A review on thromboangiitis obliterans pathophysiology: thrombosis and angiitis, which is to blame?

A century has passed since thromboangiitis obliterans (TAO), or Buerger's disease, was first described, but the etiology remains unclear. It is still uncertain as to whether thrombosis or vascular inflammation is the first event. TAO is an episodic inflammatory and thrombotic-occlusive vascular disease of unknown origin. The involvement of the distal vessels and nerves within the neuro-vascular bundles occurs almost always in legs and occasionally in arms. The cumulative data demonstrate that at the cellular and molecular levels, at least four main components of inflammatory reactions, including endothelial cells, platelets, leukocytes and sensory neurons, might be involved in TAO pathogenesis. The interactions among these cells in an altered microenvironment of small- and medium-sized vessels may also orchestrate the onset of TAO events. In this review, the factors that may promote thrombosis and angiitis are reconsidered at three levels: (1) host characteristics such as male gender and genetic background; (2) probable triggers including cigarette smoking and infectious agents; and (3) environmental factors such as chronic anxiety and mental stress as a consequence of low socioeconomic status. At each level, the interactions among vascular endothelium, platelets, leukocytes and sensory neurons are discussed.     

Coexistence of vitreous and crystalline phases of H2O at ambient temperature

Formation of vitreous ice during rapid compression of water at room temperature is important for biology and the study of biological systems. Here, we show that Raman spectra of rapidly compressed water at greater than 1 GPa at room temperature exhibits the signature of high-density amorphous ice, whereas the X-ray diffraction (XRD) pattern is dominated by crystalline ice VI. To resolve this apparent contradiction, we used molecular dynamics simulations to calculate full vibrational spectra and diffraction patterns of mixtures of vitreous ice and ice VI, including embedded interfaces between the two phases. We show quantitatively that Raman spectra, which probe the local polarizability with respect to atomic displacements, are dominated by the vitreous phase, whereas a small amount of the crystalline component is readily apparent by XRD. The results of our combined experimental and theoretical studies have implications for detecting vitreous phases of water, survival of biological systems under extreme conditions, and biological imaging. The results provide additional insight into the stable and metastable phases of H₂O as a function of pressure and temperature, as well as of other materials undergoing pressure-induced amorphization and other metastable transitions.

Life as we know it on Earth depends on water. However, water also poses a critical challenge to life when it freezes at atmospheric pressure and low temperatures. The crystallization of H₂O to form hexagonal ice (ice Ih) under these conditions is accompanied by its well-known expansion, which has a dramatic impact on the structure and function of living cells. This crystallization of H₂O disrupts biological membranes and intracellular organization in living organisms and also displaces and concentrates salts and nutrients in the space between crystals (1). Like many liquids, however, rapid cooling of H₂O at ambient pressure to below its glass-transition temperature results in the formation of an amorphous phase known as low-density amorphous ice. Amorphous solid H₂O provides a chance for biological functions to survive where life otherwise cannot exist. Low-density amorphous ice is not the only amorphous form of H₂O. Ice I_h transforms to high-density amorphous (HDA) ice by application of ∼1 GPa of pressure at temperatures below 130 K (2, 3). In addition, a distinct, very-high-density amorphous state (vHDA) can form by isobaric heating and cooling of the HDA (4). low-density amorphous, high-density amorphous, and very-high-density amorphous state ice thus represent the three dominant, solid amorphous forms of H₂O at low temperatures.Solid amorphous phases of H₂O are broadly important in biology and biological applications. That amorphous H₂O which can exist over a broad range of temperatures, from cryogenic conditions to room temperature, is particularly interesting in the context of biological systems. Managing ice crystals is vital for extremophiles to survive damaging effects of H₂O crystallization. These organisms inhibit the growth of ice crystals and regulate the size and shape of the crystals using special antifreeze proteins (5, 6). Additionally, amorphous phases of H₂O are important in preserving biological samples in cryotomography applications. In cryotomography, the amorphous H₂O at low temperature is utilized routinely for sample preparation (7, 8), and significant efforts have been devoted to increase information obtained from cryotomography techniques. The low-temperature regime of amorphous H₂O routinely accessed in cryotomography creates challenges for light microscopy due to freezing of index-matching medium and objectives, which result in lowering the resolution of light microscopy in these applications. Room-temperature amorphous phases of H₂O are, therefore, advantageous for light microscopy applications and further development of techniques such as correlative light and electron microscopy (9–11).While formation of amorphous phases of H₂O below 200 K has been reported in many studies (2, 3, 12–16), a particularly interesting result is the observation of the Raman signature of HDA ice during fast compression of water at room temperature and moderate pressures (17). On the other hand, independent X-ray diffraction (XRD) measurements of H₂O on fast compression could not verify the formation of amorphous H₂O above 200 K (18). Here, we report high-resolution micro-Raman and synchrotron XRD measurements conducted in parallel in rapidly compressed samples of water in diamond anvil cells (DACs). Our findings, that are supported by molecular dynamics simulations, shed light on the nature of the HDA ice at room temperature and reconciled conflicting previous reports.     

The IL-18, IL-12, and IFN-γ expression in HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients,HTLV-1 carriers,and healthy subjects

Journal of NeuroVirology - Interleukin (IL)-12, IL-18, and interferon gamma (IFN-γ) can induce Th1-inflammatory responses in favor of HTLV-1-associated myelopathy/tropical spastic paraparesis...     

Evaluation of the diagnostic advantage of intraoral D and E film for detecting interproximal caries

Clinicians strive to reduce the exposure of patients to X-ray radiation in an effort to decrease its harmful effects on the body. A potential strategy for achieving this goal is the use of high-speed films that require less exposure to radiation to generate a diagnostic image. There are two film types commonly used in intraoral radiography: high speed or "Ekta-speed" film (Type E) and normal speed or Ultra-speed film (Type D). Type E film requires nearly half of the exposure time that is required by Type D films to produce an acceptable diagnostic image; however, the diagnosis quality and usability of these film types are under question. The purpose of this research is to compare the diagnostic quality of Type E with Type D film when used to diagnose proximal caries. In this study 40 pairs of extracted maxillary premolar teeth were chosen and divided into four groups of 10 pairs. Cavities were made on proximal surfaces at different depths (0.5, 1, 1.5, and 2 mm) for each group. Bitewing radiographs were then taken on each pair of teeth using Type E film and then again using Type D film. Radiographs were evaluated by two oral radiologists and two operative dentistry specialists who recorded the perceived diagnostic depth of the prepared cavities. Our data showed both Type D and E films are suitable for use in diagnosing proximal caries, and despite a minor discrepancy between them no significant difference was found with regard to their value in diagnosing proximal caries.     

High prevalence of HTLV-I infection in Mashhad, Northeast Iran: A population-based seroepidemiology survey

Background

Mashhad, in the northeast of Iran has been suggested as an endemic area for human T cell lymphotropic virus type I (HTLV-I) infection since 1996.

Objectives

We performed a community-based seroepidemiology study to examine the prevalence and risk factors for HTLV-I infection in the city of Mashhad.

Study design

Between May and September 2009, overall 1678 subjects from all the 12 geographical area of Mashhad were selected randomly by multistage cluster sampling for HTLV antibody. The study population included 763 males and 915 females, with the mean age of 29.1 ± 18.5 years. 1654 serum samples were assessed for HTLV antibody using ELISA and reactive samples were confirmed by Western blot and PCR.

Results

The overall prevalence of HTLV-I infection in whole population was 2.12% (95% CI, 1.48–2.93) with no significant difference between males and females (p = 0.093) and the prevalence of HTLV-II seropositivity was 0.12% (95% CI, 0.02–0.44).The HTLV-I Infection was associated with age (p < 0.001), marital status (p < 0.001), education (p = 0.047), and history of blood transfusion (p = 0.009), surgery (p < 0.001), traditional cupping (p = 0.002), and hospitalization (p = 0.004). In logistic regression analysis, age was the only variable that had a significant relation with the infection (p = 0.006, OR = 4.33).

Conclusions

Our results demonstrated that Mashhad still remains an endemic area for HTLV-I infection despite routine blood screening. Thus, further strategies are needed for prevention of the virus transmission in whole population.     

Trans‐catheter closure of patent ductus arteriosus—What is the best device?

Background : Over the past three decades, transcatheter occlusion of patent ductus arteriosus (PDA) has evolved to be the procedure of choice. Gianturco and Flipper coils are the most commonly used coils in the United States for closure of small and moderate size PDAs. For larger PDAs, interventionalists in the United States commonly use the Amplatzer Duct Occluder (ADO) and those in Europe use the ADO or the Nit‐Occlud Coils (NOC). A comparison between Gianturco coils, Flipper coils, ADO, and NOC has never been made. Objective : To compare the success and complication rate associated with the four different devices used for transcatheter closure of PDA. Success was defined as complete closure of PDA with absence of a residual shunt (R.S.) at six months follow‐up. Methods : Two institutions collaborated in combining their data to evaluate the results of transcatheter closure of PDA. Results : Totally, 546 patients underwent successful PDA occlusion at both institutions. Gianturco and Flipper coils were used in 120 (22%) and 119 (22%) patients respectively. A total of 152 (28%) patients received ADO and 155 (28%) patients received NOC. Immediate R.S. were noted in 226 (41.4%) patients in the entire study group with the NOC group having the highest percentage of R.S. (80/155, 51.6%, P = 0.004). Of the 484 patients with follow‐up echocardiograms at 6 months, 35 (7.2%) patients had persistent R.S. The NOC (3/143, 2.1%) and ADO (5/150, 3.3%) groups had the least R.S. at six months follow‐up. Conclusion : Per our definition of success, the Nit‐Occlud coils and the Amplatzer duct‐occluder devices had significantly higher success rate for PDA occlusion versus the coils. © 2010 Wiley‐Liss, Inc.     

Frequent loss of heterozygosity at 8p22 chromosomal region in diffuse type of gastric cancer

AIM： TO study the loss of heterozygosity （LOH） at 8p21-23 locus in diffuse gastric cancer.
METHODS： To evaluate the involvement of this region in gastric cancer, we used eight microsatellite markers covering two Mb of mentioned region, to perform a high-resolution analysis of allele loss in 42 cases of late diffuse gastric adenocarcinoma.
RESULTS： Six of these STS makers： D8S1149, D8S1645, D8S1643, D8S1508, D8S1591, and D8S1145 showed 36%, 28%, 37%, 41%, 44% and 53% LOH, respectively.
CONCLUSION： A critical region of loss, close to the NAT2 locus and relatively far from FEZ1 gene currently postulated as tumor suppressor gene in this region.     

The impact of interferon-alpha treatment on clinical and immunovirological aspects of HTLV-1-associated myelopathy in northeast of Iran

Human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic inflammatory myelopathy. The pathophysiology of HAM/TSP is not yet fully understood; therefore, effective therapy remains a challenging issue. This study was designed to evaluate the efficacy of interferon-alpha (IFN-α) in HAM/TSP patients in the Northeast of Iran. Forty-nine patients with a definite diagnosis of HAM/TSP were enrolled in this clinical trial. For six months, the patients received three million international units of subcutaneous IFN-α-2b per each injection. The dose regimen was daily injection for the first month, three times administration per week for the months 2 and 3, twice weekly injection for the months 4 and 5 and weekly injection for the sixth month. The clinical and laboratory responses were evaluated based on neurologic examinations and immunovirological markers. IFN-α had significant but temporary effect on the motor and urinary functions of the patients. Comparing to the baseline values, proviral load was significantly decreased one month after treatment in responders (495.20±306.87 to 262.69±219.24 p=0.02) and non-responders (624.86±261.90 to 428.28±259.88 p=0.03). Anti-HTLV-1 antibody titers were significantly decreased among responders (1152.1±200.5 to 511.6±98.2 p=0.009) and non-responders (1280.1±368.1 to 537.6±187 p=0.007). Flow cytometry showed no significant changes in CD4, CD8, CD4CD25 and CD16CD56 counts with IFN-α. The positive impact of IFN-α was observed during the treatment period with significant effects on some clinical aspects of HAM/TSP.