Modified keystone flap used to repair nose defect after Mohs micrographic surgery.

Mohs micrographic surgery (MMS) is a surgical technique used to remove skin tumors with a complete evaluation of the margins. The keystone flap technique is generally used to repair large surgical defects on limbs. We present a case where a modified keystone flap technique was used to close a large defect after Mohs micrographic surgery in a patient with a basal cell carcinoma on the nose. An excellent functional and aesthetic result was obtained with no complications during or after the procedure. We offer a novel indication for this technique for surgical defects in this area.

Molecular Characterization and In Silico Analysis of the Pheromone-Binding Protein of the European Grapevine Moth Lobesia botrana (Denis & Schiffermüller) (Lepidoptera, Tortricidae).

The European grapevine moth Lobesia botrana (Denis & Schiffermüller) is an economically important insect in Europe. The species invaded vineyards in Chile, Argentina, and California during 2008-2010 causing severe problems. A major component of the sex pheromone, (E,Z)-7,9-dodecadienyl acetate (E7,Z9-12:Ac), is used in a mating disruption technique when grapevine moth populations are low or to monitor pest numbers. It is thought that these sexual pheromones are blends of volatiles that typically are specific to a species and are transported in the insect antenna by pheromone-binding proteins (PBPs) across the sensillar lymph to the olfactory receptors. Currently, an increasing number of Lepidopteran PBPs are being identified and cloned. However, there are no studies of the olfactory system and of proteins involved in the olfactory perception of L. botrana at the molecular level. In the present study, we report, for the first time, the sequence of a PBP from L. botrana (LbotPBP), which was determined using reverse transcription technology. Homology modeling was used to generate the three-dimensional protein structure. The model suggests that PBP consists of six α-helices as follows: Lys2-Met23 (α1), Thr28-Phe36 (α2), Arg46-Leu59 (α3), His70-Asn80 (α4), Glu84-Asn100 (α5), and Cys108-Lys125 (α6), held together by three disulfide bridges, Cys19-Cys54, Cys50-Cys108, and Cys97-Cys117. Docking simulations based on this model suggested that Trp114 is a key residue in the recognition of acetate pheromones, such as E7,Z9-12:Ac. In silico results in this study are consistent with previous findings in which E7,Z9-12:Ac acts as the most active compound in behavioral and electroantennographic assays.

Influence of trial registration on reporting quality of randomized trials: study from highest ranked journals.

OBJECTIVE: To evaluate the reporting quality of key methodological items of randomized control trials (RCTs) in 55 of the highest ranked journals. STUDY DESIGN AND SETTING: A list of the highest top ranked journals was identified, and a search for detecting RCTs in those journals was made. Two hundred sixty four journals were screened and 55 of them were identified having at least one RCT. Three RCTs were randomly selected a priori from each journal; 148 RCTs were finally included. RCTs were assessed by two reviewers using the Consolidated Standards of Reporting Trials (CONSORT) statement. RESULTS: Only 11 (8%) RCTs had all items adequately reported. In addition, 36% of RCTs reported that the study was registered in any trial registry. We found a significant difference in the quality of reporting for baseline characteristics, recruitment, participant's flow, and randomization implementation between those studies having reported the registration of their RCT in a trial registry and those that have not. Adherence to key methodological items of the CONSORT statement was as follows: sample size determination (60%), sequence generation (49%), allocation concealment (40%), and blinding (25%). CONCLUSIONS: Reporting of varied CONSORT items remains suboptimal. Registration in a trial registry was associated with improved reporting. Further efforts to enhance RCT registration could contribute to this improvement.

Nuevas perspectivas en la genética de la diabetes mellitus tipo 2 y sus complicaciones crónicas / New perspectives in the genetics of diabetes mellitus and its complications

This review describes the advances in the knowledge about the genetic aspects of common chronic complications of diabetes with prognostic significance, such as diabetic nephropathy and cardiovascular diseases. It is well known that the genetic factors responsible for chronic complications are different from those that cause diabetes mellitus. Until recently, the studies were limited to the analysis of individual genes associated or related to multifactorial diseases. However at the present time the "genome wide association studies" lead to a great advance in knowledge. The analysis of genetic variations or polymorphisms allows the understanding of human individuality and the predisposition towards certain diseases. A new research field appeared in 2004, when small messenger RNAs, called microRNA related to diabetes mellitus and its chronic complications, were identified. The function of these RNAs is to regulate several target genes. These affect insulin secretion and action and genes related to microangiopathic and specific macroangiopahic complications. This new knowledge will identify new genes related to the disease and will allow the development of therapeutic strategies devised according to individual susceptibility towards specific chronic complication.

Framework for a low-cost intra-operative image-guided neuronavigator including brain shift compensation.

In this paper we present a methodology to address the problem of brain tissue deformation referred to as 'brain-shift'. This deformation occurs throughout a neurosurgery intervention and strongly alters the accuracy of the neuronavigation systems used to date in clinical routine which rely solely on pre-operative patient imaging to locate the surgical target, such as a tumour or a functional area. After a general description of the framework of our intra-operative image-guided system, we describe a procedure to generate patient specific finite element meshes of the brain and propose a biomechanical model which can take into account tissue deformations and surgical procedures that modify the brain structure, like tumour or tissue resection.

Determinación de nicotina, cotinina y cafeína por CG-NPD-EM en leche materna de puérperas atendidas en el hospital 'Las Higueras', Talcahuano, Chile / Measurement of Nicotine, Cotinine and Caffeine by GC-NPD-MS in human breast milk simples of puerperals hospitalizad in 'Las Higueras', Talcahuano, Chile

La utilización de la lecha materna como matriz biológica alternativa para el análisis toxicológico, proporciona información relevante al momento de evaluar el riesgo de exposición al neonato a diversas sustancias químicas. La nicotina, su metabolito, cotinina y la cafeína, poseen propiedades físicoquímicas que facilitan el paso de las mismas hacia la leche materna. Se determinaron las concentraciones de nicotina, cotinina y cafeína en leche materna de 48 madres puérperas (M=28 años) elegidas a través de un muestreo al azar simple. Las muestras se recolectaron en envases estériles por extracción manual. Se obtuvo consentimiento informado y se completó un cuestionario con los datos demográficos de la madre del neonato, el hábito de fumar e ingesta de bebidas cafeinazas durante el embarazo. La determinación simultánea de nicotina, cotinina y cafeína se realizó por Cromatografía de Gases/Espectometría de Masas con doble sistema de detección. La metodología demostró ser exacta, precisa y lineal en el rango estudiado con un coeficiente de determinación (r2) mayor a 0,9990 para nicotina y cotinina, y mayor a 0,9970 para la cafeína. Se encontró nicotina en el 19% de los casos (14,7 a 55,2ng/mL), cotinina en el 4% (10,5 y 13,8 ng/mL) y cafeína en el 25% 9 a 250 ng/mL). La cotinina son biomarcadores que indican que las madres fumaron durante la lactogénesis. También, el espectrómetro de masas detectó la presencia de Petidina (n=1), Metronizadol (n=1), Metamizol (n=19) y Aminofenazona (n=19) en las muestras de leche materna evaluadas lo que permite visualizar a esta metodología como una valiosa herramienta para ampliar el espectro de futuros estudios toxicológicos (AU)

Human milk used as an alternative matrix for toxicological analysis offers relevant information to evaluate the neonatal risk of exposition to a variety of chemical substances. Nicotine, its metabolite, cotinine, and caffeine, have the necessaries physicochemical properties to be transferred to the human breast milk. We measured nicotine, cotinine and caffeine concentrations in human milk samples of 48 puerperals mothers (M=28 years old) elected randomly. The samples were collected in sterile containers by manual expression, and then transported to the lab where they were kept at -30ºC until the analysis. The mothers, with signed consent, filled a questioner with socio demographic data smoking habit, and intake of caffeine beverages during pregnancy. The simultaneous determination of nicotine, cotinine and caffeine in human milk samples was made by Gas Chromatography/Mass Spectrometry, with a double detection system. The methodology was 2exact, precise and lineal, with a determination coefficient (r ) greater than 0,9990 for nicotine and cotinine, and 0,9970 for caffeine. We found nicotine in 19% of the samples (14,7 to 55, 2 ng/mL), cotinine in 4% (10,5 to 136,8 ng/mL) and caffeine in 25% (9 to 250 ng/mL). The application of the analytical method allowed the determination of nicotine and cotinine as biomarkers of the smoking behaviour during lactogenesis, and gave us the possibility to determine the presence of Pethidine (n=1), Methronidazole (n=1), Methamizole (n=19) and Aminophenazone (n=19) in the human milk samples analyzed, that led us to visualize this methodology as an important tool to expand future toxicological studies (AU)

Restriction in the usage of variable beta regions in T-cells infiltrating valvular tissue from rheumatic heart disease patients.

Rheumatic Heart Disease (RHD) is a delayed consequence of a pharyngeal infection with group A streptococcus (GAS), usually ascribed to a cross-reactive immune response to the host's cardiac tissues. Several GAS proteins have been reported to be superantigens, also raising the possibility that T cells in RHD could be driven by superantigens. We therefore analysed the variable beta (V beta) repertoire of T cells infiltrating heart valves from chronic RHD patients undergoing elective valvular surgery. We analysed 15 valve specimens from patients with longstanding quiescent RHD and control valves from four non-rheumatic individuals. Total RNA was extracted from fresh valve tissue and employed to amplify 22 V beta genes by RT-PCR. In valvular tissue, a restricted number of only 2 to 9 V beta regions were detected as opposed to the findings in control valves. In 8 RHD valves, the expression of V beta1, 2, 3, 5.1, 7, 8, 9 or 14 was marked. These V beta regions have been related to GAS superantigens. Our results evidence the presence of a restricted set of T lymphocytes in valvular tissue from a majority of patients with chronic RHD and suggest that valvular sequelae in these patients might be related to a local antigen or superantigen driven inflammatory process that persists even many years after the initial triggering event.

Purification and characterisation of Bst LVI restriction endonuclease, a thermostable isoschizomer of ClaI from Bacillus stearothermophilus LV.

This work describes the purification and biochemical characterization of BstLVI restriction endonuclease, a thermostable isoschizomer of ClaI, from Bacillus stearothermophilus LV. The enzyme was purified by successive DEAE-cellulose, Affi-Gel Blue and Heparin-Sepharose CL-6B column chromatography. A molecular weight of 37,000 was determined for Bst LVI by gel filtration. As expected from thermophilic proteins, the enzyme showed a high stability towards heat and also to other known protein-denaturing agents.