Enhanced Transport of Nandrolone Decanoate Drug by Human Serum Albumin in Presence of [BMIM]PF6 and [BMIM]BF4.

The interaction of nandrolone decanoate drug dissolved in (2%) [BMIM]BF4 or [BMIM]PF6 with human serum albumin (HSA) at different temperatures in the range of 285-310 K was examined by fluorescence quenching. Stern-Volmer equation and its modified form were used to determine the interaction parameters K and n. The results revealed that binding affinities of HSA for nandrolone decanoate drug in 2% [BMIM]BF4 or [BMIM]PF6 are in the order of 105 M-1 and the number of bound drug molecules per HSA macromolecule are approximated to 1 at all temperatures studied. The thermodynamic parameters: free energy change (∆Go), enthalpy change (∆Ho) and entropy change (∆So) for HSA-nandrolone decanoate/ionic liquid were calculated according to van't Hoff equation. Data analysis indicated that both electrostatic interactions and hydrophobic ineractions played important roles in the interaction of nandrolone decanoate drug with HSA.

Palatal rugae morphology in an adult mediterranean population.

BACKGROUND: The use of the palatal rugae in forensic odontology is based on their unique and individual characteristics. Few studies have assessed the palatal rugae in Mediterranean populations and none in the Lebanese population. OBJECTIVE: Assess the shape and other morphological features of the palatal rugae in a Lebanese adult population, and compare them with reported similar features in other populations. MATERIALS AND METHODS: Rugae characteristics were assessed on the maxillary dental casts of 217 non-growing subjects (95 males, 122 females, age 25.5 ± 7.6 years) according to guidelines established by Thomas and Kotze (1983) and Lysell (1955). The overall number of rugae and numbers of primary rugae (> 5mm in length), secondary rugae (3-5mm) and fragmentary rugae (2-3mm) on either side were recorded. Rugae were classified according to shape, direction and presence of unification. Z-tests were used to compare the proportions between right and left sides and between genders. The mean numbers of rugae in each category were compared with independent samples t-tests between males and females; paired samples t-tests were employed to compare mean numbers of rugae in each category between right and left sides. The data were compared with published reports on other Mediterranean cohorts. RESULTS: The average number of rugae was 7.7 per individual, 3.81 on the right and 3.89 on the left. Curved, wavy and straight rugae patterns were equally common (one third each). The spatial direction of most rugae (49.3%) was backward. Circular, non-specific and convergent rugae were rare (< 2% each). Rugae numbers (total, primary, secondary, fragmentary) were symmetrical but shape, direction and the occurrence of convergence were asymmetrical (p < 0.05). None of the examined characteristics showed gender dimorphism. Tabulated comparisons disclosed the equality of rugae patterns as major differences with findings from other Mediterranean studies. CONCLUSIONS: The palatal rugae in the Lebanese population display shape distinct from other reported Mediterranean and non-Caucasian populations. Studies in large samples and primary comparisons with other Mediterranean populations are warranted.

Association among geometric configurations of palatal rugae.

BACKGROUND: The associations between the length and morphological shape-related characteristics of palatal rugae have not been fully explored. OBJECTIVE: We aimed to assess the possible association among various geometric configurations of the palatal rugae in an adult population. MATERIALS AND METHODS: The maxillary dental casts of 217 non-growing subjects (95 males, 122 females, mean age 25.5±7.6 years) were scanned (laser scanning system Perceptron ScanWorks® V5) and digitized for linear measurements. The casts were also surveyed for visual categorization into curved, wavy, straight and other topographical forms, along with spatial direction of the rugae and the presence of unification. The rugae were categorized as primary, secondary, and fragmentary based on their lengths (> 5mm, 2-3mm, < 2mm, respectively). Chi square and one-way ANOVA and post-hoc tests were used to compare the palatal rugae groupings. RESULTS: Primary and backward-directed rugae prevailed in the total sample (84.7% and 49.3%, respectively). Wavy form was dominant among primary lengths, while straight form was associated with the shorter secondary and fragmentary groups (p=0.0042). Absence of unification was the norm (88.8%). CONCLUSIONS: Associations of length and shape characteristics among palatal rugae combine wavy patterns with increased length, and straight forms with shorter folds. These features contribute to the definition of ruga individuality in combination rather than separately.

Controlled reoxygenation during cardiopulmonary bypass decreases markers of organ damage, inflammation, and oxidative stress in single-ventricle patients undergoing pediatric heart surgery.

OBJECTIVE: Single-ventricle patients undergoing pediatric heart surgery are a high-risk group owing to reoxygenation injury during cardiopulmonary bypass (CPB). The present study investigated the effects of controlled reoxygenation CPB on biomarkers of organ damage, inflammation, stress, and long-term functional outcomes in cyanotic patients with either a single or double ventricle during open heart surgery. METHODS: Cyanotic patients with either a single (n = 32) or double (n = 47) ventricle undergoing surgical correction were randomized to receive CPB using either standard oxygen levels or controlled reoxygenation. The markers of cardiac injury, inflammation, stress, and cerebral and hepatic injury were measured preoperatively, at 10 and 30 minutes after starting CPB, and at 10 minutes and 4 and 24 hours after CPB. The data were analyzed using a mixed regression model. RESULTS: No difference was found in the pre- or intraoperative characteristics between the standard and controlled reoxygenation CPB groups for single- or double-ventricle patients. In the single-ventricle patients, controlled reoxygenation CPB significantly (P < .05) decreased the markers of organ damage, inflammation, stress, and oxidative stress. In contrast, the markers of inflammation and cardiac injury were not altered by controlled reoxygenation CPB in the double-ventricle patients. CONCLUSIONS: Controlled reoxygenation CPB decreased the markers of organ damage, stress, inflammation, and oxidative stress in single-ventricle patients undergoing cardiac surgery.

Study of KIR genes in Lebanese patients with tuberculosis.

A total of 103 Lebanese tuberculosis (TB) cases and 38 controls without TB were studied for the killer cell immunoglobulin-like receptors (KIR) genotypic profile using polymerase chain reaction sequence-specific primers. Patients and controls were assigned to the AA, AB or BB genotypes based on their A or B haplotype genetic make-up, and KIR gene frequencies were compared. We found an increase in the KIR A haplotype in TB patients compared to controls, and only KIR 2DL3 was found to be significantly more prevalent among TB patients. This confirms the findings of another unique international study performed in the Mexican population showing a greater repertoire of inhibitory KIR genes among TB patients than controls.

Discriminant value of serum HBV DNA levels as predictors of liver fibrosis in chronic hepatitis B.

Current guidelines recommend antiviral therapy in chronic hepatitis B (HBV) patients with significant histological disease. We aimed to compare histological fibrosis (METAVIR, ≥F2) in patients with HBV DNA ≥20,000 IU/mL vs. ≥2000 IU/mL and identify predictors of fibrosis. We performed prospective liver biopsies on 203 HBeAg-negative patients in four groups: Group I (n = 55): HBV DNA ≥20,000 IU/mL and persistently elevated alanine aminotransferase (ALT) levels (PEALT; >40 U/L); Group II (n = 34): HBV DNA ≥20,000 IU/mL and persistently normal ALT (PNALT); Group III (n = 40): HBV DNA <20,000 IU/mL and PEALT; and Group IV (n = 74): HBV DNA <20,000 IU/mL, and PNALT. We reanalysed all groups in relation to updated cut-off for treatable viremia (2000 IU/mL). Genotype D was detected in 86% of patients. Hepatic fibrosis ≥F2 was detected in 72.7%, 52.9%, 57.5% and 18.9% in Groups I-IV, respectively (P < 0.0001). Except in Group II with a trend for lower ≥F2 fibrosis (P = 0.067), there was no significant difference by using HBV DNA cut-off 20,000 vs. 2000 IU/mL. Multivariate logistic regression analysis identified study Group IV (OR, 0.0276; CI: 0.088-0.868; P = 0.0276) and milder (A0-1) necroinflammatory grade (OR, 0.135; CI: 0.063-0.287; P < 0.0001) as independent predictors of ≥F2 fibrosis. The specificity, positive and negative predictive values for PEALT in detection of ≥F2 fibrosis for viremia ≥2000 IU/mL (80%, 69% and 65%, respectively) or ≥20,000 IU/mL (86%, 73% and 63%, respectively) were similar, with a marginal gain in sensitivity (51% vs. 42%, respectively). Significant fibrosis is prevalent in a large proportion of HBeAg-negative patients with high viremia and persistently normal ALT. Lower HBV DNA cut-offs could be adopted with marginal gains in fibrosis detection and without loss of diagnostic accuracy.

Retrograde hot-shot cardioplegia in patients with left ventricular hypertrophy undergoing aortic valve replacement.

BACKGROUND: Intermittent antegrade cold-blood cardioplegia followed by terminal warm-blood cardioplegic reperfusion or hot-shot is reported to reduce myocardial injury in the setting of coronary surgery. The efficacy of this cardioplegic technique in patients with left ventricular hypertrophy secondary to aortic stenosis remains uncertain. METHODS: Thirty-six patients with left ventricular hypertrophy undergoing aortic valve replacement were prospectively randomized to cold-blood cardioplegia either alone (cold-blood cardioplegia group) or with retrograde hot-shot (hot-shot group). Reperfusion injury was assessed by measuring myocardial levels of adenosine triphosphate and lactate in left and right ventricular biopsies taken 5 minutes after institution of cardiopulmonary bypass and 20 minutes after removal of cross-clamp using high-performance liquid chromatography and enzymatic techniques. Myocardial injury was assessed by serial release of troponin I up to 48 hours postoperatively. Overall clinical outcome was prospectively collected. RESULTS: Baseline and intraoperative characteristics were similar between groups. In the hot-shot group, there were no significant changes in the myocardial concentration of adenosine triphosphate and lactate in both left and right ventricular biopsies after reperfusion. In the cold-blood cardioplegia group, there was a trend to a fall in adenosine triphosphate levels in the left and right ventricular biopsies after reperfusion, but this reached statistical significance only in the right ventricle. Troponin I release was raised in both groups at 4 and 12 hours after surgery (p < 0.05), but did not reach levels of myocardial infarction. CONCLUSIONS: The terminal retrograde hot-shot reperfusion does not add any extra benefit to antegrade cold-blood cardioplegia in preventing myocardial injury in patients with left ventricular hypertrophy undergoing aortic valve replacement. Nevertheless, it appears to reduce ischemic stress in the right ventricle. There was no difference in clinical outcome between groups.

Changes in myocardial free amino acids during pediatric cardiac surgery: a randomised controlled trial of three cardioplegic techniques.

OBJECTIVE: The developing heart has a much greater dependence on amino acid (AA) metabolism than the adult heart in determining its ischemic tolerance. Blood cardioplegia preserves myocardial free AAs in adult hearts but no clinical studies have looked at the effect of different cardioplegic techniques on intracellular free AAs in the pediatric heart. METHODS: Pediatric patients were randomised to receive intermittent antegrade cold crystalloid (CC), cold blood (CB) or cold blood cardioplegia with a 'hot shot' (CB+HS). Right ventricular biopsies were collected prior to ischemia, at the end of ischemia and 20 min after reperfusion. Amino acid levels were analysed as repeated measures, adjusting for baseline levels. Data were analysed separately for acyanotic and cyanotic patients. RESULTS: Of 103 patients recruited, 32 (22 acyanotic and 10 cyanotic), 36 (24/12) and 35 (25/10), respectively were allocated to CC, CB and CB+HS groups. Cyanotic patients were significantly younger with longer cross-clamp times. In acyanotic patients, there were no significant effects of cardioplegic method on aspartate, glutamine, taurine, alanine or branched chain AA levels (all p>0.05). However, in cyanotic patients, there were significant interactions of cardioplegic method and time (all p<0.05) for all amino acids, with patients allocated to CB+HS having higher levels after reperfusion compared with CC, and patients allocated to CB having intermediate levels. CONCLUSIONS: For cyanotic patients (younger, longer cross-clamp times), CB+HS preserves myocardial free AAs better than CC; CB gives an intermediate effect. In acyanotic patients, AA levels (all p>0.15) and group means were similar both at the end of ischemia and after reperfusion.

T-cell presentation of antigen requires cell-to-cell contact for proliferation and anergy induction. Differential MHC requirements for superantigen and autoantigen.

MHC class II+ human T-cell clones are able to simultaneously present and respond to peptide Ag and superantigen resulting in both proliferation and subsequent anergy. A major question remains as to whether a single T cell can present to itself or whether T-T cell interactions are required. We have employed a novel technique for inhibiting cell-to-cell contact that encapsulates individual T cells in agarose gel microdrops. Myelin basic protein-reactive individual CD4+ T-cell clones entrapped within these microdrops neither proliferated nor became anergized to either peptide Ag or Staphylococcal enterotoxin B (SEB), suggesting that cell-to-cell contact was required for T-cell presentation of Ag leading to proliferation and anergy. PMA treatment induced T-cell migration out of gel microdrops, restoring cell-to-cell contact and resulting in proliferation and anergy after T-cell coculture with peptide or superantigen. However, analysis of [Ca+2]i release revealed differences in T-cell responses to SEB versus peptide Ag. The addition of SEB, but not peptide Ag, induced a calcium flux in solitary T cells. Additionally, alpha HLA-DR mAb blocked peptide but not SEB-induced proliferation and anergy induction. Thus, SEB generated an early signal in solitary T cells that may not be a result of self stimulation via MHC class II. However, subsequent cell-to-cell contact was required for proliferation and anergy induction by SEB. These results indicate that peptide Ag requires a MHC class II-dependent cell-to-cell interaction for calcium flux, proliferation, and anergy induction, whereas SEB requires a MHC class II independent cell-to-cell interaction for proliferation and anergy induction after a TCR-generated calcium flux.