Genome-Wide Identification and Expression Profiling of CONSTANS-Like Genes in Pepper (Capsicum annuum): Gaining an Insight to Their Phylogenetic Evolution and Stress-Specific Roles.

CONSTANS-like (COL) genes play important regulatory roles in multiple growth and development processes of plants but have rarely been studied in Capsicum annuum. This study explored the evolutionary relationship and expression patterns of COL genes from C. annuum. A total of 10 COL genes were identified in the genome of the cultivated pepper Zunla-1 and were named CaCOL01-10. These genes were unequally distributed among five chromosomes and could be divided into three groups based on differences in gene structure characteristics. During evolutionary history, duplications and retentions were divergent among different groups of COL genes. Tandem duplication caused amplification of group I genes. Genetic distance among COL genes was the largest in group III, suggesting that group III genes undergo more relaxed selection pressure compared with the other groups. Expression patterns of CaCOLs in tissues were significantly different, with CaCOL08 exhibiting the highest expression in stem and leaf. Some COL orthologous genes showed markedly different expression patterns in pepper compared with tomato, such as COL_1 orthologs, which may be involved in fruit development in pepper. In addition, CaCOLs participated in the regulation of abiotic stresses to varying degrees. Five CaCOL genes were induced by cold, and CaCOL02 and CaCOL03 were specifically upregulated by cold and downregulated by heat. This study provides a theoretical basis for the in-depth understanding of the functions of COL genes in pepper and their molecular mechanisms involved in growth and development and responses to abiotic stresses.

Sternocleidomastoid Tendinopathy in a Pediatric Athlete.

To our knowledge, this case report describes the first known case of sternocleidomastoid tendinopathy, occurring in a pediatric athlete who had gone undiagnosed for a period of 2 yrs. She presented to our pain clinic with bilateral otalgia, occipital headaches, and occasional bouts of tinnitus and dizziness. An extensive workup by otolaryngology (ENT) including computed tomography imaging of the head, ear pressure equalization, and an attempt at therapeutic tonsillectomy left her with no diagnosis and no symptom relief. A clinical diagnosis of sternocleidomastoid tendinopathy was made at the initial visit based on history and physical examination findings, after excluding other diagnoses. Conservative treatment with physical therapy, acupuncture, and a short course of meloxicam and gabapentin resulted in total symptom resolution. This case is a unique reminder to clinicians that head, neck, and ear pain may precipitate from musculoskeletal origins. It emphasizes the importance of understanding local anatomy, obtaining a thorough history, and performing a detailed physical examination in arriving at an accurate diagnosis.

Insight into chlorine evolution during hydrothermal carbonization of medical waste model.

In order to reveal the chlorine behavior during hydrothermal carbonization (HTC) of medical waste, polyvinyl chloride and medical waste model (MW) were respectively treated by HTC at temperature ranging from 220 °C to 300 °C for 30 min. HTC products were characterized by Fourier Transform Infrared Spectrometer, X-ray Photoelectron Spectroscopy, etc. It is found that HTC can efficiently remove chlorine from both polyvinyl chloride and MW. The most dramatical dechlorination can be induced by HTC at around 240 °C. With HTC temperature increased, organic chlorine in HT-MW and solid product from polyvinyl chloride HTC (HT-PVC) is decreased. Interestingly, with 240 °C HTC, the organic chlorine of HT-MW was 15.30%, much lower than that of HT-PVC of 86.84%, indicating the cellulosic materials in MW can significantly boost the conversion of organic chlorine into inorganic form in HTC at 240 °C. While spherical particles assigned to HTC of cellulosic materials aggregate at the pores of polyvinyl chloride particle, trapping the release of chlorine into the liquid, consequently to lower dechlorination efficiency compared to that of polyvinyl chloride. Since the chlorine retain in the solid product was mainly in form of inorganic, further dechlorination is potential for MW by combining HTC with leaching/extracting.

Successful Treatment of Gluteal Pain from Obturator Internus Tendinitis and Bursitis with Ultrasound-Guided Injection.

This case report describes what the authors believe is the first case of a patient with obturator internus tendinitis and bursitis successfully treated with a corticosteroid injection using a trans-tendinous lateral to medial approach. The patient presented with right gluteal pain not relieved by physical therapy or right hip and ischial bursa corticosteroid injections. Pelvic and lumbar spine MRIs and EMG/NCS findings were unremarkable. Physical examination demonstrated tenderness to palpation at the right middle lower gluteal region. Ultrasound imaging with sonopalpation identified the maximal local tender point as the right obturator internus muscle and/or its underlying bursa. A 22-gauge 3.5-inch needle was inserted in-plane to the transducer and longitudinal to the obturator internus from a lateral to medial direction, an approach previously described in cadavers. The obturator internus tendon sheath and bursa were injected with 2.5 ml of 0.5% lidocaine combined with 10 mg of triamcinolone. The patient reported immediate complete relief of pain with continued relief at 2 and 6 months post-injection. This case report demonstrates an injection of the obturator internus tendon sheath and bursa using a trans-tendinous approach, which may be successful for treatment of patients presenting with persistent gluteal pain from obturator internus tendinitis and bursitis.

A tomato plastidic ATP/ADP transporter gene SlAATP increases starch content in transgenic Arabidopsis.

A plastidic ATP/ADP transporter (AATP) is responsible for importing ATP from the cytosol into plastids. Increasing the ATP supply is a potential way to facilitate anabolic synthesis in heterotrophic plastids of plants. In this work, a gene encoding the AATP protein, named SlAATP, was successfully isolated from tomato. Expression of SlAATP was induced by exogenous sucrose treatment in tomato. The coding region of SlAATP was cloned into a binary vector under the control of 35S promoter and then transformed into Arabidopsis to obtain transgenic plants. Constitutive expression of SlAATP significantly increased the starch accumulation in the transgenic plants. Real-time quantitative PCR (qRT-PCR) analysis showed that constitutive expression of StAATP up-regulated the expression of phosphoglucomutase (AtPGM), ADP-glucose pyrophosphorylase (AtAGPase), granule-bound starch synthase (AtGBSS I and AtGBSS II), soluble starch synthases (AtSSS I, AtSSS II, AtSSS III and AtSSS IV) and starch branching enzyme (AtSBE I and AtSBE II) genes involved in starch biosynthesis in the transgenic Arabidopsis plants. Meanwhile, enzymatic analyses indicated that the major enzymes (AGPase, GBSS, SSS and SBE) involved in the starch biosynthesis exhibited higher activities in the transgenic plants compared to the wild-type (WT). These findings suggest that SlAATP may improve starch content of Arabidopsis by up-regulating the expression of the related genes and increasing the activities of the major enzymes invovled in starch biosynthesis. The manipulation of SlAATP expression might be used for increasing starch accumulation of plants in the future.

Use of Platelet-Rich Plasma in Intra-Articular Knee Injections for Osteoarthritis: A Systematic Review.

OBJECTIVE: To systematically analyze the literature on the use of platelet-rich plasma (PRP) for intra-articular injections of the knee and its efficacy in the treatment of knee osteoarthritis (OA). DESIGN: Systematic literature reviews were conducted in PubMed, Embase, and CINAHL (ie, Cumulative Index to Nursing and Allied Health Literature) on October 30, 2013, using the keywords "platelet-rich plasma" and "knee" and "osteoarthritis." Inclusion criteria included (1) studies with human subjects, (2) prospective clinical studies (including either clinical trials or observational studies), and (3) full-text articles published in English. Exclusion criteria were: (1) animal studies; (2) retrospective studies; (3) patients with previous surgical intervention with total knee arthroplasty or reconstruction of the anterior cruciate ligaments; and (4) articles not published in English RESULTS: A total of 319 abstracts and titles were reviewed (60 from PubMed, 250 from Embase, and 9 from CINAHL). A total of 8 relevant journal articles were identified, all of which were published between 2010 and 2013. One-half of the studies were prospective observational studies that included only PRP treatment; the rest were prospective comparative studies including both PRP and controls-2 were randomized controlled trials. Of the 4 comparative studies, 3 compared PRP with hyaluronic acid, which was considered as a commonly used effective treatment for knee OA; the other one used saline injection (ie, placebo) as the control. Although most of the analyses suffered from small sample size and was thus inconclusive, the findings consistently indicated that PRP might have better outcomes in patients with a lesser degree of degeneration and in younger patients. CONCLUSION: PRP intra-articular injections of the knee may be an effective alternative treatment for knee OA. However, current studies are at best inconclusive regarding the efficacy of the PRP treatment. A large, multicenter randomized trial study is needed to further assess the efficacy of PRP treatment for patients with knee OA.

Ganglion cyst at the fibular head causing common peroneal neuropathy diagnosed with ultrasound and electrodiagnostic examination: a case report.

The common peroneal nerve is a major source of innervation to the lower limb, but it is sometimes compressed or entrapped at the fibular head. The authors present what they believe is the first reported case where peroneal nerve impingement caused by ganglion cyst compression of the nerve at the fibular head was diagnosed using a combination of ultrasound imaging and electrodiagnostic studies. The authors described the history, physical examination, electrodiagnostic findings, and musculoskeletal ultrasound findings of a patient with a left foot drop caused by a ganglion cyst compressing the common peroneal nerve at the fibular head. The increasing role of ultrasound imaging to evaluate musculoskeletal pathology is discussed.

Optimal needle entry angle for cervical transforaminal epidural injections.

BACKGROUND: Cervical epidural steroid injections can be performed through either interlaminar or transforaminal approaches, although the interlaminar approach is more frequently used, for cervical radicular pain as a result of cervical disc herniation or spinal stenosis. Cervical selective nerve root block (CSNRB) is an injection that uses a similar approach to that of cervical transforaminal epidural steroid injection (CTFESI) but CSNRB is mainly used for diagnostic injection, often with local anesthetic only. OBJECTIVE: The aim of this study was to investigate an optimal needle entry angle for cervical transforaminal epidural steroid injection (CTFESI) or cervical selective nerve root block (CSNRB) using the fluoroscopically guided anterior oblique approach. The angle for optimal entry into the neuroforamen was measured at various vertebral levels using cross-sectional cervical spine computed tomography (CT) scans. STUDY DESIGN: Retrospective case series analysis. METHODS: From March 2009 to July 2012, consecutive patients with presumed discogenic neck pain underwent cervical post discography CT scans. The axial images of these CT scans were used to measure the optimal angle for needle entry into the neuroforamen. The angles were taken bilaterally at levels of C3-4, C4-5, C5-6, C6-7, and C7-T1. The average angle between the patient's left and right side was calculated. A total of 190 patients were analyzed, including 73 men and 117 women, with ages ranging from 21 to 78 years old. RESULTS: In both men and women, the mean optimal angle (in degrees) with standard deviation measured in the 190 patients at C3-4, C4-5, C5-6, C6-7, and C7-T1 were 48 ± 4, 49 ± 4, 49 ± 4, 49 ± 5, 48 ± 6, respectively. The 95% confidence interval for the true value of the parameter is within 39.84 to 57.56 degrees. LIMITATIONS: The data for the optimal needle entry angle for CTFESI has yet to be tested or confirmed in clinical studies. CONCLUSION: This is the first study investigating the optimal needle entry angle for performing CTFESIs or CSNRB. Based on a patient population of 190, the optimal entry angle using the anterior oblique approach appears to be between the range of 33 to 68 degrees with an average of slightly less than 50 degrees. Further research with angle of needle entry and/or initial fluoroscopic alignment of approximately 50 degrees in CTFESI or CSNRB is warranted to confirm the usefulness of these findings.

Factors influencing the persistence of organochlorine pesticides in surface soil from the region around the Hongze Lake, China.

Contamination by organochlorine pesticides (OCPs), such as hexachlorobenzene (HCB), DDTs and hexachlorocyclohexane isomers (HCHs) was examined in surface soils from paddy, upland and wetland fields in the region around the Hongze Lake in 2009, and some factors influencing residual levels of OCPs in soils were analyzed. DDTs and HCHs were the predominant contaminants in soils. The residual levels of OCPs in cultivated soils were significantly higher than those of corresponding counterparts in wetland soils. It indicated the agricultural usage amount of OCPs principally accounted for the presence of their residues in soil. Among these organochlorines and their metabolites detected in the soil samples, ß-HCH and p, p'-DDE were the two dominant substances of HCHs and DDTs, respectively. The ratio of w(DDT)/w(DDD+DDE) and the ratio α-HCH/γ-HCH also suggested residual HCHs and DDTs in soil resulted from technical HCH (no elimination of Lindane) and DDT applied in this region in the past and there has been no recent input. The analysis of linear correlation indicated that soil pH and TOC influenced the residues of α-HCH and ß-HCH, respectively. The principal component analysis (PCA) showed the contents of OCPs in soils probably were related to their usage amount in the past and octanol-water coefficient (Kow). Compared with the corresponding data from other places and the protection guidelines of Netherlands, US EPA and China, the region around the Hongze Lake may be generally categorized as a slightly polluted area and it is suitable for agriculture production.

Efficacy and safety of hyaluronan treatment in combination therapy with home exercise for knee osteoarthritis pain.

OBJECTIVE: To assess the efficacy and safety of intra-articular injections of sodium hyaluronate combined with a home exercise program (HEP) in the management of pain associated with osteoarthritis (OA) of the knee. DESIGN: Single-blinded, parallel-design, 1-year clinical study with sequential enrollment. SETTING: University-based outpatient physiatric practice. PARTICIPANTS: Sixty patients (18 men, 42 women; age, > or =50 y) with moderate-to-severe pain associated with OA of the knee. INTERVENTIONS: (1) Five weekly intra-articular hyaluronate injections (5-HYL); (2) 3 weekly intra-articular hyaluronate injections (3-HYL); or (3) a combination of an HEP with 3 weekly intra-articular hyaluronate injections (3-HYL+HEP). MAIN OUTCOME MEASURES: The primary outcome measure was a 100-mm visual analog scale for pain after a 50-foot walk (15.24 m). Secondary measures included the Western Ontario and McMaster Universities Osteoarthritis Index subscales. RESULTS: The 3-HYL+HEP group had significantly faster onset of pain relief compared with the 3-HYL (P<.01) and 5-HYL groups (P=.01). All groups showed a mean symptomatic improvement from baseline (reduction in baseline pain at 3 mo was 59%, 49%, and 48% for the 3-HYL+HEP, 3-HYL, and 5-HYL groups, respectively) that was clinically and statistically significant. There were no between-group differences in the incidence or nature of adverse events. CONCLUSIONS: The combined use of hyaluronate injections with HEP should be considered for management of moderate-to-severe pain in patients with knee OA.

Injections in patients with osteoarthritis and other musculoskeletal disorders: use of synthetic injection models for teaching physiatry residents.

This study examined whether resident injection skills could be enhanced using synthetic injection models. A total of 30 physiatry residents underwent written and injection-model pretesting and posttesting. After randomization into injection-model and control groups, the experimental group trained by watching an instructional videotape and by using models that gave visual feedback on injection accuracy, whereas the control group studied technical aspects of injections. Immediately after patient injections, a blinded attending graded residents on the required level of verbal or manual assistance. The experimental group performed significantly better during patient injections as per first injection data (i.e., the scores obtained from performing a procedure for the first time on each particular body region; P = 0.013), total injection data (i.e., the mean scores obtained from performing all procedures on each particular body region; P = 0.017), and postrotation practical testing (P < 0.007) but not for didactic knowledge (postrotation written testing; P < 0.039). Data analysis by body region showed significant benefit only for occasionally performed patient injection procedures. The benefit was most evident in less experienced residents. Injection-model accuracy testing correlated with actual patient injections, both for first injections into each major body region (r = 0.52, P = 0.005) and for all injections (r = 0.55, P = 0.003). Consideration should be given for incorporating injection-model training into residency education, especially for residents with less injection experience and for occasionally performed procedures. The overall correlation between model practical testing and subsequent patient injection performance suggests that models can measure injection competence.

Pyridoxine hydrochloride treatment of carpal tunnel syndrome: a review.

It has been hypothesized that idiopathic carpal tunnel syndrome (CTS) is a manifestation of vitamin B6 deficiency. Some claim that B6 supplementation can alleviate symptoms. Others argue that pain relief occurs because of vitamin B6's anti-nociceptive properties or because B6 supplementation addresses an unrecognized peripheral neuropathy. Few studies on CTS and B6 employed electrodiagnostic techniques in diagnosis, and few showed a correlation between symptoms and improved electrodiagnostic parameters with supplementation. Other studies failed to measure or estimate B6 levels. Nevertheless, it appears reasonable to recommend vitamin B6 supplementation to people with CTS. Some patients will improve symptomatically with low risks of toxicity in recommended doses.

Central post-stroke pain syndrome: yet another use for gabapentin?

Although gabapentin was originally developed for treating partial seizures, it has been used mainly to treat various peripheral neuropathic pain conditions; however, there is very limited experience with gabapentin for the treatment of pain conditions of the central nervous system like central post-stroke pain syndrome. We report the case of a 45-yr old man with central post-stroke pain syndrome who failed to respond to a variety of oral analgesics, but within 2 wk of the inception of gabapentin therapy, his average pain was significantly reduced and his level of function improved. We conclude that gabapentin may be an effective medication for the treatment of central post-stroke pain syndrome.

Gabapentin in the treatment of neuropathic pain after spinal cord injury: a prospective, randomized, double-blind, crossover trial.

BACKGROUND: Neuropathic pain is a common complaint after traumatic spinal cord injury (SCI). Gabapentin, a synthetic structural analogue of GABA, has been shown to have beneficial effects in the treatment of neuropathic pain in other diagnostic groups; however, no standardized clinical trial has been performed to evaluate its efficacy after SCI. DESIGN: A 10-week, prospective, randomized, double-blind, crossover, and placebo-controlled clinical trial. OBJECTIVE: To determine the efficacy of gabapentin in the treatment of SCI-related neuropathic pain. METHODS: Seven subjects with neuropathic pain, who were more than 30 days post-SCI, completed the study. Two groups received a 4-week course of gabapentin and placebo in a randomized crossover design with a 2-week washout period. The Neuropathic Pain Scale was used to record daily pain levels. Data were analyzed using the Wilcoxon signed rank test. RESULTS: Gabapentin has some beneficial effects on certain types of neuropathic pain. There was a significant decrease of "unpleasant feeling" and a trend toward a decrease in both the "pain intensity" and "burning sensation" at the fourth week of gabapentin treatment compared with those on the placebo. No significant difference was found among other pain descriptors during the gabapentin and placebo treatment, although this may have been limited by the small sample size and low maximum dosage of gabapentin. CONCLUSIONS: Gabapentin reduces certain types of neuropathic pain in the SCI population. Future studies with larger sample sizes, higher dosages, and quicker titration will help further determine the efficacy of gabapentin in the treatment of SCI-related neuropathic pain.

Pain, dizziness, and central nervous system blood flow in cervical extension: vascular correlations to beauty parlor stroke syndrome and salon sink radiculopathy.

OBJECTIVE: Professional shampoos have previously been implicated in beauty parlor stroke syndrome and salon sink radiculopathy. The purpose of this study was to record pain, dizziness, and cervical blood flow while subjects were specifically placed into the salon sink position and to determine whether an additional cervical support would alter these symptoms and measurements. DESIGN: In 25 volunteers who reported previous dizziness from salon shampoos, we recorded subjective levels of pain and dizziness and objective measurements of blood flow within the vertebral and carotid arteries at baseline and then during cervical extension into a salon sink, with and without additional cervical support. RESULTS: When the additional cervical support was not used, there was significantly greater dizziness, neck pain, and carotid blood flow. No statistically significant differences were seen in the vertebral artery blood flow when comparing the three positions. CONCLUSIONS: Pain and dizziness were commonly reproduced in this previously symptomatic population but significantly less frequently when a supplemental cervical support was used. Individuals with a history of such symptoms should probably exercise caution when deciding whether to receive a salon sink shampoo.