Round Pendant Around the Neck–Thyroid. A Review

The rare situation of thyroid stone is discussed with literature review and case report. A case of isolated solitary stone of the thyroid is documented here. There are incidences of calcification in the thyroid gland commonly associated with carcinoma thyroid and multinodular goiter. But solitary stone of thyroid is reported rarely and one such case is reported from India. The possibility of malignancy is high, in case of calcification of thyroid swellings. Hence, isolated calcification should be surgically treated even if fine needle aspiration cytology is negative for malignancy.     

Efficacy of red and infrared lasers in treatment of temporomandibular disorders — a double-blind,randomized, parallel clinical trial

Aim:

Low-level laser therapy has still not been well established, and it is important to define a standardized protocol for the treatment of temporomandibular disorders (TMDs) using low level laser. There is no consensus on controlled clinical trials concerning the best option for laser therapy with regard to wavelength. The aim of this study was to evaluate the efficacy of red and infrared laser therapy in patients with TMD, using a randomized parallel-group double-blind trial.

Methodology:

Each hemiface of 19 subjects was randomized to receive intervention, in a total of 116 sensitive points. Pain was measured at baseline and time intervals of 24 hours, 30 days, 90 days, and 180 days after treatment. Irradiation of 4 J/cm² in the temporomandibular joints and 8 J/cm² in the muscles was used in three sessions.

Results:

Both treatments had statistically significant results (P<0·001); there was statistical difference between them at 180 days in favor of the infrared laser (P?=?0·039). There was improvement in 24 hours, which extended up to 180 days in both groups.

Conclusion:

Both lasers are effective in the treatment and remission of TMD symptoms.     

Defining Talar Head and Neck Pathology: The Malvern Classification System

Talar fractures account for <1% of all fractures in the body and 3% to 6% of pedal fractures. Of these fractures, avulsion and neck fractures represent the most and second most common type, respectively. Several classification systems exist for talar fractures of the talar dome (Berndt-Hardy), talar neck dislocation (Hawkins), and talar body (Sneppen) anatomic locations. Although diverse, they are not all encompassing for fracture patterns of the talus. Another set of pathologic issues occur about the talar head and neck region that can be seen in the clinical setting. Thus, a new classification system (Malvern classification system for talar head/neck fractures) was devised and defined for this location. The system represents a comprehensive review of the available published data and synthesis into an organized classification system.     

Anti‐EF‐Tu IgG titers increase with age and may contribute to protection against the respiratory pathogen Haemophilus influenzae

Non‐typeable Haemophilus influenzae (NTHi) is a pathogen that commonly colonizes the nasopharynx of preschool children, causing opportunistic infections including acute otitis media (AOM). Patients suffering from chronic obstructive pulmonary disease (COPD) are persistently colonized with NTHi and occasionally suffer from exacerbations by the bacterium leading to increased morbidity. Elongation‐factor thermo unstable (EF‐Tu), a protein critical for bacterial protein synthesis, has been found to moonlight on the surface of several bacteria. Here, we show that antibodies against NTHi EF‐Tu were present in children already at 18 months of age, and that the IgG antibody titers increased with age. Children harboring NTHi in the nasopharynx also displayed significantly higher IgG concentrations. Interestingly, children suffering from AOM had significantly higher anti‐EF‐Tu IgG levels when NTHi was the causative agent. Human sera recognized mainly the central and C‐terminal part of the EF‐Tu molecule and peptide‐based epitope mapping confirmed similar binding patterns for sera from humans and immunized mice. Immunization of BALB/c and otitis‐prone Junbo (C3H/HeH) mice promoted lower infection rates in the nasopharynx and middle ear, respectively. In conclusion, our results suggest that IgG directed against NTHi EF‐Tu may play an important role in the host immune response against NTHi.     

Sequential divergence and the multiplicative origin of community diversity

Phenotypic and genetic variation in one species can influence the composition of interacting organisms within communities and across ecosystems. As a result, the divergence of one species may not be an isolated process, as the origin of one taxon could create new niche opportunities for other species to exploit, leading to the genesis of many new taxa in a process termed “sequential divergence.” Here, we test for such a multiplicative effect of sequential divergence in a community of host-specific parasitoid wasps, Diachasma alloeum, Utetes canaliculatus, and Diachasmimorpha mellea (Hymenoptera: Braconidae), that attack Rhagoletis pomonella fruit flies (Diptera: Tephritidae). Flies in the R. pomonella species complex radiated by sympatrically shifting and ecologically adapting to new host plants, the most recent example being the apple-infesting host race of R. pomonella formed via a host plant shift from hawthorn-infesting flies within the last 160 y. Using population genetics, field-based behavioral observations, host fruit odor discrimination assays, and analyses of life history timing, we show that the same host-related ecological selection pressures that differentially adapt and reproductively isolate Rhagoletis to their respective host plants (host-associated differences in the timing of adult eclosion, host fruit odor preference and avoidance behaviors, and mating site fidelity) cascade through the ecosystem and induce host-associated genetic divergence for each of the three members of the parasitoid community. Thus, divergent selection at lower trophic levels can potentially multiplicatively and rapidly amplify biodiversity at higher levels on an ecological time scale, which may sequentially contribute to the rich diversity of life.Population divergence is a fundamental evolutionary process contributing to the diversity of life (1). Studies of how new life forms originate typically focus on how barriers to gene flow evolve in specific lineages, resulting in their divergence into descendent daughter taxa. As a result, evolutionary biologists now have a good understanding of how variation within a population is transformed by selection into differences between taxa (1–3). What is less well understood is whether the divergence of one population has consequences that ripple through the trophic levels of an ecosystem and affect entire communities of interacting organisms. Studies in paleontology (4–6), community ecology (7, 8), systematics (8, 9), and ecosystem genetics (10, 11) suggest that evolutionary change in one lineage can influence entire communities of organisms. For example, when the genotype/phenotype of a “foundation” species influences the relative fitness of other species, evolutionary change(s) in this genotype/phenotype may affect organisms in adjacent trophic levels (10, 11). If these evolutionary changes are linked to ecological adaptation and reproductive isolation (RI), associated organisms may diverge in parallel, potentially creating entire coevolved communities distinct from one another (12–15). Therefore, population divergence may not always be an isolated process, as the differentiation of one taxon could beget the divergence of many others.Such “sequential” or “cascading” divergence events may be particularly relevant to understanding why some groups of organisms, like plants, the insects that feed on them, and the parasitoids that attack the insects, are more diverse and species-rich than other groups (8, 9, 12–15). Specifically, when phytophagous insects diversify by adapting to new host plants, they create a new habitat for their parasitoids to exploit (Fig. 1). If a parasitoid shifts to the new habitat, it can encounter the same divergent ecological selection pressures as its insect host, which could result in the parallel divergence of insect host and parasitoid (12–15) (Fig. 1A). Moreover, sequential divergence may have multiplicative effects in generating biodiversity, as the shift of an insect to a new plant may open a new niche opportunity for not just one but the entire community of parasitoids attacking the insect host (12, 13) (Fig. 1B). However, few convincing examples of sequential divergence exist (12–15), and in no study is there both genetic and ecological evidence for sequential divergence multiplicatively amplifying biodiversity.Open in a separate windowFig. 1.Three scenarios of codivergence in a host−parasitoid system. (A) A single sequential divergence event, (B) sequential divergence with multiplicative amplification of biodiversity, and (C) cospeciation in allopatry. In A, codivergence is driven by the cascade of divergent ecological selection pressures across trophic levels in sympatry. Here, a degree of divergent ecological adaptation must accompany the host shift such that parasitoids are not merely moving between geographically separated hosts. In B, the multiplicative effects of sequential divergence can be seen as several members of the parasitoid community diverge in parallel with their host. In C, codivergence (cospeciation) occurs after host plant, fly, and parasitoid populations become jointly geographically isolated (black bar), resulting in parallel allopatric speciation. Here, little differentiation need accompany the initial host shift of fly or parasitoid. Cospeciation is not necessarily driven by the creation and adaptation to new niches but by the concordant geographic and reproductive separation of hosts and parasitoids.Here, we test for the multiplicative effects of sequential divergence in the community of parasitoid wasps (Hymenoptera: Braconidae) that attack fruit flies in the Rhagoletis pomonella sibling species complex (Diptera: Tephritidae) (Fig. 2). Several features of the biology and biogeography of the Rhagoletis−parasitoid system make it ideal for investigating the multiplicative divergence hypothesis and allow us to directly test multiple criteria supporting sympatric host race formation (16) and sequential divergence (12, 13), summarized in 1–3, 17–19), the hypothesized initial stage of ecological speciation (16, 17). The short time frame and sympatric spatial context of R. pomonella’s shift to apple exclude passive codivergence or speciation (Fig. 1C) as an explanation for differentiation. Specifically, fly and wasp populations could not have diverged in concert, because they became jointly geographically separated in the past (Fig. 1C). Rather, if flies and wasps display concordant adaptations, it is likely due to the direct effects of divergent ecological selection resulting from host shifts cascading from host plants to flies to parasitoids (Fig. 1 A and B).Open in a separate windowFig. 2.The community of host-specific parasitoids that attack members of the (A) Rhagoletis pomonella sibling species complex: (B) D. alloeum, (C) D. mellea, and (D) U. canaliculatus that (E) emerge from the fly pupal case as adults following overwintering. (Scale bar, 1 mm.)

Table 1.

Summary of conditions (criteria) conducive to and supporting hypotheses of sympatric host race formation (modified from ref. 16) and sequential divergence (modified from refs. 12 and 13)

Improved detection of accessory pathways that bridge posterior septal and left posterior regions in the Wolff-Parkinson-White syndrome.

To improve the detection of accessory pathways that bridge the posterior septum and left posterior free wall, catheter maps of the coronary sinus from 21 patients (group I) who needed dissection of both these anatomic regions were compared with data from 23 (group II) with pathways confined to the posterior septum and from 9 (group III) with left posterior pathways. A decapolar catheter was used to map the coronary sinus in 0.5 to 1 cm steps. Intraoperative mapping was performed with a 16-electrode band. Catheter maps during atrial pacing and orthodromic supraventricular tachycardia were analyzed for the site of earliest activation and for differences in a new directional measure of conduction time between adjacent mapping sites. The site of earliest activation alone did not distinguish accessory pathways that bridged both anatomic regions, because 14 of 21 patients (66%) in group I would have been misclassified to either group II or III. In contrast, anterograde and retrograde directional conduction times distinguished patients in group I from those in groups II (p less than 0.01 to less than 0.0003) and III (p less than 0.04 to less than 0.0001). A multivariate model that incorporated the observed differences in directional interelectrode conduction times improved the identification of group I patients, with a sensitivity of 87% and a specificity of 90%. The results define new features in activation patterns measurable during catheter mapping that identify accessory pathways that bridge the posterior septum and left posterior free wall.     

Structural changes of tumor necrosis factor alpha associated with membrane insertion and channel formation.

Low pH enhances tumor necrosis factor alpha (TNF)-induced cytolysis of cancer cells and TNF-membrane interactions that include binding, insertion, and ion-channel formation. We have also found that TNF increases Na+ influx in cells. Here, we examined the structural features of the TNF-membrane interaction pathway that lead to channel formation. Fluorometric studies link TNF's acid-enhanced membrane interactions to rapid but reversible acquisition of hydrophobic surface properties. Intramembranous photolabeling shows that (i) protonation of TNF promotes membrane insertion, (ii) the physical state of the target bilayer affects the kinetics and efficiency of TNF insertion, and (iii) binding and insertion of TNF are two distinct events. Acidification relaxes the trimeric structure of soluble TNF so that the cryptic carboxyl termini, centrally located at the base of the trimer cone, become susceptible to carboxypeptidase Y. After membrane insertion, TNF exhibits a trimeric configuration in which the carboxyl termini are no longer exposed; however, the proximal salt-bridged Lys-11 residues as well as regional surface amino acids (Glu-23, Arg-32, and Arg-44) are notably more accessible to proteases. The sequenced cleavage products bear the membrane-restricted photoreactive probe, proof that surface-cleaved TNF has an intramembranous disposition. In summary, the trimer's structural plasticity is a major determinant of its channel-forming ability. Channel formation occurs when cracked or partially splayed trimers bind and penetrate the bilayer. Reannealing leads to a slightly relaxed trimeric structure. The directionality of bilayer penetration conforms with x-ray data showing that receptor binding to the monomer interfaces of TNF poises the tip of the trimeric cone directly above the target cell membrane.     

Isolation and amino acid sequence analysis of a 4,000-dalton dynorphin from porcine pituitary.

A 4,000-dalton dynorphin was isolated from porcine pituitary. It has 32 amino acids (Mr = 3,986), with the previously described heptadecapeptide (now called dynorphin A) at its amino terminus and a related tridecapeptide, dynorphin B, at its carboxyl terminus. The two peptides are separated by the "processing signal" Lys-Arg.