Hydroxycitric acid and capsaicin combination alleviates obesity-induced testicular apoptosis, oxidative stress and inflammation

Recent research in rodents suggests that oxidative stress, inflammation, and apoptosis in the testes caused by high-fat diets (HFD) are a cause of male infertility. To investigate the therapeutic efficacy of the combination of hydroxycitric acid and capsaicin (HCC) against male reproductive disorders, we developed an HFD-induced obese rat model. Rats received HFD supplementation for 21 weeks, which induced obesity. From week 16, HCC (100 mg/kg body weight) was administered to investigate its potential to treat testicular toxicity. According to the results of the current study, treatment of obese rats with HCC improved their sperm quality, increased the production of testosterone, follicle-stimulating hormone, and luteinizing hormone and significantly increased the activities of steroidogenic enzymes and corresponding mRNA levels. In addition, HCC decreased lipid peroxidation and nitric oxide levels in both spermatozoa and testes while increasing the expression of mRNA for the antioxidant enzymes superoxide dismutase, catalase, and glutathione peroxidase in the testes, which in turn reduced oxidative stress in the testes. Moreover, after HCC treatment, testicular tissues showed a remarkable decrease in mRNA levels responsible for inflammation (TNF-α, IL-6, NF-κB) and apoptosis (Bax and Bcl-2). Our results suggest that HCC may alleviate obesity-induced male reproductive dysfunction by attenuating oxidative stress, inflammation, and apoptosis in the testes of HFD-induced obese male rats.

--Eleven tips for operational researchers working with health programmes: our experience based on implementing differentiated tuberculosis care in south India

Due to the workload and lack of a critical mass of trained operational researchers within their ranks, health systems and programmes may not be able to dedicate sufficient time to conducting operational research (OR). Hence, they may need the technical support of operational researchers from research/academic organisations. Additionally, there is a knowledge gap regarding implementing differentiated tuberculosis (TB) care in programme settings. In this 'how we did it' paper, we share our experience of implementing a differentiated TB care model along with an inbuilt OR component in Tamil Nadu, a southern state in India. This was a health system initiative through a collaboration of the State TB cell with the Indian Council of Medical Research institutes and the World Health Organisation country office in India. The learnings are in the form of eleven tips: four broad principles (OR on priority areas and make it a health system initiative, implement simple and holistic ideas, embed OR within routine programme settings, aim for long-term engagement), four related to strategic planning (big team of investigators, joint leadership, decentralised decision-making, working in advance) and three about implementation planning (conducting pilots, smart use of e-tools and operational research publications at frequent intervals). These may act as a guide for other Indian states, high TB burden countries that want to implement differentiated care, and for operational researchers in providing technical assistance for strengthening implementation and conducting OR in health systems and programmes (TB or other health programmes). Following these tips may increase the chances of i) an enriching engagement, ii) policy/practice change, and iii) sustainable implementation.

The First Differentiated TB Care Model From India: Delays and Predictors of Losses in the Care Cascade

To reduce TB deaths in resource-limited settings, a differentiated care strategy can be used to triage patients with high risk of severe illness (i.e., those with very severe undernutrition, respiratory insufficiency, or inability to stand without support) at diagnosis and refer them for comprehensive assessment and inpatient care. Globally, there are few examples of implementing this type of strategy in routine program settings. Beginning in April 2022, the Indian state of Tamil Nadu implemented a differentiated care strategy called Tamil Nadu-Kasanoi Erappila Thittam (TN-KET) for all adults aged 15 years and older with drug-susceptible TB notified by public facilities. Before evaluating the impact on TB deaths, we sought to understand the retention and delays in the care cascade as well as predictors of losses. During April-June 2022, 14,961 TB patients were notified and 11,599 (78%) were triaged. Of those triaged, 1,509 (13%) were at high risk of severe illness; of these, 1,128 (75%) were comprehensively assessed at a nodal inpatient care facility. Of 993 confirmed as severely ill, 909 (92%) were admitted, with 8% unfavorable admission outcomes (4% deaths). Median admission duration was 4 days. From diagnosis, the median delay in triaging and admission of severely ill patients was 1 day each. Likelihood of triaging decreased for people with extrapulmonary TB, those diagnosed in high-notification districts or teaching hospitals, and those transferred out of district. Predictors of not being comprehensively assessed included: aged 25-34 years, able to stand without support, and diagnosis at a primary or secondary-level facility. Inability to stand without support was a predictor of unfavorable admission outcomes. To conclude, the first quarter of implementation suggests that TN-KET was feasible to implement but could be improved by addressing predictors of losses in the care cascade and increasing admission duration.

Effect of S-allylcysteine against diabetic nephropathy via inhibition of MEK1/2-ERK1/2-RSK2 signalling pathway in streptozotocin-nicotinamide-induced diabetic rats

OBJECTIVE

In the current study, we evaluated the ameliorative effect of S-allylcysteine (SAC) against streptozotocin (STZ)-nicotinamide (NAD)-induced diabetic nephropathy (DN) in rats and also an attempt was made to establish the molecular mechanism of SAC.

METHODS

DN rats were orally supplemented with SAC (150 mg/kg body weight) for a period of 45 days and the effect of SAC on urinary albumin excretion, metabolic parameters, and tubular injury biomarkers by ELISA, total levels and phosphorylation of MEK1/2, ERK1/2, and RSK2 by western blotting analysis in control and experimental rats were assessed.

RESULTS

From this study, we observed that SAC considerably decreased polydipsia, poly urea, polyphagia, albuminuria and the levels of urinary N-acetyl-beta-D-glucosaminidase, neutrophil gelatinase-associated lipocalin, transforming growth factor-β1 and SAC effectively altered the pathological changes in DN rats. SAC also reserved renal cortical phosphorylation of MEK1/2, ERK1/2 and RSK2.

CONCLUSION

Hence this study recommended that SAC can successfully protect the DN through regulation of MEK1/2-ERK1/2-RSK2 signalling.

Formulation, Evaluation and Comparison of the Polyherbal Shampoo with the Commercial Shampoos

<p>The present study investigated the effect of Liquid Polyherbal shampoo prepared using herbal extracts with a prominence on safety and efficacy. Polyherbal shampoos prepared using the natural extracts like Pomegranate peel, Reetha, Amla &amp; Hibiscus in different concentrations. Physico-chemical properties and its stability evaluated for manufactured Polyherbal shampoos. Statistical software used to optimize the formulations and to understand main &amp; interaction effects on the shampoo properties along with comparison with commercial products. Prepared Liquid Polyherbal shampoos pH values are nearer to the skin pH. The shampoos containing higher level of Pomegranate content revealed higher detergency and anti-dandruff effect, Amla as well as Reetha showed significant effect on the foaming capacity and cleaning action and similar to commercial formulations. Higher quantity of Hibiscus concentration shown better conditioning behaviour. The manufactured shampoos were stable, unvarying, thicker and comparable as that of commercially marketed shampoos. Based on the Design expert statistical evaluation of results, liquid shampoo formulations containing 1%-3% w/w of Amla, 6%-10% w/w of Pomegranate, 10%-15% w/w Reetha and 11.25%–15% w/w of Hibiscus Polyherbal shampoos exhibited superior performance compared with marketed formulations. LS6, LS16, LS17 &amp; LS20 preparations were identified as the greatest and optimum formulations based on physico-chemical related properties. The identified Polyherbal shampoos have an excellent cleansing, detergency, anti-dandruff effect, conditioning and foaming ability and is ideal for normal hair and has favourable pH with stable organoleptic features. Selected formulations stability results found satisfactory up to 6 months. </p>

Adapting undergraduate paediatric medical education to the challenges of COVID-19 pandemic: perspective of NUS Medicine

COVID-19 significantly impacted the teaching-learning-assessment activities in many medical schools. In this article, we discuss the impact of COVID-19 on the Yong Loo Lin School of Medicine, National University of Singapore, focusing on paediatric training and the adaptations of the system and the people. The school developed strategies to promptly disseminate information and safety measures to protect all its staff and students. By leveraging on the school’s infrastructure for technology-enabled learning, good-quality medical training and reliable assessments were able to be carried out swiftly. The paediatric curriculum was crafted based on these principles, and it provided distance-based learning with live and interactive sessions to teach core clinical skills. The faculty also tapped on standardised patients to provide consistent and life-like scenarios. Measures were implemented to minimise challenges with technology-enabled learning. Collectively, efforts from the staff, support from the leadership and students’ adaptations tremendously helped to ease the transition.

Mitigating Perspectives of Asiatic Acid in the Renal Derangements of Streptozotocin-Nicotinamide Induced Diabetic Rats

BACKGROUND

The present study was conducted to evaluate the mitigating effects of Asiatic Acid (AA), on the changes in carbohydrate metabolism, insulin signaling molecules and renal function markers in Streptozotocin (STZ)-Nicotinamide (NAD) induced diabetic rats.

METHODS

AA (20 mg/kg BW) was supplemented orally to the diabetic rats for 42 days. The levels of plasma glucose, Hemoglobin (Hb), glycosylated hemoglobin (HbA1c) insulin and renal function markers, carbohydrate metabolic enzymes in the kidney and insulin signaling molecules in skeletal muscle were measured.

RESULTS

The administration of AA elicited a significant decrease in the levels of plasma glucose, insulin resistance, HbA1c, urea, uric acid, creatinine, glycogen, glycogen synthase, glucose-6- phosphatase, and fructose-1,6-bisphosphatase and a significant increase of body weight development, insulin, Hb, hexokinase, and glycogen phosphorylase and mRNA expressions of insulin signaling molecule like insulin receptor 1, insulin receptor 2 and glucose transporter-4 in the STZ-NAD induced diabetic rats. Further, the protective effect of AA was evidenced by its histological annotation of the kidney tissues.

CONCLUSION

Hence, this study concluded that AA can protect against renal dysfunction by attenuating carbohydrate metabolic disorder and subsequently enhances glucose utilization and renal function in STZ-NAD-induced diabetic rats.

Antiobesity efficacy of asiatic acid: down-regulation of adipogenic and inflammatory processes in high fat diet induced obese rats

In the current study, we evaluated the effects of Asiatic acid (AA) on lipid metabolic markers in HFD-induced obese Sprague-Dawley rat model. AA (20 mg/kg BW) was administered orally to HFD-fed rats for 42 days. Changes in body composition, glucose, insulin resistance (IR) and lipid profiles of tissues, plasma and the pattern of gene expression of peroxisome proliferator-activated receptor-γ (PPAR-γ) and its target genes fatty-acid synthase (FAS), adipocyte protein-2 (aP2) and uncoupling protein-2 (UCP-2) and pro-inflammatory factor tumor necrosis factor (TNF)-α were observed in experimental rats. Oral administration of AA exerts therapeutic effects similar to orlistat in attenuating body weight gain, glucose, IR, plasma and tissue lipids and mRNA levels of PPAR-γ, FAS, aP2 and inflammatory factor TNF-α and increasing UCP-2 expression in HFD-fed rats. Hence, these findings concluded that AA attenuate HFD-induced obesity by modulating PPAR-γ and its target genes and regulate lipid metabolism, suggesting their possible antiobesity effects.

Neurosurgery in paediatric strokes

Paediatric strokes are a different entity owing to the difference in pathological entity causing the stroke as well as difficulty in treatment and management due to the presence of a growing brain and small vascular volume making surgery and endovascular intervention dangerous. Yet, the high neuronal plasticity coupled with unique surgical and endovascular procedures makes surgery in these conditions rewarding with improving morbidity and mortality statistics. The field is young and dynamic leading to constant change and updating. We attempt to review the current recommendations with our own experience in paediatric neurosurgery for paediatric strokes and present an overview of common conditions causing paediatric strokes. A brief review of the literature is also supplied for reference.

Evaluation of the Antioxidant and Antidiabetic Potential of the Poly Herbal Formulation: Identification of Bioactive Factors

BACKGROUND AND OBJECTIVES

The present investigation is intended to prepare a Poly Herbal Formulation (PHF) with Piper nigrum (fruits), Terminalia paniculata (bark) and Bauhinia purpurea (bark) and assess their antioxidant and glucose-lowering effects utilizing in vitro models.

METHODS

The individual plant methanolic extracts and PHF are exposed to phytochemical examination and to distinguish the bioactive factors by GC-MS. We assessed the antioxidant properties of individual plant extracts and the PHF by using the DPPH scavenging method, H2O2 scavenging assay, TBARS assay and total antioxidant estimation. Likewise, the anti-diabetic activity was assessed by ɑ-amylase and α-glucosidase enzyme inhibition and glucose diffusion inhibitory techniques.

RESULTS

We found that PHF contains a high measure of total phenolics, total flavonoids and tannin compared to individual plant extracts. The GC-MS identified the bioactive components. We also found that PHF had significantly higher antioxidant and glucose-lowering effects than the individual plant concentrates.

CONCLUSION

In conclusion, it could be reasoned that due to the nearness of antioxidant components, the PHF has good potential in the administration of hyperglycemia, diabetes and the related state of oxidative stress. This study shows that PHF is superior to individual plant extracts, supporting the conventional PHF concept.

Reversal of high fat diet-induced obesity through modulating lipid metabolic enzymes and inflammatory markers expressions in rats

In this study, we evaluated the ameliorative potential of Cucurbita maxima seeds oil (CSO (100 mg/kg body weight)) supplementation to high fat diet (HFD)-induced obese rats for 30 days on the changes in body weight, markers of lipid metabolism such as LDL, HDL, triglycerides, total cholesterol, adiponectin, leptin, amylase, and lipase. We also investigated the effects of CSO on the changes of lipid metabolic enzymes such as fatty-acid synthase, acetyl CoA carboxylase, carnitine palmitoyl transferase-1, HMG CoA reductase, and inflammatory markers (TNF-α and IL-6). Administration of CSO revealed significant diminution in body weight gain, altered the activity, expressions of lipid marker enzymes and inflammatory markers. It demonstrated that CSO had considerably altered these parameters when evaluated with HFD control rats. In conclusion, this study suggested that CSO might ameliorate the HFD-induced obesity by altering the enzymes and mRNA expressions important to lipid metabolism.

Asthma-Alleviating Potential of 6-Gingerol: Effect on Cytokines, Related mRNA and c-Myc, and NFAT1 Expression in Ovalbumin-Sensitized Asthma in Rats

In this study, we aimed at assessing the therapeutical potential of 6-gingerol ([5S]-5-hydroxy-1-[4-hydroxy- 3-methoxyphenyl]-3-decanone) against ovalbumin-sensitized asthma in rats. The rats were treated intraperitoneally with 6-gingerol (75 mg/kg body weight) for 30 days and a theophylline (200 mg/kg body weight)-treated group as a control. Changes in the levels of T-cell-linked cytokines (interleukin-4 [IL-4], IL-5, IL-13, and interferon-gamma [IFN-?]), total immunoglobulin E (IgE), gene expressions of bitter taste-sensing type 2-receptor 10 (T2R10), inositol 1,4,5-triphosphate receptor 1 (IP3R1), Orai1 and protein expressions of nuclear factor of activated T cells 1 (NFAT1), c-Myc and histopathological changes were observed in rats. 6-Gingerol exerts its beneficial impacts like theophylline in lessening IL-4, IL-5, and IL-13, and IgE and increasing the level of IFN-?. Significant down-regulation of T2R10 gene expression and up-regulation of IP3R1 and Orai1 gene expression were observed in experimental rats and these alterations were normalized after treatment with 6-gingerol or theophylline. The histopathological study revealed that the accumulation of glycoprotein and thickness of alveolar epithelium in asthmatic rats and supplementation with 6-gingerol or theophylline in asthmatic rats restored these changes to normal. In conclusion, 6-gingerol has a protective effect on lungs in ovalbumin-sensitized asthma in rats.

Highly reactive crystalline-phase-embedded strontium-bioactive nanorods for multimodal bioactive applications

In the present work, a crystallization-induced strontium-bioactive material, with a composition similar to Bioglass 45S5 system, was obtained using a sol-gel-assisted microwave method with nanorod morphologies of 30-80 nm in size. The effect of crystallization induced in the glass network, and its influence on the bioactivity and mechanical properties of bone and dentin regeneration, were the main novel findings of this work. Rietveld analysis of X-ray diffraction spectra showed the best fit with sodium (combeite, Na2Ca2Si3O9) and calcium (clinophosinaite, Ca2Na6O14P2Si2; calcium strontium silicate, Ca1.5O4SiSr0.5; and calcium carbonate, CaCO3) enriched crystal systems. Multinuclear solid-state NMR studies provided detailed atomistic insight into the presence of crystalline mineral phases in the bioactive material. The dentin matrix and antibacterial studies showed good results for 5% strontium-substituted calcium compared with basic 45S5 composition due to its smaller particle size (30 nm), which suggested applications to dentin regeneration. Simulation studies have been demonstrated with clinophosinaite crystal data from the XRD spectra, with the glycoprotein salivary metabolites also showing that 5% strontium-substituted calcium has a higher binding affinity for the salivary compound, which is suitable for dentin regeneration applications. In vitro apatite formation studies showed that this material is suitable for bone regeneration applications.

Role of fuel additives on reduction of NOX emission from a diesel engine powered by camphor oil biofuel

The present study intends to explore the effect of the addition of fuel additives with camphor oil (CMO) on the characteristics of a twin-cylinder compression ignition (CI) engine. The lower viscosity and boiling point of CMO when compared to diesel could improve the fuel atomization, evaporation, and air/fuel mixing process. However, the lower cetane index of CMO limits its use as a drop in fuel for diesel in CI engine. In general, NO_X emission increases for less viscous and low cetane (LVLC) fuels due to pronounced premixed combustion phase. To improve the ignition characteristics and decrease NO_X emissions, fuel additives such as diglyme (DGE)-a cetane enhancer, cumene (CU)-an antioxidant, and eugenol (EU) and acetone (A)-bio-additives, are added 10% by volume with CMO. The engine used for the experimentation is a twin-cylinder tractor engine that runs at a constant speed of 1500 rpm. The engine was operated with diesel initially to attain warm-up condition, which facilitates the operation of neat CMO. At full load condition, brake thermal efficiency (BTE) for CMO is higher (29.6%) than that of diesel (28.1%), while NO_X emission is increased by 9.4%. With DGE10 (10% DGE + 90% CMO), the ignition characteristics of CMO are improved and BTE is increased to 31.7% at full load condition. With EU10 (10% EU + 90% CMO) and A10 (10% A + 90% CMO), NO_X emission is decreased by 24.6 and 17.8% when compared to diesel, while BTE is comparable to diesel. While HC and CO emission decreased for DGE10 and CU10, they increased for EU10 and A10 when compared to baseline diesel and CMO.

Antiobesity potential of Piperonal: promising modulation of body composition, lipid profiles and obesogenic marker expression in HFD-induced obese rats

Background

Black pepper or Piper nigrum is a well-known spice, rich in a variety of bioactive compounds, and widely used in many cuisines across the world. In the Indian traditional systems of medicine, it is used to treat gastric and respiratory ailments. The purpose of this investigation is to study the antihyperlipidemic and antiobesity effects of piperonal in high-fat diet (HFD)-induced obese rats.

Methods

Piperonal, an active constituent of Piper nigrum seeds, was isolated and confirmed by HPLC, ¹H and ¹³C NMR spectroscopy. Male SD rats were fed on HFD for 22 weeks; Piperonal was supplemented from the 16th week as mentioned in the experimental design. Changes in body weight and body composition were measured by TOBEC, bone mineral composition and density were measured by DXA, and adipose tissue distribution was measured by 7 T–MRI. Plasma levels of glucose, insulin, insulin resistance and lipid profiles of plasma, liver and kidney, adipocyte hormones and liver antioxidants were evaluated using standard kit methods. Expression levels of adipogenic and lipogenic genes, such as PPAR-γ, FAS, Fab-4, UCP-2, SREBP-1c, ACC, HMG-COA and TNF-α were measured by RT-PCR. Histopathological examination of adipose and liver tissues was also carried out in experimental rats.

Results

HFD substantially induced body weight, fat%, adipocyte size, circulatory and tissue lipid profiles. It elevated the plasma levels of insulin, insulin resistance and leptin but decreased the levels of adiponectin, BMC and BMD. Increased expression of PPAR-γ, FAS, Fab-4, UCP-2, SREBP-1c, ACC, and TNF-α was noticed in HFD-fed rats. However, supplementation of piperonal (20, 30 and 40 mg/kg b.wt) for 42 days considerably and dose-dependently attenuated the HFD-induced alterations, with the maximum therapeutic activity being noticed at 40 mg/kg b.wt.

Conclusions

Piperonal significantly attenuated HFD-induced body weight and biochemical changes through modulation of key lipid metabolizing and obesogenic genes. Our findings demonstrate the efficacy of piperonal as a potent antiobesity agent, provide scientific evidence for its traditional use and suggest the possible mechanism of action.

A Relook of Cefuroxime in Community Infections: An Option Still Beneficial

In community and family practice, infections are a common OPD presentation. In the management of common bacterial infections seen in community especially RTI, UTI, SSTI; cefuroxime a second generation cephalosporin with a broad spectrum of activity can be used for empirical treatment. To know current place of cefuroxime in the management of infections, physicians, surgeons, microbiologist, chest physician, gynecologist and pediatrician came together to discuss and debate their experience with cefuroxime and its place in today's world. Cefuroxime is a drug which balances efficacy with safety. Several international bodies and guidelines including the US FDA and The British Thoracic Society, the World Society of Emergency Surgery (WSES) have recommended cefuroxime for the management of community acquired pneumonia and skin and soft tissue infection respectively. Cefuroxime has been recommended in the 2015 list of the US FDA list of drugs which can be used safely during pregnancy. Cefuroxime can become a useful empiric choice antibiotic for the Indian physicians treating urinary tract infections, respiratory tract infections and skin and soft tissue infections in their outpatient departments.

Prediction of User Interests for Providing Relevant Information Using Relevance Feedback and Re-ranking

Predicting user interest based on their browsing pattern is useful in relevant information retrieval. In such a scenario, queries must be unambiguous and precise. For a broad-topic and ambiguous query, different users may with different interests may search for information from the internet. The inference and analysis of user search goals using rules will be helpful to enhance the relevancy and user experience. A major deficiency of generic search system is that they have static model which is to be applied for all the users and hence are not adaptable to individual users. User interest is important when performing clustering so that it is possible to enhance the personalization. In this paper, a new approach is proposed to infer user interests based on their queries and fast profile logs and to provide relevant information to users based on personalization. For this purpose, a framework is designed to analyze different user profiles and interests while query processing including relevance analysis. Implicit Feedback sessions are also constructed from user profiles based on mouse and button clicks made in their current and past queries. In addition, browsing behaviors of users are analyzed using rules and also using the feedback sessions. Temporary documents are generated in this work for representing the feedback sessions effectively. Finally, personalization is made based on browsing behavior and relevant information is provided to the users. From the experiments conducted in this work, it is observed that the proposed model provide most accurate and relevant contents to the users when compared with other related work.

Elevated snoRNA biogenesis is essential in breast cancer

Hyperactive ribosomal biogenesis is widely observed in cancer, which has been partly attributed to the increased rDNA transcription by Pol I in cancer. However, whether small nucleolar RNAs (snoRNAs), a class of non-coding RNAs crucial in ribosomal RNA (rRNA) maturation and functionality, are involved in cancer remains elusive. We report that snoRNAs and fibrillarin (FBL, an enzymatic small nucleolar ribonucleoprotein, snoRNP) are frequently overexpressed in both murine and human breast cancer as well as in prostate cancers, and significantly, that this overexpression is essential for tumorigenicity in vitro and in vivo. We demonstrate that when the elevated snoRNA pathway is suppressed, the tumor suppressor p53 can act as a sentinel of snoRNP perturbation, the activation of which mediates the growth inhibitory effect. On the other hand, high level of FBL interferes with the activation of p53 by stress. We further show that p53 activation by FBL knockdown is not only regulated by the ribosomal protein-MDM2-mediated protein stabilization pathway, but also by enhanced PTB-dependent, cap-independent translation. Together, our data uncover an essential role of deregulated snoRNA biogenesis in tumors and a new mechanism of nucleolar modulation of p53.

Low-dose arsenic induces chemotherapy protection via p53/NF-κB-mediated metabolic regulation

Most chemotherapeutical drugs kill cancer cells chiefly by inducing DNA damage, which unfortunately also causes undesirable injuries to normal tissues, mainly due to p53 activation. We report a novel strategy of normal tissue-protection that involves p53/NF-κB coordinated metabolic regulation. Pretreatment of untransformed cells with low doses of arsenic induced concerted p53 suppression and NF-κB activation, which elicited a marked induction of glycolysis. Significantly, this metabolic shift provided cells effective protection against cytotoxic chemotherapy, coupling the metabolic pathway to cellular resistance. Using both in vitro and in vivo models, we demonstrated an absolute requirement of functional p53 in arsenic-mediated protection. Consistently, a brief arsenic-pretreatment selectively protected only normal tissues but not tumors from toxicity of chemotherapy. An indispensable role of glycolysis in protecting normal tissues was demonstrated by using an inhibitor of glycolysis, 2-deoxyglucose, which almost totally abolished low-dose arsenic-mediated protection. Together, our work demonstrates that low-dose arsenic renders normal cells and tissues resistance to chemotherapy-induced toxicity by inducting glycolysis.

P2-02-04: Novel Functions of vps34 in Non-Transformed Epithelial Cells: Regulation of Cell Proliferation and Tumorigenesis

Autophagic and endocytic pathways are tightly regulated membrane rearrangement processes that are crucial for homeostasis, development and disease. A list of proteins regulating these cellular processes show altered expression in cancers, suggesting derailed autophagy or endocytosis as an emerging feature of cancer. Class III phosphatidylinositol 3-kinase (PI3kinase) Vps34 regulates both autophagic and endocytic systems by recruiting proteins containing PtdIns3P binding domains. Recently, many new insights into the biology of class III PI3Kinase have been reported. Most of these studies, however, used mainly transformed cells. It is unclear whether class III PI3Kinase works similarly in non-transformed cells. In the recent study, we explored this by depleting both transformed and non-transformed mammary epithelial cell lines of Vps34 using shRNA. In consistent with previous finding, vps34-depleted cells are defect in formation of FYVE-GFP puncta, and showed altered early and recycling endosome dynamics. In a shark contrast to transformed cells where knockdown of Vps34 was associated with decreased growth, Vps34 deficiency in non-transformed cells resulted in a marked increase in cell proliferation. The deregulated autophagy function found in Vps34-depleted cells appeared to be not involved in cell growth regulation as silence of either Atg7 or Beclin1 expression did not affect the growth rate. On the other hand, reporter luciferase-based ten-pathway screens suggested an altered activity of the MAPK pathway. Indeed, biochemical analysis indicated a sustained ERK activation resulting from the impediment of endosome-mediated EGFR turnover in Vps34 deficient cells. A contribution of the endosomal pathway to Vps34-mediated regulation of cell proliferation was further confirmed by using Rab5 and Rab11 mutants that deregulated early and recycling endosome, respectively. Importantly, inactivation of Vps34 compromised the cellular barrier against oncogene-mediated transformation, as demonstrated by the increased susceptibility of Vps34 depleted cells to Ras-induced colony formation in vitro and tumor development in mice. All together, our data uncover a novel role for the class III PI3Kinase-endosomal pathway in regulation of cell proliferation.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-02-04.

Identification of sublattice damages in swift heavy ion irradiated N-doped 6H-SiC polytype studied by solid state NMR

We have studied N-doped 6H-SiC in its pristine and Swift Heavy Ion (SHI) irradiated (150 MeV Ag(12+) ions) forms by solid state Nuclear Magnetic Resonance (NMR) at 7.01 T using (13)C and (29)Si as probe nuclei under magic angle spinning. We show that increased levels of nitrogen doping, than used before, lead to the observation of Knight shifts emanating from an increase in electron density in the conduction band, which in (13)C far exceed those in (29)Si MAS spectra. We have rationalized the differential effects in the MAS spectra and site-dependent paramagnetic shifts in terms of the nitrogen doping at the A, B, and C lattice sites. N-doping has a profound effect on (29)Si spin-lattice relaxation, and the site-dependent relaxation behavior is attributed to a difference in conduction electron properties at the different lattice sites. (29)Si T(1) measurements serve to identify the sublattice damages in SHI irradiated 6H-SiC. By determining the spin-lattice relaxation rates as a function of the SHI irradiation ion fluences, the change in relaxation behavior is correlated to the damage production mechanism. The sublattice damage leads to discernable changes in the interaction between the mobile unpaired electrons in the conduction band and the nuclear site, which profoundly influence the NMR relaxation properties. Our relaxation studies also provide evidence for site-dependent localized effects and a decrease in carrier spin density in the conduction band for the SHI irradiated 6H-SiC.

A novel p53-based strategy for protection of gastrointestinal track and bone marrow (BM) from 5-fluorouracil (5-FU)

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Background: Acute toxicity from DNA damaging agents such as radiation and chemotherapy is mainly mediated by p53 which, upon activation, induces massive apoptotic cell death in sensitive tissues such as GI track and BM. Expanding from our recent finding that low-dose arsenic can temporarily and reversibly suppress p53 activation and subsequent tissue damages in normal tissues but not in carcinomas due to distinct differences in p53 status, we used a mouse tumor xenograft model to test the potential of arsenic in protecting the GI track and BM from one of the most commonly used chemotherapeutic agents for GI malignancies, 5-FU, without compromising tumor control.

Methods: Arsenic pretreatment was done by feeding sex-matched mice (4-6 weeks old) with water with or without 1.0 mg/L sodium arsenic for 3 days. Mice were randomized into 4 groups: A. control; B. arsenic only; C. 5-FU (30 mg/kg body weight i.v. for 5 days) only; D. arsenic and 5-FU. 5- FU-induced GI track and BM damages were analyzed histologically with H&E staining 4 weeks after last treatment. Body weight was monitored as a measure of toxicity. Lung carcinoma NCI-H358 was used to generate a mouse xenograft model. Treatments were initiated 3 weeks after implantation when the lung carcinomas reached an average volume of 100 mm3. Tumor volumes were measured periodically. Two independent experiments were done with10 mice per group.

Results: Tumor sizes at 9 weeks were (mean±SE in mm3): 528.1±62.81, 504.04±55.19, 133.02±35.74, 114.47±17.49 for groups A,B,C and D respectively (p=ns, C vs. D). The corresponding body weights were (in gm): 34.6±1.5, 36.4±2.1, 31±1.2, and 35.4±1.8 (p=0.0001, t-test, C vs D). 5-FU treatment was associated with severe damages to small intestine and BM, and such damages were significantly reduced by low-dose arsenic pretreatment by histological examination.

Conclusions: Our data demonstrate that a brief treatment with low-dose arsenic is associated with a marked protection of GI track and BM without compromising the ability of 5-FU to kill carcinoma cells.Our data have provided proof-of- principle for the use of low-dose arsenic to protect GI track and BM from toxicity of 5-FU, and for potential 5-FU dose intensification in clinical settings.

No significant financial relationships to disclose.

Heteronuclear dipolar decoupling effects on multiple-quantum and satellite-transition magic-angle spinning NMR spectra

We here report on the influence of heteronuclear dipolar decoupling on the (27)Al 3QMAS, 5QMAS, and the double-quantum filter-satellite-transition magic-angle spinning (DQF-STMAS) spectra of a strongly dipolar-coupled system, gibbsite. The requirements for heteronuclear dipolar decoupling increase with the order of coherence evolving in the indirect dimension of a two-dimensional (2D) experiment. The isotropic line width of the high-resolution 2D spectra, in samples like gibbsite, is composed of four parts: the distribution of isotropic shifts (delta(ISO), delta(QIS)), the homogeneous broadening related to the proton-proton flip-flop terms, the (27)Al-(27)Al homonulcear dipolar couplings, and the (1)H-(27)Al heteronuclear dipolar couplings. It is shown that, even in the case of gibbsite, where a strong proton-proton bath exists, the main resolution limiting factor in these experiments resides in the (1)H-(27)Al dipolar interaction.

Comparative evaluation of ultrasound-guided continuous infraclavicular brachial plexus block with stimulating catheter and traditional technique: a prospective-randomized trial

BACKGROUND

Secondary catheter failure has been reported in up to 40% of patients with continuous peripheral nerve blocks resulting in failure to provide pain relief after the initial block wears off. Introduction of stimulating catheters as well as ultrasound for regional anaesthesia has facilitated correct placement of catheter tip, closer to the plexus. This randomized study was conducted to compare the efficacy of continuous infraclavicular brachial plexus blocks using non-stimulating catheter, stimulating catheter and ultrasound-guided catheter placement with nerve stimulation assistance.

METHODS

Patients undergoing elective hand surgery were randomly allocated to receive continuous infraclavicular brachial plexus block using non-stimulating catheter [group traditional nerve stimulation (TR)], stimulating catheter [group stimulating catheter (ST)] or ultrasound-guided catheter placement with nerve stimulation assistance [group ultrasound guidance with nerve stimulation assistance (US)]. Motor and sensory blocks were assessed every 5 min and primary block success was determined at 30 min. After resolution of the primary block, threshold stimulating current and resulting response, spread of drug on re-injection as seen ultrasonographically and the capacity to re-establish block was documented. Complications and need for supplement was noted.

RESULTS

The primary block success was significantly higher in the US group [96% US, 58% ST, 59% TR (P=0.0005)]. Secondary catheter failure was significantly lower in the US group [9% US, 17% ST, 86% TR (P<0.0001)]. Axillary nerve was blocked more predictably in the US group (100% US, 79% ST, 50% TR (P=0.0003).

CONCLUSION

In this study, ultrasound guidance with nerve stimulation assistance significantly improved primary success and reduced secondary catheter failure in continuous infraclavicular brachial plexus blocks.

Gender and socio-cultural determinants of delay to diagnosis of TB in Bangladesh, India and Malawi

SETTING

Tuberculosis (TB) control programmes in Bangladesh, India and Malawi.

OBJECTIVE

To compare the interval from symptom onset to diagnosis of TB for men and women, and to assess socio-cultural and gender-related features of illness explaining diagnostic delay.

DESIGN

Semi-structured Explanatory Model Interview Catalogue (EMIC) interviews were administered to 100 or more patients at each site, assessing categories of distress, perceived causes and help seeking. Based on time from initial symptoms to diagnosis of TB, patients were classified with problem delay (>90 days), timely diagnosis (< or =30 days) or moderate delay. EMIC interview data were analysed to explain problem delay.

RESULTS

The median interval from symptom onset to diagnosis was longest in India and shortest in Malawi. With adjustment for confounding, female sex (Bangladesh), and status of married woman (India) and housewife (Malawi) were associated with problem delay. Prominent non-specific symptoms--chest pain (Bangladesh) and breathlessness (Malawi)--were also significant. Cough in India, widely associated with TB, was associated with timely diagnosis. Sanitation as a perceived cause linked to poor urban conditions was associated with delayed diagnosis in India. Specific prior help seeking with circuitous referral patterns was identified.

CONCLUSION

The study identified gender- and illness-related features of diagnostic delay. Further research distinguishing patient and provider delay is needed.

Use of ultrasound guidance and contrast enhancement: a study of continuous infraclavicular brachial plexus approach

PURPOSE

We describe our experience of combining the use of ultrasound (US) guidance with contrast enhancement and peripheral nerve stimulation for the insertion of infraclavicular brachial plexus catheters.

METHODS

Thirty patients scheduled to have upper limb surgery under regional block were studied. Under US guidance and peripheral nerve stimulation assistance, continuous peripheral nerve block needle and stimulating catheter were placed in the infraclavicular area. Needle and catheter tip location was confirmed with agitated 5% dextrose and seen under colour Doppler with US before injecting local anaesthetic (LA). Patients were evaluated in terms of onset times and efficacy of block. Post-operatively, on block recession a catheter was stimulated and visualization of spread of LA during injection through the catheter was done. Secondary block (subsequent to re-injection of LA) was assessed. Patients were followed-up for a week.

RESULTS

Mean time to onset of block was 19.7 (+/- 4.9) min. There were no incomplete blocks and all components of the plexus were blocked completely. Post-operatively, in 95.7% of patients, the spread of hand-agitated LA via the catheter could be seen by color Doppler with ultrasonography. All patients had excellent post-operative analgesia and high degree of satisfaction. There were no complications.

CONCLUSION

Contrast enhancement with US guidance during infraclavicular brachial plexus block enables direct visualization of needle and catheter tip location. Our early experience suggests that this leads to successful initial and subsequent post-operative block. Further controlled studies are needed to compare this technique with more prevalent and conventional techniques of catheter insertion.