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Monoclonal gammopathy of renal significance (MGRS) has gained importance because identifying the monoclonal deposit and addressing it, rather than treating renal dysfunction as the primary pathology, has salvaged the patients from progressing into end-stage renal disease. Since it affects elderly population, there could be a propensity to misdiagnose them with cardiorenal syndrome. We present four patients of MGRS diagnosed from our center. They presented with proteinuria or unexplained renal dysfunction. Three of the patients were diagnosed to have amyloidosis, of which two had lambda-type and one had kappa amyloidosis. The fourth patient had fibrillary glomerulonephritis with kappa restriction, further evaluation of which led to diagnosis of chronic lymphocytic leukemia. Absence of "M" band in protein electrophoresis and a normal bone marrow study should not stop physicians from further evaluation. Quantitative serum immunofixation electrophoresis and electron microscopic examination of renal biopsy have become a comprehensive diagnostic tool in such patients. [ABSTRACT FROM AUTHOR]

Phosphatidylinositol 3-kinases (PI3Ks) are characterized by the presence of a C2 domain at the N-terminal end (class I, III); or at both the N-terminal and C-terminal ends (class II), sometimes including a Plextrin homology domain and/or a Ras domain. Plant PI3Ks are analogous to the class III mammalian PI3K. An N-terminal fragment (~170 aa) of the tomato PI3K regulatory domain including the C2 domain, was cloned and expressed in a bacterial system. This protein was purified to homogeneity and its physicochemical properties analyzed. The purified protein showed strong binding with monophosphorylated phosphatidylinositols, and the binding was dependent on calcium ion concentration and pH. In the overall tertiary structure of PI3K, C2 domain showed unique characteristics, having three antiparallel beta-sheets, hydrophobic regions, acidic as well as alkaline motifs, that can enable its membrane binding upon activation. To elucidate the functional significance of C2 domain, transgenic tobacco plants expressing the C2 domain of PI3K were generated. Transgenic plants showed defective pollen development and disrupted seed set. Flowers from the PI3K–C2 transgenic plants showed delayed wilting, and a decrease in ethylene production. It is likely that introduction of the PI3K–C2 segment may have interfered with the normal binding of PI3K to the membrane, delaying the onset of membrane lipid catabolism that lead to senescence. Image 1 • Tomato PI3K–C2 fragment was cloned, purified and biochemically characterized. • Transgenic tobacco plants expressing the C2-GFP domain were generated. • Flowers from the transgenic plants showed delayed flower senescence. • Over-expression of C2 may have interfered with the normal binding of PI3K to the membrane, delaying senescence. [ABSTRACT FROM AUTHOR]

Membrane deterioration is an inherent aspect of the advancement in senescence and loss in fruit quality during storage. Postharvest technologies used for extending shelf life and quality are targeted to reduce membrane damage through downregulating or blocking ethylene action. In this study, mature green tomato fruit were treated with inhibitors of ethylene receptor (ETR), phosphatidylinositol 3-kinase (PI3K) and phospholipase D (PLD), all recognized to be targets of regulation of fruit ripening. The inhibitors used included 1-methylcyclopropene (1-MCP, an ethylene receptor blocker), wortmannin (an inhibitor of PI3K), and hexanal (a PLD inhibitor). Fruit were treated at optimal levels of the inhibitors and were stored at 21 °C for 10 days. Color development was strongly delayed in wortmannin treated tomatoes just as in 1-MCP treated fruit; while, changes in respiration, firmness and ethylene evolution were very similar to that of control fruit. Hexanal delayed the initiation of these changes; while 1-MCP and wortmannin blocked the ripening process. Changes in expression levels of key genes involved in ethylene signalling, phosphoinositide metabolism, and lycopene synthesis that occurred in response to inhibitors, suggested potential roles for PI3K and PLD in ethylene signalling. Furthermore, fruit treated with all the three inhibitors showed a marked reduction in PLD transcript levels; suggesting that, regulation of PLD gene expression is a common critical regulatory point that regulates ripening. Lowered PLD levels may reduce membrane lipid catabolism and the generation of phosphatidic acid (PA), an intermediate in ethylene signalling regulation through downstream components. [ABSTRACT FROM AUTHOR]

Aqueous compositions of hexanal, an inhibitor of phospholipase D, has been shown to enhance the shelf life and quality of fruits and vegetables. In the present study, sweet bell pepper fruit were exposed to hexanal vapor and its effect on quality attributes, shelf-life, and antioxidant enzyme activities were evaluated during storage at 7 day intervals for 21 d. Peppers subjected to hexanal vapor treatments (0.005, 0.01, and 0.02%, w/w) showed a significant (p < 0.05) delay in ripening process and preservation of postharvest qualities than untreated peppers, even at 21 d of storage. Treated fruit were characterized by increased firmness, a reduction in physiological water loss and lower electrical conductivity than control fruit, which indicated better membrane preservation. These treatments also resulted in an increase in the levels of antioxidant enzyme activities, specifically that of superoxide dismutase, catalase, glutathione reductase and guaiacol peroxidase. Evidences from the present study indicate that postharvest hexanal vapor treatment at optimal levels can effectively enhance the quality and shelf life of sweet bell peppers. [ABSTRACT FROM AUTHOR]

Phosphatidylinositol 3-kinase (PI3K) is a key enzyme that phosphorylates phosphatidylinositol at 3'-hydroxyl position of the inositol head group initiating the generation of several phosphorylated phosphatidylinositols, collectively referred to as phosphoinositides. The function of PI3K in plant senescence and ethylene signal transduction process was studied by expression of Solanum lycopersicum PI3K in transgenic Nicotiana tabacum, and delineating its effect on flower senescence. Detached flowers of transgenic tobacco plants with overexpressed Sl-PI3K (OX) displayed accelerated senescence and reduced longevity, when compared to the flowers of wild type plants. Flowers from PI3K-overexpressing plants showed enhanced ethylene production and upregulated expression of 1-aminocyclopropane-1-carboxylic acid oxidase 1 (ACO1). Real time polymerase chain reaction (PCR) analysis showed that PI3K was expressed at a higher level in OX flowers than in the control. Seedlings of OX-lines also demonstrated a triple response phenotype with characteristic exaggerated apical hook, shorter hypocotyls and increased sensitivity to 1-aminocyclopropane-1-carboxylate than the control wild type seedlings. In floral tissue from OX-lines, Solanum lycopersicum phosphatidylinositol 3-kinase green fluorescent protein (PI3K-GFP) chimera protein was localized primarily in stomata, potentially in cytoplasm and membrane adjacent to stomatal pores in the guard cells. Immunoblot analysis of PI3K expression in OX lines demonstrated increased protein level compared to the control. Results of the present study suggest that PI3K plays a crucial role in senescence by enhancing ethylene biosynthesis and signaling. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Sling surgery is common for stress urinary incontinence (SUI). Yet many women have stress-predominant mixed urinary incontinence (MUI). The change in urgency/urge urinary incontinence (U/UUI) following treatment is not well documented. Our aim was to assess changes in U/UUI in women undergoing a sling placement for MUI and correlate this with improvement in quality of life (QOL). Methods: This was a retrospective review of women treated for SUI with either an autologous rectus fascia pubovaginal sling (AF-PVS) or synthetic retropubic midurethral sling (MUS). Validated questionnaires-Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), and visual analog scale (VAS) were obtained pre- and postoperatively. The independent association between change in storage symptoms and subjective cure-as defined by improved overall score on UDI-6, VAS score ≥ 7, or both -were assessed using multivariate logistic regression. Results: Nine hundred and twenty-seven women were identified for inclusion; 718 (77.5 %) had preoperative MUI, of whom 487 (67.8 %) received an MUS and 231 (32.2 %) an AF-PVS. Similar objective cure rates were noted following MUS vs. AF-PVS (78.2 % vs. 71.9 %, p = 0.315). Subjectively, women treated with MUS experienced greater improvement in U/UUI (72.8 % vs. 57.6 %, p = <0.001) than AF-PVS. Multivariate analysis showed MUS patients were more than twice as likely to show subjective improvement in UDI-6 and VAS scores than the AF-PVS cohort. Postoperatively, validated questionnaires were significantly associated with storage symptom outcome. Conclusions: Patients with U/UUI experience significant symptom improvement following treatment for MUI. QoL assessment following surgery is directly correlated with improvement in U/UUI. [ABSTRACT FROM AUTHOR]

Primulina dryas ( P. dryas ), a popular ornamental plant species has recently gained interest among hobbyists and collectors due to its attractive foliage and flowers. An efficient protocol for in vitro regeneration of P. dryas from leaf and petiole explants was developed using thidiazuron (TDZ) as the sole inductive stimulus. The objective of this study was to evaluate the potential of P. dryas for mass propagation in vitro. Orientation of the explants on the culture medium also affected regeneration with significant enhancement in the number of shoots and somatic embryos when the abaxial surface of the leaf was in contact with the culture medium. Explants also showed a capacity to regenerate on a medium devoid of growth regulators indicating active endogenous hormone metabolism sufficient to stimulate de novo differentiation. The inhibitors of auxin biosynthesis and transport, p -chlorophenoxyisobutyric acid (PCIB) and 2,3,5-triiodobenzoic acid (TIBA) significantly reduced regeneration in an optimal growth environment suggesting the involvement of endogenous auxin in regeneration of P. dryas . Growth and development of regenerants was further improved in temporary immersion bioreactors and the resulting plants were successfully transplanted in the greenhouse. High efficiency and reproducibility of Primulina regeneration system reported here may facilitate large scale production of this ornamental species. [ABSTRACT FROM AUTHOR]

Highlights: [•] Quality of greenhouse tomato can be enhanced by preharvest application of hexanal-containing aqueous formulations and enhanced freshness formulation. [•] Postharvest dips in “enhanced freshness formulation” are also effective in enhancing shelf life of tomatoes. [•] Increased firmness, red colour, ascorbic acid levels, etc., are features observed in tomatoes treated with “enhanced freshness formulation” indicative of better quality. [Copyright &y& Elsevier]

The Turkish ecotype of Puccinellia distans displays exceptional boron (B) tolerance, >1,250 mg B L, compared to <50 mg B L for Gypsophila arrostil. In the present study, we compare the molecular basis for the difference in B tolerance between the two species by constructing high B-responsive suppression subtractive hybridization libraries to identify the upregulated genes. A total of 219 and 113 unique non-redundant expressed sequence tags (ESTs) were identified and functionally classified in P. distans and G. arrostil, respectively. In addition, 63 ESTs were down-regulated in P. distans in response to high B. The majority of the high B upregulated genes belong to four categories: metabolism, protein synthesis, cellular organization, and stress/defense. We hypothesize that the superior B tolerance exhibited by P. distans may be due to its ability to restrict the accumulation of B in plant tissues through the upregulated expression of efflux transporters comparable to the Bot1 transporter of barley. In addition, our results are consistent with the view that other molecular mechanisms involved in stress/defense, such as detoxification, anti-oxidative, and signaling pathways, are needed to tolerate B-toxicity stress. Key message The molecular basis of boron tolerance of two plant species ( Puccinellia distans and Gypsophila arrostil) that differ greatly in their boron tolerance was studied in this manuscript. [ABSTRACT FROM AUTHOR]

Excessive application of phosphorus (P)-rich manures to agricultural lands often results in P-accumulation in soils leading to water pollution through runoffs and leaching. Use of suitable plant species that can extract and sequester excess P from soil into their biomass is an effective method of remediation of P-contaminated soils. Knowledge on the molecular responses of plants to high P-accumulation and tolerance is lacking. Therefore, a suppression subtractive hybridization (SSH) strategy was employed to identify and elucidate the pattern of gene expression related to P-tolerance and accumulation in cucumber (Cucumis sativus L.), a P-accumulator plant. RNA isolated from cucumber grown in high P was used for 'tester' cDNA synthesis and SSH library preparation. A total of 63 cDNAs were identified as showing upregulated expression in this plant in response to high P. No putative function could be assigned to 7 (11%) of the 63 upregulated high P-modulated genes and 11 expressed sequence tags (ESTs) (17%) did not match database entries. The remaining 45 ESTs were grouped into five functional classes. The majority of these ESTs belonged to three groups: 'metabolism', 'protein synthesis/degradation and signaling' and 'cell structure/cell wall'. Only six 'stress/defense'-related ESTs were identified from this library. The results of reverse northern blot analysis was further confirmed and validated through semi-quantitative RT-PCR carried out with representative ESTs identified in this study. The research reported here may contribute to a preliminary understanding of the high P-related gene expression in this P-accumulating plant. [ABSTRACT FROM AUTHOR]

Abstract: Sunflower (Helianthus annuus L.) is a commercially important oilseed crop. Previous studies proved that this crop is a promising plant species for phytoextraction of excess soil phosphorus (P) because of its superior P accumulating characteristics. Suppression subtractive hybridization (SSH) strategy was employed to isolate and characterize genes that are induced in response to high P in this crop. SSH library was prepared using cDNA generated from plants treated with high P as the ‘tester’. Based on the results of dot blot analysis, 360 positive cDNA clones were selected from the SSH library for sequencing. A total of 89 non-redundant expressed sequence tags (ESTs) were identified as high P-responsive genes and they were classified into 6 functional groups. Several genes involved in metabolism showed markedly preferential expression in the library. For further confirmation, thirteen of the representative ESTs were selected from all categories for RT-PCR analysis and the results showed up-regulation of these genes in response to high P-treatment. The gene expression data derived from this study suggested that several of the up-regulated genes identified under high P-treatment might be involved in P-accumulation and tolerance in this plant. [Copyright &y& Elsevier]

Purpose: Treatment options for antimuscarinic refractory neurogenic detrusor overactivity (NDO) are botulinum toxin type A injections (BTX-A) and augmentation cystoplasty (AC). We estimated initial and cumulative 5-year costs of these treatments. Materials and methods: Base case is an individual with antimuscarinic refractory NDO and decreased bladder compliance. Primary analysis is from the health care payor perspective. Model probabilities and ranges were derived from literature and chart review. Reimbursements were derived from the average of insurance carriers. Complication cost calculations were based on standard practice. Decision-analysis model was made with TreeAge Pro Healthcare 2009 Software, Inc. and rolled back for cost calculation. One-way sensitivity analysis was performed on all variables, and two-way sensitivity analyses were based on these results. Results: Average reimbursement for one BTX-A injection and AC was $2,946.83 and $25,041.53, respectively. BTX-A treatment was less expensive over 5 years, costing $28,065. The model was only sensitive within a reasonable clinical range for Botox durability. BTX-A was more cost-effective over 5 years if the effect lasted for >5.1 months. The model was based on an AC complication rate of 40%. If the P < 14%, AC was cheaper over 5 years. The model was sensitive to surgeons costs of BTX-A ($3,027) and facility costs of BTX-A ($1,004) and AC ($17,100). Conclusions: This is the first cost analysis of BTX-A and AC. BTX-A is cheaper at durations >5.1 months and AC was cheaper when the cost of BTX-A increases or the AC complication rate dropped below 14%. [ABSTRACT FROM AUTHOR]

Abstract: Recurrent application of animal manure to the soil often results in accumulation of phosphorus (P) in the soil over time. Use of temperate forages like Lolium multiflorum capable of extracting excess P from manure impacted soil is an attractive strategy for P phytoremediation. Two genotypes of L. multiflorum, ‘Gulf and Marshall’ were grown in soil and hydroponic media containing various concentrations of poultry manure and their P accumulation potential was determined. A decline in the biomass with an increase in manure concentration beyond 10gkg−1 soil in Gulf and 25gkg−1 soil in Marshall was noticed. Gulf grass accumulated more P content (7gkg−1 dry weight) as compared to Marshall (6gkg−1 dry weight) in both roots and shoots. Maximum shoot P content was observed in the soil amended with 10g poultry manure, while root P was highest at the concentration of 50g poultry manurekg−1 in the soil. Both cultivars yielded the highest biomass when grown in the presence of 10g poultry manure in modified Hoagland''s media. Presence of chelators in the media did not produce any noticeable effect on P accumulation in either grass and the biomass was appreciably enhanced by all concentrations of the chelators. Gulf and Marshall ryegrass seedlings were grown hydroponically in various poultry manure fractions. Both phytase and acid phosphatase (APase) enzyme activities in the root increased substantially in response to P-sufficient condition. In the presence of various poultry manure fractions, an intermediate level of both enzymes was measured compared to the P-sufficient condition, while the lowest enzyme activity was observed in the absence of any P source in the media. The level of APase and phytase activities was more or less the same in the two grasses under various growth conditions. An additional APase isoform was induced specifically in response to P-starvation from the two grass cultivars. Phytase and APase assays carried out in the P-starved and P-replenished grass seedlings further confirmed that during P deficiency, the enzyme activity was lowest and results of PAGE indicated that an APase isoform was induced under P-starvation. [Copyright &y& Elsevier]

A reprint of the article "Take Home Message: Female Urology/Incontinence/Urodynamics," by Priya Padmanabhan, published in a 2013 issue of "AUANews" is presented. Particular focus is given to abstracts of studies presented at the 2013 American Urological Association (AUA) annual meeting. These studies included the advancement in treatment strategies and management options, such as the use of sacral nerve stimulation, transobturator tape and tension-free vaginal tape.

• Hexanal exposure for a minimum of 6 h was essential to delay pepper fruit ripening. • Head space hexanal concentration decreased in the presence of pepper fruit. • Volatile emission was higher in hexanal treated fruit. • Hexanal repressed carotenoid biosynthesis gene expression in pepper. • Phospholipase Dα expression was lnhibited in hexanal treated fruit. Phospholipase D (PLD) is a key enzyme involved in membrane lipid catabolism. Hexanal, a C6 volatile aldehyde is a strong PLD -inhibitor, and has been observed to enhance the shelf life and quality of horticultural produce. In the present study, the effect of hexanal vapor exposure on the postharvest quality and ripening response of bell pepper fruit was evaluated. Hexanal exposure for a minimum of 6 h was found to be essential to delay ripening in bell pepper fruit. Quantification of head space hexanal levels in the presence of pepper fruit revealed a gradual decrease in concentration, while it remained relatively steady close to the peak value in the absence of pepper fruit. Hexanal treated bell peppers subjected to 21 d of postharvest storage evolved higher levels of aroma volatiles than untreated peppers. Hexanal vapor treatment induced significant alterations in the transcript accumulation and expression of genes involved in the carotenoid biosynthetic pathway, antioxidant enzyme systems, and the LOX pathway in stored pepper fruit. Real time PCR analysis also confirmed the near-complete downregulation of expression of genes encoding PLD α, β, δ and ζ isoforms in hexanal vapor treated peppers. The results suggest that hexanal vapor treatment can beneficially influence the expression of genes in multiple biochemical pathways, which could ultimately result in enhancing the shelf life and quality of horticultural produce. [ABSTRACT FROM AUTHOR]

The article presents abstracts on female urology, incontinence and urodynamics (UDS) topics which include the efficacy of stress incontinence surgical treatment, the most common forms of treatment for urinary incontinence, and outcomes of lower urinary tract reconstruction in patients with myelomeningocele.

Objective: The objective of this study was to compare maternity leave satisfaction between physicians and nonphysicians. Currently, paid maternal leave is not guaranteed in the United States, resulting in palpable dissatisfaction among parents. Previous studies have shown associations between length of paid leave and career satisfaction and maternal happiness. Materials and Methods: A Qualtrics® electronic survey was distributed to female professionals through email and social media from April 2019 to March 2020. Inclusion criterion was ≥1 child by birth or adoption, or active pregnancy. Continuous and categorical data were analyzed using two-sample t-test and chi-square, respectively. Results: Of 808 respondents, 77% were physicians. Mean age at birth/adoption of first child was higher in physicians versus nonphysicians (32.1 years vs. 29.7 years; p < 0.001). Physicians took shorter maternity leave than nonphysicians (10.9 weeks vs. 12.0 weeks, p = 0.017) with half of that time paid by employers (5.4 weeks vs. 5.9 weeks, p = 0.2). Dissatisfaction was high among physicians (85.1%) and nonphysicians (92.4%) that correlates with maternity leave compensation dissatisfaction (49% vs. 71.3%, p < 0.001). Thirty-four percent of physicians versus 41% of nonphysicians stated that their health was negatively impacted by maternity leave length. Physicians and nonphysicians reported similar incidences of depression, and breastfeeding, delivery, and other postpartum complications. When queried, 38.8% of physicians and 57% of nonphysicians said they would desire >16 weeks of paid maternity leave (p < 0.001). Conclusions: In conclusion, dissatisfaction among professional women on maternity leave duration and compensation is high in the United States. Given health implications for both mother and child, this should invite further discussion and changes. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the impact of injectable agents on subsequent incontinence surgery outcomes to assess safety and efficacy of this treatment combination. Periurethral bulking agents are a minimally invasive treatment option for stress urinary incontinence (SUI), but often lack durability necessitating further surgical intervention. Methods: Retrospective review of 43 patients with SUI following bulking agent who underwent subsequent sling placement from November 2000 to September 2009 were evaluated for demographics, symptoms, urodynamics (UDS), bulking agent characteristics, concomitant procedures, pad requirements per day (PPD), subjective outcomes, and complications. Results: Mean patient age was 67 years, with mean follow-up of 37.3 months. All demonstrated SUI, and mixed urinary incontinence (MUI) was noted in 81.4%. Almost half (48.8%) had undergone a prior antiincontinence procedure. Mean number of injections was 3. After a bulking injection, 25 autologous fascia pubovaginal slings, 13 midurethral slings, and 5 biological pubovaginal slings were placed. Concomitant pelvic surgery was performed in 37.2%. Postoperatively, mean PPD decreased from 5.3 to 0.65, with a 60.5% subjective cure rate (no pads or leakage under any circumstances). No association was seen between number or type of injection, or type of sling with regards to patient outcomes. Results were significantly related to concomitant surgery (P = .007). SUI recurred in 8 patients (18.6%), which was not statistically associated with other parameters. Complications included urinary retention (8 patients) de novo urgency (1 patient), UTI (4 patients), abdominal wound infection (3 patients), and cystotomy (1 patient). Conclusions: Prior treatment with bulking agents does not appear to negatively affect outcomes for future antiincontinence surgery in our patient population. [ABSTRACT FROM AUTHOR]

Objective: Augmentation cystoplasty is a treatment option for neurogenic lower urinary tract dysfunction as well as severe, refractory, complicated idiopathic overactive bladder. In some patients, symptoms may persist or recur postoperatively, and there is little guidance on management in this setting. In this study, we reviewed the use of intravesical onabotulinum toxin type A (BTX-A) in patients who had undergone augmentation cystoplasty. Material and methods: Retrospective chart review was performed at two institutions, identifying patients who underwent augmentation cystoplasty and were subsequently treated with intravesical BTX-A. Demographics, and preoperative and postoperative findings were collected. Results: In total, 21 (16 female, 5 male) patients (mean age: 37.2 years) with previous augmentation cystoplasty were identified. In 17 patients with urodynamic data, mean maximum cystometric capacity was 312 mL, and decreased compliance and detrusor overactivity were noted in 53% and 48% patients, respectively. Combined intradetrusor/intra-augment injections were performed in 11 patients, and the remaining 10 patients received detrusor-only injections. A total of 18 patients (86%) reported subjective improvement with no significant difference associated with site of injection (p=0.59). A total of 17 patients (77%) underwent repeat injections; on average, patients underwent 3.3 injections with interval of 8.8 months between injections. Conclusion: BTX-A injection was shown to subjectively improve storage symptoms and continence after augmentation cystoplasty in the majority of patients. In this cohort, patients had good subjective response regardless of site of injection, and most patients benefited from repeat injections. Prospective studies are needed to better evaluate the efficacy and ideal sites of BTX-A injection in the setting of refractory voiding dysfunction following augmentation cystoplasty. [ABSTRACT FROM AUTHOR]

A correction to the article "Change in urinary storage symptoms following treatment for female stress urinary incontinence,"that appeared in the 2016 issue is presented.