Metformin pretreatment potentiates the antiproliferative action of doxorubicin against breast cancer

OBJECTIVES

The present study aimed to evaluate the effect of metformin pretreatment on the potentiation of antiproliferative action of doxorubicin against breast cancer.

MATERIAL AND METHODS

Female Wistar rats were administered with 7,12-Dimethylbenz(a)anthracene (DMBA) (35mg) in 1mL olive oil subcutaneously beneath the mammary gland. Animals were pretreated with metformin (Met) 200mg/kg two weeks before DMBA administration. DMBA control groups received doxorubicin (Dox) (4mg/kg and 2mg/kg), Met (200mg/kg) alone and in combination with Dox (4mg/kg). Met pre-treated DMBA control groups received Dox 4mg/kg and 2mg/kg.

RESULTS

Met pre-treated groups treated with Dox exhibited a decrease in tumor incidence, tumor volume and increased survival rate than the DMBA group. Organ-to-body weight ratios and histopathology of heart, liver and lungs of Met pre-treated groups treated with Dox showed lesser toxicity than Dox treated DMBA control groups. There was a noteworthy decrease in malondialdehyde levels and a substantial increase in the levels of reduced glutathione together with a significant decrease in the levels of inflammatory markers like IL-6, IL-1β and NF-κB in Met pre-treated groups treated with Dox. Histopathology of breast tumors revealed better control of tumors in Met pre-treated groups treated with Dox than DMBA control group. Immunohistochemistry and real-time PCR data revealed a significant reduction in Ki67 expression in Met pre-treated groups treated with Dox as compared to the DMBA control group.

CONCLUSION

The present study suggests that metformin pretreatment potentiates the antiproliferative action of doxorubicin against breast cancer.

Hearing Efficiency in Oral Submucous Fibrosis: A Clinical Study

Oral Submucous fibrosis (OSMF) is a chronic insidious disease of oral mucosa that occurs due to areca-nut chewing, consumption of chillies, autoimmunity and genetic predisposition. The disease starts with burning sensation and inability to tolerate spicy foods with gradual reduction in mouth opening due to fibrosis of the oral mucosa. The extension of fibrosis into the naso pharynx leads to reduction in hearing efficiency. As very few studies had been done to evaluate the hearing disability in OSMF patients, this study had been undertaken to prove the same. To evaluate hearing efficiency in patients with Oral Submucous Fibrosis of various grades of severity. Presentation includes 30 patients of osmf with various grades and evaluated for hearing efficacy by audiometry. Hearing threshold was compared in different grades of osmf. The present study revealed a significant association between OSMF and hearing deficit. Involvement of the palatal muscles with OSMF may decrease the patency of the Eustachian tube, leading to conductive hearing loss. Therefore, the protocol for managing OSMF patients should include ENT consultation and treatment for hearing deficit in order to increase the success rate of treatment.

Molecular Alterations in Oral Carcinogenesis: Significant Risk Predictors in Malignant Transformation and Tumor Progression

In this study an attempt was made to establish the significance of a battery of molecular alterations and thereby identify risk predictors in oral carcinogenesis. For this purpose, EGFR, Stat3, H-ras, c-myc, p53, cyclin D1, p16, Rb, Ki-67 and Bcl-2 were localized immunohistochemically in normal mucosa (n=12), hyperplasia (n=35), dysplasia (n=25), early stage carcinoma (n=65) and advanced stage carcinoma (n=70). Deregulation occurred at an early stage and the number of alterations increased with disease progression. Using multivariate logistic regression analysis, the significant risk predictor for hyperplasia from normal mucosa was Ki-67 (OR=5.75, p=0.021); the significant risk predictors for dysplasia from hyperplasia were EGFR (OR=12.96, p=0.002), Stat3 (OR=17.16, p=0.0001), p16 (OR=5.50, p=0.039) and c-myc (OR=5.99, p=0.052); the significant risk predictors for early stage carcinoma from dysplasia were p53 (OR=6.63, p=0.0001) and Rb (OR=3.81, p=0.056); and the significant risk predictors for further progression were EGFR (OR=5.50, p=0.0001), Stat3 (OR=4.49, p=0.0001), H-ras (OR=4.05, p=0.001) and c-myc (OR=2.99, p=0.015). Cyclin D1 holds a key position linking upstream signaling pathways to cell cycle regulation. Gene products of the mitogenic signaling pathway play an equally significant role as cell cycle regulatory proteins in the hyperplasia-dysplasia-early-advanced-carcinoma sequence and together may provide a reference panel of markers for use in defining premalignant lesions and predicting the risk of malignant transformation and tumor progression.

Development of a sensitive PCR-dot blot assay to supplement serological tests for diagnosing Lyme disease

Laboratory diagnosis of Lyme disease is difficult and presently dependent on detecting Borrelia burgdorferi-specific antibodies in patient serum with the disadvantage that the immune response to B. burgdorferi can be weak or variable, or alternatively, the slow and inefficient culture confirmation of B. burgdorferi. PCR tests have previously shown poor sensitivity and are not routinely used for diagnosis. We developed a sensitive and specific Lyme Multiplex PCR-dot blot assay (LM-PCR assay) applicable to blood and urine samples to supplement western blot (WB) serological tests for detecting B. burgdorferi infection. The LM-PCR assay utilizes specific DNA hybridization to purify B. burgdorferi DNA followed by PCR amplification of flagellin and OspA gene fragments and their detection by southern dot blots. Results of the assay on 107 and 402 clinical samples from patients with suspected Lyme disease from Houston, Texas or received at the IGeneX laboratory in Palo Alto, California, respectively, were analyzed together with WB findings. The LM-PCR assay was highly specific for B. burgdorferi. In the Texas samples, 23 (21.5%) patients antibody-negative in WB assays by current US Centers for Disease Control (CDC) recommended criteria were positive by LM-PCR performed on urine, serum or whole blood samples. With IGeneX samples, of the 402 LM-PCR positive blood samples, only 70 met the CDC criteria for positive WBs, while 236 met IGeneX criteria for positive WB. Use of the LM-PCR assay and optimization of current CDC serological criteria can improve the diagnosis of Lyme disease.

Mechanical Implications of Crimping in Collagen Fibres of Human Spinal Ligaments

The crimp morphology of collagen fibres from human cadaveric anterior longitudinal, posterior longitudinal and interspinous ligaments was demonstrated by the analysis of extinction and transmission bands seen across the axis of the fibres on transmission polarization microscopy. The experimentally observed force/strain behaviour of the fibres at low tensile forces was correlated quantitatively with their crimp structure. The initial extension of the fibres in the toe region of the stress-strain curve can be attributed to the deformity of crimps. Further confirmation of the crimp morphology, notably in rat tail tendons, by scanning electron microscopy, X-ray diffraction and transmission electron microscopy is discussed. Finally, it is suggested the crimp structure does alter in diseases and ageing. This may account for associated changes in the mechanical behaviour of the tissues.

Supramolecular structures fabricated through the epitaxial growth of semiconducting poly(3-hexylthiophene) on carbon nanotubes as building blocks of nanoscale electronics

The supramolecular architecture of P3HT crystallized as nanofibers on CNTs for photovoltaic devices.

Age estimation by using dental radiographs

Background:

Estimation of age is important in forensic sciences as a way to establish the identity of human remains. Of the various parts of the body used in age estimation, teeth are the least affected by the taphonomic process. Their durability means that they are sometimes the only body part available for study. Several methods of age estimation have been studied using bone and teeth, and among them, tooth wear and apposition of secondary dentine are the currently available non-destructive methods.

Objectives:

The purpose of the study was to determine the age of adults by using Kvaal's method as well as to establish the relationship of chronological age and dental age with its reliability and limitations on digital panoramic radiographs.

Materials and Methods:

The present study was based on panoramic radiographs that consisted of two groups. One hundred orthopantomographs with Kvaal's criteria (Group A) and 50 orthopantomographs without Kvaal's criteria (Group B) were included. Various parameters were measured and the result was analyzed by means of SPSS-12.0 program statistical data.

Result and Conclusion:

On the basis of Kvaal's criteria, the difference between chronological age and real age was 8.3 years. This suggests that the accuracy of this method depends on the precision of measurements and quality and number of the orthopantomographs.

Stability-indicating HPLC Method for Simultaneous Determination of Montelukast and Fexofenadine Hydrochloride

A simple, specific, accurate, and stability-indicating reversed-phase high-performance liquid chromatographic method was developed for the simultaneous determination of montelukast and fexofenadine hydrochloride, using a Lichrospher^® 100, RP-18e column and a mobile phase composed of methanol:0.1% o-phosphoric acid (90:10 v/v), pH 6.8. The retention times of montelukast and fexofenadine hydrochloride were found to be 10.16 and 12.03 min, respectively. Linearity was established for montelukast and fexofenadine hydrochloride in the range of 2-10 μg/ml and 24-120 μg/ml, respectively. The percentage recoveries of montelukast and fexofenadine hydrochloride were found to be in the range of 99.09 and 99.81%, respectively. Both the drugs were subjected to acid and base hydrolysis, oxidation, photolytic, and thermal degradation conditions. The degradation products of montelukast and fexofenadine hydrochloride were well resolved from the pure drug with significant differences in their retention time values. This method can be successfully employed for simultaneous quantitative analysis of montelukast and fexofenadine hydrochloride in bulk drugs and formulations.

A new family of folate-decorated and carbon nanotube-mediated drug delivery system: synthesis and drug delivery response

We describe here a new family of folate-decorated and carbon nanotube (CNT)-mediated drug delivery system that involves uniquely combining carbon nanotubes with anticancer drug (doxorubicin) for controlled drug release, which is gaining significant attention. The synthesis of nanocarrier involved attachment of doxorubicin (DOX) to CNT surface via π-π stacking interaction, followed by encapsulation of CNTs with folic acid-conjugated chitosan. The π-π stacking interaction, ascribed as a non-covalent type of functionalization, allows controlled release of drug. Furthermore, encapsulation of CNTs enhances the stability of the nanocarrier in aqueous medium because of the hydrophilicity and cationic charge of chitosan. The unique integration of drug targeting and visualization has high potential to address the current challenges in cancer therapy. Thus, it is attractive to consider the possibility of investigating a drug delivery system that combines the biodegradable chitosan and carbon nanotubes (CNTs).

Structure-process-property relationship of the polar graphene oxide-mediated cellular response and stimulated growth of osteoblasts on hybrid chitosan network structure nanocomposite scaffolds

We here describe the structure-process-property relationship of graphene oxide-mediated proliferation and growth of osteoblasts in conjunction with the physico-chemical, mechanical, and structural properties. Chitosan-graphene network structure scaffolds were synthesized by covalent linkage of the carboxyl groups of graphene oxide with the amine groups of chitosan. The negatively charged graphene oxide in chitosan scaffolds was an important physico-chemical factor influencing cell-scaffold interactions. Furthermore, it was advantageous in enhancing the biocompatibility of the scaffolds and the degradation products of the scaffolds. The high water retention ability, hydrophilic nature, and high degree of interconnectivity of the porous structure of chitosan-graphene oxide scaffolds facilitated cell attachment and proliferation and improved the stability against enzymatic degradation. The cells infiltrated and colonized the pores of the scaffolds and established cell-cell interactions. The interconnectivity of the porous structure of the scaffolds helps the flow of medium throughout the scaffold for even cell adhesion. Moreover, the seeded cells were able to infiltrate inside the pores of chitosan-graphene oxide scaffolds, suggesting that the incorporation of polar graphene oxide in scaffolds is promising for bone tissue engineering.

Extracellular matrix turnover and disease severity in Anderson-Fabry disease

BACKGROUND

Anderson-Fabry Disease (AFD) is an inherited metabolic disease associated with premature death secondary to cardiovascular and renal disease. Patients with AFD develop progressive left ventricular (LV) remodelling and heart failure. We hypothesized that altered extracellular matrix (ECM) turnover contributes to the pathophysiology of cardiac disease in AFD.

METHODS AND RESULTS

Twenty-nine consecutive patients (44.1 +/- 11.7 years, 15 male) with AFD and 21 normal controls (39.7 +/- 11.3 years, 10 male) had serum analysed for matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of matrix metalloproteinase-1 and -2 (TIMP-1, TIMP-2). All patients underwent clinical assessment, echocardiography and Mainz Severity Score Index (MSSI) measurement, a validated severity score in AFD. MMP-9 levels were significantly higher in patients than controls (1003.8 +/- 337.8 ng/ml vs 576.7 +/- 276.3 ng/ml respectively, p < 0.001). There were no differences in TIMP levels between patients and controls. There was a positive correlation between MMP-9 levels and MSSI (r = 0.5, p = 0.01). There was a negative correlation between MMP-9 and endocardial fractional shortening (FS) (r = -0.5, p = 0.01) and mid-wall FS (r = -0.6, p = 0.001). There was no correlation between other echocardiographic parameters and MMP-9 levels. These relations were independent of age and sex using stepwise linear regression analysis.

CONCLUSIONS

Patients with AFD have abnormal ECM turnover compared to normal controls. The correlation between MMP-9 levels and systolic function suggests that altered ECM turnover is important in cardiac remodelling. The association between MMP-9 and overall disease severity suggests that circulating levels of MMP-9 may provide a useful marker for assessing the response of patients with AFD to enzyme replacement treatment.

Dobutamine stress echocardiography and cardiac troponin T for the detection of significant coronary artery disease and predicting outcome in renal transplant candidates

AIMS

Ischaemic heart disease is the leading cause of mortality and morbidity in patients with end-stage renal disease (ESRD) and after renal transplantation. However, the optimal non-invasive test for coronary artery disease (CAD) diagnosis in this population has yet to be established. The aim of this study was to assess the diagnostic accuracy of dobutamine stress echocardiography (DSE) and baseline plasma cardiac troponin T (cTnT) for detecting significant CAD and predicting adverse cardiac events in patients referred for renal transplantation.

METHODS

Coronary angiography, DSE, and baseline cTnT measurements were performed in 118 consecutive patients (mean age 52+/-12 years, 75 male) with ESRD (mean creatinine 608+/-272 micromol/L) referred for renal transplantation. The mean follow-up period was 1.32+/-0.48 years. Significant CAD was defined as a reduction in luminal diameter >70% by visual estimation in at least one major epicardial vessel. An abnormal DSE result defined as the development of a new regional wall motion abnormality in one or more normal resting segments or a deterioration of wall motion in one or more resting hypokinetic segments. A baseline cTnT>0.1 microg/L was taken as positive.

RESULTS

Significant CAD in at least one vessel was present in 35 patients (30%). The number of patients with significant 3 vessel and 2 vessel disease was 6 and 7, respectively. An abnormal DSE result was present in 36 (31%) patients. Thirty-one (26%) had cTnT>0.1 microg/L. Sixty-four (54%) patients were on dialysis and 46 (39%) were diabetic. The sensitivity, specificity, positive and negative predictive values for DSE in detecting significant coronary artery disease were 88%, 94%, 86% and 95%, respectively. The same values for a raised cTnT were 54%, 62%, 40% and 74%, respectively. The combination of an abnormal DSE result and raised cTnT gave values of 61%, 91%, 76%, and 80%, respectively. Over the follow-up period, mortality was significantly higher in those with a raised baseline cTnT but not those with an abnormal DSE result or significant CAD.

CONCLUSION

DSE is an accurate technique for the detection of significant CAD in renal transplant candidates. An elevated cTnT does not predict significant CAD in this population and when used in conjunction with DSE, reduces the sensitivity of the combined tests. cTnT is an important marker of prognosis in renal transplant candidates.

Coronary microvascular dysfunction in male patients with Anderson-Fabry disease and the effect of treatment with alpha galactosidase A

OBJECTIVE

To measure coronary flow reserve (CFR), an index of microvascular function, in Anderson-Fabry disease (AFD) at baseline and after enzyme replacement therapy (ERT).

METHODS AND RESULTS

Mean (SD) myocardial blood flow (MBF) at rest and during hyperaemia (adenosine 140 microg/kg/min) was measured in 10 male, non-smoking patients (53.8 (10.9) years, cholesterol 5.5 (1.3) mmol/l) and in 24 age matched male, non-smoking controls (52.0 (7.6) years, cholesterol 4.5 (0.6) mmol/l) by positron emission tomography (PET). Resting and hyperaemic MBF and CFR (hyperaemic/resting MBF) were reduced in patients compared with controls (0.99 (0.17) v 1.17 (0.25) ml/g/min, p < 0.05; 1.37 (0.32) v 3.44 (0.78) ml/g/min, p < 0.0001; and 1.41 (0.39) v 3.03 (0.85), p < 0.0001, respectively). This coronary microvascular dysfunction was independent of cholesterol concentrations. PET was repeated in five patients after 10.1 (2.3) months of ERT; resting and hyperaemic MBF and CFR were unchanged after ERT (0.99 (0.16) v 0.99 (0.16) ml/g/min; 1.56 (0.29) v 1.71 (0.3) ml/g/min; and 1.6 (0.37) v 1.74 (0.28), respectively; all not significant).

CONCLUSIONS

The results of the present study show that patients with AFD have very abnormal coronary microvascular function. These preliminary data suggest that ERT has no effect on coronary microvascular dysfunction. Further work is necessary to determine whether treatment at an earlier stage in the course of the disease may improve coronary microvascular function in patients with AFD.

Fabry disease and the heart: an overview of the natural history and the effect of enzyme replacement therapy

Fabry disease is a genetic disorder caused by the deficiency of alpha-galactosidase A, resulting in the lysosomal accumulation of glycosphingolipids. Fabry disease may result in cardiac, cerebral and renal complications. Cardiac abnormalities in patients with Fabry disease were first described in the 1960s. In the 1990s a form of Fabry disease confined to the heart was reported; however, this variant is extremely rare and a more appropriate concept is of cardiac predominance of the disease in some patients. Up to 60% of males with classic Fabry disease have cardiac abnormalities, including left ventricular hypertrophy, valvular dysfunction and conduction abnormalities. Recent data suggest that left ventricular mass and systolic function in patients with Fabry disease improve after 12 months of enzyme replacement therapy (ERT); however, many of the patients studied are relatively young and have mild cardiac abnormalities, suggesting that more research into the efficacy of ERT in older patients is necessary.

CONCLUSION

Cardiac manifestations are common in patients with Fabry disease and are not confined to a 'cardiac variant' of the disease.

Anesthesia for thoracoscopy

Thoracoscopy has become a widely used method of achieving minimally invasive thoracic surgery. The anesthesiologist providing perioperative care for VATS is challenged to evaluate the patient carefully; to design a safe anesthetic regimen, taking into account preexisting disorders; to ameliorate physiologic alterations associated with one-lung ventilation and CO2 insufflation; and to provide safe, effective perioperative anesthesia and postoperative pain control.

Detection of rRNA from four respiratory pathogens using an automated Q beta replicase assay

Ribosomal RNA targets from Mycobacterium avium complex (23S), Mycoplasma pneumoniae (16S), Pneumocystis carinii (18S) and Legionella pneumophila (16S) were detected in four separate assays on a model automated Q-beta amplification instrument. Sandwich hybridization, reversible target capture, detector probe amplification and fluorescent signal detection occurred in closed, disposable packs at 38 degrees C. Packs were injected with 0.5 ml samples in 3.06 M guanidine thiocyanate. Ten samples per run were read after 7 h, requiring only 4 min loading time. Synthetic RNA transcripts and purified, natural RNAs from up to four different strains per assay were diluted to 10(6) or fewer molecules per sample (approximately 100 cells for prokaryotes, 10 cells for Pneumocystis). All analytes were detected at 10(6) targets. The limits of detection were found at 10(5) to 10(4). Discrimination against competitor RNA was tested using up to 10(9) molecules (1000 X excess) of appropriate test strains. Samples containing either zero targets or 10(7) competitors produced negative results in 95 to 100% of the samples, depending on the assay. Closely related Legionella and Mycoplasma species cross-reacted at high challenge levels of 10(9) molecules as a result of sequence similarities in the target regions. These results demonstrate the utility and versatility of an automated, high sensitivity, closed system for amplified analysis of direct-from-sample testing of respiratory pathogens.

Diversity of host species and strains of Pneumocystis carinii is based on rRNA sequences

We have amplified by PCR Pneumocystis carinii cytoplasmic small-subunit rRNA (variously referred to as 16S-like or 18S-like rRNA) genes from DNA extracted from bronchoalveolar lavage and induced sputum specimens from patients positive for P. carinii and from infected ferret lung tissue. The amplification products were cloned into pUC18, and individual clones were sequenced. Comparison of the determined sequences with each other and with published rat and partial human P.carinii small-subunit rRNA gene sequences reveals that, although all P. carinii small-subunit rRNAs are closely related (approximately 96% identity), small-subunit rRNA genes isolated from different host species (human, rat, and ferret) exhibit distinctive patterns of sequence variation. Two types of sequences were isolated from the infected ferret lung tissue, one as a predominant species and the other as a minor species. There was 96% identity between the two types. In situ hybridization of the infected ferret lung tissue with oligonucleotide probes specific for each type revealed that there were two distinct strains of P. carinii present in the ferret lung tissue. Unlike the ferret P. carinii isolates, the small-subunit rRNA gene sequences from different human P. carinii isolates have greater than 99% identity and are distinct from all rat and ferret sequences so far inspected or reported in the literature. Southern blot hybridization analysis of PCR amplification products from several additional bronchoalveolar lavage or induced sputum specimens from P. carinii-infected patients, using a 32P-labeled oligonucleotide probe specific for human P. carinii, also suggests that all of the human P. carinii isolates are identical. These findings indicate that human P. carinii isolates may represent a distinct species of P. carinii distinguishable from rat and ferret P. carinii on the basis of characterization of small-subunit rRNA gene sequences.

Q-beta replicase-amplified assay for detection of Mycobacterium tuberculosis directly from clinical specimens

We report the results of a study conducted to evaluate the performance of manual Q-Beta replicase-amplified Mycobacterium tuberculosis complex assay compared with that of culture for detecting M. tuberculosis directly from digested sputum pellets. A total of 261 specimens submitted to three tuberculosis testing laboratories were analyzed. Culture and acid-fast bacillus smear results were provided by the tuberculosis testing laboratories. Of these 261 specimens, 34 (13% prevalence rate) were positive for M. tuberculosis by culture. The samples were digested and decontaminated by the testing laboratories by using their standard digestion and decontamination procedures. An aliquot of the digested and decontaminated pellet was sent to GENE-TRAK. The digested and decontaminated pellet was neutralized by washing it with 0.067 M phosphate buffer (pH 6.8), and the bacteria present in the washed pellet were heat inactivated at 100 degrees C for 15 min. The samples were combined with sample processing buffer containing GuSCN and were treated for 6 min in the GENE-TRAK Sample Processing Instrument to release the nucleic acids. The release rRNA was analyzed in a manual Q-Beta replicase assay format which incorporates elements of sandwich hybridization, reversible target capture, and Q-beta replicase signal amplification technologies. In comparison with culture, the overall assay sensitivity and specificity were 97.1 and 96.5%, respectively. The positive predictive value was 80.5%, and the negative predictive value was 99.5%. After analysis of discrepant results, the assay sensitivity and specificity were 97.3 and 97.8, respectively, and the prevalence rate was 14%. The positive predictive value and the negative predictive value were 87.8 and 99.5%, respectively. The Q-Beta replicase assay is rapid sensitive, semiquantitative, and specific for the direct detection of M. tuberculosis from clinical specimens.

Detection of Mycobacterium tuberculosis directly from spiked human sputum by Q-beta replicase-amplified assay

We report on a rapid, sensitive, Q-Beta replicase-amplified nucleic acid hybridization assay for the detection of Mycobacterium tuberculosis directly from spiked human sputum. Specimens were processed by either an N-acetyl-L-cysteine-NaOH or a 2% NaOH digestion-decontamination method and then washed to neutralize the pH of the cell pellet. The washed sputum pellets were heated at 100 degrees C to inactivate the M. tuberculosis organisms. The heat-inactivated samples were mechanically lysed at 5,000 rpm for 6 min in the GENE-TRAK Sample Processing Instrument in the presence of zirconium oxide beads and a buffer containing guanidine thiocyanate. The released nucleic acid was subjected to the GENE-TRAK Q-Beta replicase-amplified, dual-capture assay. The assay sensitivity was 10(3) purified rRNA targets or 1 CFU of M. tuberculosis spiked into M. tuberculosis-negative human sputum. There was a low level of noise because of the limitations of performing a signal amplification assay in an open system. High levels of other mycobacterial rRNA (approximately 10(7) organisms), including rRNAs of Mycobacterium avium and Mycobacterium gordonae, did not interfere with the sensitivity of the assay.

Novel, ultrasensitive, Q-beta replicase-amplified hybridization assay for detection of Chlamydia trachomatis

A sensitive, nonisotopic hybridization assay termed "dual capture" is described. The assay rapidly and specifically detects very low levels of target nucleic acids and organisms. The assay is based on the principles of sandwich hybridization, reversible target capture, and Q-Beta replicase amplification. The assay can be completed in less than 4 h, and in the described model format, it detects Chlamydia trachomatis rRNA or rDNA. Up to 96 samples can be analyzed simultaneously. The assay employs two types of probes: a test-specific capture probe, which mediates the cycling of the target probe complex on and off derivatized magnetic beads, and a replicatable RNA detector molecule containing a sequence complementary to and adjacent to the capture probe site on the target. Following reversible target capture, detection of the signal is accomplished by replication of the detector molecule by Q-Beta replicase in the presence of propidium iodide. A specific assay signal can be detected from as few as 1,000 molecules above the background. In a limited study of 94 urogenital samples the assay detected five of the six culture-positive samples and did not detect the C. trachomatis target in 85 of the 88 culture-negative samples.

Cheilitis glandularis

Cheilitis glandularis is reported in two farmers with characteristic clinical and histopathological features. Both patients were treated with vermilionectomy. The prognosis was good.

The role of magnesium on the structure of biological apatites

X-ray diffraction, infrared absorption spectroscopy, and chemical investigation have been carried out on deproteinated samples of turkey leg tendon at different degrees of calcification. The inorganic phase consists of poorly crystalline B carbonated apatite. On increasing calcification, the apatite crystal size, as well as its thermal stability, increase while the relative magnesium content is reduced. On the other hand, synchrotron X-ray diffraction data clearly indicate that apatite lattice parameters do not change as the crystals get larger. At the last stage of calcification the crystal size, chemical composition, and thermal conversion of the apatite crystallites approximate those of bone samples, which have been examined for comparison. The results provide a quantitative relationship between relative magnesium content and extent of apatite conversion into B-tricalcium phosphate by heat treatment. Furthermore, they suggest that the smaller crystallites laid down inside the gap region of the collagen fibrils are richer in magnesium than the longer ones that fill the space between collagen fibrils.

High-pressure scanning electron microscopy of insulating materials: a new approach

A new SEM technique for imaging uncoated non-conducting specimens at high beam voltages is described which employs a high-pressure environment and an electric field to achieve charge neutralization. During imaging, the specimen surface is kept at a stable low voltage, near earth potential, by directing a flow of positive gas ions at the specimen surface under the action of an electric bias field at a pressure of about 200 Pa. In this way charge neutrality is continuously maintained to obtain micrographs free of charging artefacts. Images are formed by specimen current detection containing both secondary electron and backscattered electron signal information. Micrographs of geological, ceramic, and semiconductor materials obtained with this method are presented. The technique is also useful for the SEM examination of histological sections of biological specimens without any further preparation. A simple theory for the charge neutralization process is described. It is based on the interaction of the primary and emissive signal components with the surrounding gas medium and the resulting neutralizing currents. Further micrographs are presented to illustrate the pressure dependence of the charge neutralization process in two glass specimens which show clearly identifiable charging artefacts in conventional microscopy.

EXAFS study of structural disorder in carbonate-containing hydroxyapatites

A structural characterization of pure hydroxyapatite and partially carbonated hydroxyapatites has been performed using EXAFS spectroscopy, X-ray diffraction, and infrared spectroscopy. Our findings show that marked structural changes within the hydroxyapatite unit cell accompany the substitution of the phosphate anion. Extended X-ray Absorption Fine Structure (EXAFS) spectroscopy has shown that the incorporation of carbonate into the phosphate site alters the structural geometry beyond the nearest neighbor oxygen coordination to calcium in a manner consistent with an increase in structural disorder. The nearest neighbor coordination to calcium is not detectably affected by the presence of carbonate.

Characterization of an Onchocerca-specific DNA clone from Onchocerca volvulus

A genomic library of a savanna isolate of Onchocerca volvulus was screened to detect recombinant plasmids containing highly repeated DNA sequences of this parasite. Four recombinant plasmids were identified which hybridized specifically to Onchocerca DNA, but not to DNA from humans, black flies, Brugia malayi, B. pahangi, or Wuchereria bancrofti. The recombinant plasmids had a low level of homology to Dirofilaria immitis. All recombinant plasmids contain related DNA sequences based on Southern hybridization analysis. Sequences related to these recombinant plasmids are present in different geographic isolates of O. volvulus and O. ochengi, an animal parasite. Two of the recombinant plasmids contain sequences also found in O. lienalis. One recombinant plasmid, puOvs3, has been characterized in detail, including DNA sequence determination. Radiolabeled puOvs3 is able to detect 100 pg of genomic DNA isolated from O. volvulus worms from both savanna and forest regions. It can differentiate O. volvulus from O. ochengi by Southern blot analysis.

The 5' flanking sequence of a Trypanosoma brucei variable surface glycoprotein gene

The mechanism controlling transcription at several telomeric expression sites for variable surface glycoprotein (VSG) genes in Trypanosoma brucei is unknown. Most VSG genes in expression sites have a region 5' of the gene lacking restriction enzyme sites. This 'barren region' is involved in recombination events which replace the VSG gene with a copy of a different, non-telomeric, VSG gene leading to a switch in VSG expression. Alterations in the barren region have been considered as possible modulators of expression of the adjacent VSG gene in other switching events where no gene replacement occurs. The expressed copy of the ILTat 1.3 VSG gene remains in its expression site, on a 160 kilobase (kb) chromosome, in trypanosomes not expressing the ILTat 1.3 VSG. Here we report the complete sequence of the barren region adjacent to this gene, determined both from trypanosomes expressing the gene and from those that are not. The sequence is identical whether or not the ILTat 1.3 VSG gene is expressed. This confirms that alterations in the barren region are not involved in modulation of expression of the gene, as suggested by restriction enzyme mapping. Sequence data from the 5' flanking region of a second telomeric gene copy on an 80 kb minichromosome, and from the ILTat 1.3 expression site after replacement of the ILTat 1.3 gene by another gene from a minichromosome, provide evidence that telomeric VSG genes on minichromosomes are also flanked by long repeat arrays, and that these arrays are involved in inter-telomeric gene replacements as well as replacements by non-telomeric genes.

Characterization of a ribosomal DNA clone of Brugia malayi

The structure of ribosomal DNA (rDNA) clone pBmr7 from microfilariae of the human parasite Brugia malayi has been examined in detail by Southern blot analysis and S-1 mapping techniques. The results demonstrate that this clone contains regions homologous to 28S, 18S and 5.8S rDNAs. A noncoding or 'spacer' region lies between the 3' end of 28S rDNA and the 5' end of 18S rDNA. An AccI-Sau3AI fragment of approximately 900 bp from this spacer region cross-hybridizes to genomic DNA fragments of different sizes from Brugia pahangi and Dirofilaria immitis. The differences observed in hybridization suggest that this rDNA fragment can be used to differentiate between various filariid species.

The development of tissue around various prosthetic implants used as replacements for ligaments and tendons

Currently, no ideal prosthesis is available for the repair or replacement of tendons and ligaments. Although filamentous carbon is a useful fibrogenic material, it does not fulfill the ideal requirements of a soft-tissue prosthesis. A number of other synthetic fibers were examined for biocompatibility and fibrogenic properties in both cell culture and in vivo implantation. It was found that the less extensible materials could adversely affect the normal morphology of the induced collagen. None of the materials examined exhibited mechanical properties similar to those of collagen; therefore, a composite prosthesis was designed to incorporate three criteria: mechanical characteristics similar to those of the normal tissue, fibrogenic capability to induce replacement collagen, and replacement collagen developing with normal morphologic characteristics. A prototype prosthesis for the Achilles tendon in rabbits, evaluated by mechanical and histologic methods, shows that these criteria can be fulfilled and thus form the basis for future prosthetic tendon and ligament research.

Morphology of human palmaris longus tendon

A systematic morphological investigation of human palmaris longus tendons by polarisation microscopy and low angle x-ray diffraction is reported. It is shown that contrary to some previously reported observations, and in common with other tension bearing soft collagenous tissues, the fibres in this tendon are crimped. A new method of preparation of the tissue enabling one to see directly the crimped organisation in scanning electron microscopy was used to reinforce the findings by other methods.

Relationship between multiple copies of a T. brucei variable surface glycoprotein gene whose expression is not controlled by duplication

Unlike many other T. brucei variable surface glycoprotein (VSG) genes, the IITat 1.3 gene is not duplicated when it is expressed. Analysis of the multiple copies of this gene present in all IITaR 1 trypanosome clones by restriction enzyme mapping and sequencing shows that the expressed copy may have arisen by duplication and transposition to a telomeric site, as is observed for those VSG genes whose expression is linked to duplication. The existence of a mechanism selecting between a number of complete telomeric VSG gene copies for expression is implied by these results. Comparisons of the nontelomeric copies of the IITat 1.3 gene are consistent with involvement of gene duplication and mutational drift in the evolution of new VSG genes.

Application of physical methods in the investigations of crystal-related arthropathies

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The distribution of surface strain in the cadaveric lumbar spine

The fourth lumbar vertebrae and L4-5 discs from six cadaveric lumbar spines were subjected to detailed strain gauge analysis under conditions of controlled loading. With central compression loads, maximal compressive strain was found to occur near the bases of the pedicles and on both superficial and deep surfaces of the pars interarticularis, which emphasises the importance of the posterior elements of lumbar vertebrae in transmitting load. Radial bulge and tangential strain of the disc wall were maximal at the posterolateral surface, in agreement with the fact that disc degeneration and prolapse commonly occur there. Under posterior offset loads simulating extension, both compressive and tensile strains were found to be increased on both surfaces of the pars interarticularis, which suggests that hyperextension may lead to stress fractures and spondylolisthesis. Posterior offset loads also increased the radial bulge of the posterior disc wall and tangential strain at the anterior surface of the disc. Anterior offset loads simulating flexion increased the radial bulge of the anterior disc wall and tangential strain at the posterior surface of the disc. These findings are compatible with movement of the nucleus pulposus within the disc during flexion and extension. This hypothesis was supported by post-mortem discography.

Low tension studies of collagen fibres from ligaments of the human spine

On polarization microscopy collagen fibres from human cadaveric anterior longitudinal, posterior longitudinal, and interspinous ligaments show a series of transmission and extinction bands. By observing changes in this pattern on rotating the polarizing stage and on rotating the fibres a crimped structure of the fibres was deduced and its parameters were calculated. From these data the force/strain behaviour of the fibres under low tension was calculated. This corresponded closely with the results from mechanical measurement. At the same time we documented alterations in the transmission and extinction patterns while under tensile load. The results suggest that it is the crimped structure that is responsible for the high extensibility of the collagen fibres under low tension. The initial extension is by deformity of the crimp segment. This avoids risk of tearing the collagen fibres.

Surface strain distribution in isolated single lumbar vertebrae

The surface strains of isolated single lumbar vertebrae under compressive load were examined by the techniques of brittlecoat and photoelastic analysis. Directions of principal strain components have been determined. Areas of stress concentration were found around the vertebral rims, near the pedicles, and around the foramina of the basivertebral veins.

Bone deformation recorded in vivo from strain gauges attached to the human tibial shaft

A strain gauge rosette was attached to the midshaft of a man's tibia. This demonstrated that during every stride the bone surface was subjected to a number of discrete deformation cycles. During each cycle the bone was deformed from a particular direction, released at least partially and then deformed from another direction. This feature has been observed from a number of sites in experimental animals. The largest deformation occurred while the subject was running; the principal tension then reached 850 microstrain applied in line with the bone's long axis at 13 times 10-3 microstrain per second. When walking the largest deformation occurred prior to 'toe off'; compression was then the larger principal strain about minus 400 microstrain applied at 37 degrees to the bone's long axis at minus 4 times 10-3 microstrain per second. These strain values are the same order of size as those recorded from the long bones of sheep and pigs during their locomotion.