rss_2.0Asian Biomedicine FeedSciendo RSS Feed for Asian Biomedicine Biomedicine 's Cover impairment in the elderly: the need for a comprehensive approach levels of interleukin-34 and RANKL as multivariable predictors of bone erosion seen by ultrasonography in patients with ankylosing spondylitis<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Ankylosing spondylitis (AS) is a chronic inflammatory arthritic disease, and sacroiliitis, enthesitis, and propensity for sacroiliac and spinal fusion are characteristic pathological features. Interleukin-34 (IL-34) plays a role in the induction and differentiation of osteoclasts. Other inflammatory factors are not directly involved in the induction and differentiation, but play an indirect role by modulating the level of receptor activator of nuclear factor-κB (RANKL) and other molecules during the process of inflammatory bone destruction in AS. However, to our knowledge, the relationship between enthesitis and bone erosion, and IL-34 and RANKL in AS has not yet been elucidated.</p> </sec> <sec><title style='display:none'>Objective</title> <p>To determine the correlation between serum IL-34, RANKL, and disease severity including enthesitis and bone erosion in patients with AS and develop multivariable predictive model.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a cross-sectional study of 40 patients with AS, compared with 40 patients with osteoarthritis, and 40 healthy volunteers. Their serum levels of IL-34 and RANKL were measured using enzyme-linked immunosorbent assays (ELISAs). Enthesitis and bone erosion were assessed with real-time ultrasonography. Spearman rank correlation coefficients were determined to analyze the relationship between the variables. Multiple logistic regression was used to determine associations and receiver operating characteristic (ROC) curve analyses were conducted to determine the diagnostic performance of cytokine levels.</p> </sec> <sec><title style='display:none'>Results</title> <p>In patients with AS, serum levels of IL-34 (878.9 ± 116.4 pg/mL) and RANKL (155.6 ± 13.8 pg/mL) were significantly (<italic>P</italic> &lt; 0.01) higher than those in patients with osteoarthritis (626.6 ± 79.0 and 138.1 ± 15.3 pg/mL, respectively) or a healthy group (612.9 ± 61.1 and 104.9 ± 15.4 pg/mL, respectively). Serum levels of IL-34 were not significantly correlated with the levels of RANKL. In patients with AS, serum levels of IL-34 and RANKL adjusted for age and weight were significantly correlated with enthesitis (0.798, <italic>P</italic> &lt; 0.01; 0.347, <italic>P</italic> &lt; 0.05, respectively) and bone erosion (0.822, <italic>P</italic> &lt; 0.01; 0.368, <italic>P</italic> &lt; 0.05, respectively). The area under the ROC curve (AUC) for the serum levels of IL-34 was 0.995 between patients with AS and healthy individuals. When serum level of IL-34 was &gt;697.1 pg/mL, the sensitivity (SE) was &gt;99% and specificity (SP) was 95.0%. The AUC for IL-34 was 0.982 between patients with AS and patients with osteoarthritis. When serum IL-34 was &gt;688.4 pg/mL, the SE was &gt;99% and SP 85.0%. IL-34 correlation with the number of bone erosions of enthesis was <italic>r<sub>s</sub></italic> = 0.795, <italic>P</italic> &lt; 0.01. The AUC for serum RANKL was 0.993 between patients with AS and healthy individuals. When serum RANKL was &gt;126.2 pg/mL, the SE was 97.5% and SP 97.5%. The AUC for serum RANKL was 0.798 between patients with AS and patients with osteoarthritis. When serum RANKL was &gt;149.3 pg/mL, the SE was 70% and SP was 80.0%.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>In patients with AS, serum levels of IL-34 and RANKL may be useful indicators of enthesitis, especially for bone erosions. IL-34 is associated with AS-associated enthesis damage and is a potential biomarker for predicting subsequent progression in patients with AS.</p> </sec> </abstract>ARTICLE2022-04-29T00:00:00.000+00:00Serotonin receptor subtype-2B signaling is associated with interleukin-18-induced cardiomyoblast hypertrophy in vitro<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>In patients with heart failure, interleukin-18 (IL-18) levels increase in the circulatory system and injured myocardial tissue. Serotonin (5-hydroxytryptamine) receptors subtype 2B (HTR2B) play an essential role in cardiac function and development, and their overexpression in rats leads to myocardial hypertrophy. Epigallocatechin gallate (EGCG) is cardioprotective in myocardial ischemia–reperfusion injury in rats and can prevent pressure overload-mediated cardiac hypertrophy in vivo. Mice deficient in peroxisome proliferator-activated receptor delta (PPARδ) can have cardiac dysfunction, myocardial hypertrophy, and heart failure. Matrix metalloproteinases (MMPs) are possibly involved in cardiac remodeling. However, the relationship between IL-18 signaling, cardiac hypertrophy, and the molecular mechanisms involved remain to be fully elucidated.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To elucidate the relationship between HTR2B and IL-18-induced myocardial hypertrophy and examine the antihypertrophic effects of EGCG and PPARδ.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We induced H9c2 cardiomyoblast hypertrophy with IL-18 in vitro and investigated the downstream signaling by real-time polymerase chain reaction (PCR) and western blotting. Hypertrophy was assessed by flow cytometry. We determined the effects of EGCG and PPARδ on IL-18-induced hypertrophic signaling via HTR2B-dependent mechanisms.</p> </sec> <sec><title style='display:none'>Results</title> <p>IL-18-induced H9c2 hypertrophy upregulated brain natriuretic peptide (BNP) protein and mRNA expression by inducing the expression of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and the hypertrophy was attenuated by pretreatment with EGCG (20 μM) and L-165,041 (2 μM), a PPARδ agonist. IL-18 upregulated the expression of HTR2B, which was inhibited by pretreatment with EGCG and L-165,041. SB215505 (0.1 μM), a HTR2B antagonist and siRNA for HTR2B, attenuated H9c2 hypertrophy significantly. Inhibition of HTR2B also downregulated the expression of MMP-3 and MMP-9.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>IL-18 and HTR2B play critical roles in cardiomyoblast hypertrophy. EGCG and L-165,041 inhibit the expression of HTR2B and augment remodeling of H9c2 cardiomyoblasts, possibly mediated by MMP-3 and MMP-9.</p> </sec> </abstract>ARTICLE2022-04-29T00:00:00.000+00:00Pancreaticopleural fistula in a Thai boy with c.101A>G substitution variant-related chronic pancreatitis: a case report and literature review<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Chronic pancreatitis is the most common etiology of pancreaticopleural fistula (PPF) in children, and underlying genetic variations are now widely known, accounting for most chronic pediatric pancreatitis.</p> </sec> <sec><title style='display:none'>Case report</title> <p>We describe a case of previously undetected chronic pancreatitis and PPF with a <italic>SPINK1</italic> variation in a 10-year-old Thai boy who presented with massive left pleural effusion. Magnetic resonance cholangiopancreatography (MRCP) revealed disruption of the pancreatic duct, which was communicating with a large pancreatic pseudocyst with mediastinal extension. The patient subsequently underwent endoscopic intervention with improved clinical symptoms. We also reviewed the imaging findings of 12 other reported cases of pediatric PPF.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Massive pleural effusion due to PPF can be an atypical manifestation in children with chronic pancreatitis. MRCP is the preferable imaging study for PPF due to the production of highly detailed images of pancreatic duct disruptions and anatomy, and the imaging is helpful to guide for appropriate treatment. Tests for genetic variation are also recommended in a child with chronic pancreatitis.</p> </sec> </abstract>ARTICLE2022-04-29T00:00:00.000+00:00Atorvastatin reduces alloxan-induced impairment of aversive stimulus memory in mice<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>An association between dysregulated glucose levels in patients with diabetes mellitus and detrimental effects on the central nervous system, particularly in Alzheimer disease, has been recognized. Atorvastatin treatment has improved memory and cognition in some patients with diabetes mellitus and Alzheimer disease.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To determine possible neuroprotective effects of atorvastatin on memory and cognition by measuring changes in an adverse stimulus avoidance learning deficit induced by alloxan in a murine model of diabetes mellitus and impaired memory and cognition.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We administered 150 mg/kg and 100 mg/kg alloxan in saline (intraperitoneally, i.p.) at a 48 h interval to produce a model of diabetes mellitus in male BALB/c mice. An oral glucose tolerance test (OGTT) was used to assess blood glucose regulation. After demonstrating hyperglycemia in mice (n = 7 per group) we administered vehicle (saline, i.p.), atorvastatin (10 mg/kg, i.p.), or liraglutide (200 μg/kg, i.p.) for 28 d except for those in a negative control group, which were given saline instead of alloxan, and a group administered atorvastatin alone, which were given saline instead of alloxan followed by atorvastatin (10 mg/kg, i.p.) for 28 d. Locomotor activity was measured 24 h after the final drug treatments, and subsequently their learned behavioral response to an adverse electrical stimulus to their plantar paw surface in a dark compartment was measured using a passive avoidance apparatus (Ugo Basile) in a model of impaired memory and cognition associated with Alzheimer disease. To determine any deficit in their learned avoidance of the adverse stimulus, we measured the initial latency or time mice spent in an illuminated white compartment before entering the dark compartment in the learning trial, and on the day after learning to avoid the adverse stimulus, the retention period latency in the light compartment and time spent in the dark compartment.</p> </sec> <sec><title style='display:none'>Results</title> <p>Atorvastatin alone produced no significant change in blood glucose levels (<italic>F</italic><sub>4,10</sub> = 0.80, <italic>P</italic> = 0.55) within 2 h. Liraglutide decreased blood glucose levels after 0.5 h (<italic>F</italic><sub>4,10</sub> = 11.7, <italic>P</italic> &lt; 0.001). We found no significant change in locomotor activity in any group. In mice with alloxan-induced diabetes, atorvastatin significantly attenuated the decreased avoidance associated with the diabetes (<italic>F</italic><sub>4,30</sub> = 38.0, <italic>P</italic> = 0.02) and liraglutide also significantly attenuated the decreased avoidance (<italic>F</italic><sub>4,30</sub> = 38.0, <italic>P</italic> &lt; 0.001). Atorvastatin alone had no significant effect on the adversive learned response compared with vehicle treatment (<italic>F</italic><sub>4,30</sub> = 38.0, <italic>P</italic> &gt; 0.05). Atorvastatin significantly decreased the time mice with alloxan-induced diabetes spent in the dark compartment compared with mice in the diabetes group without atorvastatin treatment (<italic>F</italic><sub>4,30</sub> = 53.9, <italic>P</italic> = 0.046). Liraglutide also significantly reduced the time mice with alloxan-induced diabetes spent in the dark compartment compared with vehicle-treated mice with alloxan-induced diabetes (<italic>F</italic><sub>4,30</sub> = 53.9, <italic>P</italic> &lt; 0.001). Atorvastatin treatment alone had no significant effect on the time mice spent in dark compartment compared with the control group (<italic>F</italic><sub>4,30</sub> = 53.9, <italic>P</italic> &gt; 0.05).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Atorvastatin significantly attenuated the adverse stimulus avoidance learning deficit in the alloxan-induced murine model of diabetes suggesting decreased impairment of memory and cognition.</p> </sec> </abstract>ARTICLE2022-04-29T00:00:00.000+00:00Chirality of antidepressive drugs: an overview of stereoselectivity<abstract> <title style='display:none'>Abstract</title> <p>Stereochemistry plays an important role in drug design because the enantiomers of a drug frequently vary in their biological action and pharmacokinetic profiles. Racemates of a drug with either an inactive or an unsafe enantiomer can lead to detrimental effects. The manufacturing industry may still produce racemates, but such decisions must pass through rigorous analyses of the pharmacological and pharmacokinetic characteristics of the particular enantiomer related to the racemates. The pharmacokinetics of antidepressants or antidepressive agents is stereoselective and predominantly favors one enantiomer. The use of pure enantiomers offers (i) better specificity than the racemates in terms of certain pharmacological actions, (ii) enhanced clinical indications, and (iii) optimized pharmacokinetics. Therefore, controlling the stereoselectivity in the pharmacokinetics of antidepressive drugs is of critical importance in dealing with depression and psychiatric conditions. The objective of this review is to highlight the importance of the stereochemistry of antidepressants in the context of the design and development of new chirally pure pharmaceuticals, the potential complications caused by using racemates, and the benefits of using pure enantiomers.</p> </abstract>ARTICLE2022-04-29T00:00:00.000+00:00Diagnostic accuracy of complete blood cell count and neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and platelet-to-lymphocyte ratios for neonatal infection<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Complete blood cell (CBC) counts and neutrophil-to-lymphocyte (NLR), lymphocyte-to-monocyte (LMR), and platelet-to-lymphocyte ratios (PLR) are simple measurements that are conducted as part of routine diagnostic procedures.</p> </sec> <sec><title style='display:none'>Objective</title> <p>To determine the diagnostic importance, specificity, and sensitivity of these measurements for the diagnosis of neonatal infections and in discriminating between neonatal sepsis and various other infections.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a retrospective study of data from a consecutive series of 232 neonatal patients admitted to Yildirim Beyazit University Yenimahalle Training and Research Hospital in Ankara for 2 years from 2016 to 2018. We included patients with a diagnosis of or clinically suspected infection, and healthy neonates were included as controls. Data included CBC counts, and bacterial culture results, considered the criterion standard for the diagnosis of neonatal sepsis. NLR, LMR, and PLR were calculated. We compared data using independent Student <italic>t</italic> and Mann–Whitney <italic>U</italic> tests and determined the sensitivity, specificity, and likelihood ratio (LHOR) of the characteristics for neonatal sepsis using receiver operating characteristic curve analyses.</p> </sec> <sec><title style='display:none'>Results</title> <p>We included data from 155 neonatal patients with a diagnosis or suspicion of infection and 77 healthy neonates. NLR was significantly higher in neonates with sepsis or fever due to dehydration (<italic>P</italic> &lt; 0.001) than in neonates with other infections or healthy neonates. LMR was significantly higher in neonates with sepsis or viral infection than in those with other infections or healthy controls (<italic>P</italic> = 0.003). In neonates with early-onset sepsis (EOS), we found cut-off values of ≥4.79 [area under curve (AUC) 0.845, 95% confidence interval (CI) 0.76–0.93, LHOR 11.6, specificity 98.7%, sensitivity 15%] for NLR, ≥1.24 (AUC 0.295; CI 0.18–0.41, LHOR 1.02, specificity 2.6%, sensitivity 100%) for LMR, and ≥37.72 (AUC 0.268; CI 0.15–0.39, LHOR 0.86, specificity 7.8%, sensitivity 80%) for PLR. We found cut-off values of ≥4.94 (AUC 0.667; CI 0.56–0.77, LHOR 4.16, specificity 98.7%, sensitivity 5.4%) for NLR and ≥10.92 (AUC 0.384; CI 0.26–0.51, LHOR 6.24, specificity 98.7%, sensitivity 8.1%) for LMR in those with late-onset sepsis (LOS).</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>CBCs, NLR, LMR, and PLR may be useful for the differential diagnosis of EOS and LOS, and neonates with sepsis from those with other infection. NLR may be a useful diagnostic test to identify neonatal patients with septicemia more quickly than other commonly used diagnostic tests such as blood cultures. NLR has high specificity and LHOR, but low sensitivity.</p> </sec> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00PIWI-interacting RNA (piRNA): a narrative review of its biogenesis, function, and emerging role in lung cancer<abstract> <title style='display:none'>Abstract</title> <p>Cancer remains elusive in many aspects, especially in its causes and control. After protein profiling, genetic screening, and mutation studies, scientists now have turned their attention to epigenetic modulation. This new arena has brought to light the world of noncoding RNA (ncRNA). Although very complicated and often confusing, ncRNA domains are now among the most attractive molecular markers for epigenetic control of cancer. Long ncRNA and microRNA (miRNA) have been studied best among the noncoding genome and huge data have accumulated regarding their inhibitory and promoting effects in cancer. Another sector of ncRNAs is the world of PIWI-interacting RNAs (piRNAs). Initially discovered with the asymmetric division of germline stem cells in the <italic>Drosophila</italic> ovary, piRNAs have a unique capability to associate with mammalian proteins analogous to P-element induced wimpy testis (PIWI) in <italic>Drosophila</italic> and are capable of silencing transposons. After a brief introduction to its discovery timelines, the present narrative review covers the biogenesis, function, and role of piRNAs in lung cancer. The effects on lung cancer are highlighted under sections of cell proliferation, stemness maintenance, metastasis, and overall survival, and the review concludes with a discussion of recent discoveries of another class of small ncRNAs, the piRNA-like RNAs (piR-Ls).</p> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00Multivariable analysis of clinical and laboratory data manifestations predicting severity and mortality risk in patients with Coronavirus disease 2019 in the mountainous west of Iran: a retrospective single-center study<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Few reports have addressed the clinical and laboratory features of patients with coronavirus disease-2019 (COVID-19) in mountainous areas, especially in Iran.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To report the clinical and laboratory data and manifestations predicting mortality of patients with COVID-19 in the west of Iran.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a retrospective cohort study of 286 patients hospitalized with COVID-19 between 25 February 2020 and 12 May 2020 to describe their clinical symptoms and laboratory test findings when they were admitted at the Hajar Hospital affiliated with the Shahrekord University of Medical Sciences, and a multivariable analysis of factors that predict their disease severity and mortality.</p> </sec> <sec><title style='display:none'>Results</title> <p>After hospital admission, 18 patients died and 268 were discharged. Older age [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.01–1.04, <italic>P</italic> = 0.001], presence of underlying diseases (OR = 1.86, 95% CI = 1.01–3.45, <italic>P</italic> = 0.04), elevated hematocrit (OR = 1.08, 95% CI = 1.03–1.13, <italic>P</italic> = 0.002), and increase in red blood cell distribution width (RDW) coefficient of variation (OR = 1.18, 95% CI = 1.02–1.36, <italic>P</italic> = 0.02) were significantly associated with disease severity. Older age (OR = 1.00, 95% CI = 1.00–1.07, <italic>P</italic> = 0.03), hypocalcemia (OR = 0.20, 95% CI = 0.09–0.58, <italic>P</italic> = 0.002), hypophosphatemia (OR = 0.50, 95% CI = 0.26–1.02, <italic>P</italic> = 0.04), and increase in platelet-larger cell ratio (P-LCR; OR = 1.10, 95% CI = 1.00–1.15, <italic>P</italic> = 0.04) were significantly associated with mortality. The areas under the receiver operating characteristic curves were as follows: calcium 0.759; lactate dehydrogenase (LDH) 0.731; phosphorus 0.725; bilirubin 0.689; C-reactive protein 0.679; and RDW – standard deviation (RDW-SD) 0.624.</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Those who did not survive tended to be elderly and had a greater incidence of comorbidities. Elevated LDH, decreased levels of calcium and phosphorus, and anemia at diagnosis were associated with greater risk of death for these Iranian patients hospitalized with COVID-19. Regular assessment of these markers would help to manage patients with COVID-19.</p> </sec> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00Optimal diagnosis and management of non-alcoholic fatty liver disease manifestations and etiological risk factors in patients hospitalized with COVID-19 in Turkey<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Coronavirus disease 2019 (COVID-19) can affect the neurological as well as the respiratory system. Neurological manifestations may involve the central or peripheral nervous systems, or musculoskeletal system. Findings can range from mild presentations, such as headache and anosmia, to severe complications, such as stroke and seizure.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>To evaluate the neurological findings and to determine etiological risk factors for mortality in patients hospitalized for COVID-19.</p> </sec> <sec><title style='display:none'>Methods</title> <p>Medical records of patients with COVID-19 who were hospitalized and sought neurological consultation between March 2020 and March 2021 at a reference pandemic hospital in Turkey were reviewed retrospectively in a cross-sectional study design.</p> </sec> <sec><title style='display:none'>Result</title> <p>We included data from 150 (94 male) patients. Their mean age ± standard deviation was 68.56 ± 16.02 (range 21–97) years. The patients were categorized into 2 groups according to any acute neurological event or progression of neurological disease. Ischemic cerebrovascular events, seizures, and encephalopathy were the most common acute neurological events, while deterioration in consciousness, epileptic seizures, and Parkinson disease were observed in those with progression of neurological disease. Abnormal neurological findings were found at a mean of 7.8 ± 9.7 days following COVID-19 diagnosis and 50 (a third of) patients died. A logistic regression model found that advanced age, increased Modified Charlson Comorbidity Index (MCCI) score, and prolonged duration of hospitalization were factors significantly associated with increased mortality; however, sex and day of abnormal neurological findings after COVID-19 diagnosis were not. Common conditions accompanying neurological events were hypertension, coronary artery disease–heart failure, and diabetes mellitus.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>COVID-19 may present with neurological symptoms in our Turkish patients and comorbidities are often present.</p> </sec> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00Association between serum uric acid level and non-alcoholic fatty liver disease in Koreans<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>The association between serum uric acid (SUA) levels and non-alcoholic fatty liver disease (NAFLD) is controversial.</p> </sec> <sec><title style='display:none'>Objectives</title> <p>We compared the association of SUA levels with NAFLD, abnormal alanine transferase (ALT), and the degree of liver fibrosis to clarify the association of SUA levels with NAFLD.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We conducted a retrospective cross-sectional study. Adult patients who underwent a health check-up (N = 1,343) were included for analysis. Fatty liver was diagnosed by abdominal ultrasonography. The degree of liver fibrosis was determined using the NAFLD fibrosis score (NFS). Pearson correlation analysis showed a stronger correlation of SUA level with the fatty liver index (<italic>r</italic> = 0.40, <italic>P</italic> &lt; 0.001) than the correlation with serum ALT level (<italic>r</italic> = 0.28, <italic>P</italic> &lt; 0.001), or NFS (<italic>r</italic> = 0.018, <italic>P</italic> = 0.51). SUA levels in patients with NAFLD and an abnormal liver function test (LFT) result were significantly higher than levels in patients without NAFLD and abnormal LFT results. By contrast, there was no significant association of SUA level with NFS grade. When age, male sex, body mass index, the presence of hypertension, diabetic mellitus, and NAFLD, abnormality of ALT level, and SUA level were included in binary logistic regression to evaluate risk factors for elevated NFS grade, hyperuricemia was not significantly associated with NFS grade (OR = 0.94, <italic>P</italic> = 0.75).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Pearson correlation and logistic regression together indicated SUA level is more closely associated with hepatic steatosis than abnormal liver function test or hepatic fibrosis.</p> </sec> </abstract>ARTICLE2022-02-28T00:00:00.000+00:00Injectable calcium phosphate and styrene–butadiene polymer-based root canal filling material<abstract><title style='display:none'>Abstract</title><sec><title style='display:none'>Background</title><p>Three-dimensional obturation of the root canal system is mandatory for a successful root canal treatment. Using a filling material with optimal properties may enable the root canal to be sealed well and therefore obtain the desired obturation.</p></sec><sec><title style='display:none'>Objective</title><p>To develop a new injectable paste endodontic filling material using calcium phosphate powder and a styrene–butadiene emulsion polymer.</p></sec><sec><title style='display:none'>Methods</title><p>The powder phase comprised an equivalent molar ratio of tetracalcium phosphate, anhydrous dicalcium phosphate, bismuth oxide, and calcium chloride. The liquid phase comprised a styrene–butadiene rubber emulsion in distilled water. The powder and the liquid were mixed to achieve a paste consistency. The paste was subjected to various tests including flow, setting time, dimensional change, solubility, and radiopacity to indicate its suitability as a root canal filling material. All these tests were conducted according to the American National Standards Institute–American Dental Association for endodontic sealing materials. After passing these tests, the paste was submitted to an injectability test.</p></sec><sec><title style='display:none'>Results</title><p>The material showed acceptable flowability with 19.1 ± 1.3 min setting time and 0.61 ± 0.16% shrinkage after 30 days of storage. We found the highest solubility at 24 h (6.62 ± 0.58%), then the solubility decreased to 1.09 ± 0.08% within 3 days. The material was more radiopaque than a 3 mm step on an aluminum wedge. Furthermore, the material showed good injectability of 93.67 ± 1.80%.</p></sec><sec><title style='display:none'>Conclusions</title><p>The calcium phosphate powder in styrene–butadiene emulsion met basic requirements for a root canal filling material with promising properties.</p></sec></abstract>ARTICLE2021-02-21T00:00:00.000+00:00Atypical complication in an adult patient with dengue and autoimmune hemolytic anemia: a case report<abstract><title style='display:none'>Abstract</title><p>Severe dengue infection is associated with life-threatening complications, including severe bleeding. The bleeding tendency is typically associated with the shock phase of infection, for which blood replacement may be needed. However, repetitive blood transfusion can lead to volume overload. Administration of recombinant activated factor VII (rFVIIa) might be used to counteract bleeding without inducing volume overload. We describe the case of a patient with severe dengue infection who presented with intractable bleeding; he was initially treated with massive blood transfusions, which resulted in volume overload. He was then treated with rFVIIa to reverse the bleeding. During the second week of his hospitalization, his hematocrit dropped precipitously, and autoimmune hemolytic anemia was diagnosed. Supportive treatment was provided until recovery. Autoimmune hemolytic anemia is a rare complication in adult patients with dengue. Supportive care was effective for this atypical complication.</p></abstract>ARTICLE2021-02-21T00:00:00.000+00:00Gene polymorphisms and diseases in Asians features of normal lung change in asymptomatic elderly patients<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.431_s_001_w2aab3b7b3b1b6b1aab1c17b1Aa"><title style='display:none' id="d574916e16891_w2aab3b7b3b1b6b1aab1c17b1aAa">Background</title><p>Not all morphological lung changes in the elderly contribute to respiratory disease and may be a consequence of normal aging.</p></sec><sec id="j_1905-7415.0905.431_s_002_w2aab3b7b3b1b6b1aab1c17b2Aa"><title style='display:none' id="d574916e16900_w2aab3b7b3b1b6b1aab1c17b2aAa">Objectives</title><p>To describe the changes in asymptomatic elderly patients compared with those in younger patients in a Thai population.</p></sec><sec id="j_1905-7415.0905.431_s_003_w2aab3b7b3b1b6b1aab1c17b3Aa"><title style='display:none' id="d574916e16909_w2aab3b7b3b1b6b1aab1c17b3aAa">Methods</title><p>The study cohort comprised 60 participants without respiratory symptoms in three groups of 20 by age: 20-40 years, 41-60 years, and &gt;60 years. Participants were prospectively selected from patients referred for computed tomography (CT) of the abdomen, or head and neck, and underwent sequential CT during deep breathing at four lung levels. Two observers scored images by consensus. We compared groups using Pearson chi-square and Fisher exact tests, and used receiver operating characteristic curves to categorize bronchiectasis and bronchial wall thickening by age.</p></sec><sec id="j_1905-7415.0905.431_s_004_w2aab3b7b3b1b6b1aab1c17b4Aa"><title style='display:none' id="d574916e16918_w2aab3b7b3b1b6b1aab1c17b4aAa">Results</title><p>Air trapping was related to age (5/20 group 1, 7/20 group 2, and 18/20 group 3 (<italic>P</italic> &lt;0.01)) and was most prevalent in lower lobes (78%, <italic>P</italic> &lt; 0.01). Reticulation was found in only one middle aged patient (<italic>P</italic> = 0.36). Bronchiectasis was more common in patients &lt;56 years (7/23) than &lt;56 years (3/37), <italic>P</italic> = 0.035. Bronchial wall thickening (7/23 in patients &gt;56 years and 2/37 in patients &lt;56 years, <italic>P</italic> = 0.02) and extensive air trapping were related to age (0/6 group 1, 1/6 group 2, and 5/6 group 3, <italic>P</italic> = 0.02). Findings were independent of smoking history.</p></sec><sec id="j_1905-7415.0905.431_s_005_w2aab3b7b3b1b6b1aab1c17b5Aa"><title style='display:none' id="d574916e16947_w2aab3b7b3b1b6b1aab1c17b5aAa">Conclusions</title><p>Asymptomatic older patients had higher prevalence of bronchiectasis, bronchial wall thickening, and air trapping, independent of smoking history.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Multidrug resistance gene 1 polymorphisms in pediatric patients with leukemia at a national referral hospital in Indonesia<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.432_s_001_w2aab3b7b4b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e7487_w2aab3b7b4b1b6b1aab1c16b1aAa">Background</title><p>Acute lymphoblastic leukemia (ALL) is the most prevalent cancer in the pediatric population. From 25% to 30% of patients with ALL will have a relapse that leads to death when they are teenagers. At Cipto Mangunkusumo Hospital, 40% of 126 pediatric patients with ALL relapsed from 2005 to 2011. A multiple variant of multidrug resistance gene 1 (<italic>MDR1</italic>) is C3435T, which can be used to understand the genetic basis of susceptibility to relapse.</p></sec><sec id="j_1905-7415.0905.432_s_002_w2aab3b7b4b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e7499_w2aab3b7b4b1b6b1aab1c16b2aAa">Objectives</title><p>To identify the profile of <italic>MDR1</italic> polymorphism in pediatric Indonesian patients with ALL.</p></sec><sec id="j_1905-7415.0905.432_s_003_w2aab3b7b4b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e7511_w2aab3b7b4b1b6b1aab1c16b3aAa">Methods</title><p>We collected data from 44 patients with ALL who attended Cipto Mangunkusumo Hospital between January and June 2014. We investigated a silent C3435T polymorphism in <italic>MDR1</italic> exon 26 with polymerase chain reaction- restriction fragment length polymorphism using <italic>Mbo</italic>I.</p></sec><sec id="j_1905-7415.0905.432_s_004_w2aab3b7b4b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e7526_w2aab3b7b4b1b6b1aab1c16b4aAa">Results</title><p>There were 32 male and 12 female patient participants in this study. Eighteen patients were 1–3 years old and 26 were over 3 years. The mean age at 1–3 years was 2.4 ± 0.86, and over 3 years it was 6.3 ± 2.67 years. There were 27 patients with ALL in the standard risk group and 17 in the high risk group. We determined that the 25 samples from patients with ALL in the standard risk group were not digestible (allele T) and the 6 samples from patients with ALL in the high risk group were digestible (allele C).</p></sec><sec id="j_1905-7415.0905.432_s_005_w2aab3b7b4b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e7536_w2aab3b7b4b1b6b1aab1c16b5aAa">Conclusions</title><p>The prevalence of the T allele was higher than that of the C allele in pediatric Indonesian patients with ALL.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Comparing goniometric and radiographic measurement of Q angle of the knee<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.433_s_001_w2aab3b7b5b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e3933_w2aab3b7b5b1b6b1aab1c16b1aAa">Background</title><p>The Q angle is a relevant clinical diagnostic measurement to detect various disorders of the knee. The common method used to measure the Q angle in the routine clinical practice is by radiography. An alternative to radiographic measurement is goniometry, by which exposure to x-rays can be avoided.</p></sec><sec id="j_1905-7415.0905.433_s_002_w2aab3b7b5b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e3942_w2aab3b7b5b1b6b1aab1c16b2aAa">Objectives</title><p>To compare and correlate the goniometric measurement of Q angle with radiographic measurement of the Q angle in patients with acute knee pain.</p></sec><sec id="j_1905-7415.0905.433_s_003_w2aab3b7b5b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e3951_w2aab3b7b5b1b6b1aab1c16b3aAa">Methods</title><p>We selected 45 patient participants with a mean age of 32.5 years who satisfied the inclusion criteria for this study. All the patients underwent goniometric measurement of the Q angle followed by x-ray imaging of the entire lower limb. Later the bony prominences were marked on the x-ray image and the Q angle formed was measured using a protractor. The Pearson correlation coefficient between the goniometric and radiographic measurements was determined.</p></sec><sec id="j_1905-7415.0905.433_s_004_w2aab3b7b5b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e3960_w2aab3b7b5b1b6b1aab1c16b4aAa">Results</title><p>We found a significant relationship between Q angles obtained using a goniometer and x-ray imaging in the supine position (r = 0.91, P = 0.001). The mean difference between the goniometric measurement of Q angle and the radiographic measurement was 0.1°, which is not significant.</p></sec><sec id="j_1905-7415.0905.433_s_005_w2aab3b7b5b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e3970_w2aab3b7b5b1b6b1aab1c16b5aAa">Conclusions</title><p>Goniometry can be used to measure Q angle as accurately as radiography, and can be used as an inexpensive and radiation free alternative.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Soluble lectin-like oxidized low density lipoprotein receptor-1 in metabolic syndrome<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.439_s_001_w2aab3b7c11b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e236_w2aab3b7c11b1b6b1aab1c16b1aAa">Background</title><p>Serum levels of soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) reflect increases in LOX-1 receptor expression associated with inflammation and metabolic disorders.</p></sec><sec id="j_1905-7415.0905.439_s_002_w2aab3b7c11b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e245_w2aab3b7c11b1b6b1aab1c16b2aAa">Objectives</title><p>To examine sLOX-1 levels in metabolic syndrome and association of sLOX-1 with classical risk factors, and with metabolic syndrome, a clustering of metabolic disorders associated with cardiovascular risk factors.</p></sec><sec id="j_1905-7415.0905.439_s_003_w2aab3b7c11b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e254_w2aab3b7c11b1b6b1aab1c16b3aAa">Methods</title><p>We selected 148 serum samples from patient participants with metabolic syndrome and 206 samples from patients with non-metabolic syndrome as controls, using the modified National Cholesterol Educational Program Adult Treatment Panel III (NCEP-ATP III) criteria.</p></sec><sec id="j_1905-7415.0905.439_s_004_w2aab3b7c11b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e263_w2aab3b7c11b1b6b1aab1c16b4aAa">Results</title><p>Levels of sLOX-1 were increased significantly in participants with metabolic syndrome (P &lt; 0.001). Serum sLOX-1 was positively associated with body mass index (BMI), blood pressure, fasting plasma glucose, triglyceride, and total cholesterol, but negatively associated with high-density lipoprotein cholesterol. Analysis of serum sLOX-1 for metabolic syndrome showed 99.03% specificity and 100% sensitivity. The area under the receiver operating characteristic curve was 0.998 (95%CI 0.996-1.001, P &lt; 0.001). A univariate analysis showed sLOX-1 was significantly correlated with metabolic syndrome, but was not after adjustment for sex, age, blood pressure, and BMI. Multivariate regression analysis found that being overweight (82.3; 95%CI 10.7–631.9), hyperglycemia (1.1; 95%CI 1.1–1.2), and hypertriglyceridemia (1.1; 95%CI 1.0–1.1) were significantly correlated with metabolic syndrome. HDL cholesterol was a protective factor (0.96; 95%CI: 0.93–0.99).</p></sec><sec id="j_1905-7415.0905.439_s_005_w2aab3b7c11b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e273_w2aab3b7c11b1b6b1aab1c16b5aAa">Conclusions</title><p>Serum sLOX-1 is a suitable biomarker for diagnosis of metabolic syndrome. However, univariate and multivariate analysis suggested that sLOX-1 may be a modulating factor, and not an independent risk factor.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00Coinheritance of Southeast Asian ovalocytosis and the β-thalassemia trait in a Malay family<abstract><title style='display:none'>Abstract</title><sec id="j_1905-7415.0905.442_s_001_w2aab3b7c13b1b6b1aab1c16b1Aa"><title style='display:none' id="d574916e9282_w2aab3b7c13b1b6b1aab1c16b1aAa">Background</title><p>Southeast Asian ovalocytosis (SAO) is a red blood cell membrane disorder caused by a 27 base pair (bp) deletion in the <italic>SLC4A1</italic> that transcribes to a truncated variant of band-3 glycoprotein. β-Thalassemia is another red blood cell disorder, caused by mutant alleles in the β-globin gene that lead to globin chain impairment. Both conditions occur in Southeast Asian countries, including Malaysia.</p></sec><sec id="j_1905-7415.0905.442_s_002_w2aab3b7c13b1b6b1aab1c16b2Aa"><title style='display:none' id="d574916e9294_w2aab3b7c13b1b6b1aab1c16b2aAa">Objectives</title><p>This report describes hematological and molecular features of a patient with both SAO and β-thalassemia and her children.</p></sec><sec id="j_1905-7415.0905.442_s_003_w2aab3b7c13b1b6b1aab1c16b3Aa"><title style='display:none' id="d574916e9303_w2aab3b7c13b1b6b1aab1c16b3aAa">Methods</title><p>A 58-year-old Malay woman presented to our clinic with dizziness, tiredness, and easy fatigability. She was mildly anaemic. Analysis of her complete blood counts and her peripheral blood smear revealed microcytic hypochromic anaemia with large numbers of macro-ovalocytes and stomatocytes.</p></sec><sec id="j_1905-7415.0905.442_s_004_w2aab3b7c13b1b6b1aab1c16b4Aa"><title style='display:none' id="d574916e9312_w2aab3b7c13b1b6b1aab1c16b4aAa">Results</title><p>Hemoglobin and globin gene studies revealed heterozygous β-thalassemia, and further analysis demonstrated a heterozygous 27 bp deletion on the <italic>SLC4A1</italic> gene consistent with SAO. Analysis of the patient’s offspring showed co-inheritance of β-thalassemia and SAO in her elder daughter and son, and SAO alone in another daughter.</p></sec><sec id="j_1905-7415.0905.442_s_005_w2aab3b7c13b1b6b1aab1c16b5Aa"><title style='display:none' id="d574916e9325_w2aab3b7c13b1b6b1aab1c16b5aAa">Conclusions</title><p>High frequencies of SAO and different β-thalassemia mutations are present in the Malaysian population, thus coinheritance of SAO and β-thalassemia is not uncommon. However, this coinheritance is rarely reported, possibly because the red blood cell indices are overlooked and peripheral smear examinations are not routine.</p></sec></abstract>ARTICLE2017-01-31T00:00:00.000+00:00en-us-1