In vivo wear. Part I: The Michigan computer-graphic measuring system

Three-dimensional coordinate measuring machines for examining the quality of industrial castings were reviewed. The concept was modified and successfully converted to examine the minute geometric configurations of the surfaces of dental materials. The wear of composites has undoubtedly precipitated this perceptive, thorough study.     

Cholinergic receptor induction and JNK activation in acute pancreatitis

BACKGROUND: Cholecystokinin-A (CCK-A) and cholinergic receptor pathways, capable of activating stress kinases p38 mitogen-activated protein kinase (p38(MAPK)) and cJUN N-terminal kinase (JNK), are implicated in the pathogenesis of ligation-induced acute pancreatitis in rats. As ligation-induced acute pancreatitis in rats is associated with CCK-A receptor induction and p38(MAPK) activation, and as receptor induction could amplify acinar hyperstimulation and exacerbate cell stress, we tested the hypothesis that the cholinergic M3 receptor is induced and JNK is activated in this model. METHODS: Cholinergic M3 receptor expression and JNK activation was compared in rats 1, 3, or 24 hours after sham operation or duct ligation. RESULTS: Immunoblot analysis of pancreatic homogenates showed a time-dependent increase in cholinergic M3 receptor protein, total JNK, and phospho-JNK after duct ligation. CONCLUSIONS: There is a rapid and progressive cholinergic M3 receptor induction and JNK activation in ligation-induced acute pancreatitis in rats. These findings may have significance in the mechanism of disease pathogenesis.     

Intra-articular steroids in knee osteoarthritis: a comparative study of triamcinolone hexacetonide and methylprednisolone acetate

The aim of this study was to compare the effectiveness of triamcinolone hexacetonide (THA) and methylprednisolone acetate (MPA), given via the intra-articular route at equipotent dosage to patients with symptomatic knee OA with effusion, in a double-blind randomized comparative trial. Consecutive hospital-referred patients who fulfilled the American College of Rheumatology criteria for knee OA (clinical and radiographic) were randomly allocated to receive either THA 20 mg (1 ml) or MPA 40 mg (1 ml). All patients had synovial fluid aspirated from their knee joint at the time of injection. Assessments were made at 0, 3 and 8 weeks by a second operator, thus blinding both patient and assessor. Outcomes measured at each visit were: knee pain in the previous 48 h (expressed on a 100 mm visual analog scale; VAS), stair climb time (SCT) and Lequesne index score (LEQ). Changes in VAS, SCT and LEQ were compared between the groups using a Students paired t test. Fifty-seven patients were studied (44 female, 13 male) with a mean age of 62.5 years. Both steroids gave significant pain relief (VAS) at week 3 (p<0.01) but only MPA showed an effect on VAS and LEQ scores at week 8 compared to baseline (p<0.05). THA was more effective than MPA at pain reduction at week 3 (p<0.01); this difference was lost at week 8 (p=0.17). There was no significant difference between the two drugs in functional endpoints (SCT, LEQ) at either 3 or 8 weeks. Both THA and MPA offer at least temporary symptomatic benefit in knee OA. THA is more effective than MPA at week 3, but its effect is lost by week 8. MPA still has an effect at week 8.Abbreviations i.a. Intra-articular - LEQ Lequesne index score - OA Osteoarthritis - MPA Methylprednisolone acetate - SCT Stair climb time - THA Triamcinolone hexacetonide - VAS Visual analog scale     

Rheumatoid arthritis in the developing world

The general impression is that rheumatoid arthritis (RA) has a lower prevalence and a milder course in developing countries. Epidemiological studies from different regions show that varying prevalence is possibly related to urbanization. The data suggest that where severe disability does occur, it presents a significant health challenge because of scarce medical and social resources. Disease-modifying anti-rheumatic drugs (DMARDs) remain the mainstay of therapy to alter the natural history of the disease. New therapies are unlikely to be of general benefit in the developing world because of financial constraints and increased risk of infections, particularly tuberculosis, associated with the use of tumour necrosis factor-alpha blockers. Instead, future research in poorer communities should be directed at assessing the burden of disease, the role of early aggressive therapy with DMARDs in combination with glucocorticoids for the majority of patients with RA, and finally, sourcing targeted biological therapies through clinical trials and grants for compassionate use in patients with refractory disease.     

End-of-life practices in a tertiary intensive care unit in Saudi Arabia

Our aim was to evaluate end-of-life practices in a tertiary intensive care unit in Saudi Arabia. A prospective observational study was conducted in the medical-surgical intensive care unit of a teaching hospital in Riyadh, Saudi Arabia. Over the course of the one-year study period, 176 patients died and 77% of these deaths were preceded by end-of-life decisions. Of these, 66% made do-not-resuscitate decisions, 30% decided to withhold life support and 4% withdrew life support. These decisions were made after a median time of four days (Q1 to Q3: 1 to 9) and at least one day before death (Q1 to Q3: 1 to 4). The patients' families or surrogates were informed for 88% of the decisions and all decisions were documented in the patients' medical records. Despite religious and cultural values, more than three-quarters of the patients whose deaths were preceded by end-of-life decisions gave do-not-resuscitate decisions before death. These decisions should be made early in the patients' stay in the intensive care unit.     

Lycopersene: A review on extraction,identification and purification and applications

Lycopersene is a stable and safe triterpenoid. Lycopersen had utilized as an antioxidant, antimutagenic, antiproliferative, cytotoxicity, antibacterial and pesticide. Obtaining pure Lycopersene from natural sources is very important for fundamental research and the above applications. The present overview provides an up-to-date and comprehensive summary of the various methods used for extraction, isolation and purification of Lycopersene from natural sources with its applications in food, cosmetics and pharmaceutical fields. Many different extraction methods ranging from conventional techniques (e.g. Soxhlet extraction, Maceration and Rotary evaporator) and other advanced extraction technologies (e.g. Solid-phase microextraction, steam distillation with Clevenger, Clevenger apparatus, Chromatography on SiO₂ column, centrifuge, sonication) had been used to obtain Lycopersene from flora and fauna. Purification techniques, alone or in combination, have been investigated for isolation and purification of Lycopersene from crude extracts in various natural sources. The review of Lycopersene identified cap areas like purity and application in various fields.