Liver fat content determined by magnetic resonance imaging and spectroscopy

Hepatic steatosis as the most prevalent liver disorder can either be related to alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD). In both conditions, hepatocytes excessively accumulate fatcontaining vacuoles within their cytoplasm, which is the key histological feature. In contrast to ALD, NAFLD is commonly associated with metabolic syndrome, obesity and insulin resistance. To determine increased liver fat content, liver biopsy is currently considered the gold standard. Besides the...     

The management of sex offenders: perspectives for psychiatry

In the effort to identify and manage sex offenders, the differences between legal and medical/psychiatric terminology and approaches are readily apparent. This article discusses the different definitions and approaches of the two fields and considers both the behaviors that create risk to others and the strategies for reducing that risk. Particular attention is paid to the subcategory of paraphilic sex offenders. Treatment goals, modalities, and efficacies are discussed, as are evolving legal strategies for risk control and the need for interaction between law and medicine/psychiatry in order to accomplish common goals of risk management.     

Polymerization of proteins into amyloid protofibrils shares common critical oligomeric states but differs in the mechanisms of their formation

Amyloid protofibril formation of phosphoglycerate kinase (PGK) and Syrian hamster prion protein (SHaPrP(90-232)) were investigated by static and dynamic light scattering, size exclusion chromatography and electron microscopy. Changes in secondary structure were monitored by Fourier transform infrared spectroscopy and by circular dichroism. Protofibril formation of the two proteins is found to be a two-stage process. At the beginning, an ensemble of critical oligomers is built up. These critical oligomeric states possess a predominant β-sheet structure and do not interact considerably with monomers. Initial oligomerization and transition to β-sheet structure are coupled events differing in their details for both proteins. Intermediate oligomeric states (dimers, trimers, etc.) are populated in case of PGK, whereas SHaPrP(90-232) behaves according to an apparent two-state reaction between monomers and octamers rich in β-structure with a reaction order varying between 2 and 4. All oligomers coalesce to PGK protofibrils in the second stage, while SHaPrP(90-232) protofibrils are only formed by a subpopulation. The rates of both growth stages can be tuned in case of PGK by different salts preserving the underlying generalized diffusion-collision mechanism. The different kinetics of the early misfolding and oligomerization events of the two proteins argue against a common mechanism of protofibril formation. A classification scheme for misassembly mechanisms of proteins based on energy landscapes is presented. It includes scenarios of downhill polymerization to which protofibril formation of PGK and SHaPrP(90-232) belong.     

Physical properties, durability, and energy-dissipation function of dual-density orthotic materials used in insoles for diabetic patients

BACKGROUND: Patients with neuropathic conditions may develop plantar bony deformities through neuropathic collapse, frequently placing the skin and soft tissues at risk. Orthoses have been used to accommodate and distribute plantar pressures over a large surface area, thereby minimizing peak loading pressures in small regions and reducing the risk of ulceration. METHODS: A previously described bony prominence model (Brodsky et al.) was used to test the pressure-absorbing and force-transmission properties of various orthotic material combinations used in our outpatient clinic. Six materials were tested in five combinations of materials for their compressive properties: [MS]: medium plastazote (M) + soft plastazote (S); [MN]: medium plastazote (M) + nickelplast (N); [NP] nickelplast (N) + Poron (P); [MO] medium plastazote (M) + Spenco (O); and [MC] medium plastazote (M) + P-cell (C). Materials were tested for 100,000 cycles using a materials-testing system (MTS) apparatus (MTS Systems Corporation, Cary, NC) and software. Stress-strain curves comparing the measured peak pressure to the elastic deformation, or the percentage of compression a material experiences with respect to its original thickness, were plotted for each orthotic combination. RESULTS: For MS, MN, MO, and to a lesser extent, MC, a trend was noted for decreased elastic deformation with increased testing. Additionally, the peak pressures before and after testing for each 10,000 testing cycle for each of the orthotic combinations were plotted. For both MN and NP, no demonstrable difference was noted in the peak pressures in the pretesting and post-testing for the 100,000 cycles. The MO showed a trend for increased peak pressures after each testing cycle. Both the MC and MS peak pressures markedly increased with respect to pretesting value. Also, the MN, MO, and MS all showed an overall trend for increased load cell values with increasing cycles at fast loading. CONCLUSIONS: These data showed that some orthotic combinations are more effective than others at reducing peak pressures during compression testing using our bony prominence model. Further studies are needed to test the orthotic combinations for shear and combined shear and compression modes.