Curative Effects of Two New Endometrial Ablation Procedures Using Radiofrequency Thermocoagulation for the Treatment of Severe Abnormal Uterine Bleeding

Severe Abnormal Uterine Bleeding (SAUB) is a common gynecological disorder. The clinical characteristics include disordered menstrual cycle and massive bleeding that can cause anemia or secondary infection. Current treatment mainly relies on drug therapy or surgical removal of the uterus, each having its significant disadvantages. How to preserve the uterus, reduce the pain from surgery, and achieve better treatment effects have been well known but remaining as unresolved issues. This study aims at evaluating two types of radiofrequency (RF) thermocoagulation procedures for the treatment of SAUB: the RF-A procedure group included 25 SAUB patients ≥45 years of age treated for amenorrhea; the RF-B procedure group included 51 patients at <45 years of age treated for the control of excessive bleeding. Post-treatment ratings of menstrual satisfaction and pre-/post-treatment menstrual scores—pictorial blood loss assessment chart (PBAC)—and hemoglobin levels were collected; and the mean length of follow-up was 72 months. Also, 38 SAUB patients treated with standard drug regimens served as a control group. The results of the study showed that following RF treatment, the average long-term patient menstrual satisfaction was greater than 92 %. In both the RF groups, PBAC scores and hemoglobin levels were significantly improved from baseline (p < .05). Compared with the control group, PBAC scores and hemoglobin levels were also significantly better for the RF groups at 6–24-month post-operation. Patients experienced no hysterectomy in association with the RF procedures. In conclusion, this pilot study suggests that the novel RF procedures are both safe and effective in treating patients with SAUB. Further investigation is necessary to evaluate their application in broader clinical indication.     

A Strategy for the Molecular Diagnosis in Hemophilia A in Chinese Population

Hemophilia A is an x-linked recessive inherited bleeding disorder. So far, more than 1,885 disease-causing mutations of factor VIII gene have been identified. Clinic confers a great challenge for the molecular diagnosis. We aim to make a better strategy for the molecular diagnosis in Hemophilia A. First, factor VIII intron 22 inversion and intron 1 inversion mutations were detected using Inversion-PCR and double-tube multiple PCRs. And then, non-inversion mutations were analyzed by denaturing high performance liquid chromatography and/or direct sequencing. Novel mutations were further analyzed the conservation and 3D structures by a B domain deleted crystallographic model and bioinformatics. Finally, we can indirectly confirm the diagnosis by linkage analysis for the patients with the confusing diagnosis by the techniques mentioned above. Eleven patients with the factor VIII Inv 22 were found, and the remaining 16 patients were found with 11 different mutations, of which 3 was novel mutations affecting A1, B domains and splicing site. Moreover, the prenatal diagnosis was performed on 14 fetuses. Ten fetuses were successfully confirmed to be normal, 1 fetus to be a heterozygote with factor VIII c.3275–3276 ins A and 3 fetuses to be hemizygotes with factor VIII Inv 22 mutation.     

Synthesis of imidazole-containing analogues of farnesyl pyrophosphate and evaluation of their biological activity on protein farnesyltransferase

With the aim of creating new bisubstrate inhibitors of protein farnesyltransferase (FTase), new carboxylic farnesyl pyrophosphate analogues have been designed and synthesized. The original structures are built around three elements: a prenyl moiety, a 1,4-diacid motif and an imidazole ring. All the compounds were evaluated for their ability to inhibit FTase and compared with the corresponding derivatives lacking the imidazole ring, synthesized for that purpose. These new compounds are not bisubstrate inhibitors probably because the imidazole ring is not in the right position to interact with the zinc atom. However these derivatives display FPP competitive inhibition with a good activity in the carboxylic farnesyl pyrophosphate analogues series.     

Are all Mexican odonate species documented? An assessment of species richness

With the aim of protecting Mexican diversity, one current governmental task is to complete national biological inventories. In the case of odonate insects, several researchers have hypothesized that species richness is complete (205 dragonflies and 151 damselflies), but there has not been any formal exercise to test this. Thus, we have investigated whether odonate species richness (for Mexican endemics, dragonflies (suborder Anisoptera), damselflies (suborder Zygoptera) and total species) is complete using sample-based and coverage-based rarefaction curves. Along with this, we also showed how good distribution data are in the country. The rarefaction curves have indicated 100% completeness for all groups suggesting that the inventory is complete. However, species' distribution data is highly patchy regarding areas either well (e.g. central Mexico) or badly (e.g. coast of Guerrero and Oaxaca) collected. We encourage researchers to continue odonate sampling in order to support at least three conservation actions: (i) conservation assessment of endangered species; (ii) knowledge of range shifts given rising global temperatures; and (iii) increase public interest and awareness in protected, touristic areas.     

The immunogenicity to the first anti-TNF therapy determines the outcome of switching to a second anti-TNF therapy in spondyloarthritis patients

Introduction

Anti-TNF drugs have proven to be effective against spondyloarthritis (SpA), although 30% of patients fail to respond or experience adverse events leading to treatment discontinuation. In rheumatoid arthritis, the presence of anti-drug antibodies (ADA) against the first TNF inhibitor influences the outcome after switching. Our aim was to assess whether the response to a second anti-TNF drug is related to the previous development of ADA to the first anti-TNF drug SpA patients.

Methods

Forty-two SpA patients began a second anti-TNF drug after failing to respond to the first anti-TNF therapy. Clinical activity was assessed by the Ankylosing Spondylitis Disease Activity Score (ASDAS) at baseline (at the beginning of the first and second anti-TNF therapy) and at 6 months after switching. The drug and ADA levels were measured by ELISA before each administration.

Results

All patients were treated with anti-TNF drugs and mainly due to inefficacy were switched to a second anti-TNF drug. Eleven of 42 (26.2%) developed ADA during the first biologic treatment. At baseline, no differences in ASDAS were found in patients with or without ADA to the first anti-TNF drug (3.52 ± 1.03 without ADA vs. 3.14 ± 0.95 with ADA, p = 0.399) and to the second anti-TNF drug (3.36 ± 0.94 without ADA vs. 3.09 ± 0.91 with ADA, p = 0.466). At 6 months after switching, patients with previous ADA had lower disease activity (1.62 ± 0.93 with ADA vs. 2.79 ± 1.01 without ADA, p = 0.002) and most patients without ADA had high disease activity state by the ASDAS (25 out of 31 (80.6%) without ADA vs. 3 out of 11 (27.3%) with ADA, p = 0.002).

Conclusions

In SpA the failure to respond to the first anti-TNF drug due to the presence of ADA predicts a better clinical response to a second anti-TNF drug.     

Tryptophan reaction with free radicals arisen from carbon tetrachloride in a model system. A mass spectrometric study

SUMMARY

The interaction between free radicals derived from the thermal decomposition of carbon tetrachloride and N-acetyl-d, l-tryptophan ethyl ester (TRPAE) under anaerobic and aerobic conditions was studied. The structure of the reaction products formed was deciphered by the GC/MS analysis of their trimethylsilyl derivatives. Under anaerobic conditions no formation of reaction products was detected. Under aerobic conditions the following products were identified:

• 1. A chloro hydroxy unsaturated adduct of TRPAE (2 isomers).

• 2. A dichloro hydroxy unsaturated adduct of TRPAE.

• 3. 12 products which are different pyrrolo[2,3-b]indol derivatives.

Some of the products appeared to have an hydroxyl group as a substituent, all of them contained chlorine and only one contained carbon from CCl₄. Interestingly, the formation of those adducts not containing CCl₃ would be missed during the regular procedures toxicologists use to determine the so-called ‘covalent binding’ employing ¹⁴CCl₄.

Concerning the potential relevance of these findings, we hypothesize that if interactions similar to those here reported occurred at least in part during CCl₄ poisoning, the resulting critical proteins containing tryptophan, e.g. membrane or other and enzymes containing the amino acid in their active center, might be impaired.     

The past,present and future of thermophilous Cyperus polystachyos Rottb. (Cyperaceae) on the island of Ischia (southern Italy)

Cyperus polystachyos is a hygrophilous, thermophilous and heliophilous plant with a punctiform distribution in southern Italy, where it is almost exclusively found on Ischia, an island in the Bay of Naples characterized by widespread volcanic hydrothermal activity. This species is a native of tropical and subtropical areas and there is evidence for ancient isolation events in the creation of its current distribution pattern. We have studied the historical literature available for this plant since 1800 and collected temporal and spatial presence data of this species in order to develop a habitat suitability map based on a GIS approach and using a multiple linear regression model. Moreover, we have used univariate and multivariate statistical analysis. The results show the importance of the environmental mosaic around fumaroles to preserve the species; urbanization and geothermal energy use of fumaroles in the past and the combination of abandonment of the typical agricultural system and the natural occurrence of reforestation in the present are the main causes of the decline in the number of populations.     

Identification and preliminary validation of novel biomarkers of acute hepatic ischaemia/reperfusion injury using dual-platform proteomic/degradomic approaches

Hepatic ischaemia/reperfusion (I/R), a major cause of liver damage associated with multiple trauma, haemorrhagic and septic shock, and liver transplantation, contributes significantly to multiple organ failure. Development of novel sensitive biomarkers that detect early stages of liver damage is vital for effective management and treatment of ischaemic liver injury. By using high-throughput immunoblotting and cation–anion exchange chromatography/reversed-phase liquid chromatography-tandem mass-spectrometry, we identified several hepatic proteins, including argininosuccinate synthase (ASS) and estrogen sulfotransferase (EST-1), which were degraded in the liver and rapidly released into circulation during I/R injury. ASS accumulated in serum within 10 min, reached a steady state at 30 min, and persisted up until 3 h after reperfusion following 30 min of total hepatic ischaemia. EST-1 appeared rapidly in blood and attained maximum within 1 hour followed by a decline at 3 h of reperfusion. No ASS or EST-1 protein was detected in serum of control or sham operated rats. ASS and EST-1 exhibited greater sensitivity and specificity toward I/R liver injury as compared with alanine aminotransferase (ALT), an established marker of hepatocellular necrosis. In contrast, serum ASS and EST-1 were undetectable in rats with chronic alcoholic liver disease, while the levels of ALT protein were significantly increased. In addition, ASS, but not EST-1 or ALT accumulated in blood only 6 h after treatment with hepatotoxic combination of lipopolysaccharide and D-galactosamine. These data demonstrate the utility of ASS and EST-1 as novel sensitive and specific biomarkers of acute liver ischaemic injury for prospective clinical studies.