Coronary artery calcium and cardiovascular disease prediction by scanner type: the multi-ethnic study of atherosclerosis.

AIM: To evaluate the predictive value of coronary artery calcium (CAC) scoring methods across cardiac computed tomography (CT) scanner types. MATERIALS AND METHODS: CAC was measured in participants from the MESA (Multi-Ethnic Study of Atherosclerosis), a prospective cohort study of participants free of baseline cardiovascular disease (CVD), using either EBCT (electron beam CT) or MDCT (multidetector CT). The risks for incident coronary heart disease (CHD) and CVD events were compared for CAC scores per SD using Cox proportional hazards models with multivariable adjustment in 3,362 MESA participants with detectable CAC. RESULTS: Using the Agatston score, the hazard ratio (HR) and 95% confidence interval (CI) for CHD was 1.50 (1.27,1.78) for EBCT and 1.60 (1.37,1.87) for MDCT. Using volume and density scores, the HR for CHD was 2.14 (1.71,2.68) for volume and 0.61 (0.48,0.76) for density on EBCT and 1.73 (1.42,2.11) for volume and 0.88 (0.71,1.10) for density on MDCT. Similar results were seen for CVD risk and in analyses stratified by sex, body mass index (BMI), and age. The volume and density score model demonstrated higher areas under the curve (AUC) for CHD than the Agatston score with EBCT (0.702, 95% CI: 0.666,0.738 versus 0.677, 95% CI: 0.638,0.715, p<0.001) and MDCT (0.669, 95% CI: 0.632,0.705 versus 0.660, 95% CI: 0.622,0.697, p=0.216). CONCLUSION: The CAC volume and density scores provide better risk prediction than the Agatston score for CHD and CVD events, regardless of CT scanner type. CAC density was strongly and inversely associated with CHD risk. Both density and volume score prediction were stronger for EBCT than MDCT.

Hybrid Pixel-Waveform (HPWF) Enabled CdTe Detectors for Small Animal Gamma-Ray Imaging Applications.

This paper presents the design and preliminary evaluation of small-pixel CdTe gamma ray detectors equipped with a hybrid pixel-waveform (HPWF) readout system for gamma ray imaging applications with additional discussion on CZT due to its similarity. The HPWF readout system utilizes a pixelated anode readout circuitry which is designed to only provide the pixel address. This readout circuitry works in coincidence with a high-speed digitizer to sample the cathode waveform which provides the energy, timing, and depth-of-interaction (DOI) information. This work focuses on the developed and experimentally evaluated prototype HPWF-CdTe detectors with a custom CMOS pixel-ASIC to readout small anode pixels of 350 µm in size, and a discrete waveform sampling circuitry to digitize the signal waveform induced on the large cathode. The intrinsic timing, energy, and spatial resolution were experimentally evaluated in this paper in conjunction with methods for depth of interaction (DOI) partitioning of the CdTe crystal. While the experimental studies discussed in this paper are primarily for evaluating HPWF detectors for small animal PET imaging, these detectors could find their applications for ultrahigh-resolution SPECT and other imaging modalities.

Fetal hydantoin syndrome: A case report.

Fetal hydantoin syndrome (FHS) is a spectrum of defects caused to the developing fetus by exposure to the teratogenic effects of antiepileptic drug (AED) phenytoin during pregnancy. Its clinical manifestations include limb abnormalities, ocular defects, central nervous system anomalies, intrauterine growth restriction, and hand and phalangeal anomalies. This case report presents an 8-year-old child born to an epileptic mother with a history of AED therapy, with features suggestive of FHS.

Inhibition of mitochondrial ß-oxidation by miR-107 promotes hepatic lipid accumulation and impairs glucose tolerance in vivo.

BACKGROUND: Hepatic expression of microRNA-107 is ubiquitously upregulated in various metabolic diseases. In our previous study, we had demonstrated that fatty acid synthase (FASN) is a target of miR-107. miR-107-FASN interaction, by inducing endoplasmic reticulum (ER) stress, promotes lipid accumulation in hepatocytes. Here, we explore the possible mechanism(s) of the miR-107-FASN-ER stress on hepatic lipid metabolism. METHODS: HepG2 cells were transfected with the scramble or miR-107 and/or its inhibitor. Transcript levels of lipid droplet membrane proteins, apolipoproteins and ß-oxidation genes were quantified by quantitative reverse transcription-PCR. Cells were treated with tunicamycin (Tm, 1 h) and 4-PBA (4-phenyl butyric acid, 8 h) or transfected with hydroxyacyl-CoA dehydrogenase/3-ketoacyl-CoA thiolase/enoyl-CoA hydratase, apha subunit (HADHA) short interfering RNA or its overexpression vector. Mice were injected with the scramble or mmu-miR-107 (2.5 mg kg(-1) body weight) and random glucose levels were measured and oral glucose tolerance test was performed. Serum levels of cholesterol, triglyceride and serum glutamic oxaloacetic transaminase/serum glutamic-pyruvic transaminase (SGOT/SGPT) were evaluated. Hepatic tissues were collected to estimate levels of miR-107 and mitochondrial ß-oxidation genes. Six-micrometer-thick cryosections of hepatic tissues were prepared and stained with Oil Red O for lipid accumulation. RESULTS: miR-107 does not alter the expression of lipid metabolism-related transcription factors, lipid droplet components and apolipiprotein B. miR-107 significantly decreased the levels of the mitochondrial ß-oxidation enzyme, HADHA in HepG2 cells (P<0.01), which was prevented by the miR-107 inhibitor. Similar decrease was observed with Tm (P<0.001), suggesting that HADHA inhibition is promoted by ER stress induction. Interestingly, miR-107-mediated HADHA suppression was rescued by the ER stress inhibitor, 4-PBA (P<0.01). HADHA overexpression rescued miR-107-induced lipid accumulation (P<0.01). miR-107 injection in mice increased random blood glucose levels (P<0.05) and impaired glucose tolerance (P<0.05). Hepatic levels of Hadha were significantly decreased (P<0.001 and P<0.05) accompanied by increased lipid accumulation (P<0.001). CONCLUSIONS: miR-107 promotes hepatic lipid accumulation by suppressing transcript levels of HADHA, induces hyperglycemia and impairs glucose tolerance. We conclude that miR-107 regulation of fatty acid oxidation is an important contributor toward hepatic lipid accumulation.

Histone deacetylase inhibitors valproic acid and sodium butyrate enhance prostaglandins release in lipopolysaccharide-activated primary microglia.

Modifications of histone deacetylases (HDACs) may be involved in microglia-driven neuroinflammatory responses. Recent studies suggest that several inflammatory molecules can regulate the extent of neurodegeneration and regeneration in the central nervous system (CNS). In the present study, we investigated the effects of HDAC inhibitors (HDACi) valproic acid (VPA) and sodium butyrate (NaBut) on the release of prostaglandins (PGs) in lipopolysaccharide (LPS)-activated microglia. We found that VPA and NaBut significantly enhanced LPS-induced release of PGE2, PGD2 and 8-iso-PGF2α. In addition, both compounds increased cyclooxygenase-2 and microsomal prostaglandin E synthase immunoreactivity and gene expression in LPS-stimulated microglia. Interestingly, treatment of activated microglia with HDACi also enhanced the gene expression and the release of different pro-inflammatory cytokines. Microglia activation with LPS leads to IκB-α degradation, as well as p38, ERK1/2 and JNK MAPKs phosphorylation and thus activation, which is not affected by treatment with VPA and NaBut. Furthermore, VPA and NaBut treatment induced histone acetylation at H3-K18 in microglia. We suggest that VPA and NaBut-driven increase in PGs release in LPS-activated microglia might be regulated at the transcriptional level and involves histone hyperacetylation. Our data demonstrate that VPA and NaBut are able to modulate microglia responses to inflammatory insults and thus possibly can regulate the CNS degenerative and regenerative processes.

Validation of Tanaka and Johnston's analysis in western UP Indian population.

OBJECTIVE: To examine the applicability of the Tanaka and Johnston's method of prediction in a western UP population and to develop a new prediction method for this specific population if necessary. MATERIALS AND METHODS: 150 western UP school children (87 males and 63 females) with a mean age of 15.5 years were randomly selected. The mesio-distal crown diameters of the permanent canine and premolars were measured and comparisons were done between the actual tooth sizes and the values predicted by the Tanaka and Johnston method. RESULTS: Significant sexual dimorphism was found in the tooth sizes. There were significant differences between the actual measurements and the predicted measurements derived by the Tanaka and Johnston prediction method. New linear regression equations were derived for both the genders for tooth size prediction in western UP population. CONCLUSION: There are limitations in the application of the Tanaka and Johnston's prediction method to a western UP population. A gender discrepancy is seen between the males and the females. New regression equations were formulated for both the males and the females separately.

Preventing dental caries in children: Indian scenario.

The prevalence of dental caries in developing countries like India is increasing to an alarming level in contrast to developed countries where it has decreased because of variety of preventive measures at the community and individual level. There is no State or Centre funded programs for prevention of dental diseases in India. The present review enlists the targeted prevention of dental caries in permanent teeth of 6 to 16 years old children presenting for dental care.

Inguinal hernia is not a sign of colon cancer: results of a prospective screening trial.

BACKGROUND: It has been suggested that patients with an inguinal hernia harbour an increased risk for colorectal cancer. METHODS: In a prospective clinical trial, we compared the prevalence of colonic neoplasms in 100 cases with inguinal hernia and 100 controls without inguinal hernia. The number, size, histology type, and the location of all colorectal lesions found during a screening flexible sigmoidoscopy were recorded. RESULTS: Not a single case of colorectal cancer was detected in the patients with inguinal hernia pending surgical repair. In the asymptomatic control subjects, one Dukes A and one Dukes B1 colon cancer were detected. Polypectomy was performed in 15% and 17% of the case and control subjects, respectively. During a 5-year period following the initial screening procedure, none of the case or control subjects was diagnosed with colon cancer. CONCLUSIONS: The decision for or against performing an endoscopic procedure in a patient with inguinal hernia should be guided by the general principles of screening for colorectal cancer. The mere presence of an inguinal hernia does not automatically increase the risk of colorectal cancer.

Quantitation of urinary hydroxypyridinium cross-links from collagen by high-performance liquid chromatography.

Pyridinoline and deoxypyridinoline are intermolecular cross-links in mature collagen in bone and cartilage. The urinary excretion of the two compounds correlates well to bone turnover. A fast, sensitive, and accurate isocratic ion-pairing reverse-phase high-performance liquid chromatography method for measurement of pyridinoline and deoxypyridinoline in urine has been established. Intra- and inter-assay precision were 5-7% and 12-14%, respectively. Recovery for pyridinoline was 97.4% and for deoxypyridinoline 94.3%. The detection limit was 0.4 pmol. Pyridinoline:creatinine and deoxypyridinoline: creatinine ratios in healthy subjects, were 38.8 nmol:mmol and 13.0 nmol:mmol, respectively. Increased values of both cross-links were observed in children, in the age group 20-29 in both sexes, and in post-menopausal women.

A1A2BO, MN, RH blood group markers in tribes of Raipur district, Madhya Pradesh, (India).

Raipur district is located in the South-eastern part of Madhya Pradesh state (Fig. 1). Phenotype and gene frequencies of blood groups A1A2BO, MN and RH among Gond, Kawar and Halba, three dominant tribes inhabiting the district, are reported.

Prevalence of HBsAg carriers among some tribes of Madhya Pradesh.

Prevalence of HBsAg was determined in 1314 sera obtained from 11 different tribal populations of five districts of Madhya Pradesh. Reversed passive haemagglutination assay was used for screening showed a HBsAg carrier rate of 2.99 to 21.54 per cent among the various tribes. Significant regional variation was also observed.

Computed tomographic spectrum of neurocysticercosis.

Computed tomography (CT) is a very sensitive modality for the diagnosis of neurocysticercosis. Fifty eight patients were evaluated by plain radiography and CT scans. The initial presentation was as seizure disorder (33), raised intracranial tension (19), meningoencephalitis (5) and psychiatric manifestation (1). Histologically confirmed subcutaneous nodules were seen in 20 cases and ocular cyst in 2 cases. CT scan showed multiple calcification in 8 cases, disc lesions in 30,ring lesions in 3, and a combination of disc and ring lesions in another 13 cases. Low attenuation lesions were seen in 4 cases in combination with disc/disc and ring lesions. All 58 cases had supratentorial lesions while 19 cases had infratentorial lesions in addition. Perifocal or generalised oedema was seen in 33 and 11 cases respectively. The ventricles were compressed in one case, large in 2 cases and normal in the rest. CT scan is valuable in the diagnosis of neurocysticercosis. Its significance is different in the various clinical and radiological groups.

Auto antibodies to nucleosides in systemic lupus erythematosus.

Serological studies in 110 patients with systemic lupus erythematosus (SLE) have shown that autoantibodies to DNA and RNA had subspecificity to adenosine (30.9%), cytidine (79%), guanosine (44.5%), thymidine (20%) and uracil (56.3%). It was also observed that DNA antibodies are heterogenous and that antibody with specificity for both the native confirmation as well as exposed nucleoside of the denatured molecule were present in sera of most of the patients with SLE. There was also alteration in the pattern of antibody to nucleoside in some patients who were treated with steroids or immunosuppressive drugs.

Systemic lupus erythematosus in Indian children.

Twenty cases of systemic lupus erythematosus (SLE) in prepubertal children (less than 14 years of age) were seen over a period of 14 years. The male:female ratio was 1:2.3, and the mean age at onset was 9.37 years. Fever with joint involvement was the commonest presenting manifestation (60%), followed by nephrotic syndrome (25%). Notable clinical features included a high incidence of renal involvement (75%), significant hypertension (45%) and reversibility of acute renal failure (2 cases). The other organs and systems involved included: mucocutaneous manifestations (60%), cardiovascular system (30%), respiratory system (25%), neuropsychiatric manifestations (45%), and anemia (75%). Raynaud's phenomenon and thrombocytopenia were rare while leucopenia was not seen in a single patient. Immunological abnormalities noted were 100% positivity for antinuclear antibodies, and 87.5 and 75% positivity for antibodies to double-stranded and single-stranded DNA, respectively. Hypocomplementemia was seen in 75% of patients tested.

[Ionized calcium, total calcium and albumin corrected calcium in the serum in 1213 patients with suspected calcium metabolic diseases. A prospective multicenter study]. / Ioniseret calcium, totalcalcium og albumin-korrigeret calcium i serum hos 1.213 patienter mistaenkt for calciummetabolisk sygdom. En prospektiv multicenterundersøgelse.

The correlation between serum ionized calcium, serum total calcium and albumin corrected total calcium was investigated in a prospective multicentre investigation of 1,213 patients with suspected calcium metabolic disease. 31.0% of the patients were misclassified when serum total calcium was measured instead of serum ionized calcium. The diagnostic discrepancy between the two methods decreased with the calculation of albumin corrected total calcium or calculated ionized calcium (17.9%). On justing for the analytical error connected with the measurement of ionized calcium, 11.2% of the patients were still misclassified. It is not possible precisely to predict serum ionized calcium from the measurement of serum total calcium and we recommend measurement of serum ionized calcium in patients believed to have calcium metabolic disease.

Comparison of serum total calcium, albumin-corrected total calcium, and ionized calcium in 1213 patients with suspected calcium disorders.

The correlations between serum ionized calcium, serum total calcium, total calcium corrected for albumin and calculated ionized calcium were investigated in a prospective multicentre investigation of 1213 patients suspected of having calcium metabolic disease. Diagnostic discordance between serum total calcium and measured ionized calcium was found in 31% of the patients. With the calculation of albumin-corrected total calcium or calculated ionized calcium the discordance decreased to 17.9%. The diagnostic discordance which could be ascribed to the analytical imprecision (CV = 1.5%) amounted to only 6.7%. Although we found highly significant correlations between the parameters, a considerable scatter around the regression line made prediction of ionized calcium from albumin-corrected total calcium unreliable in many patients.