Imaging methods in polymyalgia rheumatica: a systematic review.

Polymyalgia rheumatica (PMR) is an inflammatory joint disease in patients over 50 years of age with pain and prolonged morning stiffness in the shoulder and hip girdles and neck. The lack of specific clinical findings, laboratory signs, biomarker and established imaging methods makes it difficult to diagnose patients with this disease. The aim of the systematic review is to present the literature data on the use of imaging methods for early diagnosis, assessment of disease activity and therapeutic response in PMR. At the same time, the advantages, disadvantages and contraindications of each method are considered. A literature search was carried out in PubMed and Scopus up to June 2022. Studies were selected that met the following criteria: (1) English language publications in peer-reviewed journals, (2) cohort or case-control studies and a series of more than five clinical cases, (3) studies of newly diagnosed or suspected PMR patients according to classification criteria or expert opinion, (4) imaging evaluation of articular, extraarticular and vascular impairment in PMR. Out of a total of 1431 publications, 61 articles were selected, which differed in the imaging techniques used: radiography (5), scintigraphy (4), magnetic resonance imaging (14), PET/CT (14) and ultrasound (24). Prevalence of extraarticular involvement (tendons, entheses and bursae) was identified in patients with PMR. In a significant number of cases, subclinical vasculitis of the large vessels was found, confirming the common pathogenetic pathways of the two diseases. The diagnostic, therapeutic and prognostic potential of imaging methods in PMR has been relatively poorly studied and remains to be clarified.

Adipogenic potential of stem cells derived from rabbit subcutaneous and visceral adipose tissue in vitro.

Rabbits are considered as appropriate animal models to study some obesity-associated abnormalities because of the similarity of their blood lipid profile and metabolism to humans. The current study was focused on comparison of adipose differentiation ability in rabbit adipose-derived stem cells (ADSC) in vitro. Subcutaneous and visceral stromal vascular fractions (SVF) were isolated from three 28-d-old New Zealand rabbits by collagenase digestion. Supernatants from both isolates were collected 24 h after the initial plating. On the fourth passage, all isolated cell types undergo triplicate adipogenic induction. The adipose induction potential was calculated as percentage of increasing optical density (OD) values. The data revealed that with increasing the number of induction cycles, the induction tendency in visceral ADSC decreased in contrast to the subcutaneous ones. Although the supernatants did not reach induction levels of their relevant precursors, they follow the same pattern in both subcutaneous and visceral ADSC. All cell types successfully passed osteogenic and chondrogenic differentiation. In conclusion, the best adipose induction ability was observed in directly plated subcutaneous cell population. The increase of induction numbers depressed adipose induction ability in cell populations derived from visceral fat depots.

Apoptosis in human ovarian tissue after conventional freezing or vitrification and xenotransplantation.

One of the new emerging techniques to preserve reproductive potential of cancer patients is cryopreservation of ovarian fragments prior to medical treatment and their retransplantation after healing. In order to investigate and compare apoptosis in human ovarian tissue after conventional ("slow") freezing and vitrification, we used a xenograft model in which conventionally frozen, vitrified and fresh non treated human ovarian tissue pieces were subcutaneously transplanted in SCID mice. The tissue samples were weekly, during four weeks, recovered from scarified SCID mice. The apoptosis was examined by immunohistochemical staining with the anti-caspase-3 antibody. There was a significant difference between the amount of apoptotic cells in cryopreserved ovarian tissue independent from mode of cooling compare to the control. The ovarian tissue after vitrification showed a significantly higher amount of apoptotic cells, than in slow frozen. The results obtained after comparative study of two different cryopreservation methods show that vitrification of human ovarian tissue could become a practice-relevant alternative to slow cryopreservation only after further improvement.

[A case of metachronous carcinoma of the colon diagnosed and radical operated with restorative anastomosis after more than 5 years from the first left hemicolectomy]. / Sluchai na metakhronen kartsinom na kolona, diagnostitsiran i radikalno operiran s restorativna anastomoza sled poveche ot 5 godoni ot prekhodnata liava khemikolektomiia.

The authors described their observation about the female patient with an advanced carcinoma (T4) of the descendent colon where left hemicolectomy was done in the beginning of 1998. The patient is operated again after more than 5 years because of the cancer in the site of the anastomosis. Radical reresection with restorative anasomosis is performed and for this reason the colon is putting via mesenteric radix. The case is analyzed and there are suggestion about is this a local recurrence or "de novo" carcinoma It is important to follow up the patients during lifetime for early uncovering of local recurrence. Endocoloscopy and scener are preferable for this aim.

[Revascularization syndrome after reconstruction of the leg artery in critical ischemia--clinic and treatment]. / Revaskularizatsionen sindrom sled rekonstruktsii na podbedrenite arterii na krainitsi v kritichna iskhemiia--klinika i lechenie.

Restoration of blood flow to severely ischemic limbs may produce compartment and revascularization syndrome. It may require fasciotomies to be performed to decompress leg compartments. In cases when the skin edges are not close to each other skin grafting is a method of choice to close the defect without functional muscular and nerve deficit.

[Factors influencing successful rate of intrauterine insemination]. / Faktori, vliiaeshti vurkhu rezultativnostta na programite za intrauterinna inseminatsiia.

Intrauterine insemination (IUI) is a method for the treatment of marital infertility involving the intrauterine or fallopian deposition of washed spermatozoa, depending on the amount of inseminated semen. Numerous factors may be affect of pregnancy rates after IUI.

Kinetics of solubilization of n-decane and benzene by micellar solutions of sodium dodecyl sulfate.

We observed the diminishing of single microscopic oil drops to study the kinetics of solubilization of n-decane and benzene by micellar solutions of sodium dodecyl sulfate (SDS). Each drop is located in a horizontal glass capillary of inner diameter 0.06 cm filled with a thermostated surfactant solution; the small vertical dimension of the cell prevents the appearance of uncontrollable thermal convections. The experiments show that the radius of an n-decane drop decreases linearly with time, whereas for benzene this dependence is nonlinear. To interpret the data, a kinetic model of solubilization is developed. It accounts for the diffusion and capturing of dissolved oil molecules by the surfactant micelles, as well as for the finite rate of oil dissolution at the oil-water interface. By processing the data, we determined the rate constant of solubilization for a given oil and surfactant. It turns out that the elementary act of catching a dissolved oil molecule by a surfactant micelle occurs under a barrier (rather than diffusion) control. The effective rate of solubilization is greater for the oil, which exhibits a higher equilibrium solubility in pure water (benzene), despite the lower value of the solubilization rate constant for this oil.

[Preimplantation genetic diagnosis: current status and perspective]. / Preimplantatsionna genetichna diagnostika: s'vremenno s'stoianie i perspektivi.

Scientific and clinical aspects of preimplantation genetic are represented.

Myosin VIIA is specifically associated with calmodulin and microtubule-associated protein-2B (MAP-2B).

Myosin VIIA is a motor molecule with a conserved head domain and tail region unique to myosin VIIA, which probably defines its unique function in vivo. In an attempt to further characterize myosin VIIA function we set out to identify molecule(s) that specifically associate with it. We demonstrate that 17 and 55 kDa proteins from mouse kidney and cochlea co-purify with myosin VIIA on affinity columns carrying immobilized anti-myosin VIIA antibody. N-terminal sequencing and immunoblotting analysis identified the 17 kDa protein as calmodulin, whereas MS and immunoblotting analysis identified the 55 kDa protein as microtubule-associated protein-2B (MAP-2B). Myosin VIIA can also be co-immunoprecipitated from kidney homogenate using anti-calmodulin or anti-MAP2 (recognizing isoforms 2A and 2B) antibodies, confirming the strong association between calmodulin and myosin VIIA and between MAP-2B and myosin VIIA. Myosin VIIA binds to calmodulin with an apparent K(d) of 10(-9) M. Scatchard analysis of the binding of myosin VIIA to MAP-2B provided evidence for two binding sites, with K(d) values of 10(-10) and 10(-9) M, which have been mapped to medial and C-terminal tail domains of myosin VIIA. The characterization of the interaction of calmodulin and MAP-2B with myosin VIIA provides new insights into the function of myosin VIIA.

[Effect of different co-culture systems on human sperm motility and longevity]. / Vliianie na razlichni sistemi za ko-kultivirane vurkhu motiliteta i prezhiviaemostta na choveshki spermatozoidi.

The experiments were conducted to evaluate the ability of different somatic-cell monolayers (human oviductal cells, granulose cells, MDBK-cells) for supporting motility and survival rates of human spermatozoa in-vitro. Results indicate that co-culture with epithelial cells enhanced human sperm longevity.

Effect of a fluorinated pyrimidine on cachexia and tumour growth in murine cachexia models: relationship with a proteolysis inducing factor.

The fluorinated pyrimidine nucleoside, 5'-deoxy-5-fluorouridine (5'-dFUrd) has been shown to effectively attenuate the progress of cachexia in the murine adenocarcinomas MAC16 and colon 26 as well as in the human uterine cervical carcinoma xenograft, Yumoto. Although concomitant inhibition of tumour growth was observed in all three models this was not sufficient to account for the preservation of body weight. An attempt has been made to correlate the anti-cachectic activity of 5'-dFUrd with the presence of a tumour produced proteolysis-inducing factor (PIF), thought to be responsible for the development of cachexia in the MAC16 model. Two variants of colon 26 adenocarcinoma were employed, clone 20 which produces profound cachexia, and clone 5 which produces no change in body weight in recipient animals. Mice bearing the colon 26, clone 20 variant showed evidence for the presence of PIF in tumour, serum and urine, while there was no evidence for the presence of PIF in tumour or body fluids of mice bearing the clone 5 tumours. Treatment of animals bearing the clone 20 variant with 5'-dF Urd led to the disappearance of PIF from the tumour, serum and urine concomitant with the attenuation of the development of cachexia. The human cervical carcinoma, Yumoto, which also induced cachexia in recipiant animals, showed expression of PIF in tumour, serum and urine in control and vehicle-treated mice, but was absent in mice treated with 5'-dFUrd. Thus in these experimental models cachexia appears to be correlated with the presence of PIF.

[Use of frozen human semen]. / Izpolzvane na zamrazena choveshka semenna technost.

The necessity of establishing of monitored donor's genetic bank in Bulgaria is of exceptional necessity at the moment, when health care in our country is in reorganization and is set on a new base. Our studies were directed towards the organization of bank for cryopreservation of spermatozoa taken of: Donor's genetic material for the needs of obstetric and gynaecological laboratories From men that are expected to go through an X-ray or chemical treatment because of tumors or are planned for operation of the testicules. The genetic bank in IBIR is organised accordance with Bulgarian Legislation.

Characteristics of patients with pancreatic cancer expressing a novel cancer cachectic factor.

BACKGROUND: Recently a novel tumour-derived cachectic factor was identified in the murine MAC16 colonic adenocarcinoma model of cachexia. This factor, provisionally named proteolysis-inducing factor (PIF), was subsequently identified in the urine of weight-losing patients with cancer but not in the urine of weight-stable patients with cancer or weight-losing controls with benign disease. This study determined the nutritional characteristics of patients with pancreatic cancer who excrete PIF in the urine and investigated the relationship between PIF and the acute-phase protein response. METHODS: PIF was isolated from urine by precipitation and ultrafiltration and was then identified by Western blotting of nitrocellulose membranes using a previously developed monoclonal antibody. Full nutritional assessment of patients was undertaken at the same time as urine collection. RESULTS: PIF was detected in the urine of 80 per cent of patients (n = 55). These patients had a significantly greater total weight loss and rate of weight loss than patients whose urine did not contain PIF (median 12.5 (range 4-43) kg versus 4.5 (0-14) kg; P < 0.0002). No association was evident between the presence of PIF in patients' urine and serum C-reactive protein (CRP) concentration. Furthermore, the accelerated weight loss associated with PIF expression also appeared to be independent of the acute-phase response. Overall the presence of PIF was not associated with reduced survival, although the previously reported association between raised CRP concentration and poor prognosis was confirmed. CONCLUSION: PIF is associated with an accelerated rate of weight loss in patients with a tumour of the pancreatic head. This observation appears to be independent of the effect of an increased hepatic acute-phase protein response.

Role of a proteolysis-inducing factor (PIF) in cachexia induced by a human melanoma (G361).

Human melanoma, G361, which induces cachexia in nude mice, has been shown to produce a proteolysis-inducing factor (PIF) of Mr 24000, which is immunologically identical to that isolated from a cachexia-inducing murine tumour (MAC16). Biosynthetic labelling of G361 cells using a combination of [35S]sulphate and [6-3H]glucosamine gave a single component of Mr 24000 after affinity chromatography employing a murine monoclonal antibody. The material contained both radiolabels and, after digestion with peptide N-glycosidase F, two fragments were produced of Mr 14000 and 10000 also containing both radiolabels. Digestion with O-glycosidase produced three fragments of Mr 14000, 6000 and 4000, the first two of which contained both radiolabels, while the third only contained 3H. This digestion pattern is the same as that previously observed with PIF from the MAC16 tumour and is commensurate with one N-linked sulphated oligosaccharide chain of Mr 10000, one O-linked sulphated oligosaccharide chain of Mr 6000 and a central polypeptide chain of Mr 4000 with some residual carbohydrate. When PIF from G361 cells was administered to female NMRI mice (20 g) a pronounced depression of body weight (1.36+/-0.36 g; P < 0.0001 from control) was observed over a 24 h period without a decrease in either food or water consumption. Body composition analysis showed a significant decrease in the non-fat carcass mass without a change in carcass fat or body water. This result suggests that depletion of lean body mass in mice bearing G361 melanoma arises from the production of PIF.

Purification and characterization of a tumor lipid-mobilizing factor.

Cancer patients with weight loss showed urinary excretion of a lipid-mobilizing factor (LMF), determined by the ability to stimulate lipolysis in isolated murine epididymal adipocytes. Such bioactivity was not detectable in the urine of cancer patients without weight loss or in normal subjects. The LMF was purified using a combination of ion exchange, exclusion, and hydrophobic interaction chromatographies to give a single component of apparent Mr 43,000, which showed homology in amino acid sequence with human plasma Zn-alpha2-glycoprotein. Both substances showed the same mobility on denaturing and nondenaturing gels and the same chymotrypsin digestion pattern, both stained heavily for carbohydrate, and they showed similar immunoreactivity. Polyclonal antisera to human plasma Zn-alpha2-glycoprotein was also capable of neutralization of the bioactivity of human LMF in vitro. Using competitive PCR to quantify expression of Zn-alpha2-glycoprotein, we found that only those tumors that were capable of producing a decrease in carcass lipid expressed mRNA for Zn-alpha2-glycoprotein. These results provide strong evidence to suggest that tumor production of Zn-alpha2-glycoprotein is responsible for the lipid catabolism seen in cancer patients.

Structural analysis of a tumor-produced sulfated glycoprotein capable of initiating muscle protein degradation.

A material of Mr 24,000 has been isolated from a cachexia-inducing mouse tumor (MAC16) and shown to initiate protein degradation in isolated gastrocnemius muscle. Biological activity was destroyed by preincubation with peptide N-glycosidase F (PNGase F) and endo-alpha-N-acetylgalactosaminidase (O-glycosidase) but not by neuraminidase or trypsin. Antibody reactivity was destroyed by treatment with periodate, indicating carbohydrate moieties to be the antigenic determinants. Antigenic activity was also reduced by treatment with PNGase F and O-glycosidase and was completely destroyed by treatment with chondroitinase ABC but was unaffected by treatment with either trypsin or chymotrypsin, confirming that the N- and O-linked sulfated oligosaccharide chains were both the antigenic and biological determinants. Biosynthetic labeling of MAC16 cells using a combination of [35S]sulfate and [6-3H]GlcN gave a single component of Mr 24,000 containing both radiolabels. Similar material could not be isolated from a cell line (MAC13) originating from a tumor that does not cause cachexia in vivo. Digestion of 3H/35S material with PNGase F produced two fragments of Mr 14,000 and 10,000 containing both radiolabels, and digestion with O-glycosidase produced three fragments of Mr 14,000, 6,000, and 4, 000, the first two contained both radiolabels and the third contained only 3H. Digestion of the fragment of Mr 14,000 released by PNGase F with O-glycosidase also gave fragments of Mr 6,000 and 4, 000. The products from both digestions were acidic as determined by anion exchange chromatography on DEAE-cellulose. The negative charge on the fragment of Mr 4,000 was removed by treatment with alkaline phosphatase. This suggests that the charge originated from phosphate residues, and this has been confirmed by biosynthetic labeling of MAC16 cells with [32P]orthophosphate, where radiolabel was incorporated into material of Mr 24,000 and into the fragment of Mr 4,000 after treatment with O-glycosidase. To determine the size of the polypeptide core MAC16 cells were biosynthetically labeled with L-[2,5-3H]His which after chemical deglycosylation produced a major component of Mr 4,000. These results suggest a model for the Mr 24, 000 material consisting of a central polypeptide chain of Mr 4,000 and with phosphate residues that may be attached to the polypeptide or a short oligosaccharide chain containing GlcN, one O-linked sulfated oligosaccharide chain containing GlcN, and of Mr 6,000 and one N-linked sulfated oligosaccharide chain of Mr 10,000 also containing GlcN. Neither chain was cleaved into disaccharides with chondroitinase ABC, suggesting that the material is a sulfated glycoprotein.

Induction of cachexia in mice by a product isolated from the urine of cachectic cancer patients.

Urine from cancer patients with weight loss showed the presence of an antigen of M(r) 24,000 detected with a monoclonal antibody formed by fusion of splenocytes from mice with cancer cachexia. The antigen was not present in the urine of normal subjects, patients with weight loss from conditions other than cancer or from cancer patients who were weight stable or with low weight loss (1 kg month(-1)). The antigen was present in the urine from subjects with carcinomas of the pancreas, breast, lung and ovary. The antigen was purified from urine using a combination of affinity chromatography with the mouse monoclonal antibody and reversed-phase high-performance liquid chromotography (HPLC). This procedure gave a 200,000-fold purification of the protein over that in the original urine extract and the material isolated was homogeneous, as determined by silver staining of gels. The N-terminal amino acid sequence showed no homology with any of the recognized cytokines. Administration of this material to mice caused a significant (P<0.005) reduction in body weight when compared with a control group receiving material purified in the same way from the urine of a normal subject. Weight loss occurred without a reduction in food and water intake and was prevented by prior administration of the mouse monoclonal antibody. Body composition analysis showed a decrease in both fat and non-fat carcass mass without a change in water content. The effects on body composition were reversed in mice treated with the monoclonal antibody. There was a decrease in protein synthesis and an increase in degradation in skeletal muscle. Protein degradation was associated with an increased prostaglandin E2 (PGE2) release. Both protein degradation and PGE2 release were significantly reduced in mice pretreated with the monoclonal antibody. These results show that the material of M(r) 24,000 present in the urine of cachectic cancer patients is capable of producing a syndrome of cachexia in mice.

Effect of pentoxifylline on motility and longevity of fresh and thawed dog spermatozoa.

The effect of pentoxifylline on fresh and frozen-thawed dog spermatozoa was evaluated. In Expt 1, 0.0036 mol l-1 or 0.0072 mol l-1 pentoxifylline was added to fresh dog spermatozoa. Semen was incubated at 25 degrees C or 39 degrees C. In Expt 2, pentoxifylline was added either before freezing or in the process of thawing at a final concentration of 0.0072 mol l-1. Addition of pentoxifylline significantly increased the percentage of progressively motile spermatozoa in fresh semen. The most beneficial effect of pentoxifylline on frozen-thawed semen was observed (P < 0.001) when it was added to semen in the process of thawing.

Suicide by self-inflicted burns.

Eighty-nine patients who had made an attempt on their life by self-burning were reviewed. For 12 years (1983-94) these patients were treated at the Institute of Emergency Medicine 'Pirogov', Sofia (Bulgaria). The gender distribution was almost equal (48 males: 41 females); the most vulnerable age was 20-40 years (57 patients) (64.05 per cent). Flame was the preferred thermal agent of attempted suicide (chosen by 72 patients), followed by electricity (11 patients). Thirty-one of the injured persons died (34.8 per cent). Forty-six of those who survived were operated on (116 surgical interventions: an average of 2.52 operations per patient) the mean length of treatment was 56.3 days. Eleven of the operated patients died subsequently (average stay in the hospital 8.20 days). There were some difficulties in collecting data about this method of self-harming. Twenty-three of the patients had recognized psychic disorders, in 43 of the patients the accident was preceeded by an agitated depression; in 15 by severe alcoholism. Emphasis is placed on the role of joint teams of physicians, psychologists and sociologists, for the treatment of these difficult patients.