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Importance: The diagnosis of ramp lesions can be problematic, even with arthroscopy, due to their extreme posteromedial position. Consequently, they have been colloquially referred to as the "hidden lesions" of the knee. Undiagnosed and untreated injuries in this knee region may be associated with ongoing dynamic rotational laxity of the knee after anterior cruciate ligament reconstruction and an increased risk of anterior cruciate ligament graft failure., Aim: This study aimed to systematically review the literature to assess the sensitivity, specificity and accuracy of magnetic resonance imaging (MRI) for detecting ramp lesions in children and adolescents with anterior cruciate ligament (ACL)-deficient knees. It was hypothesized that MRI has poor sensitivity for identifying ramp lesions in children and adolescents., Evidence Review: A systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following search terms were used in the title, abstract and keywords fields: "ramp" or "meniscus" AND "children" or "adolescents." The outcome data extracted from the studies were incidence of ramp in concomitant with ACL lesion, MRI sensitivity, specificity, accuracy and positive and negative predictive values (PPV and NPV)., Findings: Of the 387 patients with ACL injury, 90 were reported to have ramp lesions (23.3%). The mean age at the time of diagnosis was 15.3 ​± ​0.81 years. The mean time from injury to MRI was 116.1 ​± ​113.5 days, while the mean time from injury to surgery was 172.6 ​± ​139.1 days. The MRI taken to detect ramp lesions in the paediatric population showed a pooled sensitivity of 50%, specificity of 75%, accuracy of 70%, PPV of 41% and NPV of 79%., Conclusions and Relevance: The prevalence of ACL-associated ramp lesions in children and adolescents is similar to that in adult populations. Magnetic resonance imaging has low sensitivity but good specificity for assessing ramp lesions. In the presence of a posteromedial tibial bone bruise or a thin fluid signal separating the posterior horn of the medial meniscus and the posteromedial capsule a ramp lesion should always be suspected., Level of Evidence: Level IV., Study Registration: PROSPERO -: CRD42023453895., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

GM3 synthase deficiency (GM3SD) is caused by biallelic variants in the ST3GAL5 gene. Early clinical features of GM3SD include infantile onset of severe irritability and feeding difficulties, early intractable seizures, growth failure, hypotonia, sensorineural hearing impairment. We describe the generation and characterization the human induced pluripotent stem cell (hiPSC) line derived from fibroblasts of a 13-year-old girl with GM3 synthase deficiency resulted compound heterozygous for two new variants in the ST3GAL5 gene, c.1166A > G (p.His389Arg) and the c.1024G > A (p.Gly342Ser). The generated hiPSC line shows a normal karyotype, expresses pluripotency markers, and is able to differentiate into the three germ layers., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Congenital Disorders of Glycosylation (CDG) are rare inherited metabolic diseases caused by genetic defects in the glycosylation of proteins and lipids. In this study, we describe the generation and characterization of one human induced pluripotent stem cell (hiPSC) line from a 15-year-old male patient with CDG. The patient carried three variants, one (c.122G > A; p.Arg41Gln) inherited from his father and two (c.445 T > G; p.Leu149Arg and the novel c.980C > G; p.Thr327Arg) inherited from his mother in the ALG8 gene (OMIM #608103). The generated hiPSC line shows a normal karyotype, expresses pluripotency markers, and is able to differentiate into the three germ layers., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

The hamstring tendons are among the most common autografts used for anterior cruciate ligament reconstruction. Typically, the ipsilateral knee's gracilis and semitendinosus tendons are harvested. More recently, studies have described the use of just 1 of the tendons (the semitendinosus [ST]) in a tripled or quadrupled configuration, particularly in all-inside reconstructions. Instead of using a double gracilis and ST, a quadrupled ST tendon allows for a graft with enough diameter to more closely mimic the natural anterior cruciate ligament while lowering the likelihood of graft rupture. The use of tourniquets has been reported to increase the risk of complications, particularly deep vein thrombosis. This Technical Note describes an anterior cruciate ligament reconstruction performed with a quadrupled ST, without the use of a tourniquet, and with only the reamers and a tibial guide as surgical instrumentation., (© 2023 The Authors.)

Hepatocellular carcinoma (HCC) is a frequent and deadly disease worldwide. The absence of effective therapies when the tumor is surgically unresectable leads to an extremely poor outcome of HCC patients. Thus, it is mandatory to elucidate the molecular pathogenesis of HCC in order to develop novel therapeutic strategies against this pernicious tumor. Mounting evidence indicates that suppression of the DNA damage response machinery might be deleterious for the survival and growth of the tumor cells. In particular, DNA dependent protein kinase catalytic subunit (DNA-PKcs), a major player in the non-homologous end-joining (NHEJ) repair process, seems to represent a valuable target for innovative anti-neoplastic therapies in cancer. DNA-PKcs levels are strongly upregulated and associated with a poor clinical outcome in various tumor types, including HCC. Importantly, DNA-PKcs not only protects tumor cells from harmful DNA insults coming either from the microenvironment or chemotherapeutic drug treatments, but also possesses additional properties, independent from its DNA repair activity, that provide growth advantages to cancer cells. These properties (metabolic and gene reprogramming, invasiveness and metastasis, resistance to apoptosis, etc.) have started to be elucidated. In the present review, we summarize the physiologic and oncogenic roles of DNA-PKcs, with a special emphasis on liver cancer. In particular, this work focuses on the molecular mechanism whereby DNA-PKcs exerts its pro-tumorigenic activity in cancer cells. In addition, the upstream regulator of DNA-PKcs activation as well as its downstream effectors thus far identified are illustrated. Furthermore, the potential therapeutic strategies aimed at inhibiting DNA-PKcs activity in HCC are discussed., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Celiac disease (CD) is one of the most common digestive disorders caused by an abnormal immune reaction to gluten. So far there are no available therapies, the only solution is a strict gluten-free diet, which however could be very challenging as gluten can be hidden in many food products. Furthermore an additional problem is related to cross-contamination of nominal gluten-free foods with gluten-based ones during manufacturing. Here we propose a lab on chip platform as a powerful tool to help food manufacturers to evaluate the real amount of gluten in their products by an accurate in-situ control of the production chain and maybe to specify the real gluten content in packages labeling. Our portable gliadin-immunochips, based on an electrochemical impedance spectroscopy transduction method, were first calibrated and then validated for both liquid and solid food matrixes by analyzing different beers and flours. The high specificity of our assay was also demonstrated by performing control experiments on rice and potatoes flours containing prolamin-like proteins. We achieved limit of quantification of 0.5 ppm for gliadin that is 20 times lower than the worldwide limit established for gluten-free food while the method of analysis is faster and cheaper than currently employed ELISA-based methods. Moreover our results on food samples were validated through a mass spectrometry standard analysis., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Downregulation of liver-specific MAT1A gene, encoding S-adenosylmethionine (SAM) synthesizing isozymes MATI/III, and upregulation of widely expressed MAT2A, encoding MATII isozyme, known as MAT1A:MAT2A switch, occurs in hepatocellular carcinoma (HCC). Being inhibited by its reaction product, MATII isoform upregulation cannot compensate for MATI/III decrease. Therefore, MAT1A:MAT2A switch contributes to decrease in SAM level in rodent and human hepatocarcinogenesis. SAM administration to carcinogen-treated rats prevents hepatocarcinogenesis, whereas MAT1A-KO mice, characterized by chronic SAM deficiency, exhibit macrovesicular steatosis, mononuclear cell infiltration in periportal areas, and HCC development. This review focuses upon the pleiotropic changes, induced by MAT1A/MAT2A switch, associated with HCC development. Epigenetic control of MATs expression occurs at transcriptional and post-transcriptional levels. In HCC cells, MAT1A/MAT2A switch is associated with global DNA hypomethylation, decrease in DNA repair, genomic instability, and signaling deregulation including c-MYC overexpression, rise in polyamine synthesis, upregulation of RAS/ERK, IKK/NF-kB, PI3K/AKT, and LKB1/AMPK axis. Furthermore, decrease in MAT1A expression and SAM levels results in increased HCC cell proliferation, cell survival, and microvascularization. All of these changes are reversed by SAM treatment in vivo or forced MAT1A overexpression or MAT2A inhibition in cultured HCC cells. In human HCC, MAT1A:MAT2A and MATI/III:MATII ratios correlate negatively with cell proliferation and genomic instability, and positively with apoptosis and global DNA methylation. This suggests that SAM decrease and MATs deregulation represent potential therapeutic targets for HCC. Finally, MATI/III:MATII ratio strongly predicts patients' survival length suggesting that MAT1A:MAT2A expression ratio is a putative prognostic marker for human HCC., (Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Background & Aims: MYBL2 is implicated in human malignancies and over expressed in hepatocellular carcinoma (HCC). We investigated Mybl2 role in the acquisition of susceptibility to HCC and tumor progression., Methods: MYBL2 mRNA and protein levels were evaluated by quantitative RT-PCR and immunoblotting, respectively. MYBL2 expression in HCC cell lines was controlled through MYBL2 cDNA or anti-MYBL2 siRNA transfection. Gene expression profile of cells transfected with MYBL2 was analyzed by microarray., Results: Low induction of Mybl2 and its target Clusterin mRNAs, in low-grade dysplastic nodules (DN), progressively increased in fast growing high-grade DN and HCC of F344 rats, susceptible to hepatocarcinogenesis, whereas no/lower increases occurred in slow growing lesions of resistant BN rats. Highest Mybl2 protein activation, prevalently nuclear, occurred in F344 than BN lesions. Highest Mybl2, Clusterin, Cdc2, and Cyclin B1 expression occurred in fast progressing DN and HCC of E2f1 transgenics, compared to c-Myc transgenics, and anti-Mybl2 siRNA had highest anti-proliferative and apoptogenic effects in cell lines from HCC of E2f1 transgenics. MYBL2 transfected HepG2 and Huh7 cells exhibited increased cell proliferation and G1-S and G2-M cell cycle phases. The opposite occurred when MYBL2 was silenced by specific siRNA. MYBL2 transfection in Huh7 cells led to upregulation of genes involved in signal transduction, cell proliferation, cell motility, and downregulation of oncosuppressor and apoptogenic genes., Conclusions: mybl2 expression and activation are under genetic control. Mybl2 upregulation induces fast growth and progression of premalignant and malignant liver, through cell cycle deregulation and activation of genes and pathways related to tumor progression., (Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Objective: To evaluate the efficacy and safety of a stainless steel miniature glaucoma drainage device (Ex-PRESS X200) implanted under a scleral flap for the surgical treatment of primary open-angle glaucoma (POAG)., Study Design: Clinical, prospective, noncomparative, nonrandomized study. The efficacy and safety were evaluated on the full sample, with a minimum follow-up of 12 months (maximum 24, mean 18)., Participants: Thirty-seven eyes of 35 patients., Methods: The Ex-PRESS device was implanted under a scleral flap in patients with POAG., Results: Preoperative intraocular pressure (IOP) was 27.6 (SD 8.7) mm Hg; at last follow-up, IOP was 12.4 (SD 3.4) mm Hg (55.1% reduction). The success rates (IOP < 18 mm Hg and < 15 mm Hg at last visit without medications) were 78.4% (29/37) and 70.3% (26/37), respectively. Kaplan-Meier analyses (probability of IOP < 18 mm Hg and < 15 mm Hg without medications) at last follow-up were 72.6% and 47.9%, respectively. Early postoperative complications were clinically mild and included postoperative IOP < 5 mm Hg: 12 cases at 1 day, 8 cases at 1 week, 3 cases at 1 month, 1 case at 3 months; serous choroidal detachment: 9 cases, of which 3 spontaneously resolved, whereas in 6 cases, hypotony and flat chamber were treated with viscoelastic injection in the anterior chamber. At last follow-up, 6 patients were treated with 2 IOP-lowering medications. No sight-threatening consequences of surgery were observed. There were 8 cases (21.6%, n = 37) of bleb needling., Conclusions: Our data support the efficacy and safety of the implantation of this device under a scleral flap. The IOP reduction obtained was significant and long standing and complications were mild.

Background: 5'-Methylthioadenosine (MTA), a product of S-adenosylmethionine (SAM) catabolism, could undergo oxidation by mono-oxygenases and auto-oxidation. MTA and SAM effects on oxidative liver injury were evaluated in CCl4-treated rats., Methods: Male Wistar rats were killed 1-48 h after poisoning with a single intraperitoneal CCl4 dose (0.15 ml/100 g) or with the same dose twice a week for 14 weeks. Daily doses of MTA or SAM (384 micromol/kg), started 1 week before acute CCl4 administration or with chronic treatment, were continued up to the time of sacrifice., Results: Acute and chronic CCl4 intoxication decreased MTA and, to a lesser extent, SAM and reduced glutathione (GSH) liver levels. MTA administration increased liver MTA without affecting SAM and GSH. SAM treatment caused complete/partial recovery of these compounds. MTA and, to a lesser extent, SAM prevented an increase in liver phospholipid hydroperoxides in acutely and chronically intoxicated rats and in prolyl hydroxylase activity and trichrome-positive areas in chronically treated rats. MTA prevented upregulation of Tgf-beta1, Collagen-alpha1 (I) and Tgf-alpha genes in liver of chronically intoxicated rats, and TGF-beta1-induced transdifferentiation to myofibroblasts and growth stimulation by platelet-derived growth factor-b of stellate cells in vitro., Conclusions: MTA and SAM protect against oxidative liver injury through partially different mechanisms.

A rapid and simple reversed-phase liquid chromatographic method that did not require the derivatization of 4-amino-3-hydroxybutyric acid (GABOB) was developed and validated. The method proved to be suitable for the determination of GABOB concentrations in finished pharmaceutical product (tablets). The method was developed using a RP-18 column, UV detection at 210 nm and 0.01 M sodium heptasulphonate solution, at pH 2.4, as the mobile phase. Different validation parameters were included and satisfactorily evaluated. The specificity of the method was demonstrated. Linearity was established in the range 0.40-0.60 mg/ml (r=0.997). The method showed excellent accuracy (100.1%). Precision (repeatability) gave a relative standard deviation value of 0.68%, while the intermediate precision was 1.70%. A robustness test showing the influence of different pH values and counter-ion concentrations was also performed.