Feasibility of transcutaneous electrical muscle stimulation in acute exacerbation of COPD

Transcutaneous electrical muscle stimulation is a well-established intervention for rehabilitation of clinically stable patients with chronic obstructive pulmonary disease. This study investigated feasibility and safety of this method during acute exacerbation of chronic obstructive pulmonary disease. We included 19 patients (71 ± 6 years, 76% men) who underwent two sessions/day during hospitalization (15 ± 1 training sessions). They reported good tolerability and excellent safety profile of transcutaneous electrical muscle stimulation. Our results set the stage for future research to determine specific benefit of transcutaneous electrical muscle stimulation, either alone or in combination with nutritional support and pharmacological therapy.     

Development and characterization of a novel mAb against bilitranslocase - a new biomarker of renal carcinoma

Background

Bilitranslocase (TC 2.A.65.1.1) is a bilirubin-specific membrane transporter, found on absorptive (stomach and intestine) and excretory (kidney and liver) epithelia and in vascular endothelium. Polyclonal antibodies have been raised in rabbits in the past, using a synthetic peptide corresponding to AA65-77 of rat liver bilitranslocase, as an antigen. Affinity-purified antibodies from immune sera have been found to inhibit various membrane transport functions, including the bilirubin uptake into human hepatocytes and the uptake of some flavonoids into human vascular endothelial cells. It was described by means of immunohistochemistry using polyclonal antibodies that bilitranslocase expression is severely down-regulated in clear cell renal carcinoma. The aim of our work was development and characterization of high-affinity, specific mAbs against bilitranslocase, which can be used as a potential diagnostic tool in renal cell carcinoma as well as in a wide variety of biological assays on different human tissues.

Materials and methods

Mice were immunized with a multi-antigen peptide corresponding to segment 65–75 of predicted primary structure of the bilitranslocase protein. By a sequence of cloning, immune- and functional tests, we aimed at obtaining a specific monoclonal antibody which recognizes a 37 kDa membrane protein, and influences the transport activity of bilitranslocase.

Results

On the basis of previous results, specific IgM monoclonal antibodies were produced in BALB/c mice, in order to further improve and extend the immunological approach to the study of bilitranslocase in renal cancer cells as well as to develop its potential diagnostics use.

Conclusions

In this article we show an immunological approach, based on newly developed monoclonal antibodies, to a detailed biochemical and functional characterization of a protein whose gene and protein structure is still unknown. We were able to demonstrate our novel mAb as a tumor marker candidate of renal cell carcinoma, which may prove useful in the diagnostic procedures.     

The impact of image information on compressibility and degradation in medical image compression

The aim of the study was to demonstrate and critically discuss the influence of image information on compressibility and image degradation. The influence of image information on image compression was demonstrated on the axial computed tomography images of a head. The standard Joint Photographic Expert Group (JPEG) and JPEG 2000 compression methods were used in compression ratio (CR) and in quality factor (QF) compression modes. Image information was estimated by calculating image entropy, while the effects of image compression were evaluated quantitatively, by file size reduction and by local and global mean square error (MSE), and qualitatively, by visual perception of distortion in high and low contrast test patterns. In QF compression mode, a strong correlation between image entropy and file size was found for JPEG (r=0.87, p < 0.001) and JPEG 2000 (r=0.84, p < 0.001), while corresponding local MSE was constant (4.54) or nearly constant (2.36-2.37), respectively. For JPEG 2000 CR compression mode, CR was nearly constant (1:25), while local MSE varied considerably (2.26 and 10.09). The obtained qualitative and quantitative results clearly demonstrate that image degradation highly depends on image information, which indicates that the degree of image degradation cannot be guaranteed in CR but only in QF compression mode. CR is therefore not a measure of choice for expressing the degree of image degradation in medical image compression. Moreover, even when using QF compression modes, objective evaluation, and comparison of the compression methods within and between studies is often not possible due to the lack of standardization of compression quality scales.     

Pilot study of a novel serum mRNA gene panel for diagnosis of acute septic arthritis

BACKGROUND Septic arthritis is an orthopedic emergency requiring immediate surgical intervention.Current diagnostic standard of care is an invasive joint aspiration.Aspirations provide information about the inflammatory cells in the sample within a few hours,but there is often ambiguity about whether the source is infectious(e.g.bacterial) or non-infectious(e.g.gout).Cultures can take days to result,so decisions about surgery are often made with incomplete data.Novel diagnostics are thus needed.The "Sepsis MetaScore"(SMS) is an 11-mRNA host immune blood signature that can distinguish between infectious and noninfectious acute inflammation.It has been validated in multiple cohorts across heterogeneous clinical settings.AIM To study whether the SMS holds diagnostic validity in determining the etiology of acute arthritis.METHODS We conducted a blinded,prospective,non-interventional clinical study of the SMS.All patients undergoing work-up for a septic primary joint were enrolled.Patients proceeded through the normal standard-of-care pathway,including joint aspiration and inflammatory labs [white blood cell(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)].Venous blood was also drawn into PAX gene RNA-stabilizing tubes and mRNAs were measured using Nano String nCounterTM.SMS was calculated blinded to clinical results RESULTS A total of 20 samples were included,of which 11 were infected based on aspiration or intra-operative cultures.The SMS had an area under the ROC curve(AUROC) of 0.87 for separating infectious from non-infectious conditions.For comparison,the AUROCs for ESR=0.58,CRP=0.6,and WBC=0.59.At 100% sensitivity for infection,the specificity of the SMS was 40%,meaning nearly half of non-septic patients could have been ruled out for further intervention.CONCLUSION In this pilot study,SMS showed a high level of diagnostic accuracy in predicting septic joints compared to other diagnostic biomarkers.This quick blood test could be an important tool for early,accurate identification of acute septic joints and need for emergent surgery,improving clinical care and healthcare spending.     

Two Novel Homozygous SACS Mutations in Unrelated Patients Including the First Reported Case of Paternal UPD as an Etiologic Cause of ARSACS

Autosomal recessive spastic ataxia of Charlevoix–Saguenay, more commonly known as ARSACS, is an early-onset cerebellar ataxia with spasticity, amyotrophy, nystagmus, dysarthria, and peripheral neuropathy. SACS is the only gene known to be associated with the ARSACS phenotype. To date, 55 mutations have been reported; of these, only five in Italian patients. We found two novel homozygous nonsense mutations in the giant exon of SACS gene in two unrelated patients with classical ARSACS phenotype. Characterization of the homozygous nature of the mutations through genotyping of the parents, quantitative DNA analysis and indirect STS studies permitted us to confirm in one of the cases that uniparental isodisomy of the paternal chromosome 13 carrying the mutated SACS gene played an etiologic role in the disease.     

Selective adhesive luting: A novel technique for improving adhesion achieved by universal resin cements

Objective

We aimed to introduce the concept of “Selective adhesive luting—SAL” which is explained through clinical steps and supported by preliminary laboratory evidence.

Clinical Considerations

Cementation with rubber dam is difficult to perform in case of short abutment teeth and/or subgingival crown margins. By means of universal resin cements/universal adhesive systems, which can be employed in self-adhesive as well as adhesive luting procedures, this paper presents a novel technique allowing clinicians to perform reliable cementation where rubber dam isolation is difficult. The SAL technique entails the application of a universal adhesive system only on easily accessible abutment surfaces, enabling simultaneous adhesive and self-adhesive luting in different portions of the abutment. The SAL clinical workflow is explained through prosthodontic rehabilitation of maxillary right central incisor affected by microdontia and restored with a lithium-disilicate crown. Furthermore, our laboratory microshear bond strength study supports the rationale behind SAL application demonstrating higher bond strength even when the adhesive resin is placed only on one portion of the cementation substrate.

Clinical Significance

This article advocates the application of SAL technique in clinical situations where effective adhesive luting is uncertain, since it can improve the adhesion between the tooth and universal resin cements.