Molecular modelling of the antiviral action of Resveratrol derivatives against the activity of two novel SARS CoV-2 and 2019-nCoV receptors

The pandemic threat of COVID-19 causes serious concern for people and world organizations. The effect of Coronavirus disease on the lifestyle and economic status of humans is undeniable, and all of the researchers (biologists, pharmacists, physicians, and chemists) can help decrease its destructive effects. The molecular docking approach can provide a fast prediction of the positive influence the targets on the COVID-19 outbreak. In this work, we choose resveratrol (RV) derivatives (22 cases) and two newly released coordinate structures for COVID-19 as receptors [Papain-like Protease of SARS CoV-2 (PBD ID: 6W9C) and 2019-nCoV RNA-dependent RNA Polymerase (PBD ID: 6M71)]. The results show that conformational isomerism is significant and useful parameter for docking results. A wide spectrum of interactions such as Van der Waals, conventional hydrogen bond, Pi-donor hydrogen bond, Pi-Cation, Pi-sigma, Pi-Pi stacked, Amide-Pi stacked and Pi-Alkyl is detected via docking of RV derivatives and COVID-19 receptors. The potential inhibition effect of RV-13 (-184.99 kj/mol), and RV-12 (-173.76 kj/mol) is achieved at maximum value for 6W9C and 6M71, respectively.

Disaggregation of conventional soil map by generating multi realizations of soil class distribution (case study: Saadat Shahr plain, Iran)

Conventional soil maps generally depict information about soil spatial distribution in the framework of crisp boundaries of tessellated soil polygons. Such maps in standard soil survey procedures determine map unit composition on the basis of relative acreage occupied by individual major and minor soil components within soil map unit without addressing the specific location of each component in the polygon boundary. These limitations in addition to the sharp-edge boundaries of conventional soil maps are considered obstacles for modern land resource management. To increase detail in the polygon of conventional soil maps, we have produced a spatially disaggregated soil class map of a relatively flat agricultural plain called Saadat Shahr in South-Central Iran, using DSMART algorithm. DSMART is a known DSM-based disaggregation and harmonization algorithm that works through resampled classification trees to estimate the probability of the existence of each possible soil classes and also to prepare the maps of the most probable soil class, second most probable, and so on in raster format. The conventional soil map and 124 georeferenced profiles, as well as a set of numerical and categorical auxiliary data in 10-m resolutions in the extent of the study area utilized as the SCORPAN variables, were used as the inputs of the DSMART algorithm. A set of 78 independent sampling points generated by Latin hypercube sampling scheme were investigated and then used for validation of the DSMART raster outputs. The results indicated an improvement in disaggregated maps in the case of allocating soil components within the map units. In the generated DSMART, overall accuracy for seven soil subgroups was 68%. The best prediction obtained for Typic Xerorthents and Typic Calcixerepts, meanwhile a few classes were poorly predicted. For second most probable and third most probable maps, 17% and 0.5% of predicted soils match that observed respectively. This study revealed that DSMART as a disaggregation method can be used for enhancing existence soil map with poor descriptive data in the case of allocating soil classes in a more detailed way compared to the relevant original map.

Combination of ground rice husk and polyvinyl alcohol fiber in cementitious composite

In this study, ground rice husks (GRH) in combination with polyvinyl-alcohol (PVA) fiber were used to produce low-cost and high-quality hybrid cementitious composites. Different amounts of GRH (2.5, 5.0, 7.5 and 12.5% in weight of cement) were added to the concrete. The work presented in this paper provides an insight into the use of an agricultural waste as effective additive in cement based materials. The properties of resultant cementitious composites including density, water absorption, flexural behavior and compressive strength were investigated. The results have shown that incorporation of ground rice husk in combination with PVA fiber can be effective in improvement of the flexural properties of cementitious composite. The study explored the effectiveness of this type of agricultural waste as a beneficial material in fine aggregate concrete materials.

TP53-based interaction analysis identifies cis-eQTL variants for TP53BP2, FBXO28, and FAM53A that associate with survival and treatment outcome in breast cancer

TP53 overexpression is indicative of somatic TP53 mutations and associates with aggressive tumors and poor prognosis in breast cancer. We utilized a two-stage SNP association study to detect variants associated with breast cancer survival in a TP53-dependent manner. Initially, a genome-wide study (n = 575 cases) was conducted to discover candidate SNPs for genotyping and validation in the Breast Cancer Association Consortium (BCAC). The SNPs were then tested for interaction with tumor TP53 status (n = 4,610) and anthracycline treatment (n = 17,828). For SNPs interacting with anthracycline treatment, siRNA knockdown experiments were carried out to validate candidate genes.In the test for interaction between SNP genotype and TP53 status, we identified one locus, represented by rs10916264 (p(interaction) = 3.44 × 10-5; FDR-adjusted p = 0.0011) in estrogen receptor (ER) positive cases. The rs10916264 AA genotype associated with worse survival among cases with ER-positive, TP53-positive tumors (hazard ratio [HR] 2.36, 95% confidence interval [C.I] 1.45 - 3.82). This is a cis-eQTL locus for FBXO28 and TP53BP2; expression levels of these genes were associated with patient survival specifically in ER-positive, TP53-mutated tumors. Additionally, the SNP rs798755 was associated with survival in interaction with anthracycline treatment (p(interaction) = 9.57 × 10-5, FDR-adjusted p = 0.0130). RNAi-based depletion of a predicted regulatory target gene, FAM53A, indicated that this gene can modulate doxorubicin sensitivity in breast cancer cell lines.If confirmed in independent data sets, these results may be of clinical relevance in the development of prognostic and predictive marker panels for breast cancer.

FANCM c.5101C>T mutation associates with breast cancer survival and treatment outcome

Breast cancer (BC) is a heterogeneous disease, and different tumor characteristics and genetic variation may affect the clinical outcome. The FANCM c.5101C > T nonsense mutation in the Finnish population associates with increased risk of breast cancer, especially for triple‐negative breast cancer patients. To investigate the association of the mutation with disease prognosis, we studied tumor phenotype, treatment outcome, and patient survival in 3,933 invasive breast cancer patients, including 101 FANCM c.5101C > T mutation carriers and 3,832 non‐carriers. We also examined association of the mutation with nuclear immunohistochemical staining of DNA repair markers in 1,240 breast tumors. The FANCM c.5101C > T mutation associated with poor 10‐year breast cancer‐specific survival (hazard ratio (HR)=1.66, 95% confidence interval (CI) 1.09–2.52, p = 0.018), with a more pronounced survival effect among familial cases (HR = 2.93, 95% CI 1.5–5.76, p = 1.80 × 10⁻³). Poor disease outcome of the carriers was also found among the estrogen receptor (ER) positive subgroup of patients (HR = 1.8, 95% CI 1.09–2.98, p = 0.021). Reduced survival was seen especially among patients who had not received radiotherapy (HR = 3.43, 95% CI 1.6–7.34, p = 1.50 × 10⁻³) but not among radiotherapy treated patients (HR = 1.35, 95% CI 0.82–2.23, p = 0.237). Significant interaction was found between the mutation and radiotherapy (p = 0.040). Immunohistochemical analyses show that c.5101C > T carriers have reduced PAR‐activity. Our results suggest that FANCM c.5101C > T nonsense mutation carriers have a reduced breast cancer survival but postoperative radiotherapy may diminish this survival disadvantage.

What's new?

Variations in DNA repair genes can predispose individuals to breast cancer, with one example being FANCM c.5101C > T, a nonsense mutation in the Fanconi Anemia DNA repair pathway. In previous work, FANCM c.5101C > T was associated with increased breast cancer risk in the Finnish population. Here, the mutation is further shown to be associated with adverse breast cancer outcome. Mutation‐positive Finnish patients exhibited reduced long‐term survival and increased risk of disease recurrence. Survival was worse particularly for patients who were not treated with radiotherapy, indicating that FANCM c.5101C>T may interact with radiotherapy to improve disease outcome in mutation carriers.

Sonochemical assisted hydrothermal synthesis of ZnO: Cr nanoparticles loaded activated carbon for simultaneous ultrasound-assisted adsorption of ternary toxic organic dye: Derivative spectrophotometric, optimization, kinetic and isotherm study

Chromium doped zinc oxide nanoparticles (ZnO: Cr-NPs) was synthesized by ultrasonically assisted hydrothermal method and characterized by FE-SEM, XRD and TEM analysis. Subsequently, this composite ultrasonically assisted was deposited on activated carbon (ZnO: Cr-NPs-AC) and used for simultaneous ultrasound-assisted removal of three toxic organic dye namely of malachite green (MG), eosin yellow (EY) and Auramine O (AO). Dyes spectra overlap in mixture (major problem for simultaneous investigation) of this systems was extensively resolved by derivative spectrophotometric method. The magnitude of variables like initial dyes concentration, adsorbent mass and sonication time influence on dyes removal was optimized using small central composite design (CCD) combined with desirability function (DF) approach, while pH was studied by one-a-time approach. The maximized removal percentages at desirability of 0.9740 was set as follow: pH 6.0, 0.019g ZnO: Cr-NPs-AC, 3.9min sonication at 4.5, 4.8 and 4.7mgL(-1) of MG, EY and AO, respectively. Above optimized points lead to achievement of removal percentage of 98.36%, 97.24%, and 99.26% correspond to MG, EY and AO, respectively. ANOVA for each dyes based p-value less than (<0.0001) suggest highly efficiency of CCD model for prediction of data concern to simultaneous removal of these dyes within 95% confidence interval, while their F-value for MG, EY and AO is 935, 800.2, and 551.3, respectively, that confirm low participation of this them in signal. The value of multiple correlation coefficient R(2), adjusted and predicted R(2) for simultaneous removal of MG is 0.9982, 0.9972 and 0.9940, EY is 0.9979, 0.9967 and 0.9930 and for AO is 0.9970, 0.9952 and 0.9939. The adsorption rate well fitted by pseudo second-order and Langmuir model via high, economic and profitable adsorption capacity of 214.0, 189.7 and 211.6mgg(-1) for MG, EY and AO, respectively.

Highly efficient simultaneous ultrasonic assisted adsorption of brilliant green and eosin B onto ZnS nanoparticles loaded activated carbon: Artificial neural network modeling and central composite design optimization

In this work, central composite design (CCD) combined with response surface methodology (RSM) and desirability function approach (DFA) gives useful information about operational condition and also to obtain useful information about interaction and main effect of variables concerned to simultaneous ultrasound-assisted removal of brilliant green (BG) and eosin B (EB) by zinc sulfide nanoparticles loaded on activated carbon (ZnS-NPs-AC). Spectra overlap between BG and EB dyes was extensively reduced and/or omitted by derivative spectrophotometric method, while multi-layer artificial neural network (ML-ANN) model learned with Levenberg-Marquardt (LM) algorithm was used for building up a predictive model and prediction of the BG and EB removal. The ANN efficiently was able to forecast the simultaneous BG and EB removal that was confirmed by reasonable numerical value i.e. MSE of 0.0021 and R(2) of 0.9589 and MSE of 0.0022 and R(2) of 0.9455 for testing data set, respectively. The results reveal acceptable agreement among experimental data and ANN predicted results. Langmuir as the best model for fitting experimental data relevant to BG and EB removal indicates high, economic and profitable adsorption capacity (258.7 and 222.2 mg g(-1)) that supports and confirms its applicability for wastewater treatment.

Automatic Detection of the Optic Disc of the Retina: A Fast Method

Localizing the optic disc (OD) in retinal fundus images is of critical importance and many techniques have been developed for OD detection. In this paper, we present the results obtained from two fast methods, correlation and least square, to approximate the location of optic cup. These methods are simple and are not complex, while most of the OD detection algorithms are. The methods were tested on two groups of data (a total of 100 color fundus images) and were 98% successful in the detection of the optic cup. An algorithm using the vessel mask of fundus images is proposed to be run after correlation to ensure that the localization of OD in all images is successful. It was tested on 40 of the test images and had a 100% rate of success.

SNP-SNP interaction analysis of NF-κB signaling pathway on breast cancer survival

In breast cancer, constitutive activation of NF-κB has been reported, however, the impact of genetic variation of the pathway on patient prognosis has been little studied. Furthermore, a combination of genetic variants, rather than single polymorphisms, may affect disease prognosis. Here, in an extensive dataset (n = 30,431) from the Breast Cancer Association Consortium, we investigated the association of 917 SNPs in 75 genes in the NF-κB pathway with breast cancer prognosis. We explored SNP-SNP interactions on survival using the likelihood-ratio test comparing multivariate Cox' regression models of SNP pairs without and with an interaction term. We found two interacting pairs associating with prognosis: patients simultaneously homozygous for the rare alleles of rs5996080 and rs7973914 had worse survival (HRinteraction 6.98, 95% CI=3.3-14.4, P=1.42E-07), and patients carrying at least one rare allele for rs17243893 and rs57890595 had better survival (HRinteraction 0.51, 95% CI=0.3-0.6, P = 2.19E-05). Based on in silico functional analyses and literature, we speculate that the rs5996080 and rs7973914 loci may affect the BAFFR and TNFR1/TNFR3 receptors and breast cancer survival, possibly by disturbing both the canonical and non-canonical NF-κB pathways or their dynamics, whereas, rs17243893-rs57890595 interaction on survival may be mediated through TRAF2-TRAIL-R4 interplay. These results warrant further validation and functional analyses.

Enhanced simultaneous removal of malachite green and safranin O by ZnO nanorod-loaded activated carbon: modeling, optimization and adsorption isotherms

Highly improved, safe, green and rapid adsorption by loading trace amounts of ZnO nanorods on AC with high uptake capacity.

Germline variation in TP53 regulatory network genes associates with breast cancer survival and treatment outcome

Germline variation in the TP53 network genes PRKAG2, PPP2R2B, CCNG1, PIAS1 and YWHAQ was previously suggested to have an impact on drug response in vitro. Here, we investigated the effect on breast cancer survival of germline variation in these genes in 925 Finnish breast cancer patients and further analyzed five single nucleotide polymorphisms (SNPs) in PRKAG2 (rs1029946, rs4726050, rs6464153, rs7789699) and PPP2R2B (rs10477313) for 10-year survival in breast cancer patients, interaction with TP53 R72P and MDM2-SNP309, outcome after specific adjuvant therapy and correlation to tumor characteristics in 4,701 invasive cases from four data sets. We found evidence for carriers of PRKAG2-rs1029946 and PRKAG2-rs4726050 having improved survival in the pooled data (HR 0.53, 95% CI 0.3-0.9; p = 0.023 for homozygous carriers of the rare G-allele and HR 0.85, 95% CI 0.7-0.9; p = 0.049 for carriers of the rare G allele, respectively). PRKAG2-rs4726050 showed a significant interaction with MDM2-SNP309, with PRKAG2-rs4726050 rare G-allele having a dose-dependent effect for better breast cancer survival confined only to MDM2 SNP309 rare G-allele carriers (HR 0.45, 95% CI 0.2-0.7; p = 0.001). This interaction also emerged as an independent predictor of better survival (p = 0.047). PPP2R2B-rs10477313 rare A-allele was found to predict better survival (HR 0.82, 95% CI 0.6-0.9; p = 0.018), especially after hormonal therapy (HR 0.66, 95% CI 0.5-0.9; p = 0.048). These findings warrant further studies and suggest that genetic markers in TP53 network genes such as PRKAG2 and PPP2R2B might affect prognosis and treatment outcome in breast cancer patients.

MiR-34a expression has an effect for lower risk of metastasis and associates with expression patterns predicting clinical outcome in breast cancer

MiR-34a acts as a candidate tumour suppressor gene, and its expression is reduced in several cancer types. We aimed to study miR-34a expression in breast cancer and its correlation with tumour characteristics and clinical outcome, and regulatory links with other genes. We analysed miR-34a expression in 1,172 breast tumours on TMAs. 25% of the tumours showed high, 43% medium and 32% low expression of miR-34a. High miR-34a expression associated with poor prognostic factors for breast cancer: positive nodal status (p = 0.006), high tumour grade (p<0.0001), ER-negativity (p = 0.0002), HER2-positivity (p = 0.0002), high proliferation rate (p<0.0001), p53-positivity (p<0.0001), high cyclin E (p<0.0001) and γH2AX (p<0.0001). However, multivariate analysis adjusting for conventional prognostic factors indicated that high miR-34a expression in fact associated with a lower risk of recurrence or death from breast cancer (HR = 0.63, 95% CI = 0.41–0.96, p = 0.031). Gene expression analysis by differential miR-34a expression revealed an expression signature with an effect on both the 5-year and 10-year survival of the patients (p<0.001). Functional genomic analysis highlighted a novel regulatory role of the transcription factor MAZ, apart from the known control by p53, on the expression of miR-34a and a number of miR-34a targets. Our findings suggest that while miR-34a expression activation is a marker of aggressive breast tumour phenotype it exerts an independent effect for a lower risk of recurrence or death from breast cancer. We also present an expression signature of 190 genes associated with miR-34a expression. Our analysis for regulatory loops suggest that MAZ and p53 transcription factors co-operate in modulating miR-34a, as well as miR-34a targets involved in several cellular pathways. Taken together, these results suggest that the network of genes co-regulated with and targeted by miR-34a form a group of down-stream effectors that maybe of use in predicting clinical outcome, and that highlight novel regulatory mechanisms in breast cancer.

Hepatitis C prevalence studied by polymerase chain reaction and serological methods in haemodialysis patients in Mazandaran, Iran

INTRODUCTION

Patients on maintenance haemodialysis are known to have an elevated risk of acquiring hepatitis C virus (HCV) infection. The reported prevalence among haemodialysis patients in the United States ranges from eight percent to ten percent, and is considerably higher in many European and Middle Eastern countries. Therefore, a reliable diagnosis of HCV infection is essential in order to prevent the spread of the disease in dialysis units.

METHODS

All haemodialysis patients were interviewed in two dialysis units in Sari and Ghaemshahr, Iran, in 2006. Blood samples were collected and serum samples screened for anti-HCV antibodies by enzyme-linked immunosorbent assay (ELISA). All samples were retested for confirmation with polymerase chain reaction (PCR).

RESULTS

A total of 186 haemodialysis patients (mean age 58.86 +/- 16.9 years) were studied. Mean duration of haemodialysis was 3.07 +/- 0.3 years. Mean of SGOT and SGPT were 30.64 +/- 6 and 32.01 +/- 8, respectively. Among the 186 patients, 39 (21 percent) were seropositive by ELISA and 21 (11.3 percent) were PCR positive. All PCR positive patients also had positive ELISA. Association between the duration of haemodialysis and HCV seropositivity was statistically significant (p-value is 0.0001), but there was no significant correlation between number of transfusions and HCV seropositivity.

CONCLUSION

Despite the growing demand for cost-effectiveness in the health system, tight control of HCV infection by PCR and ELISA examination must remain an essential part of the routine screening in haemodialysis patients.

V-Lab-a virtual laboratory for autonomous agents-SLA-based learning controllers

In this paper, we present the use of stochastic learning automata (SLA) in multiagent robotics. In order to fully utilize and implement learning control algorithms in the control of multiagent robotics, an environment for simulation has to be first created. A virtual laboratory for simulation of autonomous agents, called V-Lab is described. The V-Lab architecture can incorporate various models of the environment as well as the agent being trained. A case study to demonstrate the use of SLA is presented.

Intestinal malrotations: a review and report of thirty cases

Intestinal malrotation is a developmental anomaly affecting the position and peritoneal attachments of the small and large bowels during organogenesis in foetal life. It has been defined as absent or incomplete rotation and fixation of the embryonic gut around the superior mesenteric artery. In the present paper, we review the definition, history, embryology/aetiology, epidemiology, symptoms and signs, diagnosis and treatment of intestinal malformations. Moreover, we report the records of 30 cases of malrotation admitted to our department over a period of five years. The final intraoperative diagnosis of the cases presented was 53.3% pure malrotation, 33.3% malrotation with mid-gut volvulus, 6.7% malrotation with duodenal atresia, 3.3% malrotation with Meckel's diverticulum and duodenal atresia, and 3.3% malrotation and biliary atresia. Preoperative imaging studies were performed for 27 cases and surgical management was successfully conducted without any mortality among the cases studied. This article provides an overview of basic and clinical aspects of intestinal malrotation. In addition, the signs and symptoms, imaging findings, and final intraoperative diagnoses presented by the subjects reported on are of potential use and clinical interest.

The results of grade IV cystocele repair using mesh

PURPOSE

To evaluate the results of grade IV cystocele repair by 4-corner bladder and bladder neck suspension technique, using prolene mesh.

MATERIAL AND METHODS

Thirty-one women with a median age of 61 years and severe anterior vaginal wall prolapse (grade IV cystocele) were treated by 4-corner bladder and bladder neck suspension technique, using prolene mesh. Of these, 3 had associated uterine prolapse, rectocele, and enterocele, one had rectocele and enterocele, and 18 had rectocele only. In these cases, pelvic floor defects were also repaired simultaneously and in 3, vaginal hysterectomy was done. Twelve patients had a previous failed cystocele repair. In a 32-month follow-up, the patients were evaluated with vaginal examination and upright cystography. Urinary continence during increased intra-abdominal pressure was also assessed, based on subjective symptoms.

RESULTS

None of the patients had cystocele recurrence. Urinary continence during increased intra-abdominal pressure was seen in all of the patients. Intraoperative rectal or bladder injury did not occur. Transfusion was not required in any of the cases. Early complications (6 to 8 weeks postoperatively) included irritative urinary symptom in 17 patients, of whom, 8 had documented urinary tract infection that were treated successfully. Late complications were spotting in 3 cases (two were treated with topical estrogen and vaginal mucosal repair was done in one), dyspareunia in 4 sexually active patients, changes in urination pattern in 28 (improved significantly with behavioral therapy), long-term urge incontinence (>8 weeks) in 5 (medical treatment was successful in these patients), and prolonged intermittent catheterization in 1. Pelvic abscess and migration of mesh were not observed.

CONCLUSION

According to our findings, using mesh in patients with grade IV cystocele, who had a previous failed surgery or weakness in supportive pelvic tissue, is an appropriate treatment modality.

Clinical measurement of muscle tone using a velocity-corrected modified Ashworth scale

OBJECTIVE

To develop a new form of the modified Ashworth scale (MAS) for muscle-tone assessment that combines the MAS score with the passive muscle-stretching velocity during the assessment of muscle tone, resulting in a measure that has higher intertester reliability than the MAS.

DESIGN

Twenty-two volunteer subjects with spinal cord injuries at a tertiary care outpatient and inpatient spinal cord injury rehabilitation center affiliated with a university were recruited for this study.

RESULTS

A decision tree in which V-MAS scores were obtained was developed. The data obtained from three independent raters, when adjusted by means of the V-MAS, showed an excellent interrater reliability.

CONCLUSIONS

Results indicated that the V-MAS is a more reliable measure. In addition, the resulting units of the V-MAS, ranging from 0 to 1, are of the same form as pendulum test data. The V-MAS method is quite simple to use because the rater need only measure the angular range and duration of the passive movement to calculate average velocity during the MAS assessment in addition to the normal MAS rating of muscle tone.

Determining flexor-tendon repair techniques via soft computing

An SC-based multi-objective decision-making method for determining the optimal flexor-tendon repair technique from experimental and clinical survey data, and with variable circumstances, was presented. Results were compared with those from the Taguchi method. Using the Taguchi method results in the need to perform ad-hoc decisions when the outcomes for individual objectives are contradictory to a particular preference or circumstance, whereas the SC-based multi-objective technique provides a rigorous straightforward computational process in which changing preferences and importance of differing objectives are easily accommodated. Also, adding more objectives is straightforward and easily accomplished. The use of fuzzy-set representations of information categories provides insight into their performance throughout the range of their universe of discourse. The ability of the technique to provide a "best" medical decision given a particular physician, hospital, patient, situation, and other criteria was also demonstrated.

Laparoscopic fenestration and modified marsupialization of posttraumatic splenic cysts using a harmonic scalpel

In recent years, the advanced laparoscopic experience has revolutionized surgery and fostered the expansion of the indications for minimally invasive surgery in the diagnosis and treatment of all intra-abdominal pathology. Total splenectomy, which traditionally was the procedure of choice in the treatment of symptomatic nonparasitic splenic cysts, recently has been changed to a more conservative approach by many authors [1, 5, 9]. The conservative methods preserve immunologic function of the spleen and prevent the potentially fatal postsplenectomy sepsis complications [9]. We successfully performed laparoscopic fenestration and modified marsupialization of these cysts using a harmonic scalpel on two patients with symptomatic splenic psuedocysts.

Intrarater reliability of manual passive movement velocity in the clinical evaluation of knee extensor muscle tone

OBJECTIVE

To quantify the relationship between therapist-applied velocity of passive movement during a manual muscle test of muscle tone and the level of muscle tone represented by the relaxation index of the pendulum test.

DESIGN

Comparison of therapist-applied passive limb movement velocity during a manual muscle test with the same subject's level of muscle tone measured by the pendulum test. Three different therapists tested each subject. The relation between the velocity scores and pendulum test scores both intratherapist and intertherapist were assessed statistically by means of analysis of variance and correlation coefficients.

SETTING

A university-affiliated tertiary care outpatient and inpatient spinal cord injury rehabilitation center.

PARTICIPANTS

Twenty-two volunteer subjects with spinal cord injuries.

MAIN OUTCOME MEASURES

Passive knee angular displacement data were collected during both manual knee muscle testing and pendulum tests by using an electrogoniometer.

RESULTS

The therapists produced significantly different movement velocities during the manual muscle tests (p < .05). A significant correlation (p < .001) was found between pendulum test scores and passive velocities, indicating that in higher levels of muscle tone, the greater stretch reflex present provided greater resistance against the therapist force and subsequently decreased the velocity of the passive stretching.

CONCLUSIONS

Measurement of average velocity during passive stretching by itself can be used to evaluate muscle tone.

Post-laparoscopic cholecystectomy bile leak secondary to an accessory duct of Luschka

Intraperitoneal bile collection following laparoscopic cholecystectomy has been reported to occur in 0.2-2% of cases and appears to be slightly higher than when the open technique is used. When the injuries of the common bile duct, technical problems with the cystic duct, diathermic injuries to the biliary tree, and iatrogenic interruption of congenital anomalous of the biliary tree are excluded, the iatrogenic transaction of the cholecystohepatic ducts commonly known as the 'Ducts of Luschka' should be considered as the cause of the biliary leak. This article reports a case of bile leakage due to an unrecognized division of a large duct of Luschka within the gall bladder fossa during laparoscopic cholecystectomy and reviews clinical diagnosis, radiological confirmation, and the appropriate treatment for this uncommon complication of laparoscopic cholecystectomy.

Ectopic thyroid nodular goiter presenting as a porta hepatis mass

An ectopic thyroid goiter was found in a 58-year-old woman who presented with abdominal and low back pain, diarrhea, and generalized weakness. Initial workup, including abdominal CT scan, revealed a mass extending from the duodenum to the porta hepatis. After resection and upon pathologic examination of the tissue, nodular arrangement of thyroid follicles and colloid lakes with focal hyperplastic and nodular goiter changes were identified.

Traumatic first rib fracture: is angiography necessary? A review of 730 cases

The two most common sites of first rib fracture were at the subclavian sulcus and in the neck of the first rib, posteriorly. Five distinct mechanisms for rib fracture were identified and included: (i) posteriorly directed trauma to the upper thorax or shoulder girdle; (ii) a direct blow to the sternum and anterior chest wall; (iii) a blow fracturing the clavicle; (iv) a strong sudden contraction of the scalenus anticus muscle; and (v) radiographic findings of a first rib fracture without history of trauma. Isolated first rib fracture regardless of mechanism of injury, results in a low incidence of major vascular injury (mean 3%), although with fracture displacement, the incidence is higher. First rib fracture associated with concomitant head, thoracic, abdominal, or long bone trauma was associated with vascular injury in 24% of cases. According to this review, specific indications for subclavian artery and aortic arch arteriography in patients with traumatic first rib fracture include widened mediastinum on chest radiography, upper-extremity pulse deficit, posteriorly displaced first rib fracture, subclavian groove fracture anteriorly, brachial plexus injury and expanding hematoma.

Clinical measurement of spasticity using the pendulum test: comparison of electrogoniometric and videotape analyses

OBJECTIVE

To compare pendulum test data obtained using an electrogoniometer with data obtained by videotape. The issue of video digitization error was also addressed.

DESIGN

The study compared pendulum test relaxation indices determined from data simultaneously collected using (1) a video (VID) camera and (2) an electrogonimeter (EG).

SETTING

A spinal cord injury rehabilitation center.

SUBJECTS

Three persons with a spinal cord injury (SCI) exhibiting mild, moderate, and severe spasticity, respectively, and a fourth, non-SCI subject.

MAIN OUTCOME MEASURE

Relaxation index as a descriptor of lower limb muscle spasticity measured using the pendulum test.

RESULTS

Multiple-digitization of VID data did not affect the reliability of this technique. It was noted that reflective markers located on body landmarks resulted in more reliable data as opposed to markers placed on the EG. Both EG and VID data were accurate and reliable.

CONCLUSIONS

In the VID method, using one digitization by a single operator is sufficient. The appropriate placement of light reflector markers are on body points. EG and VID are both reliable, highly correlated, and interchangeable in measuring spasticity using the pendulum test.