Altered expression of apoptosis-related genes in rheumatoid arthritis peripheral blood mononuclear cell and related miRNA regulation

AIM

Impaired apoptosis and proliferation resulted in autoreactive lymphocyte development and inflammation in Rheumatoid arthritis (RA). TP53, BAX, FOXO1, and RB1 are related genes in cell survival, proliferation, and inflammation which could be important in RA development and disease severity. Here we investigated their expression in peripheral blood mononuclear cells (PBMCs) from RA patients in comparison to healthy controls.

METHODS

Fifty healthy controls and 50 RA patients were selected. The quantitative real-time polymerase chain reaction was used to assess the gene expression level in PBMCs.

RESULTS

The mRNA expression of TP53 (FC = 0.65, p = .000), BAX (FC = 0.76, p = .008), FOXO1 (FC = 0.59, p = .000) and RB1 (FC = 0.50, p = .000) were significantly reduced in RA PBMCs. TP53 expression was negatively correlated with miR-16-5p (p = .032) and FOXO1 expression was negatively correlated with miR-335-5p (p = .005) and miR-34a-5p (p = .014). A positive correlation was seen between TP53 expression and its downstream gene, BAX (p = .001). FOXO1 expression was also negatively correlated with disease activity, DAS28 (p = .021).

CONCLUSION

All selected genes have downregulated expression in RA PBMCs which could be correlated with RA pathogenesis by regulating apoptosis, cell survival, inflammatory mediator production, and proliferation. Due to the correlation of miR-16-5p, miR-34a-5p, and miR-335-5p with TP53 and FOXO1 expression in RA PBMCs, they could be used as future therapeutic targets.

Upregulation of KAT2B and ESCO2 gene expression level in patients with rheumatoid arthritis

BACKGROUND

Rheumatoid arthritis (RA) is an autoimmune condition that causes progressive inflammation. It seems that alternations in epigenetic modifications contribute to RA development. The present study aimed to assess the expression pattern of K (lysine) acetyltransferase 1 (KAT1; HAT1) and lysine acetyltransferase 2B (KAT2B; PCAF), and the establishment of sister chromatid cohesion N-acetyltransferase 2 (ESCO2) in peripheral blood mononuclear cells (PBMCs) from RA patients.

METHOD AND MATERIAL

In this case-control study, we studied 50 cases with RA in comparison to 50 age- and gender-matched healthy subjects. Separation of PBMCs samples from whole blood, extraction of RNA, and reverse transcription were performed. Gene transcript levels of KAT1, KAT2B, and ESCO2 were determined using SYBR green real-time quantitative PCR.

RESULTS

Our results exhibited a significant upregulation in the expression levels of ESCO2 and KAT2B genes in patients with RA compared to normal individuals (P-value < 0.0001). Similarly, we observed higher expression of KAT1 in the patients' group when compared to the healthy controls, although the difference in expression level failed to show any significant changes (P-value = 0.485). Also, we found a positive correlation between ESCO2 and the level of erythrocyte sedimentation rate (ESR) in patients.

CONCLUSION

Collectively, our results suggest that upregulated expression of KAT2B and ESCO2 genes may be correlated to RA development. Further studies with larger sample sizes are required for understanding the potential contribution of these enzymes in the pathology of RA. Key Points • Dysregulated expression level of epigenetics enzymes was observed in PBMCs from RA patients. • The expression of KAT2B was 2.44 times higher in the PBMCs of RA patients than in the healthy subjects. • The expression of ESCO2 was upregulated (2.75 times) in the PBMCs of RA patients compared to the control group. • There was a positive correlation between ESCO2 expression and the ESR level in patients.

The role of NK cells in rheumatoid arthritis

OBJECTIVE

Natural killer (NK) cells are part of the innate immune system which not only provides a primary response to pathogenic conditions but can also play an important regulatory role in immune responses. Furthermore, these cells can influence immune responses by affecting other involved cells. Human NK cells can be classified as CD56^dim and CD56^bright; the former demonstrates mostly cytotoxic effects, while the latter comprises mostly tolerant or regulatory NK cells. These cells participate in the immunopathogenesis of rheumatoid arthritis (RA) and their role remains still unclear.

METHODS

We searched PubMed/MEDLINE and Scopus databases to review and analyze relevant literature on the impact of NK cells in the pathogenesis of RA.

RESULTS

Although the percentage of NK cells increases in peripheral blood of RA patients compared to healthy individuals, the cytotoxic function of these cells is impaired. It is demonstrated by reduced "perforin⁺ NK cells" and decreased per-cell lytic function. These cytotoxic NK cells may control the pathogenic bone absorptive function of osteoclasts by directly targeting these cells.

CONCLUSION

Collectively, the evidence collected in the current review emphasizes the possible protective role of CD56^dim NK cells in the pathogenesis of RA.

Characterization of Occult Hepatitis B Virus Infection Among Iranian Patients with Behcet's Disease; Correlation with Clinical Status

Background: Behcet's disease (BD) is a chronic multisystem vasculitis with an unknown etiology. During the past years, several reports are published on the occult hepatitis B infection (OBI), the presence of hepatitis B virus (HBV) DNA in the absence of HBsAg, in rheumatic diseases. Objectives: The current study aimed to, firstly, investigate the prevalence of OBI in patients with BD, and, secondly, its potential association with the clinical and therapeutic status of BD. Methods: HBV serological markers and HBV DNA were evaluated in 220 consecutive BD patients to detect OBI. Demographic and clinical data of OBI positive and negative groups were compared. Results: The mean age of patients was 39.24 (± 10.57), and 134 (62.9%) were male. The mean disease duration was 14.13 (± 8.63) years. No HBsAg positive case was found, but HBV DNA was found in 19 (8.6%) patients. The median viral load value was 475.84 copy/mL. We compared clinical data of 10 OBI positive and 156 OBI negative BD patients with complete and accessible data. There was no difference between the two groups concerning demographic characteristics (age, sex, and disease duration), different clinical manifestations, or types of medications (immunomodulatory, cytotoxic, and corticosteroids). Conclusions: This is the first study showing a rather high prevalence of OBI among BD patients. We did not find any correlation between OBI positivity and different clinical manifestations, medications, or HLA-B51. Further studies are needed on a larger group of patients and by molecular HBV evaluation (as well as serologic) regarding this possible association.

Serotypes, virulence genes and polymorphism of capsule gene cluster in Lactococcus garvieae isolated from diseased rainbow trout (Oncorhynchus mykiss) and mugger crocodile (Crocodylus palustris) in Iran

BACKGROUND

Lactococcus garvieae causes lactococcosis in rainbow trout in many parts of the world.

AIMS

This study was conducted for the existence of the virulent factors and differentiation of the two serotypes in L. garvieae.

METHODS

Twenty-two strains of L. garvieae isolated from diseased rainbow trout from farms in different regions and mugger crocodile of Iran, were investigated. In order to rapidly detect the presence of the hly1, hly2, hly3, NADH oxidase, sod, pgm, adhPsaA, eno, LPxTG-3, adhCI, and adhCII virulence genes, two multiplex polymerase chain reaction (PCR) assays were developed. Also, simplex PCR method was used to identify the bacterial serotypes, CGC, LPxTG-2, Adhesion, and adhPav virulence genes using the specific primer.

RESULTS

All varieties of L. garvieae contained the hly1, hly2, hly3, NADH oxidase, pgm, adhPav, LPxTG-3, sod, eno, adhPsaA, adhCI, and CGC virulence genes. Also, adhCII gene was present in all strains except one of the isolates originated from mugger crocodile. In addition, LPxTG-2 gene was only present in one of the isolates belonging to mugger crocodile. Adhesion gene was not present in all the strains. Interestingly, all the 22 strains originated from both hosts were identified as belonging to the serotype I. Based on the phylogenetic sequences of the capsule gene cluster, group all fish isolates into a cluster together with one isolate obtained from mugger crocodile.

CONCLUSION

Further studies are recommended to investigate the role of virulence genes in L. garvieae and evaluate their pathogenicity to rainbow trout.

Fermentative H2 production from food waste: Parametric analysis of factor effects

Factorial fermentation experiments on food waste (FW) inoculated with activated sludge (AS) were conducted to investigate the effects of pH and the inoculum-to-substrate ratio (ISR [g VS_AS/g TOC_FW]) on biohydrogen production. The two parameters affected the H₂ yield, the fermentation rate and the biochemical pathways. The minimum and maximum yields were 41 L H₂/kg TOC_FW (pH = 7.5, ISR = 1.74) and 156-160 L H₂/kg TOC_FW (pH = 5.5, ISR = 0.58 and 1.74). The range of carbohydrates conversion into H₂ was 0.37-1.45 mol H₂/mol hexose, corresponding to 9.4-36.2% of the theoretical threshold. A second-order predictive model for H₂ production identified an optimum region at low pHs and high ISRs, with a theoretical maximum of 168 L H₂/kg TOC_FW at pH = 5.5 and ISR = 1.74. The Spearman's correlation method revealed several relationships between the variables, suggesting the potentially governing metabolic pathways, which turned out to involve both hydrogenogenic pathways and competing reactions.

Molecular and clinical evidence of Aeromonas hydrophila and Fusarium solani co-infection in narrow-clawed crayfish Astacus leptodactylus

Co-infections occur when a host is infected by 2 or more different pathogen types, either by secondary or simultaneous infections, and are very frequent in nature. In this study, 10 narrow-clawed crayfish Astacus leptodactylus with signs of disease were collected from Haft Baram Lake (Fars province, southern Iran). Samples of fluid from inside the intact abscess and melanized lesions in the cuticle were cultured aseptically onto brain heart infusion agar and Sabouraud dextrose agar for bacterial and fungal agents, respectively. After primary colony isolation for bacterial and fungal agents, the isolates were confirmed as Aeromonas hydrophila and Fusarium solani, using specific PCR methods based on 16S rDNA and internal transcribed spacer (ITS) rDNA sequences that produced a single band of 685 bp and 600 bp, respectively. Partial sequence analysis of the F. solani ITS showed 100% sequence identity among all our samples, as well as a close genetic relationship between this isolate (GenBank accession number MG519784) and those previously reported from loggerhead sea turtle Caretta caretta in Cape Verde (FJ948133, AM412641, and DQ535186), black-blotched stingray Taeniura melanopsila in Japan (LC019016), and American manatee Trichechus manatus in Japan (AB775569). The results indicate that narrow-clawed crayfish can be infected by A. hydrophila and F. solani simultaneously, and to the best of our knowledge, this is the first report of just such a co-infection in this host. Further studies are necessary to investigate the pathogenicity of these organisms and their effects on narrow-clawed crayfish.

Epistatic Interaction of ERAP1 and HLA-B*51 in Iranian Patients with Behçet's Disease

Behçet's Disease (BD) pathogenesis remains unclear, but some genetic loci and environmental factors are proposed to play a role. Here, we investigate the association of the endoplasmic reticulum aminopeptidase-1 (ERAP1) gene variants and HLA-B*51 with BD susceptibility and clinical manifestations in Iranian patients. In the study, 748 BD patients and 776 healthy individuals were included. The MGB-TaqMan Allelic Discrimination method was used to genotype 10 common missense single nucleotide polymorphisms (SNPs) and one intronic SNP in the ERAP1 gene region. We found no significant association between the 11 SNPs and BD in allelic and genotypic association tests. However, rs30187 showed the strongest association with BD in the recessive genotype model of the risk T allele in HLA-B*51 carriers. Although this became insignificant after correcting for multiple comparisons, the homozygous rs30187 risk allele genotype (TT) increased disease susceptibility in HLA-B*51 carriers in epistasis analysis, and the rs30187 TT recessive genotype showed a significant association with risk of cardiac involvement in the all patients and articular involvements in HLA-B*51 positive patients. Our findings suggest that gene-gene interactions between HLA-B*51 and ERAP1 variants is important for BD development, however, ERAP1 variants which interact with HLA-B*51 may differ among disease phenotypes or populations.

Author Correction: Nearly all the sky is covered by Lyman-α emission around high-redshift galaxies

Change history: In this Letter, author M. Akhlaghi should be associated with affiliation (2) rather than (3). This error has been corrected online.

Flavanols are potential anti-obesity agents, a systematic review and meta-analysis of controlled clinical trials

BACKGROUND

The anti-obesity potential of flavonoids has been shown by animal and human studies. In this meta-analysis, we systematically reviewed controlled clinical trials and quantified the effects of flavonoids and flavonoid subclasses on obesity-related anthropometric measures.

METHODS AND RESULTS

PubMed, EMBASE, Scopus, Web of Science, and ProQuest databases were searched to identify trials examining the effect of flavonoids on body mass index (BMI), waist circumference, and body fat percentage. Fifty eight trials passed the eligibility process. Analysis endpoints were calculated as the mean difference between baseline and post-treatment. Flavonoids were in subclasses of flavanols, flavonols, isoflavones, flavanones, anthocyanins, and proanthocyanidins. They were mostly in the form of supplements and dosages varying from 40 to 1300 mg/day. Among flavonoid subclasses, flavanols showed potential for decreasing BMI, in the overall population (mean difference (MD) = -0.28 kg/m², P = 0.04; n = 21) and in the subgroups of Asians (MD = -0.42 kg/m²; P = 0.046; n = 13), ages < 50 years (MD = -0.50 kg/m²; P = 0.008; n = 14), BMI ≥ 25 kg/m² (MD = -0.30 kg/m²; P = 0.049; n = 15), and at doses ≥ 500 mg/day (MD = -0.36 kg/m²; P = 0.049; n = 12). Isoflavones also decreased BMI of non-Asian populations (MD = -0.26 kg/m²; P = 0.035; n = 13) and doses ≥ 75 mg/day (MD = -0.34 kg/m²; P = 0.027; n = 8). In the overall assessment, flavanols also decreased waist circumference (MD = -0.60 cm; P = 0.02; n = 18) but had no significant effect on body fat percentage. The available trials did not reveal significant effects from flavonols, flavanones, and anthocyanins on the specified anthropometric measures.

CONCLUSIONS

Overall results of this meta-analysis showed that flavanols have potential against obesity.

Barriers and reinforcing factors to self-management behaviour in rheumatoid arthritis patients: A qualitative study

OBJECTIVE

The aim of the present study was to explore the view of rheumatoid arthritis (RA) patients about the barriers and reinforcing factors in practising self-management behaviour (SMB).

METHODS

This was a qualitative study based on directed content analysis of in-depth semi-structured interviews with 30 patients. The participants were selected using a purposeful sampling approach. The interviews continued until data saturation was reached. The study was conducted over 6 months in 2014-2015 at the Rheumatology Clinic of Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

RESULTS

Three main themes and 14 subthemes were extracted. The main themes included behavioural barriers, environmental barriers and reinforcing factors. The subthemes included lack of awareness; poor physician-patient relationship; lack of motivation; negative attitude and willingness; lack of time; cost; housing conditions and in-home equipment; negative social effects; social support; consequences of SMB; and comparing yourself with others.

CONCLUSION

Behavioural and environmental barriers, as well as social support and outcomes of SMB were the most important barriers and reinforcing factors of SMB. Therefore, considering these factors in patients may help in designing programmes that attempt to reduce barriers and increase reinforcing factors, which ultimately result in higher levels of SMB and quality of life among patients.

Acute vision loss in systemic lupus erythematosus: bilateral combined retinal artery and vein occlusion as a catastrophic form of clinical flare

Presentation of a combination of branch retinal artery occlusion (BRAO)/central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) in systemic lupus erythematosus (SLE) is extremely rare. Herein, we have presented the case of a 29-year-old female with SLE, who simultaneously developed bilateral CRVO and BRAO/CRAO in the absence of antiphospholipid syndrome (APS) as a catastrophic form of clinical flare. A combinatorial diagnosis of CRVO and BRAO/CRAO should be considered during clinical flare-up in a patient with SLE who presents with rapidly progressive visual loss.

Proteomic analysis of muscle tissue from rainbow trout (Oncorhynchus mykiss) fed dietary β-glucan

The aim of this study was to examine the changes in muscle proteome of the rainbow trout fed dietary β-glucan. The experimental diets contained 0 (control), 0.1% and 0.2% β-1,3/1,6 yeast glucan. First, feeding larvae were fed to apparent satiation nine times per day with their respective diets over two months. The percentage of body weight gain and feed efficiency of fish fed 0.2% diet was significantly higher than those of fish fed the control and 0.1% diets. Fish fed the control and 0.2% diets were subjected to proteomic analysis. Proteins of the muscle tissue were analyzed using two-dimensional electrophoresis and mass spectrometry. Spots that were found to differ significantly in abundance between control and β-glucan fed fish were selected for identification. Out of 8 protein spots showing differential expression, 7 spots were successfully identified. Two protein spots that were found to be increased in abundance in the β-glucan treated rainbow trout corresponded to tropomyosin alpha-1 chain (spot 1) and slow myotomal muscle tropomyosin (spot 2). The five spots that were down-regulated with dietary β-glucan supplementation were identified as different forms of myosin: myosin light polypeptide 3-2 (spot 3), myosin light chain 1 (spots 4 and 5), fast myosin light chain 2 (spot 6) and myosin heavy chain (spot 7). The altered expression of structural proteins in fish fed β-glucan may be related to higher growth rate in rainbow trout. These findings provide basic information to understand possible mechanisms of dietary β-glucan contribution to better growth in rainbow trout.

Self Management Behaviors in Rheumatoid Arthritis Patients and Associated Factors in Tehran 2013

INTRODUCTION

Rheumatoid Arthritis (RA) is a systemic, autoimmune and inflammatory disease with an unknown etiology that is associated with progressive joint degeneration, limitation of physical activity and disability. The aim of the study was to evaluate self-management behaviors and their associated factors in RA patients.

MATERIAL & METHOD

This cross-sectional study was performed in 2013 on185 patients in Iran. Data were selected through convenient sampling. The collected data included demographic variables, disease related variables, Arthritis Impact Measurement Scale 2 (AIMS-2SF), and Self-Management Behaviors (SMB). Data were analyzed by SPSS17 using Spearman correlation and logistic regression test.

RESULT

In this study drug management, regular follow-up, and food supplement were used as the most frequently applied SMB and aquatic exercise, diet, massage therapy, and relaxation were the least common SMBs. Age, education, health status, occupation, marital status, sex, DAS28 (Disease Activity Score 28 joints), and PGA (Physician Global Assessment) were significantly related with SMB.

CONCLUSION

The result of the study highlight the influence of demographic variables, health status, and disease related data on SMB. Thus, more studies are required to find factors influencing SMB in order to improve SMB.

Prevalence and severity of depression and anxiety in patients with systemic lupus erythematosus: An epidemiologic study in Iranian patients

OBJECTIVES

We aimed to evaluate the prevalence of depression and anxiety in patients with systemic lupus erythematosus (SLE) and explore their association with demographic and clinical features.

METHODS

In this cross-sectional study, 166 SLE patients in rheumatology center of Shariati hospital, Tehran University of Medical Sciences were enrolled. SLE disease activity index (SLEDAI) and Beck and Cattell inventories for evaluation of depression and anxiety were completed for each patient.

RESULTS

The mean age of patients was 33.1 ± 11.1 years and 92.2% of them were female. Two patients (1.2%) had only depression (without anxiety), while 36 patients (21.6%) had only anxiety (without depression). Meanwhile, 105 patients (63.3%) had mixed depression-anxiety and 23 patients (13.8%) did not have either depression or anxiety. Mean daily dose of prednisolone and number of administered drugs did not show significant difference between different subgroups of patients. In assessment of clinical and therapeutic items, no significant correlation between severity of depression (P = 0.65) and anxiety (P = 0.36) with daily dose of prednisolone in SLE patients was observed. There was no significant association between SLEDAI and severity of depression or anxiety. Occupational status had significant correlation with severity of depression and anxiety (P = 0.005).On the contrary, no significant correlation between number of administered drugs and severity of depression and anxiety was present.

CONCLUSION

This study indicated the high prevalence of depression and anxiety among SLE patients and reinforced the need of a comprehensive psychiatric work-up in SLE.

Vitamin D deficiency in patients with Behcet's disease

BACKGROUND

Behcet's disease is an autoimmune, recurrent and multisystem disease. Vitamin D has immunomodulator role in immune system. So that vitamin D deficiency was reported in some autoimmune diseases. Behcet's disease as a Silk Road disease is common in Iran. The aim of this study was to detect the serum level of 25(OH) vitamin D in Behcet's patients and control group.

METHODS

In this case-control study, 112 Behcet's patients as cases group and 112 healthy individuals as controls group were enrolled. Any subject on vitamin D supplement, steroid, and immunosuppressors during the last 6 months were excluded. The serum level of 25(OH) vitamin D was measured in the two groups by ELISA method. The findings were compared via SPSS software.

RESULTS

About 57% and 17% of Behcet's patients had vitamin D deficiency and insufficiency respectively. Vitamin D deficiency was significantly more common in controls than cases group (P < 0.001). Vitamin D levels were significantly lower in controls (P < 0.001). Age and sex did not have any confounding effect on the results. There was no significant relationship between disease duration, disease activity, Pathergy test, HLA-B5, and HLA-B51 with vitamin D level in Behcet's patients.

CONCLUSIONS

Vitamin D deficiency is common among Behcet's patients. However, our results revealed vitamin D deficiency was significantly more common in healthy controls in comparison with Behcet's cases.

The relationship between plasma homocysteine level and HLA-B51 in patients with Behcet's disease: a case-control study

BACKGROUND

Various coagulation disorders have been reported to explain hypercoagulability state in Behcet's disease (BD). A possible negative association between human leukocyte antigen (HLA)-B51 and increased homocysteine level has been suggested in a previous report from Iranian patients with BD. The aim of this study was to find any possible relationship between plasma homocysteine levels and HLA-B51.

METHODS

In a case-control study, BD patients (fulfilling the new International Criteria for BD) and controls (who had similar clinical symptoms but BD was clinically excluded in them) were included. Mean plasma homocysteine levels measured by enzyme-linked immunosorbent assay in HLA-B51 positive and negative individuals both in patients and controls were compared by t-test, Mann-Whitney test and analysis of variance (F-test).

RESULTS

Ninety-six BD patients and 152 controls were recruited. There was no significant difference between HLA-B51 positive and negative individuals either in the mean plasma homocysteine levels (13.59 ± 9.03 vs. 12.95 ± 4.98 μmol/L, P = 0.514), or in the prevalence of hyperhomocysteinemia (17% vs. 21.4%, P = 0.504). This was true both for BD and control groups. In HLA-B51 positive and negative BD patients, mean plasma homocysteine levels were 14.29 ± 12.02 and 12.62 ± 4.79 μmol/L, respectively (P = 0.33), and the prevalence of hyperhomocysteinemia was 20.8% versus 19.5% (P = 0.55). In the control group, the mean plasma homocysteine levels in HLA-B51 positive and negative individuals were 12.85 ± 4.28 and 13.14 ± 5.10 μmol/L, respectively (P = 0.794), and the prevalence of hyperhomocysteinemia was 13% versus 22.1% (P = 0.23). The difference was non-significant regarding sex (P > 0.71) and disease activity (P > 0.31).

CONCLUSION

In contrast to our previous report, we found no relationship between plasma homocysteine levels and HLA-B51 in this study, either in BD or in the control group.

The dietary wood betony, Stachys lavandulifolia Vahl extract as a growth promoter and immune enhancer in common carp (Cyprinus carpio)

The present study was conducted to evaluate the efficacy of wood betony (WB), Stachys lavandulifolia extract on growth performance and some immune responses in common carp, Cyprinus carpio. Different concentrations of the WB extract 0, 2, 4 and 8% (g per 100 g of diet) were added to commercial diet. Each treatment was randomly assigned to triplicate groups of fish having average initial weight of 44 ± 0.62 g for 10 weeks. The results showed that final weight, food conversion ratio, specific growth rate and condition factor were significantly improved by WB in a dose dependent manner, where the best growth parameters were achieved in the group of fish receiving the highest concentration of WB (P<0.05). Feeding fish at 2 and 4% W/W by WB in the diet improved lysozyme activity, ACH50 and IgM levels significantly in comparison to the control (P<0.05). Group of fish fed on 4% WB in the diet had the best levels of the immune characteristics (P<0.05). Based on the results of this study, it is recommended to feed common carp with WB to improve growth and non-specific immunity.

Tissue distribution of infectious pancreatic necrosis virus serotype Sp in naturally infected cultured rainbow trout, Oncorhynchus mykiss (Walbaum): an immunohistochemical and nested-PCR study

This study investigates the occurrence and distribution pattern of infectious pancreatic necrosis virus (IPNV) within the pancreas, liver, kidney and spleen of naturally infected cultured rainbow trout, Oncorhynchus mykiss (Walbaum), using immunohistochemistry (IHC). A nested PCR was also employed to confirm the presence of the virus in the pooled tissues of the specimens. All the examined tissues except spleen were immunohistochemically positive for IPNV, but staining intensity and distribution pattern varied. The kidney tubules had the most intense and widespread staining by IHC, indicating a specific tissue tropism at least for this particular serotype. The nucleotide sequence had the greatest identity with the Sp serotype confirming the presence of the nucleic acid of IPNV in the pooled tissues. Based on the present findings, it could be concluded that the absence of lesions consistent with infectious pancreatic necrosis (IPN) disease in the H&E-stained sections cannot rule out the presence of the IPNV, and the use of an alternative rapid confirmatory method such as IHC with formalin-fixed, paraffin-embedded tissue sections is helpful for the final diagnosis of IPN in rainbow trout.

Special position for the anaesthetic management of a patient with giant neck and back masses

A neck mass is a risk factor for difficult airway during induction of anaesthesia particularly when accompanied with a giant back mass which limits positioning of the patient in the supine position. We report the management of a young woman with known recurrent neurofibroma scheduled for resection of her giant neck and back masses. Unfortunately, her dorsal thoracic mass was too huge to allow adoption of the supine position for induction of anaesthesia. In order to achieve a suitable supine position which is fundamental during airway management, we created a hole in the operating table to fit her giant back mass. Exhibition of this special operating table may help to achieve a suitable position and ease airway management which is not possible with routine tables in cases with giant posterior masses.

Endogenous Klebsiella endophthalmitis associated with liver abscess: first case report from iran

PURPOSE

To report the first case of endogenous Klebsiella endophthalmitis associated with liver abscess in Iran.

CASE REPORT

A 79-year-old man was referred to our hospital due to severe pain and visual loss in the left eye. On physical examination, conjunctival hyperemia, corneal edema, hypopyon and severe vitreous cellular reaction were identified in the left eye; however, yellowish conjunctival discoloration was more apparent in the right eye. Abdominal CT scan showed a right liver lobe abscess that was confirmed by sonographically guided percutaneous liver mass biopsy. Blood, vitreous and liver mass aspirate cultures revealed Klebsiella pneumoniae growth. The patient was thus diagnosed with endogenous Klebsiella endophthalmitis secondary to bacteremia associated with liver abscess.

CONCLUSION

This report suggests that, rather than being confined to Taiwan, endogenous endophthalmitis secondary to a liver abscess due to K. pneumoniae may be a global problem. Therefore, physicians should be aware of the possibility of endophthalmitis whenever a patient with K. pneumoniae liver abscess complains of ocular symptoms.

Methotrexate hepatotoxicity in patients with rheumatoid arthritis

BACKGROUND Increases in aminotransferases (transaminitis) are potential major adverse reactions seen with long-term use of methotrexate (MTX). The aim of this study, therefore was to evaluate the incidence of MTX induced hepatotoxicity and its risk factors among rheumatoid arthritis (RA) patients. METHODS This retrospective study described 286 patients with RA who received ≥ 7.5 mg MTX weekly in an academic rheumatology clinic over a 15 year period. The results of serial liver function tests, concurrent MTX dose, cumulative dose and use of hepatotoxic drugs were collected and statistically analyzed according to a consecutive elevation in aminotransferases which occurred over at least a two week interval. RESULTS During the study period, 286 patients (84.4% female) with mean age of 46.6±12.7 years (18-84 years) were enrolled. Transaminitis occurred among 23.7% of patients (incidence: 6.9 per 100 person-years) during 40.5±34.6 month's exposure to MTX (989.6 person-years). The time difference between onset of therapy and occurrence of transaminitis was 22.1±22.0 months. The only significant factor related to the occurrence of transaminitis was the duration of MTX therapy. The average duration of treatment among patients with transaminitis (59.6±42.3 months) was greater than those with no transaminitis (p<0.001). The cumulative dose of MTX was significantly related to the occurrence of transaminitis (p<0.001). CONCLUSION MTX hepatotoxicity is a common complication of long-term treatment with MTX. It is associated with mild liver enzyme elevation and related to the duration of therapy.

The correlation between tonsil size and academic performance is not a direct one, but the results of various factors

Chronic upper airway obstruction most often occurs when both tonsils and adenoid are enlarged but may occur when either is enlarged. Obstructive sleep syndrome in young children has been reported to be associated with an adverse effect on learning and academic performance. The aim of this study was to evaluate the effect of relative size of the tonsil on academic performance in 4th grade school children. In 320 children, physical examination to determine the size of tonsils was performed by the otorhinolaryngologist. A questionnaire was developed to assess sleep patterns and problems, and socio-demographic data for the student participants. Furthermore, their school performance was assessed using their grade in mathematics, science, reading, spelling, and handwriting. No association between tonsil size and academic performance was found. Snoring frequency, body mass index and body weight showed a positive relation with tonsil size. There was no association between tonsil size and sleepiness during the day, sleeping habits, hyperactivity, enuresis, history of tonsillectomy in children and parental cigarette smoking and education. In conclusion, this study did not show any significant relationship between tonsil size and academic performance in 4th grade students. Further studies are recommended with a larger sample size, cognitive exams for evaluation of attention, and follow-up of the students until high school, when the discrepancy of the students' academic performance is more obvious.

Preparation and evaluation of [67Ga]-DTPA-β-1–24-corticotrophin in normal rats

β-1–24-corticotrophin was successively labeled with [67Ga]-gallium chloride after residulation with freshly prepared cyclic DTPA-dianhydride. The best results of the conjugation were obtained by the addition of 1 ml of a β-1–24-corticotrophin pharmaceutical solution (1 mg/mL, pH=6.5) to a glass tube pre-coated with DTPA-dianhydride (0.01 mg) at 25 °C with continuous mild stirring for 30 min. Radio-thin layer chromatography showed an overall radiochemical purity of >90% at optimized conditions after labeling. HPLC showed a radiochemical purity more than 95% (specific activity =300–500 MBq/mg, labeling efficiency 77%). The stability of the radioconjugate was tested in presence of human serum at 37 °C. Preliminary in vivo studies in normal rats were performed to determine the biodistribution of the radioimmunoconjugate up to 30 min. Lungs showed to have the major tracer uptake which is consistent with the natural distribution of ACTH receptors in human body. Pretreatment of animals with cold peptide following labeled compound administration reduced lung uptake at least 10 and 3 times after 15 and 30 min, respectively, as well as significant decrease in adrenal uptake after 15 min. These data support the specific receptor binding of the radiolabeled compound. This tracer can be used in detection of ACTH receptor in lung and adrenal malignancies.

[201Tl](III)-bleomycin for tumor imaging

Due to interesting physical properties and wide availability of thallium-201 as a SPECT radionuclide, the idea of incorporation of this nuclide into biologically active compounds was targeted. Thallium-201 (T 1/2 = 3.04 d) in Tl+ form was converted to Tl3+ cation in presence of O3 in 6 M HCl controlled by RTLC/gel electrophoresis methods. The final evaporated activity was reacted with bleomycin in normal saline to yield [201Tl]BLM at room temperature after 0.5 h (radiochemical yield > 99%) followed by HPLC analysis. The studies showed that thallic ion is mostly incorporated into bleomycin A2 while other species in the pharmaceutical sample almost remain unlabeled. Radiochemical purity of more than 99% was obtained using RTLC, HPLC with specific activity of about 7 Ci/mmol. The stability of the tracer was checked in the final product in presence of human serum at 37 °C up to 3 d. The tracer accumulated in tumors of fibrosarcoma-bearing mice after 72 h.

Oxygen saturation improvement after adenotonsillectomy in children

The goal of this study was to establish whether adenotonsillectomy is effective on the severity of oxygen desaturation or improve oxygen saturation in children with sleep breathing disorders. Thirty-two children, aged 4-7 years, with clinical indication for adenotonsillectomy were enrolled in a non-controlled clinical trial. Pre- and postoperative nocturnal oxygen saturation monitoring was done and oxygen desaturation index as well as desaturation events were analyzed using Wilcoxon and paired Student's t-tests. Snoring was the most prevalent (87.5%) complaint before operation. The study revealed a significant improvement in the postoperative oxygen desaturation index (1.60 +/- 3.22) compared with the preoperative oxygen desaturation index (3.98 +/- 4.93) (p < 0.01). Oxygen desaturation events at the level of oxygen saturation 85-89% was significantly improved after operation (p < 0.01). No significant differences were seen in the desaturation events at the levels of oxygen saturation lower than 85%. Nocturnal oxygen saturation improves mildly after adenotonsillectomy in children with sleep breathing disorders.

Clinical evaluation of repeated propofol total intravenous anesthesia in dog

This current study designed to evaluate any possible changes in required doses and other cardiopulmonary findings after repeated propofol total intravenous anesthesia (TIVA) in dog. The study was conducted in 6 healthy sheepdogs, weight between 16.5 and 28 kg. Anaesthesia induced by 8 mg kg(-1) of propofol and maintained by continuous propofol (0.3 mg/kg/min) infusion in saline solution. All dogs received three times of propofol anaesthesia with the same protocol in a cross over design. As the animals in first, second and third time of anaesthesia allocated into groups 1, 2 and 3, respectively. Heart Rate (HR), rectal temperature (Temp), blood oxygen saturation (SpO2) by pulse oximetry and non invasive arterial blood pressures were measured. Times to the first swallowing attempt, ability to lift the head and standing were measured during recovery. The apnea was recorded in all animals but no significant difference was recorded between groups under study. Calculated doses of induction were sufficient for intubation of the animals. The average doses foe maintenance of anesthesia did not show any significant difference between groups under study. There were no significant differences found between groups in any comparable parameter. Despite of longer recovery time in group three, there were no significant differences between the Groups in different recovery times. Repeated propofol anesthesia did not improve resistance and respiratory changes in this species. However, some effects on blood pressure may happen without any effect on heart rate.

Determination of [201Tl]Tl(III) in [201Tl]TlCl solutions using HPLC

A high-performance liquid chromatography technique has been presented to measure the [(201)Tl]TlCl(3) impurity in [(201)Tl]TlCl radiopharmaceutical for precise determination of radiochemical purity. Diethylene tetraamine pentaacetic acid (DTPA) has been used for complete complexation of [(201)Tl]Tl(III). [(201)Tl]Tl(III)-DTPA was analyzed in the presence of [(201)Tl]Tl(I) using a cation exchange HPLC column.