Genetics of phenological development and implications for seed yield in lentil.

Understanding phenology, its genetics and agronomic consequences, is critical for crop adaptation. Here we aim at (1) characterising lentil response to photoperiod with a focus on five loci: the lentil ELF3 ortholog Sn, two loci linked to clusters of lentil FT orthologs and two loci without candidates in chromosomes 2 and 5 (exp. 1: 36 lines, short and long day in phytotron); (2) establishing phenology-yield relationship (exp. 2: 25 lines, 11 field environments). A vintage perspective, where we quantify time trends in phenotype over three decades of breeding, links both experiments. Yield increased linearly from older to newer varieties at 29 kg ha-1 yr-1 or 1.5% yr-1, correlated negatively with flowering time in both winter- and summer-rainfall regimes, and decoupled from biomass in favourable environments. Time to flowering shortened from older to newer varieties at -0.56 % yr-1 in the field, and -0.42 % yr-1 (short day) and -0.99 % yr-1 (long day) in the phytotron. Early-flowering lines of diverse origin carried multiple early alleles for the five loci, indicating that at least some of these loci affect phenology additively. Current germplasm primarily features the early flowering haplotype for an FTb cluster region, hence the potential to increase phenological diversity with yield implications.

Hypoxia stimulates angiogenesis and a metabolic switch in human parathyroid adenoma cells.

Hypoxia, a primary stimulus for angiogenesis, is important for tumour proliferation and survival. The effects of hypoxia on parathyroid tumour cells, which may also be important for parathyroid autotransplantation in patients, are, however, unknown. We, therefore, assessed the effects of hypoxia on gene expression in parathyroid adenoma (PA) cells from patients with primary hyperparathyroidism. Cell suspensions from human PAs were cultured under normoxic or hypoxic conditions and then subjected to cDNA expression analysis. In total, 549 genes were significantly upregulated and 873 significantly downregulated. The most highly upregulated genes (carbonic anhydrase 9 (CA9), Solute carrier family 2A1 (SLC2A1) and hypoxia-inducible lipid droplet-associated protein (HIG2)) had known involvement in hypoxia responses. Dysregulation of oxidative phosphorylation and glycolysis pathway genes were also observed, consistent with data indicating that cells shift metabolic strategy of ATP production in hypoxic conditions and that tumour cells predominantly utilise anaerobic glycolysis for energy production. Proliferation- and angiogenesis-associated genes linked with growth factor signalling, such as mitogen-activated protein kinase kinase 1 (MAP2K1), Jun proto-oncogene (JUN) and ETS proto-oncogene 1 (ETS1), were increased, however, Ras association domain family member 1 (RASSF1), an inhibitor of proliferation was also upregulated, indicating these pathways are unlikely to be biased towards proliferation. Overall, there appeared to be a shift in growth factor signalling pathways from Jak-Stat and Ras signaling to extracellular signal-regulated kinases (ERKs) and hypoxia-inducible factor (HIF)-1α signalling. Thus, our data demonstrate that PAs, under hypoxic conditions, promote the expression of genes known to stimulate angiogenesis, as well as undergoing a metabolic switch.

Ultrasonographic evaluation of Achilles tendon: Is there any difference between ankylosing spondylitis, non-radiographic axial spondyloarthropathy and controls?

PURPOSE: The aim is to evaluate Achilles tendon enthesopathy with ultrasound (US) in ankylosing spondylitis (AS) and non-radiographic axial SpA (nr-axSpA) patients and controls, and compare these groups in terms of associations between disease activity parameters and ultrasonographic Achilles enthesitis signs. METHODS: A total of 24 AS and 20 nr-axSpA patients fulfilling the Assessment in Spondyloarthritis International Working Group criteria for axSpA and 30 controls were enrolled. Demographic characteristics, erythrocyte sedimentation rate, C-reactive protein (CRP), human leukocyte antigen (HLA)-B27, Bath AS Disease Activity Index, Bath AS Functional Index, Bath AS Metrology Index, Maastricht AS Enthesitis Score (MASES), AS Disease Activity Score-CRP, modified Stoke AS Spine Score (m-SASSS) scores and ultrasonographic findings were noted. RESULTS: HLA-B27 positivity, extra-articular and peripheral involvement, disease activity, functional status, mean m-SASSS, ultrasonographic gray scale (GS) and total scores were similar between AS and nr-axSpA groups. In GS, tendon echotexture scores were significantly different across all groups (0.812 ± 0.384 in AS, 0.575 ± 0.466 in nr-axSpA, 0.017 ± 0.091 in controls; P < .001). Entheseal calcification scores were similar in AS and nr-axSpA patients, and higher than controls (P = .001). Bone profile scores were similar in patients with AS and nr-axSpA, and higher than controls (P = .010). When the correlations between US findings and disease activity and functional status were considered, power Doppler US (PDUS) and MASES total scores were positively correlated in the AS group (P = .045; r = .41). CONCLUSION: AS and nr-axSpA patients were found to be similar in various clinical, functional, and US findings indicating that these 2 entities are different phenotypic reflections of the same disease spectrum. The positive correlation between PDUS and MASES scores in AS patients substantiate the performance of MASES in evaluation of entheseal activity.

Serum uric acid in new and recent onset primary hypertension.

INTRODUCTION: Hyperuricemia is common among adults with prehypertension, especially when the microalbuminuria is present. Hyperuricemia precedes the development of hypertension. AIM: (1) To find the association of hyperuricemia in new-onset hypertensive patients. (2) To find the association of hyperuricemia in hypertensive patients with regard to gender and risk factors such as smoking and central obesity. MATERIAL AND METHODS: A total of 50 adults aged between 20 and 50 years who had mild early hypertension were selected for the study. Fifty controls without hypertension were enrolled and investigated. RESULTS: The association between uric acid (UA) and hypertension was analyzed using Student's t-test and statistical difference were assessed using Pearson coefficient. The study showed a significant difference in UA between the hypertensive subjects and the normotensive controls. There was not a significant difference between waist abnormality, smoking and UA in cases. Males have a higher degree of hyperuricemia than females in hypertensive patients. CONCLUSION: Serum UA is strongly associated with blood pressure (BP) in new and recent onset primary hypertension. The remarkable association of UA with BP in adults is consistent with recent animal model data and the hypothesis that the UA might have a pathogenic role in the development of hypertension.

A meta-analysis of 21,178 patients undergoing open or endovascular repair of abdominal aortic aneurysm.

BACKGROUND: Several studies have compared outcomes after elective open and endovascular approaches to abdominal aortic aneurysm (AAA) surgery, with varying results. METHODS: A random-effects meta-analysis was undertaken to compare operative outcomes, postoperative complications, 30-day mortality and long-term patient survival after surgery. Endpoints were compared using odds ratios (ORs), weighted mean differences (WMDs) or log hazard ratios (HRs) as appropriate. RESULTS: Forty-two studies comprising 21,178 patients (10,855 open; 10,323 endovascular) were included. In the elective setting (20,715 patients), the endovascular method was associated with a shorter stay in intensive care (WMD--36 h; P < 0.001) and a shorter total postoperative stay (WMD--5.4 days; P < 0.001). Cardiac (OR 1.76; P = 0.002) and respiratory (OR 4.01; P < 0.001) complications were more common after open surgery. In the endovascular group, 30-day mortality was lower (OR 0.46; P < 0.001). Endovascular surgery was also associated with an improved long-term aneurysm-related mortality (HR 0.39; P < 0.001). For ruptured AAA (463 patients), the less invasive operation was associated with a reduced stay in intensive care (WMD--100.4 h; P = 0.005) and a significantly lower 30-day mortality (OR 0.45; P = 0.005). CONCLUSIONS: The endovascular repair of AAA offers a clear benefit in terms of reduction in postoperative adverse events and 30-day mortality. In the longer term, it is also associated with a reduction in aneurysm-related mortality, but not in all-cause mortality.

Endovascular and open approaches to non-thrombosed popliteal aneurysm repair: a meta-analysis.

OBJECTIVE: Endovascular repair of popliteal artery aneurysms is a relatively new technique that is still undergoing evaluation. The aim of this study was to compare outcomes following open and endovascular approaches. METHODS: All published studies comparing outcomes following open and endovascular popliteal aneurysm were included. Endpoints included operative duration, length of stay, and postoperative complications including short-term patency rates. Outcomes were combined using a random-effects meta-analytical technique and differences assessed using odds ratios (OR), weighted mean difference (WMD) and log hazards ratio (HR). RESULTS: Three studies comprising 141 patients (37 endovascular; 104 open) were included. No significant differences in patient characteristics were seen. Operative duration was significantly longer for endovascular repair (WMD 120 minutes, p<0.001). Thirty day graft thrombosis (OR 5.05, p=0.06) and reintervention (OR 18.80, p=0.03) were more likely following endovascular repairs. Postoperative length of stay was shorter in the endovascular group (WMD--3.9 days, p<0.001). There was no significant difference in long-term primary patency rates (HR 1.70, p=0.53). CONCLUSIONS: Endovascular repair of popliteal artery aneurysms offers similar medium-term benefits as an open repair. However, short-term graft thrombosis and reintervention rates are significantly greater. With the current technology it is difficult to justify endovascular treatment of popliteal aneurysms.

Arterial thrombosis associated with malignant disease.

OBJECTIVE: The association between cancer and venous thrombosis is well established, however, that between malignancy and arterial thrombosis is less well described. Isolated cases have been reported and chemotherapy has been implicated as a cause though its significance compared with the malignant disease process itself is not known. This study examines the outcome of patients with malignant disease who present with arterial thrombosis. METHOD: Details of patients with malignant disease who presented with arterial thrombosis were analysed. RESULTS: Twenty patients presented with malignancy and arterial thrombosis, 16 presented in the last four years. The most common malignancy was metastatic breast cancer. Thrombosis involved the leg in 19 cases and the arm in one. Four patients also had venous thromboembolic events and one had a carotid artery thrombosis. Eight patients underwent operative treatment for their thrombosis. Five out of six thromboembolectomies and two out of three bypass procedures failed. Twelve had conservative or palliative treatment. Outcome was generally poor, two patients had major amputations and seventeen died at median follow-up of eight weeks. Survival rate from the time of presentation of arterial thrombosis was 50% at three months and 17% at one year. CONCLUSION: Patients with critical limb ischaemia due to atherosclerotic disease have an expected survival of approximately 80% at one year. The outcome of patients with arterial thrombosis associated with malignant disease is far worse. Arterial thrombosis is an agonal event in many of these patients. Conservative or palliative treatment may be the most appropriate management.

The mechanisms of Ni2+ ions sorption by AlPO4.

Sorption of Ni2+ ions by AlPO4 is studied as a function of concentrations and temperature at pH 7. Potentiometric titration, dissolution and FTIR studies are employed to determine the mechanism of the process of the uptake of Ni2+ ions which is found to be both the ion exchange and the surface precipitation of the corresponding metal phosphates. Freundlich equation is found applicable to the sorption data, and is employed to evaluate the thermodynamic parameters deltaH(o) and deltatS(o).

Sorption mechanism of Co2+ ions by AlPO4.

Sorption studies were conducted for Co2+ ions on AlPO4 at different concentrations and temperatures. Sorption of Co2+ was found to increase with increase in concentration and temperature. To determine the mechanism of the sorption process, dissolution of AlPO4 in the presence of Co2+ ions and desorption studies were performed which indicated the mechanism of sorption to be the ion exchange followed by precipitation. FTIR studies were also employed to confirm the proposed mechanism.

Activation of cerebellar climbing fibres to rat cerebellar posterior lobe from motor cortical output pathways.

1. The activation of climbing fibres projecting to the posterior lobe cerebellar cortex by focal stimulation of the cerebral corticofugal pathway was investigated in anaesthetised rats. Large climbing fibre responses were evoked in parts of crus II and paramedian lobule by stimulation of corticofugal fibres. Lesions of the pyramidal tract just rostral to the inferior olive substantially reduced these responses, suggesting that they were not mediated by relays in the rostral brainstem. 2. By comparison of latencies of climbing fibre responses evoked from different locations in the corticofugal pathway, the conduction velocities of the corticofugal fibres that mediate the responses were estimated to be 1.9 +/- 0.3 m s(-1) (mean +/- S.E.M.). The fastest conducting corticofugal fibres were estimated to conduct significantly faster (18.7 +/- 2.3 m s(-1)). 3. Climbing fibre responses with similar form and cerebellar distribution were evoked from sites in the pyramidal tract rostral and caudal to the inferior olive. This suggests that at least a proportion of the fibres that activate climbing fibres are corticospinal fibres. 4. Lesions of the dorsal column nuclei did not affect the climbing fibre responses evoked in crus II, and produced a relatively small reduction of the responses in the paramedian lobule. This implies that the climbing fibre responses were not exclusively mediated via the dorsal column nuclei. 5. Corticofugal evoked climbing fibre responses were mapped across the cerebellar hemisphere. At some sites they were co-localised with responses evoked by limb afferents. On the basis of limb afferent inputs and other work, these zones were tentatively identified as being functionally equivalent to the c1, c2 and d zones described in the cat.

Continuing experience with chemonucleolysis.

Chemonucleolysis using chymopapain is the least invasive technique used to treat a herniated lumbar pulposus. After 37 years of clinical experience, multiple clinical trials, a national multicenter, double-blind study mandated by the Food and Drug Administration, and heated controversy in the scientific community, the injection of chymopapain to treat herniated discs has (in appropriately selected patients) proven as successful as laminectomy, with fewer complications and the advantage of considerable cost savings.

Abductor paralysis and external oblique transfer.

Eighteen patients with hip abductor paralysis owing to poliomyelitis underwent external oblique muscle transfer. Five male and 13 female patients with a mean age of 15 years 5 months (range, 10-23 years) with an average follow-up of 5 years (range, 2-11 years) were studied. An improvement in gait with decreased limp and swaying and increased ability to walk long distances was seen in 17 patients. Nine patients became free of their assistive ambulatory devices. Subjective improvement was observed in 16 patients (the improved appearance being the main element of satisfaction). According to a detailed scoring system, six excellent, six good, three fair, and three poor results were identified. There was very good correlation between the scoring system and the final outcome, making it a valuable predictive point system. The transfer was suitable for flail lower limb as well.

Ilizarov lengthening in centralized fibula.

Tibial hemimelia often produces major limb length problems (1,6,9,15) as well as foot deformity. The decision to perform reconstructive surgery depends on the expected leg-length discrepancy, the anomalies of the foot, and the status of the knee (4,6,8,15). Congenital bone deficiencies usually have a constant rate of growth inhibition (8), and leg lengthening is often associated with more complications (5,13). The complication rate is also increased with the increased leg-length discrepancy (5). In tibial hemimelia with functioning quadriceps (types I and II) and a functional foot, centralization of the fibula onto the talus and synostosis with the proximal tibia is an accepted reconstructive procedure (1,4,6,7,9,15). However, when the transplanted fibula produces a functional limb for the patient, the correction of leg-length inequality would be a challenge. This is a report of such a case.

Cross-reaction with luteinizing hormone beta-core is responsible for the age-dependent increase of immunoreactive beta-core fragment of human chorionic gonadotropin in women with nonmalignant conditions.

BACKGROUND: The beta-core fragment of human chorionic gonadotropin (hCGbetacf), also termed "beta-core" and urinary gonadotropin peptide (UGP), has been reported to be present in the urine of healthy women and to increase in concentration after menopause. This could reflect cross-reaction with the equivalent metabolite of luteinizing hormone (LH), the beta-LH-core. METHODS: We measured immunoreactive LH, hCG, free alpha-subunit, and free beta-subunit hCG (hCGbeta), as well as beta-core, using the S504 RIA and Triton UGP enzyme immunoassay in 274 urine samples from women with nonmalignant gynecological conditions. The molar cross-reaction of each assay with purified beta-LH-core was determined. RESULTS: Cross-reaction with beta-LH-core was 100% in the LH and the S504 beta-core assay, 5% in the Triton UGP assay, and <0.1% in the hCG, free alpha-subunit, and free hCGbeta assays. Median urine concentrations of all analytes showed an age-dependent increase. LH and free alpha-subunit concentrations were approximately 10(3) pmol/mol creatinine; hCG and S504 beta-core were approximately 10(2) pmol/mol creatinine; free hCGbeta and Triton UGP beta-core were in the tens of pmol/mol creatinine. The S504 beta-core concentrations were 10% of those of LH. S504 beta-core was strongly correlated with LH, but not with hCG or with free hCGbeta (LH, r2 = 0.45; hCG, r2 = 0.26; free hCGbeta, r2 = 0.03). The concentrations of beta-core detected by the Triton UGP assay, which has a 5% cross-reaction with beta-LH-core, were 2% of LH and 5% of the S504 beta-core concentrations. Triton UGP values correlated strongly with LH concentrations, but less well with S504 beta-core, intact hCG, and free hCGbeta (LH, r2 = 0.44; S504 beta-core, r2 = 0.33; hCG, r2 = 0.32; free hCGbeta, r2 = 0.19). CONCLUSIONS: Immunoreactive beta-core in women free of malignancies reflects cross-reaction with concentrations of the metabolite of LH, beta-LH-core, within the health-related reference interval.

Long-term follow-up review of patients who underwent laminectomy for lumbar stenosis: a prospective study.

OBJECT: Decompressive laminectomy for stenosis is the most common operation performed in the lumbar spine in older patients. This prospective study was designed to evaluate long-term results in patients with symptomatic lumbar stenosis. METHODS: Between January 1984 and January 1995, 170 patients underwent surgery for lumbar stenosis (86 patients), lumbar stenosis and herniated disc (61 patients), or lateral recess stenosis (23 patients). The male/female ratio for each group was 43:43, 39:22, and 14:9, respectively. The average age for all groups was 61.4 years. For patients with lumbar stenosis, the success rate was 88.1 % at 6 weeks and 86.7% at 6 months. For patients with lumbar stenosis and herniated disc, the success rate was 80% at 6 weeks and 77.6% at 6 months, with no statistically significant difference between the two groups. For patients with lateral recess stenosis, the success rate was 58.7% at 6 weeks and 63.6% at 6 months; however, the sample was not large enough to be statistically significant. One year after surgery a questionnaire was sent to all patients; 163 (95.9%) responded. The success rate in patients with stenosis had declined to 69.6%, which was significant (p = 0.012); the rate for patients with stenosis and herniated disc was 77.2%; and that for lateral recess stenosis was 65.2%. Another follow-up questionnaire was sent to patients 1 to 11 years after surgery (average 5.1 years); 146 patients (85.9%) responded, 10 (5.9%) were deceased, and 14 (8.2%) were lost to follow-up review. At 1 to 11 years the success rate was 70.8% for patients with stenosis, 66.6% for those with stenosis and herniated disc, and 63.6% for those with lateral recess stenosis. Eleven patients who underwent reoperation were included in the group of patients whose surgeries proved unsuccessful, regardless of their ultimate outcome. There was no statistically significant difference in outcome between 1 year and 1 to 11 years with respect to stenosis, stenosis with herniated disc, and lateral recess stenosis. CONCLUSIONS: In conclusion, long-term improvement after laminectomy was maintained in two-thirds of these patients.

Hamstring tendon transfer for quadriceps femoris paralysis.

Fifteen cases of paralysis of the quadriceps muscles secondary to poliomyelitis were managed by hamstring tendon transfers with an average follow-up of 48 months. Results of 13.5% excellent, 73% good, and 13.5% fair were obtained, according to an objective scoring system. Significant improvement in gait pattern, relief from brace use, or "hand-on-thigh" ambulation was seen in all cases. A mean extension lag of 30 degrees was observed in patients examined in the sitting position. Lack of active terminal knee flexion, prohibiting comfortable floor sitting, was the main untoward effect and the source of complaint in four patients.

Postchemonucleolysis discectomy versus repeat discectomy: a prospective 1- to 13-year comparison.

This long-term prospective study evaluates the clinical results of subsequent laminectomy in 103 consecutive patients who initially underwent chemonucleolysis (CNL) or laminectomy for lumbar disc herniation. Between 1981 and 1994, 53 patients who had received CNL initially and then underwent laminectomy and 50 patients treated initially with laminectomy underwent a repeat laminectomy. Clinical assessment at 6 weeks showed a success rate of 80.8% for post-CNL laminectomy and 78% for repeat laminectomy. At 6 months, the success rate for patients treated with CNL was 86% versus 78.7% for laminectomy. At 12 months, the overall success rate for the CNL group was 80.4% versus 83.3% for the laminectomy group, but in patients who had not obtained relief from the first procedure the success rate for the second procedure was higher for the post-CNL patients. A questionnaire was sent to all patients for 1- to 13-year follow-up review. The average follow-up period was 6.6 years for post-CNL laminectomy and 5.2 years for repeat laminectomy. The long-term success rate (81.8%) was higher in the post-CNL group compared to 64.4% in the repeat laminectomy group. Seven patients in the post-CNL group and nine in the repeat laminectomy group had undergone a third operation. When these originally successfully treated patients were reassigned after unsuccessful outcomes, the success rate for the CNL groups was 72.7%, versus 51.1% in the laminectomy group (p = 0.049). Employment rates were 80% for patients with CNL (21.8% changed jobs) and 76.3% for patients undergoing laminectomy (48.3% changed jobs) (p = 0.036). In conclusion, patients who underwent laminectomies after receiving CNL had significantly better long-term results than those who had repeat laminectomies.

Chemonucleolysis.

Even with a history of controversy and troubling complications, chymopapain has endured the test of time to show 30 years of clinical success in the treatment of herniated nucleus pulposus. Strict attention to indications, contraindications, and technique ensures safety and efficacy of treatment. A trend to decreased dosage may result in less postinjection spasm. Between 1982-1991, 121 adverse events in 135,000 patients were reported to the Food and Drug Administration and investigated. Seven cases of fatal anaphylaxis, 24 infections, 32 bleeding problems, 32 neurologic events, and 15 miscellaneous occurrences were found. Overall mortality rate was 0.019%. All categories were of lesser incidence than complications with laminectomy. Long-term results show that improvement after chemonucleolysis is maintained, whereas the outcome after laminectomy is reported to deteriorate with time. Cost savings with chemonucleolysis over laminectomy are largely a matter of shorter hospitalization. A protocol for cervical chemonucleolysis is being developed in the United States after good results have been shown in Spain and France. Other enzymes continue under investigation, but chymopapain remains the standard to which they are compared.