Interception of Epoxide ring to quorum sensing system in Enterococcus faecalis and Staphylococcus aureus.

Quorum sensing inhibitor (QSI) has been attracting attention as anti-virulence agent which disarms pathogens of their virulence rather than killing them. QSI marking cyclic peptide-mediated QS in Gram-positive bacteria is an effective tool to overcome the crisis of antibiotic-dependent chemotherapy due to the emergence of drug resistance strain, e.g., methicillin resistant Staphylococcus aureus (MRSA) and Vancomycin resistant Enterococci (VRE). From a semi-large-scale screening thus far carried out, two Epoxide compounds, Ambuic acid and Synerazol, have been found to efficiently block agr and fsr QS systems, suggesting that the Epoxide group is involved in the mode of action of these QSIs. To address this notion, known natural Epoxide compounds, Cerulenin and Fosfomycin were examined for QSI activity for the agr and fsr systems in addition to in silico and SAR studies. As a result, most of investigated Epoxide containing antibiotics correlatively interfere with QSI activity for the agr and fsr systems under sublethal concentrations.

Characterizations of highly efficient moderately halophilic toluene degrading exiguobacterium mexicanum M7 strain isolated from Egyptian saline sediments.

Toluene and other monoaromatic compounds are released into the environment particularly saline habitats due to the inappropriate disposal methods of petroleum products. Studying the bio-removal strategy is required to clean up these hazardous hydrocarbons that threaten all ecosystem life using halophilic bacteria with higher biodegradation efficiency of monoaromatic compounds as a sole carbon and energy source. Therefore, sixteen pure halophilic bacterial isolates were obtained from saline soil of Wadi An Natrun, Egypt, which have the ability to degrade toluene and consume it as the only source of carbon and energy. Amongst these isolates, isolate M7 exhibited the best growth with considerable properties. This isolate was selected as the most potent strain and identified based on phenotypic and genotypic characterizations. The strain M7 was belonging to Exiguobacterium genus and founded to be closely matched to the Exiguobacterium mexicanum with a similarity of 99%. Using toluene as sole carbon source, strain M7 showed good growth at a wide range temperature degree (20-40ºC), pH (5-9), and salt concentrations (2.5-10%, w/v) with optimal growth conditions at 35ºC, pH 8, and 5%, respectively. The biodegradation ratio of toluene was estimated at above optimal conditions and analyzed using Purge-Trap GC-MS. The results showed that strain M7 has the potentiality to degraded 88.32% of toluene within greatly short time (48 h). The current study findings support the potential ability to use strain M7 as a biotechnological tool in many applications such as effluent treatment and toluene waste management.

Growth performance, nutrient digestibility, antioxidant state, ileal histomorphometry, and cecal ecology of broilers fed on fermented canola meal with and without exogenous enzymes.

This study was conducted to evaluate the effects of supplementation of exogenous enzymes in broiler diets that includes fermented canola meal on performance, nutrient digestibility, biochemical indication, antioxidative capacity, digestive enzyme activity, immune responses, and gut health. Five hundred 1-day-old Ross 308 broiler chicks were randomly allocated into five experimental groups (5 replicate/group), the first group: a control (CON) contained a basal diet, and the second to the fifth groups were fed diets as follows: containing 20% canola meal (CM), contains 20% fermented canola meal (FCM), contains 20% canola meal and exogenous enzymes at 0.02%/kg feed (ECM), and contains 20% fermented canola meal and exogenous enzymes at 0.02%/kg feed (EFC), respectively. At the finisher phase, the best body weight gain, feed conversion ratio, and nutrient utilization were associated with chickens fed EFC compared to other groups (P < 0.05). Total protein, albumin, alanine aminotransferase, and superoxide dismutase levels increased (P < 0.05), while cholesterol and malondialdehyde levels decreased in chickens fed on EFC. Likewise, there was a significant increase in the relative weight of the bursa of Fabricius and antibody titer against Newcastle disease, whereas the weight of abdominal fat decreased in the EFC group compared to other groups. Furthermore, there was a significant improvement in the activity of lipase and amylase enzymes (P < 0.05) in the EFC group. Fermented canola meal addition improved gut health (decreased Escherichia coli, increased Lactobacillus, and the highest values of villus height). Overall, these results confirmed that supplementing a fermented canola meal diet with exogenous enzymes improved growth performance through enhancing nutrient digestibility, immunity, antioxidant capacity, and gut health. Thus, adding enzymes to a diet containing fermented canola meal can be recommended as an alternative protein source that could be safely used to replace up to 20% soybean meal in broiler diets.

Dual Inoculation of Plant Growth-Promoting Bacillus endophyticus and Funneliformis mosseae Improves Plant Growth and Soil Properties in Ginger.

Co-inoculation with beneficial microbes has been suggested as a useful practice for the enhancement of plant growth, nutrient uptake, and soil nutrients. For the first time in Uzbekistan the role of plant-growth-promoting Bacillus endophyticus IGPEB 33 and arbuscular mycorrhizal fungi (AMF) on plant growth, the physiological properties of ginger (Zingiber officinale), and soil enzymatic activities was studied. Moreover, the coinoculation of B. endophyticus IGPEB 33 and AMF treatment significantly increased the plant height by 81%, leaf number by 70%, leaf length by 82%, and leaf width by 40% compared to the control. B. endophyticus IGPEB 33 individually increased plant height significantly by 51%, leaf number by 56%, leaf length by 67%, and leaf width by 27% as compared to the control treatment. Compared to the control, B. endophyticus IGPEB 33 and AMF individually significantly increased chlorophyll a by 81-58%, chlorophyll b by 68-37%, total chlorophyll by 74-53%, and carotenoid content by 67-55%. However, combination of B. endophyticus IGPEB 33 and AMF significantly increased chlorophyll a by 86%, chlorophyll b by 72%, total chlorophyll by 82%, and carotenoid content by 83% compared to the control. Additionally, plant-growth-promoting B. endophyticus IGPEB 33 and AMF inoculation improved soil nutrients and soil enzyme activities compared to the all treatments. Co-inoculation with plant-growth-promoting B. endophyticus and AMF could be an alternative for the production of ginger that is more beneficial to soil nutrient deficiencies. We suggest that a combination of plant-growth-promoting B. endophyticus and AMF inoculation could be a more sustainable and eco-friendly approach in a nutrient-deficient soil.

Fighting multidrug-resistant Enterococcus faecalis via interfering with virulence factors using green synthesized nanoparticles.

This study aims to synthesize silver nanoparticles by the green method and test it against specific virulence factors in multi-drug resistant Enterococcus faecalis bacteria. virulence factors of E. faecalis clinical isolates were determined and the most potent isolate was selected for further investigations. The prepared Ag-NPs were characterized using UV spectroscopy, FTIR spectroscopy, dynamic light scattering, and transmission electron microscopy (TEM). The result revealed the concentration of 0.0625 mg/ml Ag-NPs was significantly reducing virulence factors in multidrug-resistant E. faecalis without affecting planktonic cell growth. UV-Visible spectroscopy characterization revealed a characteristic surface Plasmon band [SPR] at a wavelength ranging from 256 to 345 and 510 nm in the prepared Ag-NPs. dynamic light scattering indicated it tended to an electrostatic attraction between nanoparticles in the prepared solution. TEM images revealed the average size of Ag-NPs were prepared to be 28.8 nm and the shape was spherical. Green synthesized Ag-NPs have the ability to combat multi-drug-resistant E. faecalis via reducing virulence factors, which is considered a good approach toward resolving the multidrug resistance crisis.

Secondary Metabolites of Actinomycetales as Potent Quorum Sensing Inhibitors Targeting Gram-Positive Pathogens: In Vitro and In Silico Study.

Anti-virulence agents are non-bacteriostatic and non-bactericidal emerging therapeutic options which hamper the production of virulence factors in pathogenic flora. In Staphylococcus aureus and Enterococcus faecalis, regulation of virulence genes' expression occurs through the cyclic peptide-mediated accessory gene regulator (agr) and its ortholog fsr quorum sensing systems, respectively. In the present study, we screened a set of 54 actinomycetales secondary metabolites as novel anti-virulence compounds targeting quorum sensing system of the Gram-positive bacteria. The results indicated that four compounds, Phenalinolactones A-D, BU-4664LMe, 4,5-dehydrogeldamycin, and Questinomycin A, potentially inhibit the agr quorum sensing system and hemolytic activity of S. aureus. On the other hand, Decatromicin A and B, Okilactomycin, Rishirilide A, Abyssomicin I, and Rebeccamycin selectively blocked the fsr quorum sensing system and the gelatinase production in E. faecalis at sub-lethal concentrations. Interestingly, Synerazol uniquely showed the capability to inhibit both fsr and agr quorum sensing systems. Further, in silico molecular docking studies were performed which provided closer insights into the mode of action of these compounds and proposed that the inhibitory activity of these compounds could be attributed to their potential ability to bind to the ATP-active site of S. aureus AgrA. Taken together, our study highlights the potential of actinomycetales secondary metabolites with diverse structures as anti-virulence quorum sensing inhibitors.

Evaluation of hepatoprotective effect of Nebivolol and sodium copper Chlorophyllin on CCL4-induced hepatotoxicity in mice.

OBJECTIVE: In this study, the protective effect of sodium copper chlorophyllin and nebivolol was evaluated in a mice model of CCL4 induced hepatotoxicity. Silymarin was used as a traditional hepatoprotective drug. MATERIALS AND METHODS: Thirty (30) mice were used as they were divided into five groups: the first group was the control group which received distilled water + olive oil, the second group which received 1.5 ml/kg of CCl4 diluted in olive oil three times a week, the third group which received CCl4 + Silymarin 50 mg/kg/day, the fourth group which received CCl4 + nebivolol 4 mg/kg/day, and the fifth group which received 1.5 ml/kg of CCl4+ Cu-chlorophyllin 50 mg/kg/day. The drugs were given by intraperitoneal route for 5 weeks. The detection, quantification of CCl4 induced hepatotoxicity and possible protective effect of either silymarin, nebivolol, or sodium copper chlorophyllin were assessed using biochemical analysis of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total protein, lipid profile, an assay of oxidants and antioxidants, assay of interleukin 6 (IL6) and tumor necrosis factor-alpha (TNF-α), and histopathological examination. RESULTS: The administration of carbon tetrachloride (CCl4) produced pronounced liver impairment. It significantly increased ALT, AST, ALP, malondialdehyde, and serum nitric oxide levels compared to normal control group besides a decrease in total protein, serum catalase, tissue SOD, and GSH levels. IL-6 and TNF-α levels were significantly higher while total cholesterol was significantly lower in mice receiving CCL4 compared to the normal control group. CCL4 induced severe hyperemia and congestion inside the portal area with leukocytic infiltration, hepatic degeneration, and bridge fibrosis. CONCLUSIONS: Co-administration of either silymarin, nebivolol, or sodium copper chlorophyllin with CCl4 was able to ameliorate up to almost contradict CCl4 induced hepatic injury through their anti-inflammatory and antioxidant activities.

Author Correction: Assessment of the cardioprotective effect of liraglutide on methotrexate induced cardiac dysfunction through suppression of inflammation and enhancement of angiogenesis in rats.

Correction to: European Review for Medical and Pharmacological Sciences 2021; 25 (19): 6013-6024-DOI: 10.26355/eurrev_202110_26879-PMID: 34661261, published online on 15 October 2021. After publication, the authors applied to add some corrections to the paper. They wanted to change the second affiliation of one co-author Dr. Eman Said. The second affiliation will be "Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia", instead of "College of Pharmacy, Qassim University, Al-Qassim, Saudi Arabia". There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause.  https://www.europeanreview.org/article/26879.

Correlation between phenotypic virulence traits and antibiotic resistance in Pseudomonas aeruginosa clinical isolates.

Pseudomonas aeruginosa is a ubiquitous pathogen capable of infecting virtually all tissues and its one of the standout amongst the most hazardous microorganisms of high morbidity and mortality rates especially in debilitated patients with few successful antibiotic choices available. This pathogen regulating most virulence traits by that so-called quorum sensing (QS), a cell to cell communication system. the present study was intended to phenotypically evaluate the activity of specific virulence traits (including swarming and swimming motility, protease, pyocyanin, and biofilm production) in Pseudomonas aeruginosa clinical isolates and assess the statistical correlation between these traits and antibiotic resistance. One hundred and thirteen bacterial isolates were obtained from different clinical samples and identified as P. aeruginosa, among them, 73.4% have the ability to forming biofilm with different degrees; 59.2% were able to produce pyocyanin pigment while all isolates having the ability to make swarming and swimming motility and able to produce protease enzyme with different degrees. The isolates that produce the higher levels of the virulence traits were identified by both biochemical using Vitek2 automated system and genetically via 16s rRNA gene analysis. The statistical analysis results indicate that a positive significant correlation was found between biofilm formation and other studied virulence traits except for protease (r = 0.584: 0.324, P < 0.05) while a non-significant correlation was found between biofilm formation and protease activity (r = 0.105, P ˃ 0.05). Swimming and swarming motility have a positive significant correlation with other studied virulence traits (r = 0.613: 0.297, P < 0.05) except for protease. Pyocyanin pigment production have a positive significant correlation with other studied virulence traits (r = 0.33: 0.297, P < 0.05) except for protease. on the other hand, negative significant correlations were found between biofilm formation, swimming; and swarming motility, Pyocyanin pigment production, and the susceptibility of antibiotics (r = -0.512: -0.281, P < 0.05). Detection of such correlations in P. aeruginosa is useful for study the behavior of this pathogen and may be provide a new target for the treatment of MDR infections.

Statistical optimization of chromium (VI) reduction using response surface methodology (RSM) by newly isolated Stenotrophomonas sp. (a novel strain).

Isolation of Microorganisms capable of reducing toxic chromium (VI) into less toxic one (Cr (III)) has been given attention due to their significance in bioremediation of the contaminated sites. In the present study, Stenotrophomonas sp. Crt94-4A an isolated strain from tannery wastewater and identified genetically by 16s rRNA gene sequencing was able to grow at concentrations up to 354 mg/L of Cr (VI). The results revealed 1% (w/v) NaCl, 2% (v/v) (2 × 106 CFU) inoculum size, and PH 7 in culture containing glucose and peptone as carbon and nitrogen sources respectively were the best conditions for Cr (VI) reduction. Statistical optimization was performed using Plackett-Burman design where peptone, inoculum size, and NaCl had significant effects on Cr (VI) reduction which were tested by three factors Box-Behnken design (BBD) to determine their correlation. The reduction capacity of Cr (VI) by Stenotrophomonas Sp. Crt94-4A was increased from 82, 55, and 23 to 96, 76, and 45% at 88.5, 177 and 354 mg/L of Cr (VI) respectively, which make this strain a good candidate for bioremediation of Cr (VI).

Prediction of soft tissue coverage following distal femur bone sarcoma resection: A preliminary report.

We aimed to examine the predictability of the need for soft tissue reconstruction during limb-sparing surgery through preoperative magnetic resonance (MR) imaging in patients diagnosed with a malignant bone tumor in the distal femur. The study included 42 patients who were operated for a bone sarcoma of the distal femur at our clinic between 2016 and 2018. The recorded parameters included the demographic characteristics of the patients, tumor diagnosis, tumor side, total tumor volume, tumor soft tissue component volume, tumor soft tissue component volume-to-total tumor volume ratio, tumor localization by MR imaging, the need for soft tissue reconstruction, the muscles used for soft tissue reconstruction, the biopsy site, and the biopsy type. Tumor volume was calculated on MR imaging of the distal femur region performed before surgery. Our study established cut-off values for soft tissue reconstruction need following resection as a total tumor volume of 96.4 cm3 , a tumor soft tissue component volume of 22 cm3 , a tumor soft tissue component volume-to-total tumor volume ratio of 48.9%, and tumor localization in two different regions on axial distal femoral MR images. Considering these cut-off values, by calculating tumor volume values preoperatively we can predict the need for rotational muscle flaps for soft tissue coverage following distal femur bone sarcoma resection and endoprosthesis reconstruction. Anticipating the need for soft tissue reconstruction may affect the duration and success of the operation.

Genetic and Histopathological Alterations in Caco-2 and HuH-7 Cells Treated with Secondary Metabolites of Marine fungi.

The present work aimed to study the activity of naturally derived fungal secondary metabolites as anticancer agents concerning their cytotoxicity, apoptotic, genetic, and histopathological profile. It was noticed that Aspergillus terreus, Aspergillus flavus, and Aspergillus fumigatus induced variable toxic potential that was cell type, secondary metabolite type, and concentration dependent. Human colonic adenocarcinoma cells (Caco-2) showed less sensitivity than hepatocyte-derived cellular carcinoma cells (HuH-7), and in turn, the half-maximal inhibitory concentration (IC50) was variable. Also, the apoptotic potential of Aspergillus species-derived fungal secondary metabolites was proven via detection of up-regulated pro-apoptotic genes and down-regulation of anti-apoptotic genes. The expression level was cell type dependent. Concurrently, apoptotic profile was accompanied with cellular DNA accumulation at the G2/M phase, as well as an elevation in Pre-G1 phase but not during G0/G1 and S phases. Also, there were characteristic apoptotic features of treated cells presented as abnormal intra-nuclear eosinophilic structures, dead cells with mixed euchromatin and heterochromatin, ruptured cell membranes, apoptotic cells with irregular cellular and nuclear membranes, as well as peripheral chromatin condensation. It can be concluded that Aspergillus secondary metabolites are promising agents that can be used as supplementary agents to the currently applied anti-cancer drug regimen.

Assessment of the cardioprotective effect of liraglutide on methotrexate induced cardiac dysfunction through suppression of inflammation and enhancement of angiogenesis in rats.

OBJECTIVE: Methotrexate (MTX) is one of the most commonly used anti-cancer drugs for various types of neoplasms. It is associated with multiple cytotoxic effects including nephrotoxicity, hepatotoxicity and cardiotoxicity. Liraglutide (LIR) is a potent anti-diabetic drug and also has antioxidant and anti-inflammatory properties. In this study, we tried to investigate the protective effect of LIR on MTX induced cardiotoxicity and to identify the molecular mechanisms for this protection. MATERIALS AND METHODS:  Rats were divided into 4 groups, including control group, LIR group, MTX group and LIR + MTX group. ECG was measured then blood samples were taken, and hearts were excised for biochemical and histological investigations. RESULTS: MTX group exhibited a mild non-significant irregular bradycardia, an increase of CK-MB besides a decrease of total antioxidant capacity. MTX administration also resulted in downregulation of vascular endothelial growth factor (VEGF), while caused upregulation of interleukin 1 beta (IL-1B) and interleukin 6 (IL-6) in comparison to the control group. Also, MTX group showed histological abnormalities besides negative VEGF and positive iNOS as detected by immunohistochemical staining compared to the control group. LIR administration could reverse these results. CONCLUSIONS: LIR prevented MTX induced cardiotoxicity through its antioxidant and anti-inflammatory properties.

Hydrazonoyl bromide precursors as DHFR inhibitors for the synthesis of bis-thiazolyl pyrazole derivatives; antimicrobial activities, antibiofilm, and drug combination studies against MRSA.

Microbial resistance is a big concern worldwide, making the development of new antimicrobial drugs difficult. The thiazole and pyrazole rings are important heterocyclic compounds utilized to produce a variety of antimicrobial medications. As a result, a series of new bis-thiazolyl-pyrazole derivatives 3, 4a-c, 5a, b, and 6a-c was synthesized by reacting bis hydrazonoyl bromide with several active methylene reagents in a one-pot reaction. The assigned structure was characterized entirely based on elemental and spectral analyses. The antimicrobial activity represented by MIC was performed using a resazurin-based turbidimetric (TB) assay. The results exhibited good antimicrobial activity against gram-positive strains, especially S. aureus (ATCC6538) while showing poor to moderate activity against gram-negative and fungal strains. Furthermore, the most active derivatives 3, 4a, 4c, and 5b were evaluated for MIC, MBC, antibiofilm, hemolytic assay, and drug combination testing against two S. aureus (ATCC6538) and MRSA (ACL18) strains. Additionally, bis-thiazolyl pyrazole 3, 4c, and 5b exhibited more potent inhibitory activity for DHFR with IC50 values (6.34 ± 0.26, 7.49 ± 0.28, and 3.81 ± 0.16 µM), respectively, compared with Trimethoprim (8.34 ± 0.11 µM). The bis-1-(substituted-thiazol-2-yl)-1H-pyrazole-4-carbonitrile derivative 5b was the most active member with MIC values ranging from (0.12-0.25 µM) compared to Vancomycin (1-2 µM), and MBC values ranging from (0.5-1 µM) for S. aureus (ATCC6538) and MRSA (ACL18). Surprisingly, compound 5b displayed bactericidal behavior, synergistic effect with three commercial antibiotics, and inhibited DHFR with 2.1 folds higher than Trimethoprim. Finally, good findings were obtained from in silico investigations incorporating toxicity prediction and molecular docking simulation.

Optical wireless communication performance enhancement using Hamming coding and an efficient adaptive equalizer with a deep-learning-based quality assessment.

Optical wireless communication (OWC) technology is one of several alternative technologies for addressing the radio frequency limitations for applications in both indoor and outdoor architectures. Indoor optical wireless systems suffer from noise and intersymbol interference (ISI). These degradations are produced by the wireless channel multipath effect, which causes data rate limitation and hence overall system performance degradation. On the other hand, outdoor OWC suffers from several physical impairments that affect transmission quality. Channel coding can play a vital role in the performance enhancement of OWC systems to ensure that data transmission is robust against channel impairments. In this paper, an efficient framework for OWC in developing African countries is introduced. It is suitable for OWC in both indoor and outdoor environments. The outdoor scenario will be suitable to wild areas in Africa. A detailed study of the system stages is presented to guarantee the suitable modulation, coding, equalization, and quality assessment scenarios for the OWC process, especially for tasks such as image and video communication. Hamming and low-density parity check coding techniques are utilized with an asymmetrically clipped DC-offset optical orthogonal frequency-division multiplexing (ADO-OFDM) scenario. The performance versus the complexity of both utilized techniques for channel coding is studied, and both coding techniques are compared at different coding rates. Another task studied in this paper is how to perform efficient adaptive channel estimation and hence equalization on the OWC systems to combat the effect of ISI. The proposed schemes for this task are based on the adaptive recursive least-squares (RLS) and the adaptive least mean squares (LMS) algorithms with activity detection guidance and tap decoupling techniques at the receiver side. These adaptive channel estimators are compared with the adaptive estimators based on the standard LMS and RLS algorithms. Moreover, this paper presents a new scenario for quality assessment of optical communication systems based on the regular transmission of images over the system and quality evaluation of these images at the receiver based on a trained convolutional neural network. The proposed OWC framework is very useful for developing countries in Africa due to its simplicity of implementation with high performance.

MIMO Self-Heterodyne OFDM Using Band Selection Technique.

The 5G technology is a promising technology to cope with the increasing demand for higher data rate and quality of service. In this paper, two proposed techniques are implemented for multiple input multiple output (MIMO) self-heterodyne OFDM system to enhance data rate and minimize the bit error rate (BER). In both of the two proposed techniques, Band Selection (BS) approach is used, once with Space Time Block Coded (STBC) for the first proposed technique (BS- STBC), and once again with Frequency Space Time Block Coded (FSTBC) for the second proposed technique (BS-FSTBC). The use of the BS in the proposed techniques helps to choose the sub-band with better subchannels gains for sending the information and consequently, minimize the BER. Moreover, the use of the FSTBC instead of STBC helps to use the spectral efficiently and hence increase data rate. The simulation results show that the proposed techniques BS-STBC and BS-FSTBC, for the MIMO self-heterodyne OFDM system, provide a great enhancement in the BER performance when compared to the conventional techniques. Moreover, the simulation results show that the first proposed technique BS-FSTBC outperform the second propose technique BS-STBC in term of the BER performance.

Role of the cutaneous extraneuronal cholinergic system in the pathogenesis of psoriasis: a case-control study.

BACKGROUND: Although during recent years there have been considerable advances in elucidating the mechanisms of psoriasis pathogenesis, its full understanding is still distant. A cholinergic dysfunction has been proposed in the pathophysiology of some inflammatory and autoimmune diseases, including psoriasis. AIM: To determine tissue levels of acetylcholine (ACh) and its muscarinic and nicotinic receptors (mAChR and nAChR) in psoriasis vulgaris lesions in comparison with normal control skin. METHODS: This case-control study included 30 patients with psoriasis vulgaris and 30 controls. A 4-mm punch skin biopsy was taken from the psoriatic plaques of patients and normal skin of controls. ACh level was measured in tissues using the colorimetric method, while mAChR and nAChR gene expression was determined by real-time PCR. RESULTS: The level of ACh was significantly higher in patients (mean ± SD: 5.95 ± 2.69) than in controls (1.12 ± 0.34) (P < 0.001). mAChR and nAChR expressions were significantly higher in patients compared with the controls (P < 0.001). A significant positive correlation was detected between the expression of nAChR in patients and the duration of psoriasis (r = 0.46, P = 0.01), and the body mass index of the patients correlated positively with both nAChR (r = 0.40, P = 0.027) and mAChR expression (r = 0.448, P = 0.013). CONCLUSION: Abnormalities in the cutaneous extraneuronal cholinergic system could be involved in the pathogenesis of psoriasis. The high expression of nAChRs in patients with longer disease durations might represent an attempt by the body to regulate the inflammatory cascade in psoriatic lesions. The high expression of mAChR in psoriatic lesions may provide a link between psoriasis and obesity.

Retinal vascular function in asymptomatic individuals with a positive family history of cardiovascular disease.

PURPOSE: To compare retinal microvascular function in healthy individuals with and without a positive family history (FH) of cardiovascular disease (CVD). METHODS: Retinal vessel reactivity was assessed by means of dynamic retinal vessel analysis in 38 healthy subjects aged between 30 and 66 years with a positive FH of CVD and 37 age- and gender-matched control subjects. Other assessments included blood pressure (BP) profiles, blood glucose and lipid metabolism markers, Framingham risk scores (FRS), carotid intima-media thickness (c-IMT) and brachial flow-mediated dilation (FMD). RESULTS: Family history-positive subjects showed decreased retinal arterial baseline diameter fluctuation, dilation amplitude, percent dilation, and overall constriction response slope (p = 0.001; p = 0.015; p = 0.001; and p < 0.001, respectively) and increased percent constriction (p = 0.008). On the venous side, baseline-corrected flicker response and dilation response slope were decreased in the FH-positive group (p = 0.009 and p = 0.010, respectively). There were no significant differences between groups in c-IMT scores or FMD parameters (all p > 0.05). The arterial MC% correlated negatively with decreased high-density lipoprotein cholesterol (r = -0.52, p = 0.002) in only FH-positive group. CONCLUSION: Although macrovascular function is preserved in individuals with FH positive for CVD but with low FRS, there are, however, functional impairments at the retinal microvascular level that correlate with established plasma markers for cardiovascular risk.

Mid-term and Long-term Functional and Radiographic Results of 13 Surgically Treated Adolescent Capitellum Fractures.

BACKGROUND: Capitellum fractures are rare in adolescents, and information in literature is still limited. The purpose of this study was to report the mid-term and long-term functional and radiographic results of 13 surgically treated adolescent capitellum fractures in a level I trauma center. METHODS: This retrospective study included patients aged 10 to 16 years, who underwent surgery for a capitellum fracture and were followed up for at least 12 months. Fractures were classified according to the McKee modification of the Bryan and Morrey classification, and elbow arthritis was classified using the Broberg and Morrey system. Functional outcomes were assessed with the Mayo Elbow Performance Index (MEPI) and the Turkish-language version of the shortened version of the Disabilities of Arm, Shoulder, and Hand (QuickDASH) scale. RESULTS: The mean time to surgical intervention was 4.5 days (range, 1 to 18 d). The mean flexion-extension range of motion arc was measured as 115 (range, 45 to 150) degrees. The mean restriction for extension and flexion compared with the uninjured side was measured as 10.7 (range, 0 to 45) and 11.5 (range, 0 to 45) degrees, respectively. The mean MEPI was 87.7 points (range, 50 to 100 points) with 9 patients as excellent, 1 good, 1 fair, and 2 poor results. The mean QuickDASH score was 11 (range, 0 to 57). The mean MEPI score was 95.6 and 75 and the mean QuickDASH score was 2.62 and 25.0 for early surgery group (≤3 d) and late surgery group (>3 d), respectively (P=0.073, 0.024). Elbow joint contracture developed in 4 patients. Implant removal and open release of joint contracture was applied to 2 patients. Elbow arthritis of grade 3 was observed in 2 patients and grade 2 in 1 patient. CONCLUSIONS: Capitellum fractures may be easily missed on conventional radiographs, if not suspected. Delayed diagnosis may lead to a worsening of the functional outcomes. Computerized tomography is helpful in the determination of these fractures. Early diagnosis and a well-performed surgery is essential for successful outcome. LEVEL OF EVIDENCE: Level IV-case series.

DiGeorge phenotype in the absence of 22q11 deletion - a case report.

DiGeorge syndrome is polytopic developmental field defect which is usually associated with 22q11.2 microdeletion. However, this phenotype may be caused by other conditions. We report such a case and briefly review these alternative causes for this particular phenotype.