Publisher's Note: “A suspended layer additive manufacturing approach to the bioprinting of tri-layered skin equivalents” [APL Bioeng. , 046103 (2021)]

[This corrects the article DOI: 10.1063/5.0061361.].

Attenuation of 7-ketocholesterol- and 7β-hydroxycholesterol-induced oxiapoptophagy by nutrients, synthetic molecules and oils: Potential for the prevention of age-related diseases

Age-related diseases for which there are no effective treatments include cardiovascular diseases; neurodegenerative diseases such as Alzheimer's disease; eye disorders such as cataract and age-related macular degeneration; and, more recently, Severe Acute Respiratory Syndrome (SARS-CoV-2). These diseases are associated with plasma and/or tissue increases in cholesterol derivatives mainly formed by auto-oxidation: 7-ketocholesterol, also known as 7-oxo-cholesterol, and 7β-hydroxycholesterol. The formation of these oxysterols can be considered as a consequence of mitochondrial and peroxisomal dysfunction, leading to increased in oxidative stress, which is accentuated with age. 7-ketocholesterol and 7β-hydroxycholesterol cause a specific form of cytotoxic activity defined as oxiapoptophagy, including oxidative stress and induction of death by apoptosis associated with autophagic criteria. Oxiaptophagy is associated with organelle dysfunction and in particular with mitochondrial and peroxisomal alterations involved in the induction of cell death and in the rupture of redox balance. As the criteria characterizing 7-ketocholesterol- and 7β-hydroxycholesterol-induced cytotoxicity are often simultaneously observed in major age-related diseases (cardiovascular diseases, age-related macular degeneration, Alzheimer's disease) the involvement of these oxysterols in the pathophysiology of the latter seems increasingly likely. It is therefore important to better understand the signalling pathways associated with the toxicity of 7-ketocholesterol and 7β-hydroxycholesterol in order to identify pharmacological targets, nutrients and synthetic molecules attenuating or inhibiting the cytotoxic activities of these oxysterols. Numerous natural cytoprotective compounds have been identified: vitamins, fatty acids, polyphenols, terpenes, vegetal pigments, antioxidants, mixtures of compounds (oils, plant extracts) and bacterial enzymes. However, few synthetic molecules are able to prevent 7-ketocholesterol- and/or 7β-hydroxycholesterol-induced cytotoxicity: dimethyl fumarate, monomethyl fumarate, the tyrosine kinase inhibitor AG126, memantine, simvastatine, Trolox, dimethylsufoxide, mangafodipir and mitochondrial permeability transition pore (MPTP) inhibitors. The effectiveness of these compounds, several of which are already in use in humans, makes it possible to consider using them for the treatment of certain age-related diseases associated with increased plasma and/or tissue levels of 7-ketocholesterol and/or 7β-hydroxycholesterol.

Dominant follicles development and estradiol-17β concentrations in non-ovulating and ovulating post-partum Bulgarian Murrah buffaloes

This study was designed to evaluate the dominant follicles development and the estradiol-17β concentrations in non-ovulating and ovulating post-partum buffaloes. Sixteen Bulgarian Murrah buffaloes were submitted to transrectal ultrasonographic examination from the 1st post-partum day until day 50, 3 days apart. The follicular diameter of the different categories of follicles and the ovulations was recorded. The animals were allocated into two groups: I (n = 6) non-ovulating and II (n = 10) ovulating buffaloes. Serum estradiol-17β concentrations on the days for dominant follicle registration were measured by enzyme-linked immunosorbent assay. The results were statistically processed by analysis of variance, non-parametric and correlation analysis. The mean intervals between calving and first dominant follicle detection differed significantly (p < .05) among the groups (19.5 ± 6.2 vs. 13.8 ± 5.1 days), while the mean intervals between registered dominant follicles from two successive waves were comparable. The mean follicular diameters for the same category follicles in both groups were similar. Different estradiol-17β concentrations (p < .05) for the first dominant follicle between non-ovulating (23.5 ± 7.0 pg/ml) and ovulating (33.3 ± 8.4 pg/ml) buffaloes were determined. The cumulative percentages of buffaloes with firstly detected dominant follicle and ovulating animals correlated positively (r ≥ .84; p < .05) to post-partum days. In conclusion, non-ovulating and ovulating post-partum Bulgarian Murrah buffaloes showed differences in the development of the first dominant follicle and estradiol-17β concentrations during the time of dominant follicles detection.

Anti-Platelet Fraction Isolated from Galega Officinalis

A fraction from crude extract of Galega officinalis has been purified by column chromatography on Sephadex G-25, Sepharose 4B, DEAE-Cellulose and Sephadex G-100. The final purification factor of the fraction is 120. The peak in elution profile after Sephadex G-150 shows a molecular weight of 100-140 kDa. The isolated fraction appears to have 74% polysaccharides and 23% of proteins. No loss of activity of the final fraction is observed after storage for several months at 4°C and in lyophilized condition. The fraction compounds inhibit platelet aggregation induced by ADP, collagen and thrombin.

[Intoxication syndrome in acute cholecystitis in elderly and old people]

Acute cholecystitis in elderly and old patients is characterized by quickly developing intoxication syndrome. The aim of this survey is to assess the intoxication syndrome in 46 patients, suffering from acute cholecystitis--17 men and 29 women. Clinical signs/ present status, temperature, pulse, respiration, as well as laboratory results/leucocytes, blood count, leucocyte index of intoxication-- LII / are used. The value of LII correspond with the clinical status of the patient and histological findings.

[Surgical diseases of thyroid gland]

Medical reports of 8,768 patients with various diseases of thyroid gland were analyzed. There were 1,563 (17.8) male and 7,201 (82.2%) female patients aged 6 to 86 years. One-nodular goiter was diagnosed at 13.85% patients, multinodular goiter - at 67.2%, diffuse toxic goiter - at 5.85%, thyreotoxic adenoma - at 4.91%, Hashimoto's thyroiditis - at 8.16% patients. Thyroid cancer was revealed at 1.56 patients with nodular goiter, at 8.45% - with multinodular goiter, at 2.72% - with diffuse toxic goiter, at 3.71% - with thyreotoxic adenoma, and at 27.09% patients with Hashimoto's thyroiditis. Totally thyroid cancer was diagnosed at 741 (8.45%) patients including 71.12% papillary cancer, 26.47% follicular cancer and 2.42% medullar (anablastic) cancer. Some patients had metastases. It is concluded that all the patients with goiter should be operated. At diffuse toxic goiter the surgical treatment is indicated at the patients with recurrences or after 6 - 12 months of conservative treatment without clinical improvement.

[Surgical diseases of the thyroid gland]

7264 patients with different thyreopathies have been analysed, as follows: Basedov's disease (446 = 6.13%), thyreotoxic adenoma (Plummer's disease - 974 = 14.4%), nodular struma (1077 - 14.82%), polynodular struma (3291 = 45.3%), Hashimoto's thyreoiditis (1476 = 20.31%). 2879 of them have been having indications of thyreotoxicosis 39.63%). Carcinoma has been found in 908 patients = 12.5%. In the different forms, carcinoma has been found in 5.15% of the cases of Basedov's disease, 5.03% of the cases of thyreotoxic adenoma, in 8.91% of the cases of nodular struma, in 12.57% of the patients with polynodular struma, and in 32.21% of the cases of Hashimoto's thyreoiditis. The relatively high percentage of carcinoma in Hashomoto's thyreoiditis turns the disease into precancerocis. The positions of the authors are ... concerning the operative treatment of each thyreopathy.

[To the surgical tactics in complicated colorectal carcinoma in patients with increased operative risk]

For the period comprised between 1995 and 2005, 247 patients have been under our scrutiny, all of them accepted under emergency due to a complicated colorectal carcinoma, aged between 50 and 89 years, of which 55 women, or 22.26%, and 192 men, or 79.35%. The objective of this study is to show the risk factors for the outcome of this disease, complicated by the following factors: the age factor, concommittant diseases, late diagnosis, high operative risk, as well as the results from the treatment of the patients. It that radical and relatively radical operations are achieved at least in 73 patients (29.56%), the operative mortality nearing 10%, while the 5-year survival time does not excede 32% at a minimum survival rate for this country as a whole of 60% in non-complicated colorectal operable carcinoma.

[Thymectomy for myastenia gravis: 25-year experience]

OBJECTIVE

Thymectomy is considered an effective therapeutic option for patients with myasthenia gravis (MG). We reviewed our 25-years experience with surgical treatment of MG with respect to long-term results and factors affecting outcome.

METHODS

Between 1978 and 2002, we performed 232 thymectomies for MG. Fifteen patients were lost to follow-up; the remaining 217 form the object of our study. 32 patients (28.4%) had thymoma. Myasthenia was graded according to a modified Osserman classification: 51 patients (23.5%) were in class I, 81 (37.3%) in class IIA, 52 (24%) in class IIB, 26 (12%) in class III and seven (3.2%) in class IV. Mean duration of symptoms before the operation was 14 +/- 10 months. Fifty-eight thymectomies for thymoma were performed through a median sternotomy and four through a clamshell incision. Forty-six thymectomies for non-thymomatous MG were performed through a standard cervicotomy, 155 procedures through a partial upper sternal-splitting incision and eight through a complete median sternotomy.

RESULTS

Operative mortality was 0.92% (two patients). After a mean follow-up of 119 months, 77% of all patients improved their clinical status (26% without medications and asymptomatic; 45% with a reduction of medications and/or clinically improved); 39 (18%) have a stable disease with no clinical modifications; 12 (5%) presented a deterioration of their clinical status with worse symptoms, required more medications, or both. Thirteen patients (6%) died because of MG (mean survival 34.3 +/- 3.6 months). The presence of a thymoma negatively influenced the prognosis. Younger patients showed a more favorable outcome as well as patients with a shorter duration of symptoms before the operation; patients with lower classes of myasthenia showed a higher rate of remission.

CONCLUSIONS

Thymectomy is effective in the management of patients with MG at all stages with low morbidity. Patients with thymoma present a less favorable outcome.

[Sectio ceasarea isthmicolongitudinalis--a forgotten beginning and/or groundless fear?]

A retrospective analysis of the frequency, indications, intra- and postoperative complications in isthmicotansverse (ITS) and isthmicolongitudinal (ILS) cesarean section has been conducted with a view to justifying the wider application of ISL in modern obstetrics. For a five-year period (1996-2000) at the Obstetrics and Gynecology Clinic of St. Ann Hospital-Sofia a total of 522 cesarean section were performed of which 348 (66.7%) with isthmicotansverse incision and 174 (33.3%) with isthmicolongitudinal incision. The data show that ILS were ith less blood loss and with less intra- and postoperative complications and it was applied in all types of obstetric indications and urgent cases. Having in mind the good results and the fact that ILS is a technique which could be performed by every obstetrician familiar with ITS, The authors are convinced that isthmicolongitudinal cesarean section can find a wider application in everyday obstetric practice.

Ultrasound follow-up study of arthroscoped patients with gonitis

The purpose of the present study was to evaluate by ultrasound methods and carry out a one-year follow-up study of synovial proliferation in the knee joint of patients with rheumatoid arthritis prior to and after arthroscopy and arthroscopic (AS) synovectomy.

MATERIAL AND METHODS

24 patients with a proven rheumatoid arthritis and affected knee joints were recruited for the study. Arthroscopic synovectomy of one of the affected joints was performed in all of them. The synovitis was evaluated clinically and ultrasonographically in 24 knee joints prior to the AS synovectomy and 7 days, and 3, 6 and 12 months after it.

RESULTS

Either synovial thickening or villonodular proliferation in the knee joints were the findings in the examined patients using arthrosonography. All patient showed improvement of the disease activity index after the arthroscopic synovectomy and weakening of the baseline ultrasound evidence for synovial thickening and villonodular proliferation (p < 0.001). During the 12-month follow up study two patients were found at ultrasonography to have (without any clinical evidence for that) recurrence of the synovial thickening three months after arthroscopy. Ten patients had synovial thickening or villonodular proliferation recurrence during the 12 months of follow up with clinical evidence of gonitis; one case showed ultrasonographic evidence of hydrops. There was a complete consistency between the ultrasound and arthroscopic protocols with respect to the presence of synovial proliferation and intra-articular effusion.

CONCLUSION

Arthosonography is an easy, safe, low-cost, non-invasive modality for diagnosis and follow-up of patients with rheumatoid arthritis prior to and after arthroscopic synovectomy and for assessment of the clinical prognosis in such patients.

Postnatal follow-up of the oxygenation index, arterial to alveolar oxygen tension ratio and alveolar arterial oxygen tension difference values in neonates with the respiratory distress syndrome treated with conventional ventilatory support

Recent development of sophisticated intensive care technique for use in newborn infants with the respiratory distress syndrome (RDS) has resulted in changes in the therapeutic strategies and moved the problem of neonatal survival into the realm of new therapeutic realities. At present, the mechanical ventilation methods form an integral part of the intensive care strategy of infants with RDS. They have come to the forefront of infant care because of their successful use in ventilatory support and children survival where other therapeutic modalities have failed. The present prospective observational longitudinal study was designed to assess the real-time convenience, reliability and accuracy of the changes in the oxygenation index (OI), arterial-to-alveolar oxygen tension ratio (a/A PO2) and alveolar-arterial oxygen gradient (A-a)DO2 in ventilator-dependent neonates with RDS, to analyze their feasibility and potential information yield in oxygen inhalation therapy as well as their prognostic implications and predictive value. Twenty neonates with RDS, heralded by respiratory failure which necessitated the initiation of oxygen inhalation therapy and ventilatory support within 24 hours of birth, were enrolled in the study. Ten of the infants survived and the remaining ten died. OI, (a/A PO2) and (A-a)DO2 were followed up sequentially and thoroughly analyzed as the primary outcome measures of the study. The indices were calculated on the basis of the complete monitoring of the ventilatory equipment parameters and acid-base status carried out on an hourly basis. Our results show that: 1. The combination of three indexes (OI, (a/A)PO2 and (A-a)DO2 we propose is a useful discriminating predictor of neonatal lung maturity reflecting arterial blood gas status in ventilator-dependent neonates with RDS. 2. The indices detect the efficacy of the modern conventional ventilatory support with real-time convenience and reliable accuracy forming the cornerstone of clinical decision-making in RDS neonatal intensive care and allowing timely corrections of the ventilatory equipment parameters. 3. The prospective follow-up of these indices improves the predictive value as compared to any single test of neonatal lung maturity and has important prognostic implications in the management of neonates with RDS.

Embryotoxicity and fertility study with halothane subanesthetic concentration in rats

The effect of 9 ppm halothane, a subanesthetic concentration, was studied on the reproductive ability and pregnancy outcome in white rats. Pregnant females were exposed for 4 h per day during the whole gestation period. Male animals were subjected to halothane inhalation for 4 h daily, 5 days per week for 6 or 8 months. In the exposed females higher rates were established for early interruption of pregnancy (all implants dead) and for embryonic death in the later periods of intrauterine life compared to controls. Deciduomata were found in 22.22% (P less than 0.05) of pregnant treated females. Control females mated to exposed males showed a higher incidence of preimplantation loss (36.36% (P less than 0.05) of those mated with males exposed for 6 months had deciduomata). Decreased fertility in males, expressed particularly in the 8-month treated group, was also demonstrated (13.33% inseminated females, compared to 35% in the control group).

[Acute appendicitis in young children]

Ninety two children aged up to 3 years and operated upon for acute appendicitis were observed. The clinical picture of appendicitis is described, and some diagnostic difficulties are noted. The mortality due to appendicitis in this group of patients was 15.2%.