Biochemical Model for Inflammation of the Brain: The Effect of Iron and Transferrin on Monocytes and Lipid Peroxidation

Cerebral inflammation plays a role in diseases such as multiple sclerosis (MS), Alzheimer's disease (AD), and depression. Iron is involved in infection and inflammation through free radical production. Theoretically transferrin should prohibit iron from participating in oxidative reactions, but transferrin has also been found to promote free radical damage. We reported previously that isolation of transferrin from plasma by ion exchange column chromatography produced a broad pink protein band that subsequently separated on a gel filtration column into three proteins containing many metals. In this study some properties of the three proteins were studied in 20 volunteers. Protein 3 (identified as transferrin by nephelometry) contained the most iron while Protein 1 (called "toxiferrin") contained significantly less iron (p < 0.00001). Plasma from volunteers obtained under conditions of infection/inflammation with fever (n = 5) had a significantly increased toxiferrin to transferrin ratio compared to healthy volunteers (n = 15; p < 0.001). In vitro, Protein 2 and transferrin inhibited lipid peroxidation, while toxiferrin (possibly a protease degradation product of transferrin), enhanced lipid peroxidation. Also, toxiferrin (1 mg/mL) caused a significant increase in viability of monocytes as measured by the 3-(4,5-dimethyl-thiazol-2-yl) 2,5-diphenyl tetrazolium bromide (MTT) reduction test, as well as the morphological transformation of monocytes to macrophages.     

Successful usage of tacrolimus (FK506) in resistant/relapsed rheumatic diseases

Aim: This study reports the first successful usage of tacrolimus in various resistant or relapsed rheumatic diseases in Asian patients Methods: This is an open prospective study of the efficacy of tacrolimus for patients with various relapsed/resistant rheumatic diseases who were intolerant of or failed conventional therapy. Patients were enrolled in the study from the period November 2001 to September 2002. Results: A total of 20 patients were included in the study. Their disease conditions were as follows: SLE with relapsed lupus nephritis (six patients); SLE with antiphospholipid syndrome (APS) (two patients); rheumatoid arthritis (five patients); psoriatic arthritis (three patients); scleroderma (two patients); anti–Jo?1 syndrome (two patients). Improvement in their conditions were noted in all but one patient who was intolerant to tacrolimus. Conclusions: Tacrolimus (FK506) is a new armamentarium that can be added to the choice of immunosuppressive agents for rheumatologists, especially for those patients with severe or resistant diseases.     

The application of novel mussel-inspired compounds in dentistry

ObjectiveTo give a current review of the mechanism of mussel adhesion, the application of mussel-inspired compounds in dentistry and the challenges associated with clinical application.MethodsInspired by the wet adhesion property of 3,4-dihydroxyphenol-l-alanine (Dopa) in mussel plaques, various chemical compounds have been synthesized to mimic the mussel as an adhesion model for medical applications. Similar to mussels in the marine environment, dental materials in the oral environment have to endure long-term water hydrolysis, mechanical stress and other chemical challenges. These challenges have influenced an increasing number of studies that are exploring the translation of mussel-inspired adhesion to clinical applications. Therefore, this review discusses the mussel adhesion chemistry and its related application in dentistry.ResultsMussel-inspired compounds have achieved relatively acceptable performances in various dental fields, including surface coating, metal ions chelation, dentin bonding and mucosal adhesion. However, two practical problems remain to be comprehensively addressed, namely the protection of catechol groups from oxidation, and the feasibility for clinical application.SignificanceThe mussel’s wet adhesion ability has attracted much research interest in the dental field because of its properties of moisture-resistant adhesion and surface coating. Despite the emergence of several mussel-inspired compounds in recent years, a comprehensive and timely review of their applications in dentistry is lacking. Therefore, the current review hopes to provide valuable information around the application of mussel-inspired compounds in dentistry with their pros and cons discussed.     

Dysphagia in cerebral palsy: A comparative study of the exeter dysphagia assesment technique and a multidisciplinary assessment

Eighteen children with cerebral palsy in a special school, most of whom had feeding difficulties, were studied to compare the diagnostic value of the Exeter Dysphagia Assessment Technique (EDAT) with an exhaustive clinical assessment undertaken by a multidisciplinary team experienced in the diagnosis and treatment of dysphagia of neurological origin. Four feeding skills were assessed by each method independently, viz. anticipation, intraoral sensory perception, oral-motor efficiency, and pharyngeal triggering. Comparison of the two sets of results showed agreement in at least 78% of the assessed skills. The possible reasons for the few discrepancies are discussed. The noninvasive EDAT equipment was easy to use with the children, who had a range of type and severity of cerebral palsy. The test was undertaken in their familiar surroundings and took 15 to 20 min per child. Interpretation of the results showed that EDAT provided a rapid, reliable diagnostic aid which assisted in the assessment of the degree of feeding impairment within each of the four feeding skills tested. The authors are very grateful for the financial support for this project which was provided partially by Action Research and partially by the Northcott Devon Medical Foundation     

Multiple Genetic Mutations Associated with Polymyxin Resistance in Acinetobacter baumannii

We studied polymyxin B resistance in 10 pairs of clinical Acinetobacter baumannii isolates, two of which had developed polymyxin B resistance in vivo. All polymyxin B-resistant isolates had lower growth rates than and substitution mutations in the lpx or pmrB gene compared to their parent isolates. There were significant differences in terms of antibiotic susceptibility and genetic determinants of resistance in A. baumannii isolates that had developed polymyxin B resistance in vivo compared to isolates that had developed polymyxin B resistance in vitro.     

The predictors of successful percutaneous coronary intervention in ostial left anterior descending artery chronic total occlusion

Background: Percutaneous coronary intervention (PCI) to chronic total occlusion (CTO) has become one of the treatment strategies in recent era. The ostium of the left anterior descending artery (LAD) is one of the most difficult positions for CTO revascularization. Until now, limited data has been made available for the prediction of successful ostial LAD CTO PCI. Objective: The aim of the study was to compare the differences between ostial LAD and all other CTOs and to identify the predictors of successful ostial LAD CTO PCI. Methods: This retrospective analysis included consecutive patients referred for CTO PCI between January 2001 and September 2013. Ostial LAD CTO was defined as CTO at the position whose distance between lesion and left main bifurcation was less than 1 mm. Baseline demographics, lesion characteristics, interventional procedure details, and devices were compared between the ostial LAD group and the all other CTOs group. The predictors of successful ostial LAD CTO PCI were also evaluated. Results: 621 patients who underwent CTO PCI were enrolled retrospectively to this study. A total of 70 patients of ostial LAD CTO were compared with 551 patients of all other CTOs group in this study. Ostial LAD CTO was found to have more bridging and better collaterals than all other CTOs. Procedure time, fluoroscopic time, contrast volumes, the use of contralateral injection, and the use of the retrograde approach were significantly greater in the ostial LAD CTO group. The ostial LAD CTO group also had significantly higher J‐CTO scores (2.7 ± 0.8 vs. 2.2 ± 1.1, P = 0.011) and higher Syntax Scores (28.3 ± 6.5 vs. 20.9 ± 9.7, P < 0.001). A slightly lower final success rate, but statistically non‐significant, was observed in the ostial LAD CTO group (80.0% vs. 81.9%, P = 0.706). Univariate and multivariate logistic regression revealed that without antegrade failure and with retrograde success were predictors of the success of ostial LAD CTO PCI. Syntax Score was also capable of predicting the ostial LAD CTO PCI outcome. J‐CTO score was not found to be associated with final success for ostial LAD CTO patients. Conclusions: Ostial LAD CTO resulted in higher lesion complexity in J‐CTO scores and Syntax Scores. Ostial LAD CTO PCI had a slightly lower final success rate than that of all other CTOs PCI with longer procedure duration, fluoroscopic time and larger contrast volume. Without antegrade failure, with retrograde success, and lower Syntax Score were found to predict the success of ostial LAD CTO PCI. © 2014 Wiley Periodicals, Inc.