborrheic/metabolism , Dermatitis, Seborrheic/microbiology , Humans , Psoriasis/etiology , Rosacea/etiology , Sebaceous Glands/pathology , Sebum/metabolism
12.
Can J Gastroenterol Hepatol ; 29(2): 85-90, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25803018

ABSTRACT

BACKGROUND: Optimal management of obscure gastrointestinal bleeding (OGIB) remains unclear. OBJECTIVE: To evaluate diagnostic yields and downstream clinical outcomes comparing video capsule endoscopy (VCE) with push enteroscopy (PE). METHODS: Patients with OGIB and negative esophagogastroduodenoscopies and colonoscopies were randomly assigned to VCE or PE and followed for 12 months. End points included diagnostic yield, acute or chronic bleeding, health resource utilization and crossovers. RESULTS: Data from 79 patients were analyzed (VCE n=40; PE n=39; 82.3% overt OGIB). VCE had greater diagnostic yield (72.5% versus 48.7%; P<0.05), especially in the distal small bowel (58% versus 13%; P<0.01). More VCE-identified lesions were rated possible or certain causes of bleeding (79.3% versus 35.0%; P<0.05). During follow-up, there were no differences in the rates of ongoing bleeding (acute [40.0% versus 38.5%; P not significant], chronic [32.5% versus 45.6%; P not significant]), nor in health resource utilization. Fewer VCE-first patients crossed over due to ongoing bleeding (22.5% versus 48.7%; P<0.05). CONCLUSIONS: A VCE-first approach had a significant diagnostic advantage over PE-first in patients with OGIB, especially with regard to detecting small bowel lesions, affecting clinical certainty and subsequent further small bowel investigations, with no subsequent differences in bleeding or resource utilization outcomes in follow-up. These findings question the clinical relevance of many of the discovered endoscopic lesions or the ability to treat most of these effectively over time. Improved prognostication of both patient characteristics and endoscopic lesion appearance with regard to bleeding behaviour, coupled with the impact of therapeutic deep enteroscopy, is now required using adapted, high-quality study methodologies.


Subject(s)
Capsule Endoscopy/statistics & numerical data , Double-Balloon Enteroscopy/statistics & numerical data , Gastrointestinal Hemorrhage/diagnosis , Aged , Aged, 80 and over , Female , Humans , Intestine, Small/pathology , Male , Middle Aged
13.
Mymensingh Med J ; 23(1): 56-61, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24584374

ABSTRACT

Patients with epilepsy experience recurrent, unprovoked seizures. In most of the cases seizure occurs spontaneously, but there may be association with various triggers. These triggers may act as seizure precipitating factors (SPFs). This study was done to find out the most common SPFs and their relationship to different types epileptic patients attending a tertiary care hospital in Bangladesh. This cross sectional study was carried out in specialized epilepsy weekly outdoor clinic and Medicine outpatient department (OPD) of Dhaka Medical College Hospital from January 2008 to July 2011, which included 1168 epilepsy patients. All patients attending the clinic were included in the study. Epilepsy syndromes were broadly classified into four categories using the classification system of international league against epilepsy (ILAE) namely, generalized epilepsy (GE), localization related epilepsy (LRE), symptomatic and unclassified. Each patient was evaluated and classified by consultant neurologist. All participants were interviewed through a predesigned close ended questionnaire that included a long list of 30 precipitating factors. Among all the patients 71.5% were male, with most common age group 11-20 years (36.8%). About 62% could indentify at least one precipitator. Excitation (25.2%) was the most common SPF reported by patients followed by emotional stress in 17.7%. Fever precipitated seizure in 16.4% of the subjects. A good number of them (15.5%) noticed that whenever there was sleep deprivation, they had an attack of epilepsy. However, drug withdrawal, playing outside and head trauma were also common among the patients, about 11.7%, 11.3% and 8.4% respectively. Most of the patients can identify their seizure precipitant and clustering of many SPFs suggests a common patho-physiologic mechanism for these triggers. Excitation, sleep deprivation, fever, watching television and head trauma showed a strong association with generalized epilepsy. Patients with seizure disorder should be evaluated for presence of SPFs, because identification of these might help in proper management of epilepsy.


Subject(s)
Epilepsy/complications , Seizures/etiology , Adolescent , Adult , Child , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Precipitating Factors , Surveys and Questionnaires , Tertiary Healthcare
14.
Ayu ; 35(2): 198-205, 2014 Apr.
Article in English | MEDLINE | ID: mdl-25558168

ABSTRACT

BACKGROUND: Antibiotics have been in use in the treatment of bovine mastitis since decades; however, their use is associated with cost issues and human health concern. Use of herbal drugs does not generally carry these disadvantages. Many plants/herbs have been evaluated in the treatment of bovine mastitis with additional property of immunomodulation in affected mammary gland. AIM: To evaluate a topical herbal drug in two breeds of cattle for its in-vivo immunomodulatory effect on cytokines production and antibacterial activity in bovine subclinical mastitis. MATERIALS AND METHODS: The response to treatment was evaluated by enumerating somatic cell count (SCC), determining total bacterial load, and studying the expression of different cytokines (interleukin [IL]-6, IL-8, IL-12, granulocyte macrophage-colony stimulating factor, interferon (IFN)-γ and tumor necrosis factor [TNF]-α). RESULTS: The pre- and post-treatment SCC in mastitic quarters statistically did not differ significantly, however, total bacterial load declined significantly from day 0 onwards in both the breeds. Highly significant differences (P < 0.01) were observed in all the cytokines on day 0, 5, and 21 postlast treatment in both the breeds. The expression level of all the cytokines showed a significant increase on day 5, while a decrease was noticed on day 21 in both the breeds of cattle. The comparison of cytokine expression profiles between crossbred and Gir cattle revealed a significant difference in expression of IL-6 and TNF-α. However, other cytokines exhibited a similar pattern of expression in both breeds, which was non-significant. CONCLUSION: The topical herbal drug exhibited antibacterial and immunomodulatory activities in subclinical mastitis and thus the work supports its use as alternative herbal therapy against subclinical udder infection in bovines.

15.
Indian J Cancer ; 51(4): 487-90, 2014.
Article in English | MEDLINE | ID: mdl-26842173

ABSTRACT

BACKGROUND: Data of febrile neutropenia (FN) from rural cancer centers is sparse. We did a audit of outcome of patients with FN in the period of March 2013-August 2013. The aim was to help us to develop rational antibiotic usage policies. MATERIALS AND METHODS: Retrospective analysis of all consecutive patients presenting with FN. Data regarding demographic profile, tumor type, intent of treatment, chemotherapy regimen, blood culture susceptibility details, use of antibiotics, response to antibiotics and complications of FN were noted. SPSS (Statistical Product and Service Solutions) 16 was used for analysis. RESULTS: 67 patients had FN and there were 91 episodes. The median day of presentation with FN after start of chemotherapy was 10 days. The nadir absolute neutrophil count was 161.5 and nadir platelet count 1,00,000. The median multinational association for supportive care in cancer (MASCC) Score was 24. In accordance with MASCC there were 27 high risk FN and 64 low risk FN episodes. On multivariate analysis using logistic regression MASCC score strata was the only significant variable that predicted failure to 1st line antibiotics (P = 0.03) and mortality (P = 0.01). Nine patients (9.9%) had positive isolates on blood cultures. The blood culture isolates were predominantly Gram negative (66.7%). CONCLUSION: The importance of developing local guidelines for rational antibiotic usage is highlighted.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Chemotherapy-Induced Febrile Neutropenia/complications , Drug Utilization Review , Neoplasms/drug therapy , Rural Health Services , Adult , Aged , Antineoplastic Agents/adverse effects , Cancer Care Facilities , Child , Female , Humans , India , Male , Medical Audit , Middle Aged , Retrospective Studies , Severity of Illness Index , Treatment Outcome
18.
Phytother Res ; 27(10): 1423-38, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23147906

ABSTRACT

Plant-based extracts present a large source of natural immune modulators, many of which have been used in traditional medicine for centuries. Recent research efforts have identified plant extracts as potential modulators of Toll-like receptors (TLRs), the first responders in immunological defenses in normal and disease conditions. This review aims to provide a comprehensive discussion of the modulatory effects of plant-based extracts on TLR expression, signaling, and activation. We organized the review by extraction solvent and plant part showing how they impacted the TLRs. The phytochemical components of the extracts discovered to enable these effects are diverse and vary based on the plant part. The role of the extraction solvent and differences between the different phytochemical components, such as phenolics and polysaccharides, are discussed. Plant extracts hold promising treatments for controlling inflammation and, conversely, for stimulating the immune response. Further research is needed to identify bioactive components of the extracts, mechanisms of their action, and in vivo pharmacological effects using appropriate disease models to ultimately adapt the findings for clinical use.


Subject(s)
Plant Extracts/pharmacology , Signal Transduction/drug effects , Toll-Like Receptors/drug effects , Animals , Humans , Inflammation/drug therapy , Phenols/pharmacology , Plant Extracts/chemistry , Plant Structures/chemistry , Polysaccharides/pharmacology , Solvents/chemistry , Toll-Like Receptors/metabolism
19.
Eye (Lond) ; 26(11): 1487-9, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22935669

ABSTRACT

PURPOSE: To investigate the role of silicone oil as an adjunct to iodine 125 ((125)I) brachytherapy in attenuating radiation dose and reducing radiation retinopathy. METHODS: A 16-mm COMS plaque loaded with (125)I seeds was simulated in vitro on an eye model containing silicone oil as a vitreous substitute using BrachyDose. The radiation dose ratio of silicone oil vs water to ocular structures was calculated at angles subtended from the centre of the eye. Silicone oil was then used in three choroidal melanoma patients who underwent 23-gauge vitrectomy, silicone oil placement, and (125)I brachytherapy. RESULTS: Silicone oil reduced the ocular radiation dose in vitro to 65%. Radiation dose ratios on the retina increased from 0.45 to 0.99 when moving from points diametrically opposed to the plaque's central axis. In 10-24 months' follow-up, no patients have developed radiation retinopathy. Each patient required silicone oil removal and experienced cataract progression, and one also developed a retinal detachment. CONCLUSIONS: This study confirms that silicone oil attenuates radiation dose in vitro, and may protect against radiation retinopathy clinically in patients, however it requires extensive surgical interventions. Further studies in only very selected populations using silicone oil as an adjunct to (125)I brachytherapy will best elucidate its role in shielding radiation retinopathy.


Subject(s)
Brachytherapy/methods , Choroid Neoplasms/radiotherapy , Endotamponade , Iodine Radioisotopes/therapeutic use , Melanoma/radiotherapy , Radiation Injuries/prevention & control , Radiation-Protective Agents/therapeutic use , Retina/radiation effects , Silicone Oils , Aged , Drainage , Female , Humans , Middle Aged , Radiotherapy Dosage , Vitrectomy
20.
Am J Surg Pathol ; 36(6): 929-34, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22367294

ABSTRACT

Since first described in the mid 1990s, there has been burgeoning literature on IgG4-related sclerosing disease. The number of sites that may be involved is ever increasing, with the pancreas, salivary glands, and lymph nodes being the most commonly affected organs. There are no well-documented cases arising in the gastrointestinal tract. In this report, we present the first case to our knowledge of IgG4-related sclerosing disease involving the small bowel with a distinctly unusual clinicopathologic presentation. A previously well 46-year-old woman presented with a 2-year history of intermittent abdominal pain with recent worsening due to small bowel obstruction. Following imaging, which showed jejunitis with surrounding mesenteric inflammatory changes, she proceeded to a segmental small bowel resection. The resected jejunum revealed an isolated, stenosing chronic ulcer associated with a necrotizing mesenteric arteritis. A transmural inflammatory infiltrate rich in IgG4 plasma cells was seen in the wall of the bowel and mesenteric artery. Abundant IgG4 interfollicular plasma cells were also identified in a mesenteric lymph node. The serum IgG4 level was elevated at >800 mg/dL (reference range 8 to 140 mg/dL). Although phlebitis is an almost constant feature of this disease, arteritis is not described other than in the lung and aorta. In this report, we also discuss the diagnostic pitfalls and the differential diagnoses that should be considered when this condition arises in the gastrointestinal tract.


Subject(s)
Autoimmune Diseases/diagnosis , Immunoglobulin G/immunology , Jejunal Diseases/diagnosis , Mesenteric Arteries/pathology , Polyarteritis Nodosa/diagnosis , Sclerosis/diagnosis , Ulcer/diagnosis , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Autoimmune Diseases/immunology , Autoimmune Diseases/therapy , Biomarkers , Chronic Disease , Diagnosis, Differential , Female , Humans , Intestinal Obstruction/diagnosis , Jejunal Diseases/immunology , Jejunal Diseases/therapy , Jejunum/pathology , Jejunum/surgery , Middle Aged , Mycophenolic Acid/analogs & derivatives , Mycophenolic Acid/therapeutic use , Plasma Cells/immunology , Polyarteritis Nodosa/immunology , Prednisolone/therapeutic use , Sclerosis/immunology , Sclerosis/therapy , Treatment Outcome , Ulcer/immunology
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