Interleukin-6 Receptor (IL-6R) Expression in Human Gastric Carcinoma and its Clinical Significance.

The aim of the study is to analyse the expression of Interleukin-6 receptor in different human gastric tissue and to correlate with the clinicopathological features of the patients. Immunohistochemistry was done against the IL-6R antibody and the Q-score was calculated from the staining pattern. Higher Q-scores were observed in tumour cells than the adjacent normal cells which were statistically significant. We also observed a significant correlation between the expressions of IL-6R and the clinicopathological features These findings suggest that IL-6R may represent as a therapeutic target for gastric carcinoma and serve as a prognostic indicator, as well.

Effect of Enamel Deproteinization in Primary Teeth.

OBJECTIVE: To evaluate and compare the topographical features of enamel surface, etched with different materials. STUDY DESIGN: 10 extracted human primary molars were randomly selected and cut and trimmed to 1 mm2. Each group comprised of 10 blocks and the enamel was treated as follows: Group I-35% H3PO4; Group II-5.25% NaOCl + 35% H3PO4 ;Group III-5.25% NaOCl; Group IV no treatment was carried out. All the samples were prepared for Scanning electron microscope analysis. The images were obtained and evaluated for the quality type I-II etching of the enamel surface using Auto-CAD 2011 software. STATISTICAL ANALYSIS USED: Wilcoxon Signed Ranks Test (p<0.001). RESULTS: The mean surface area of type I and II etching pattern values for Group- I was 39608.18 µm2 and Group- II was 45051.34 µm2. CONCLUSION: Deproteinization with 5.25% Sodium hypochlorite prior to acid etching could be used to increase the surface area of adhesion of composite material with the tooth surface.

Multimodal intraoperative neuromonitoring in scoliosis surgery: A two-year prospective analysis in a single centre.

AIM: The present study is a prospective analysis of neuromonitoring [somatosensory evoked potentials (SSEP) and transcranial motor evoked potentials (TcMEP)] in consecutive scoliosis surgeries done at a tertiary care spine centre. MATERIALS AND METHODS: Prospective analysis was performed on 52 consecutive patients undergoing scoliosis correction from 2013 to 2015. SSEPs were obtained by stimulating the median and tibial nerves with stimulus intensity level 20-25 mA. TcMEPs were recorded bilaterally from abductor pollicis brevis, biceps, and deltoid for the upper limb, and from tibialis anterior, quadriceps, gastrocnemius, and abductor hallucis for the lower limb. Stimulation was given in the form of a high voltage (300-400 V) stimulus. An "alert" was defined as reduction in the amplitude of at least 50% for SSEP and at least 65% for TcMEP compared to the baseline recordings and an increase in the latency by more than 10%. RESULTS: The mean age of the patients was 14.6 years (7-33 years). Thirty-nine of the patients were females and 13 were males. Baseline values in neuromuscular scoliosis were low compared to adolescent idiopathic scoliosis (AIS). There were no false negative incidents. False positive cases were due to low blood pressure and malfunctioning of the leads. CONCLUSION: Use of upper limb leads could help in identifying malposition or malfunctioning of leads to eliminate false positive results. Combined multimodal intraoperative monitoring helps in increasing the safety in scoliosis corrective surgeries with a high sensitivity and specificity. Baseline values in neuromuscular scoliosis patients are possibly lower than idiopathic scoliosis patients. Intraoperative variations must be interpreted with caution.

Phase II study of interim PET-CT-guided response-adapted therapy in advanced Hodgkin's lymphoma.

BACKGROUND: Combination chemotherapy ABVD (doxorubicin, bleomycin, vinblastine and dacarabazine) cures ∼70% of patients with advanced Hodgkin's lymphoma (aHL, stages IIB, III and IV) while more toxic escalated BEACOPP (EB, combination of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisolone) increases cure rates to 85%. Patients with a positive interim positron emission tomography-computerized tomography (PET-CT) scan after two cycles (PET-2) of ABVD have very poor outcomes with continued ABVD. Intensifying therapy with EB in PET-2-positive patients ('response-adapted therapy') may improve cure rates, whereas the negative patients can continue ABVD alone. PATIENTS AND METHODS: Eligible patients with newly diagnosed aHL received two cycles of ABVD and underwent PET-2 (scored with semi-quantitative 5-point visual criteria, 'Deauville score'). PET-2-negative patients continued four additional cycles of ABVD, whereas PET-2-positive patients received four cycles of EB. A phase II sample size of 50 was estimated keeping the lower and higher proportion of rejection of the event-free survival (EFS) as 70% and 85%, respectively. RESULTS: Fifty patients [median age 28 (12-60) years; male : female: 39 : 11; stages: IIB-3 (6%), III-29 (58%) and IV-18 (36%); International Prognostic Score (IPS): 0-3: 34 (68%); 4-7: 16 (32%)] were enrolled; 49 underwent PET-2. Eight (16%) were PET-2-positive, whereas 41 (84%) were negative. Forty-seven were evaluable for EFS and all 50 for overall survival (OS). The 2-year EFS was 76% (95% CI: 68-83) and OS was 88% (95% CI: 82-94). PET-2 was strongly prognostic-2-year EFS, negative versus positive: 82% versus 50%; P = 0.013. CONCLUSION: PET-2 response-adapted strategy could not achieve EFS of 85% in aHL. However, escalated therapy improved outcomes in PET-2-positive patients compared with historical data. TRIAL REGISTRATION: CTRI/2012/06/002741 (http://www.ctri.nic.in) and NCT01304849 (http://www.clinicaltrials.gov).

Crystal structure of [4-(2-meth-oxy-phen-yl)-3-methyl-1-phenyl-6-tri-fluoro-methyl-1H-pyrazolo-[3,4-b]pyridin-5-yl](thio-phen-2-yl)methanone.

The title compound, C26H18F3N3O2S, a 2-meth-oxy-substituted derivative, is closely related to its 4-methyl- and 4-chloro-substituted analogues and yet displays no structural relationships with them. The thio-phene ring is disorder free and the -CF3 group exhibits disorder, respectively, in contrast and similar to that observed in the 4-methyl- and 4-chloro-substituted derivatives. The torsion angle which defines the twist of the thio-phene ring is -69.6 (2)° (gauche) in the title compound, whereas it is anti-clinal in the 4-methyl- and 4-chloro-substituted derivatives, with respective values of 99.9 (2) and 99.3 (2)°. The absence of disorder in the thio-phene ring facilitates one of its ring C atoms to participate in the lone inter-molecular C-H⋯O hydrogen bond present in the crystal, leading to a characteristic C(5) chain graph-set motif linking mol-ecules related through glides along [010]. An intra-moleculr C-H⋯N hydrogen bond also occurs.

Crystal structure of 4-sulfamoylanilinium di-hydrogen phosphate.

In the crystal structure of the title mol-ecular salt, C6H9N2O2S(+)·H2PO4 (-), the sulfomylalinium cations and the di-hydrogen phosphate anions form independent [100] chains through Ns-H⋯O (s = sulfamo-yl) and O-H⋯O hydrogen bonds, respectively. The chains are cross-linked by Na-H⋯O (a = amine) hydrogen bonds, generating (010) sheets. Two C-H⋯O hydrogen bonds involving diametrically opposite C atoms in the benzene ring of the cation as donors form chains parallel to [202] in which P=O and P-OH groups are acceptors. Together, these inter-actions lead to a three-dimensional network.

Influence of Accuracy and Precision of Measurements of Long Bone Tumors in Imaging Studies-A Retrospective Study in Musculoskeletal Oncology.

The aim of this study is to evaluate the level of accuracy and precision of bone scan (BS), MRI, and digital radiography (DR) to measure long bone tumors to design custom-made prosthesis (CMP)/modular prosthesis (MP) in limb salvage surgery (LSS) with the help of phantom and patient's study. There are two separate groups: one is the phantom study and another one is the patient's study. The phantom study is done with the Jaszack Phantom for the Gamma camera and the indigenous phantom for the MRI and DR. Three independent imaging professionals (nuclear medicine physicians and radiologists) measured the distance between standardized, preselected points on the Jaszack phantom in the Gamma Camera (GC) and indigenous phantom on the coronal and sagittal view of the MRI scan and in digital radiography. The measured values were compared with the known values for phantom measurement. A total of 36 patients, which include 24 males and 12 females, 3 independent imaging professionals measured the patient's long bone in a bone scan, MRI and DR and compared it with histopathological specimen measurement after limb salvage surgery (LSS). Descriptive statistics using appropriate measures of central tendency and dispersion were employed to describe the data. Karl-Pearson correlation coefficient was used to establish the association between continuous covariates. Paired t-test was utilized to test the differences in paired values for statistical significance. A near-perfect positive correlation was evident between all three pairs of bone scan, MRI scan, and digital radiography values, and a positive agreement within 1 mm of the bone scan, MRI scan, and DR values of all three pairs was around 95%. For the phantom study, we conclude that Gamma camera and MRI measurements are equal in physical measurements (MCF-1). DR measurements were found to be near equal physical measurements and multiplication correction factor (MCF)-0.9104 and three observer's measurements values were also near normal. For the patient's study, we conclude that the bone scan, MRI, and DR measurements of 3 independent imaging professionals are near normal, and it was confirmed with pathological specimen after LSS, to confirm reliability, repeatability, reproducibility, and accuracy of the tumor length to do custom-made prosthesis or modular prosthesis for the patients who are affected by osteosarcoma and Ewing's sarcoma.

Isomorphous methyl- and chloro-substituted small heterocyclic analogues obeying the chlorine-methyl (Cl-Me) exchange rule.

The two new isomorphous structures [3-methyl-4-(4-methylphenyl)-1-phenyl-6-trifluoromethyl-1H-pyrazolo[3,4-b]pyridin-5-yl](thiophen-2-yl)methanone, C26H18F3N3OS, (I), and [4-(4-chlorophenyl)-3-methyl-1-phenyl-6-trifluoromethyl-1H-pyrazolo[3,4-b]pyridin-5-yl](thiophen-2-yl)methanone, C25H15ClF3N3OS, (II), are shown to obey the chlorine-methyl exchange rule. Both structures show extensive disorder, treatment of which greatly improves the quality of the description of the structures. In addition, it is worth noting that the presence of extensive disorder may make it difficult to detect the isomorphism automatically during data-mining procedures (such as searches of the Cambridge Structural Database).

Supramolecular architectures of N-acetyl-L-proline monohydrate and N-benzyl-L-proline.

The title compounds, N-acetyl-L-proline monohydrate, C7H11NO3·H2O, (I), and N-benzyl-L-proline, C12H15NO2, (II), crystallize in the monoclinic space group P21 with Z' = 1 and Z' = 2, respectively. The conformation of C(γ) with respect to the carboxylic acid group in (I) is C(γ)-exo or UP pucker, with the pyrrolidine ring twisted, while in (II), it is C(γ)-endo or DOWN, with the pyrrolidine ring assuming an envelope conformation. The crystal packing interactions in (I) are composed of two substructures, one characterized by an R6(6)(24) motif through O-H...O hydrogen bonds and the other by an R4(4)(23) ring through C-H...O interactions. In (II), the crystal packing interactions consist of N-H...O and C-H...O hydrogen bonds. Proline (Pro) exists in its neutral form in (I) and is zwitterionic in (II). This difference in the ionization states of Pro is manifested through the absence of N-H...O and presence of O-H...O interactions in (I), and the presence of N-H...O and absence of O-H...O hydrogen bonds in (II). While C-H...O interactions are present in both (I) and (II), the geometry of the synthons formed by them and their mode of participation in intermolecular interactions is different. Though the title compounds differ significantly in terms of modifications in the Pro skeleton, the differences in their supramolecular structures may also be viewed as a result of the molecular recognition facilitated by the presence of a solvent water molecule in (I) and the zwitterionic state of the amino acid in (II).

4-Cyano-N-ethyl-spiro-[chromene-2,4'-piperidine]-1'-carboxamide.

The title compound, C17H19N3O2, crystallizes with two independent mol-ecules (A and B) in the asymmetric unit. In both mol-ecules, the pyran ring has a twisted conformation ((5)S4), with Q = 0.301 (3) Å, θ = 116.7 (6) and ϕ= 213.6 (7)° for mol-ecule A, and Q = 0.364 (2) Å, θ = 113.7 (3) and ϕ = 213.0 (4)° for mol-ecule B. In mol-ecule B, the terminal ethyl group is disordered over two orientations with an occupancy ratio of 0.55 (1):0.45 (1). In the crystal, mol-ecules A and B form very similar but separate R1(2)(7) motifs through N-H⋯O and C-H⋯O hydrogen bonds. The resulting chains along [001] are inter-linked by weaker C-H⋯O and C-H⋯π inter-actions, forming layers parallel to the bc plane.

N-tert-But-oxy-carbonyl-α-(2-fluoro-benzyl)-l-proline.

In the title compound, C17H22FNO4, the pyrrolidine ring adopts an envelope conformation with the disordered com-ponents of the methylene C atom, with site occupancies of 0.896 (7) and 0.104 (7), being the flap on either side of the mean plane involving the other atoms of the ring. The carb-oxy-lic acid group forms dihedral angles of 72.06 (11) and 45.44 (5)° with the N-tert-but-oxy-carbonyl group and the 2-fluoro-benzyl group, respectively. In the crystal, two-dimensional layers of mol-ecules parallel to (001) are built through an R 4 (4)(23) motif generated via O-H⋯O, C-H⋯O and C-H⋯F inter-actions, and an R 2 (2)(11) motif generated by C-H⋯O and C-H⋯F inter-actions.

N-But-oxy-carbonyl-5-oxo-l-proline ethyl ester.

The mol-ecular structure of the title compound, C12H19NO5, may be visualized as made up of two nearly perpendicular planes [dihedral angle = 87.39 (12)°] and its crystal structure is a good example of C-H⋯O inter-actions assuming significance in optimizing supra-molecular aggregation in crystals in a mol-ecule which is severely imbalanced in terms of donors to acceptor atoms. The pyrrolidine ring adopts a ((3) T 2) twist conformation with puckering parameters Q = 0.2630 (4) Šand ϕ = 59 (9)°. The crystal structure features R 2 (4)(10) and R 3 (4)(26) ring motifs formed by four weak C-H⋯O inter-actions, leading to supra-molecular sheets lying parallel to the bc plane.

Supramolecular sheets in (4H-chromeno[4,3-c]isoxazol-3-yl)methanol and its hydrated 8-methyl-substituted analogue at 100 K.

The title compounds, (4H-chromeno[4,3-c]isoxazol-3-yl)methanol, C(11)H(9)NO(3), (I), and (8-methyl-4H-chromeno[4,3-c]isoxazol-3-yl)methanol monohydrate, C(12)H(11)NO(3)·H(2)O, (II), crystallize in the monoclinic space groups P2(1)/c and C2/c, respectively. The simple addition of a methyl substituent in (II) results in a change in the structure type and substantially alters the intermolecular interaction patterns, while retaining the point-group symmetry 2/m. Compound (II) crystallizes as a hydrate and the resulting hydrogen-bonding interactions involving the water molecule are the cause of differences in the hydrogen-bonded supramolecular motifs present in (I) and (II). The water molecule in (II) is disordered over two positions having very similar orientations, with occupancies of 0.571 (18) and 0.429 (18), although the pattern of hydrogen-bonding interactions for the two disordered water molecules remains essentially the same. In both compounds, the primary donor hydroxy group adopts a trans conformation with respect to the isoxazole O atom, with a torsion angle of 170.65 (8)° for (I) and 179.56 (10)° for (II), the small difference being due to differences in the hydrogen-bonding environment of the hydroxy group. In (I), molecules are linked through two independent O-H···N and C-H···O hydrogen bonds and form sheets of centrosymmetric R(4)(4)(18) and R(4)(4)(14) rings extending parallel to the (100) plane. The supramolecular motifs in (II) generate two-dimensional sheets parallel to the (100) plane through a combination of O-H···X (X = N, O) and C-H···O hydrogen bonds, leading to water-assisted noncentrosymmetric R(2)(2)(8) and R(6)(6)(20) motifs. The present work is an example of how the simple replacement of a substituent in the main molecular scaffold may transform the structure type, paving the way for a variety of supramolecular motifs and consequently altering the complexity of the intermolecular interaction patterns.

Supramolecular networks in (9-fluoro-4H-chromeno[4,3-c]isoxazol-3-yl)methanol and its 9-chloro analogue at 100 K.

The title compounds, (9-fluoro-4H-chromeno[4,3-c]isoxazol-3-yl)methanol, C(11)H(8)FNO(3), (I), and (9-chloro-4H-chromeno[4,3-c]isoxazol-3-yl)methanol, C(11)H(8)ClNO(3), (II), crystallize in the orthorhombic space group Pbca with Z' = 1 and the triclinic space group P-1 with Z' = 6, respectively. The simple replacement of F by Cl in the main molecular scaffold of (I) and (II) results in significant differences in the intermolecular interaction patterns and a corresponding change in the point-group symmetry from D(2h) to C(i) = S(2). These striking differences are manifested through the presence of C-H···F and the absence of O-H···O and C-H···O interactions in (I), and the absence of C-H···Cl and the presence of O-H···O and C-H···O interactions in (II). However, the geometry of the synthons formed by the O-H···N and O-H···X (X = F or Cl) interactions observed in the constitution of the supramolecular networks of both (I) and (II) remains similar. Also, C-H···O interactions are not preferred in the presence of F in (I), while they are much preferred in the presence of Cl in (II).

1'-Benzylspiro-[chromene-2,4'-piperi-dine]-4-carbonitrile.

In the title compound, C(21)H(20)N(2)O, the piperidine ring adopts a chair conformation while the pyran ring adopts a screw-boat conformation. The piperidine ring forms dihedral angles of 65.75 (3) and 67.79 (5)° with the chroman and methyl-substituted benzene rings, respectively. The crystal structure features weak C-H⋯π and π-π [centroid-centroid distance = 3.8098 (8) Å] inter-actions.

2-Amino-4-(4-chloro-phen-yl)-5,6,7,8,9,10-hexa-hydro-benzo[8]annulene-1,3-dicarbonitrile.

In the title compound, C(20)H(18)ClN(3), the cyclo-octene ring exhibits conformational disorder of two methyl-ene groups with a site-occupation factor of 0.859 (6) for the major occupied site. In the crystal, mol-ecules are connected into inversion dimers via pairs of weak N-H⋯N hydrogen bonds, forming an R(2) (2)(12) graph-set motif. These dimers are further connected via weak N-H⋯Cl inter-actions into chains running along [011]. There are also C-H⋯N interactions present in the crystal.

5-(4-Fluoro-benzyl-idene)-4'-(4-fluoro-phen-yl)-1,1'-dimethyl-dispiro-[piperidine-3,3'-pyrrolidine-2',3''-indoline]-4,2''-dione.

The asymmetric unit of the title compound, C(30)H(27)F(2)N(3)O(2), contains two independent mol-ecules. The pyrrolidine five-membered ring assumes an envelope conformation (with the CH(2) atom at the flap) in one mol-ecule and a twisted conformation in the other one. In both independent mol-ecules, the 4-piperidinone rings adopt a similar twisted chair conformation. In the crystal, the two independent mol-ecules form an R(2) (2)(8) dimer through a pair of N-H⋯O hydrogen bonds; the R(2) (2)(8) dimers are connected via weak C-H⋯O hydrogen bonds, leading to a chain extending along the c axis.

5-Benzoyl-2-(1H-indol-3-yl)-4-[4-(propan-2-yl)phen-yl]-4,5-dihydro-furan-3-carbonitrile.

In the title compound, C29H24N2O2, the hydrofuran ring is twisted with puckering parameters Q = 0.1553 (16) Šand ϕ = 305.0 (6)°. In the crystal, the graph-set motifs of the inter-action pattern are an R2(2)(16) motif involving dimers through N-H⋯N hydrogen bonds across centres of inversion and a C(6) motif through C-H⋯O hydrogen-bond between glide-related mol-ecules. Together, these generate [101] ladder-like chains.

1-Methyl-1'-(4-methyl-phen-yl)-2',3',5',6',7',7a'-hexa-hydro-1'H-dispiro-[piperidine-3,2'-pyrrolizine-3',3''-indoline]-4,2''-dione.

The title compound, C(26)H(29)N(3)O(2), crystallizes with two mol-ecules in the asymmetric unit, having C-H⋯O inter-actions between them and resulting in a dimer characterized by an R(2) (2)(11) motif. These dimers are linked into an ABABAB chain via N-H⋯O, N-H⋯N and C-H⋯O built edge-fused R(1) (2)(5) and R(2) (2)(7) motifs. This chain is linked to its inversion-related partner via N-H⋯O bonds with an R(2) (2)(8) motif and leads to a double chain extending along the b axis characterized by an R(6) (6)(36) motif across the inversion centres. The methyl group of the phenyl ring and the oxindole of mol-ecule A and B are involved in C-H⋯π inter-actions. One C atom of the pyrrolizine ring of mol-ecule A and its attached H atoms show positional disorder, the major and minor components being in the ratio 0.706 (7):0.294 (7).