High Serum Levels of TGF-β in Iranians With Chronic HBV Infection

Background

The transforming growth factor-β (TGF-β) is an important cytokine with anti-inflammatory properties.

Objectives

The main purpose of this study was to compare the serum levels of TGF-β in a group of chronic HBV infected (CHB) patients as well as healthy individuals from South-East of Iran.

Patients and Methods

Sixty patients with CHB as well as sixty healthy individuals were enrolled in the study. ELISA technique was applied to measure the serum levels of TGF-β in both groups.

Results

Our results revealed that the serum levels of TGF-β were significantly increased in CHB patients in compare to healthy controls.

Conclusions

According to this result, it may be concluded that high serum levels of TGF-β may be a mechanism by which immune response against HBV is suppressed.     

Evaluation of Myocardial Function by Pulsed Tissue Doppler in Kawasaki Disease

Myocarditis is a well-recognized component of Kawasaki disease, with left ventricular dysfunction occurring in more than half of patients during the acute phase. The purpose of this study was to evaluate myocardial function in patients with Kawasaki disease using pulsed tissue Doppler imaging (TDI). Twenty-five patients with the diagnosis of acute Kawasaki disease were enrolled in the study. All patients underwent echocardiographic studies at the time of diagnosis of the disease, in its acute phase, prior to treatment, and then 4 weeks later. For an aged-matched control group with fever and no cardiac disease, the same echocardiographic evaluations were performed. Peak velocities of systolic (Sa), early diastolic (Ea), and late diastolic (Aa) motion of the annulus were obtained at the lateral and septal sides in apical four-chamber view, and TDI-derived myocardial performance index (TDI-MPI) was also calculated. Peak Ea velocity of lateral mitral annulus was decreased significantly during the acute phase of illness (14 ± 4.40 vs. 17.67 ± 4.41; P = 0.028). In seven patients with carditis, changes in Ea-to-Aa ratio of septum (1.28 ± 0.278 vs. 1.78 ± 0.49; P = 0.018) and lateral mitral annulus (1.23 ± 0.496 vs. 2.11 ± 0.822; P = 0.014) were statistically significant but TDI-MPI showed no statistically significant changes. This study showed that peak mitral annular Ea velocities obtained by TDI were significantly altered in the acute phase of Kawasaki disease. TDI- MPI does not add an incremental benefit to other indexes of myocardial performance for comprehensive myocardial function in the acute phase of Kawasaki disease.     

CCR5 Δ 32 mutation is not prevalent in Iranians with chronic HBV infection

CCR5 is an important chemokine receptor involved in the recruitment of specific anti‐viral immune cells (e.g., NK cells and T cytotoxic cells) to the liver. Previous studies indicated that the Δ 32 mutation in CCR5 gene led to inactivation of CCR5. Several conflicting studies have suggested that this mutation may be associated with either recovery or persistence of HBV infection. The main purpose of this study was to compare the frequency of the Δ 32 mutation within the CCR5 gene in a group of patients infected chronically with HBV with healthy individuals from South‐East of Iran. Sixty patients with chronic HBV infection as well as 300 age‐, and sex‐match healthy individuals were enrolled in this study. Gap‐PCR was applied to determine the frequency of CCR5 Δ 32 mutation in both groups. The results demonstrated that none of the patients infected with HBV carried the CCR5 Δ 32 mutation while, 3 (1%) of the healthy individuals were found to be heterozygotic for this mutation. The CCR5 Δ 32 mutation is not a prevalent mutation in either the patients infected chronically with HBV or their health counterparts in the South‐East region of Iran. This may be attributed to either different genetic settings of the investigated population or lack of any significant correlation between this mutation and HBV pathogenicity. J. Med. Virol. 85: 964–968, 2013. © 2013 Wiley Periodicals, Inc.     

Recognition and sequestration of ω-fatty acids by a cavitand receptor

One of the largest driving forces for molecular association in aqueous solution is the hydrophobic effect, and many synthetic receptors with hydrophobic interiors have been devised for molecular recognition studies in water. Attempts to create the longer, narrower cavities appropriate for long-chain fatty acids have been thwarted by solvophobic collapse of the synthetic receptors, giving structures that have no internal spaces. The collapse generally involves the stacking of aromatic panels onto themselves. We describe here the synthesis and application of a deep cavitand receptor featuring “prestacked” aromatic panels at the upper rim of the binding pocket. The cavitand remains open and readily sequesters biologically relevant long-chain molecules—unsaturated ω-3, -6, and -9 fatty acids and derivatives such as anandamide—from aqueous media. The cavitand exists in isomeric forms with different stacking geometries and n-alkanes were used to characterize the binding modes and conformational properties. Long alkyl chains are accommodated in inverted J-shaped conformations. An analogous cavitand with electron-rich aromatic walls was prepared and comparative binding experiments indicated the role of intramolecular stacking in the binding properties of these deep container molecules.Molecular recognition of long-chain fatty acids, lipids, membrane components, and hydrocarbons in water poses the general problems of size, shape, and surface complementarity and the special problem of solubility. What types of structures offer large lipophilic surfaces but still dissolve in water? Natural receptors such as the fatty acid-binding proteins (FABPs) incorporate hydrophobic cavities within superstructures with hydrophilic surfaces. The protein backbone and dense packing of side chains prevent collapse of the cavities. Synthetic receptors of the appropriate recognition features comprise deep cavitands (1) and other open-ended host structures (2, 3) that more or less fold around their guest targets. As initially encountered by Cram et al. (4), deep cavitands are dynamic and interconvert between two conformations in organic media: a receptive “vase” form and the unreceptive “kite” form as its dimeric “velcrand” (Fig. 1) (4–8). Stacking of aromatic surfaces in the velcrand buries one face of each kite and is driven by a generalized solvophobic effect. The vase can be rigidified by covalent bonds (9–13) but in water the dynamic cavitands collapse into velcrands through the more specific hydrophobic effect. The presence of appropriate guests shifts the equilibrium to the vase conformation: The guest must fit into, fill, and solvate the cavitand host’s hydrophobic interior. Binding of guest molecules by container compounds is often dependent on the volume of the host. Recognition of long-chain, linear hydrocarbons by biological receptors and synthetic supramolecular hosts generally involves ∼55% volume occupancy and relatively low surface complementarity (14–16). Cavitands with a depth of 1 nm are readily prepared and bind medium-chain n-alkanes, from octane (C₈) to decane (C₁₀). Longer alkanes such as tetradecane (C₁₄) often induce the formation of dimeric, capsule-like assemblies in which the alkyls assume compressed conformations involving folding and coiling (17, 18). Common, long-chain fatty acids bearing saturated or unsaturated alkyl chains are not readily accommodated in dimeric capsules (19, 20) or in the vase forms of typical cavitands. Here, we report a deeper cavitand with a longer, narrower cavity that readily sequesters physiologically relevant fatty acids and derivatives from aqueous media.Open in a separate windowFig. 1.Modeled depictions of cavitand conformations. Cavitands interconvert between a vase shape (Left) and a flattened kite shape (Center). The kite can dimerize to a velcrand (Right) through solvophobic interactions, whereas the vase is favored by the presence of guests that can solvate the cavity.     

Initial experience with two-incision laparoscopic adjustable gastric banding

BackgroundTo introduce the 2-incision technique for laparoscopic adjustable gastric banding (LAGB) and report our experience with 25 consecutive patients. Newer applications of minimally invasive laparoscopic techniques have been touted as revolutionary.MethodsWe have introduced a technique for LAGB that uses 2 skin incisions: 1 incision in the right upper quadrant (2.5 cm) that accommodates 2 trocars (11 and 5 mm) through which the dissection and implantation of the band were undertaken, and a 0.5-cm incision in the left upper quadrant for the 5-mm videoscope. The band reservoir was placed in a subcutaneous pocket through the upper quadrant incision. Previously, we used a standard 5-incision technique: 2 in the right upper quadrant, 2 in the left paramedian, and 1 in the subxyphoid area to retract the liver. The data from 25 consecutive 2-incision LAGB procedures (October 2007 to April 2008) were compared with the data from 19 consecutive standard 5-incision LAGB procedures (July 2007 to October 2007). The data are presented as mean ± SD. The t test was used to compare the mean values, and P <.05 was considered significant.ResultsThe mean estimated blood loss in the 2-incision LAGB was 54 ± 2 mL compared with 17 ± 1 mL in the standard technique (P = .040). The mean operating time for the 2-incision LAGB was 119 ± 1 minutes compared with 103 ± 1 minutes for the standard technique (P = .047). No mortality or procedure-related complications (e.g., erosion, slippage) occurred in the 2 groups.ConclusionTwo-incision LAGB is feasible; however, it is associated with an increased operating time and blood loss. The operating time and blood loss might improve with standardization of the operative technique and introduction of newly designed flexible tip instruments. Additional prospective studies with a larger sample size are needed to assess the efficacy and benefit of the 2-incision technique versus the standard technique.     

Revised reference curves of bone mineral density according to age and sex for Iranian children and adolescents

Summary

Bone health evaluation in children requires an appropriate reference database. We have shown higher curves for spine aBMD in Iranian subjects than Americans, but lower curves for femoral neck and total body. These results can be used as reference values to assist Iranian clinicians in interpreting and monitoring bone densitometry results.

Purpose

Bone health evaluation requires an appropriate reference database that can identify the bone deficit according to age, sex, puberty, and race. The aim of this study was to determine bone mineral density Z-scores in Iranian children and adolescents and their comparability with other reference data.

Methods

A sample of 476 healthy children and adolescents, aged 9–18 years, from Kawar (an urban community, 50 km east of Shiraz, Iran) was selected and bone mineral measurements of the lumbar spine, femoral neck, and total body (less head) were done. Sex-specific height-for-age, weight-for-age, and BMI-for-age Z-scores, as well as bone mineral density Z-scores, were calculated.

Results

Extended reference curves for bone mineral content (BMC) and areal bone mineral density (aBMD) of the total body less head, lumbar spine, and femoral neck, for ages 9–18 years were constructed relative to sex and age. We found that median, ??2SD, and +?2SD curves for the lumbar spine aBMD were higher in Iranian subjects than in the American participants, but the curves of the femoral neck and total body were lower. Also, we showed that subjects with a lower height-for-age Z-score had a lower BMC and aBMD Z-score in the lumbar spine, femoral neck, and total body (p?<?0.001).

Conclusions

Relevant differences in bone mineral density and its curves exist between Iranian children and adolescents and other databases, revealing a significant potential for misdiagnosis. However, our results can be used to provide reference databases to assist clinicians in interpreting, assessing, and monitoring bone densitometry.