In-vitro and in-vivo cytotoxicity and efficacy evaluation of novel glycyl-glycine and alanyl-alanine conjugates of chitosan and trimethyl chitosan nano-particles as carriers for oral insulin delivery

Purpose

The aim of this research work was to explore the possibility of providing multifunctional oral insulin delivery system by conjugating several types of dipeptides on chitosan and trimethyl chitosan to be used as drug carriers.

Utility of the INTERMACS profile at the time of assessment for heart transplant

The Interagency Registry of Mechanically Assisted Circulatory Support (INTERMACS) profiles are associated with mortality in heart failure patients undergoing ventricular assist device (VAD) implantation and heart transplantation (HTx). We assessed the prognostic value of the INTERMACS profile at the time of assessment for HTx or durable VAD implantation as bridge to candidacy (BTC). A total of 503 consecutive patients considered for HTx or VAD between 2006 and 2016 were included. The associations between INTERMACS profile and (a) waitlist mortality or delisting, (b) probability of HTx, and (c) overall mortality or delisting were evaluated using multivariable analysis. Median follow-up time was 2.9 years (IQR: 0.9-5.5) during which 184 received VAD, 347 received HTx, and 73 died (27 waitlist, 46 post-transplant). INTERMACS I-II profile was associated with higher waitlist mortality or delisting (HR: 3.83, 95% CI: 1.22-12.03), and this risk was reversed by VAD implantation (HR: 0.12, 95% CI: 0.03-0.50). INTERMACS III-IV profile was associated with a higher probability of HTx (HR: 1.82, 95% CI: 1.37-2.40). INTERMACS profile was not associated with the composite outcome of overall mortality or delisting. These results emphasize the prognostic utility of INTERMACS at time of decision for advanced therapies and its potential value in selecting patients for different interventions.     

In-vitro cytotoxicity,antioxidant, bleomycin-dependent DNA damage and immunomodulatory evaluation of 1-(4-acetylphenyl)-3-aryloxypyrrolidine-2, 5-dione based derivatives

A one pot, economical, and efficient synthesis of 1-(4-acetylphenyl)-3-aryloxypyrrolidine-2,5-diones-based derivatives 5a-l have been accomplished in single steps and in satisfactory yields from 1-(4-acetylphenyl)-pyrrole-2,5-diones 3 and phenols 4a–l. All the compounds were characterized by physical, spectroscopic, and elemental analysis. The selection of the bioassays was based on proving the drug receptor binding concept. Compounds 5g, 5k, 5h, 5i, 5a, and 5f showed the highest inhibitory antioxidant activity using ABTS methods. Compounds 5k, 5g, 5c, 5h, 5b, 5d, 5f, and 5j manifested the best protective effect against DNA damage induced by bleomycin. Moreover, an in-vitro cytotoxic activity evaluation of all synthesized compounds was against four cancer cell lines using 5-Fluorouracil as a standard anticancer drug.     

Anterior Distal Femoral Osteotomy for Removal of Long Femoral Stems in Revision Knee Arthroplasty

Osteotomies of the proximal femur and proximal tibia in revision arthroplasty are well described while guidelines for distal femoral osteotomy are limited. Femoral stems are used with increasing frequency for fixation of revision components in knee arthroplasty and their removal is technically challenging particularly in the setting of infection. We describe a technique of anterior distal femoral osteotomy for revision knee arthroplasty to assist with removal of well-fixed long stemmed cemented or porous femoral components, as well as debridement of infection while preserving bone stock and soft tissue attachments.     

The State of Starch/Hydroxyapatite Composite Scaffold in Bone Tissue Engineering with Consideration for Dielectric Measurement as an Alternative Characterization Technique

Hydroxyapatite (HA) has been widely used as a scaffold in tissue engineering. HA possesses high mechanical stress and exhibits particularly excellent biocompatibility owing to its similarity to natural bone. Nonetheless, this ceramic scaffold has limited applications due to its apparent brittleness. Therefore, this had presented some difficulties when shaping implants out of HA and for sustaining a high mechanical load. Fortunately, these drawbacks can be improved by combining HA with other biomaterials. Starch was heavily considered for biomedical device applications in favor of its low cost, wide availability, and biocompatibility properties that complement HA. This review provides an insight into starch/HA composites used in the fabrication of bone tissue scaffolds and numerous factors that influence the scaffold properties. Moreover, an alternative characterization of scaffolds via dielectric and free space measurement as a potential contactless and nondestructive measurement method is also highlighted.     

Pulmonary hypertension in patients with end-stage renal disease

BACKGROUND: The aims of this study were to evaluate the incidence of unexplained pulmonary hypertension (PH) among patients with end-stage renal disease (ESRD) and to suggest possible etiologic factors. METHODS: The incidence of PH was prospectively estimated by Doppler echocardiography in 58 patients with ESRD receiving long-term hemodialysis via arteriovenous access, and in control groups of 5 patients receiving peritoneal dialysis (PD) and 12 predialysis patients without a known other cause to suggest the presence of PH. Clinical variables were compared between patients with and without PH receiving hemodialysis. Changes in pulmonary artery pressure (PAP) values before and after onset of hemodialysis via arteriovenous access, arteriovenous access compression, and successful kidney transplantation were recorded. RESULTS: PH > 35 mm Hg was found in 39.7% of patients receiving hemodialysis (mean +/- SD, 44 +/- 7 mm Hg; range, 37 to 65 mm Hg), in none of the patients receiving PD, and in 1 of 12 predialysis patients. Patients with PH receiving hemodialysis had a significantly higher cardiac output (6.9 L/min vs 5.5 L/min, p = 0.017). PH developed in four of six patients with normal PAP after onset of hemodialysis therapy via arteriovenous access. One-minute arteriovenous access compression in four patients decreased the mean systolic PAP from 52 +/- 7 to 41 +/- 4 mm Hg (p = 0.024). PH normalized in four of five patients receiving hemodialysis following kidney transplantation. Kaplan-Meier survival analysis according to PAP values revealed significant survival differences (p < 0.024). CONCLUSIONS: This study demonstrates a surprisingly high incidence of PH among patients with ESRD receiving long-term hemodialysis with surgical arteriovenous access. Both ESRD and long-term hemodialysis via arteriovenous access may be involved in the pathogenesis of PH by affecting pulmonary vascular resistance and cardiac output.     

Thyrotropin internalization is directed by a highly conserved motif in the seventh transmembrane region of its receptor

The thyrotropin (TSH) receptor is a member of G protein-coupled seven-transmembrane-segment receptors. It is characterized by a large extracellular domain linked to the seven transmembrane segments and ending with a cytoplasmic tail. Sequence alignment shows that a highly conserved motif, NPXXY where X is any amino acid, exists at the boundary between the seventh transmembrane domain and proximal part of the cytoplasmic tail of virtually all G protein-coupled receptors. This motif has been implicated as an internalization signal for several cell surface receptors, such as the low density lipoprotein (LDL), insulin and insulin-like growth factor-1 (IGF-1) receptors. The potential effects of this motif on the TSH receptor signal transduction and receptor-mediated TSH internalization was analysed by replacement of the tyrosine⁶⁷⁸ residue with an alanine residue. This mutation does not impair high affinity TSH binding, but completely abolishes the ability of cAMP response upon TSH stimulation. It also significantly reduces TSH internalization. The role of the cytoplasmic tail of the TSH receptor in receptor-mediated internalization was also assessed. Deletion of up to 56 amino acids from the C-terminus of the cytoplasmic tail enhances TSH internalization as compared to the wild-type receptor. We conclude that tyrosine⁶⁷⁸ in the NPXXY motif is required for efficient receptor-mediated TSH internalization and G protein coupling. The cytoplasmic tail of the TSH receptor may contain sequence domains which could modulate the effects of the NPXXY internalization signal.