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Glaucoma is a common and sight-threatening complication of pediatric cataract surgery Reported incidence varies due to variability in study designs and length of follow-up. Consistent and replicable risk factors for developing glaucoma following cataract surgery (GFCS) are early age at the time of surgery, microcornea, and additional surgical interventions. The exact mechanism for GFCS has yet to be completely elucidated. While medical therapy is the first line for treatment of GFCS, many eyes require surgical intervention, with various surgical modalities each posing a unique host of risks and benefits. Angle surgical techniques include goniotomy and trabeculotomy, with trabeculotomy demonstrating increased success over goniotomy as an initial procedure in pediatric eyes with GFCS given the success demonstrated throughout the literature in reducing IOP and number of IOP-lowering medications required post-operatively. The advent of microcatheter facilitated circumferential trabeculotomies lead to increased success compared to traditional

Background Many CpGs become hyper or hypo-methylated with age. Multiple methods have been developed by Horvath et al. to estimate DNA methylation (DNAm) age including Pan-tissue, Skin & Blood, PhenoAge, and GrimAge. Pan-tissue and Skin & Blood try to estimate chronological age in the normal population whereas PhenoAge and GrimAge use surrogate markers associated with mortality to estimate biological age and its departure from chronological age. Here, we applied Horvath’s four methods to calculate and compare DNAm age in 499 subjects with type 1 diabetes (T1D) from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study using DNAm data measured by Illumina EPIC array in the whole blood. Association of the four DNAm ages with development of diabetic complications including cardiovascular diseases (CVD), nephropathy, retinopathy, and neuropathy, and their risk factors were investigated. Results Pan-tissue and GrimAge were higher whereas Skin & Blood and PhenoAge were lower than chronological age (p < 0.0001). DNAm age was not associated with the risk of CVD or retinopathy over 18–20 years after DNAm measurement. However, higher PhenoAge (β = 0.023, p = 0.007) and GrimAge (β = 0.029, p = 0.002) were associated with higher albumin excretion rate (AER), an indicator of diabetic renal disease, measured over time. GrimAge was also associated with development of both diabetic peripheral neuropathy (OR = 1.07, p = 9.24E−3) and cardiovascular autonomic neuropathy (OR = 1.06, p = 0.011). Both HbA1c (β = 0.38, p = 0.026) and T1D duration (β = 0.01, p = 0.043) were associated with higher PhenoAge. Employment (β = − 1.99, p = 0.045) and leisure time (β = − 0.81, p = 0.022) physical activity were associated with lower Pan-tissue and Skin & Blood, respectively. BMI (β = 0.09, p = 0.048) and current smoking (β = 7.13, p = 9.03E−50) were positively associated with Skin & Blood and GrimAge, respectively. Blood pressure, lipid levels, pulse rate, and alcohol consumption were not associated with DNAm age regardless of the method used. Conclusions Various methods of measuring DNAm age are sub-optimal in detecting people at higher risk of developing diabetic complications although some work better than the others.

Kaolinite-urea intercalates were prepared by dry grinding kaolin KGa-1b with urea using a laboratory-scale planetary ball mill. The effect of milling conditions on the intercalation process was investigated over a wide range of urea content (25 m% - 80 m%) and milling times (up to 2 h). The purification of the complex obtained was carried out by repeated washings with isopropanol in order to remove the excess (non-intercalated) urea. For that purpose, the proportion of intercalated urea and non-intercalated urea crystals was quantified after each washing step by combining differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA) results obtained simultaneously. The optimal conditions of the intercalation were realized at a 66 m% urea loading for which a relatively low-defect complex structure was obtained in a short milling time. One drawback with the use of a high urea content (> 25 m%) during grinding was the presence of a large proportion of excess urea crystals in the as ground sample. This required repeated washing with isopropanol to purify the complex. Furthermore, the results revealed that washing with water the kaolinite-urea intercalates led to the formation of 0.84 nm kaolin hydrates and that exfoliation/delamination of kaolinite was more efficient when a high concentration of urea was used in the milling process.

Background Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus. Methods and Results A random subcohort of 349 participants was selected from the DCCT / EDIC (Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from DCCT baseline, year 1, and closeout of DCCT , and 1 to 2 years post‐ DCCT ( EDIC years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F 2α isoprostanes, and its metabolite, 2,3 dinor‐8 iso prostaglandin F 2α . Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8 iso prostaglandin F 2α , an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase, P iso prostaglandin F 2α , P =0.0092). In contrast, the oxidative markers myeloperoxidase and F 2α isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between DCCT intensive and conventional treatment groups in the change in all biomarkers across time segments. Conclusions Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique identifiers: NCT 00360815 and NCT 00360893.

Bio-agent compounds of Bacillus thuringiensis, Kurs. (Bactericide); Metarhizium anisopltiae, Metsch. (Fungicide) and biopolymer, chitosan exposed to gamma irradiation doses; 15, 30 and 60 Gy to purpose of potentiate the bio-agent efficiency against the cotton leaf worm, Spodoptera littoralis (Boisd.) treated as 4th instars larvae by LC50 of tested bio-agent compounds singly or combined with gamma irradiation doses to investigate the histopathological changes in the integument, muscle, fat body and mid gut. Most of treatments especially gamma doses of 60 Gy singly or combined with bio-agent compounds caused thickening of outer cuticle fibrous layer in the integument of S. littoralis larvae. Also, hypodermis layer had swelling and necrosis in gamma treatments and M. anisopltiae or chitosan combined with 30 Gy treatments. Also, most of treatments caused appearance of fissure and breaking down of muscles into small parts. All the bio-agent treatments caused a noticeable destruction on the fat body cells as vacuolization of the fat cells and destruction of the fat body membranous sheath. Many deleterious effects in the mid gut of S. littoralis as destruction of columnar or hyperphesia cells lining mid gut, losses of brush border with increase of goblet cells. Dose of 60 Gy is considered the best dose used in the current study to potentiate the bio-agent effects on S. littoralis larvae compared with other gamma irradiation doses used.

The present study aimed to find out the relationship and correlation among biochemical constituents (total carbohydrates, total phenols and free amino acids) with defense enzymes (protease, alpha esterase and ascorbic acid oxidase) in seed and leaves of five corn varieties (Sc128 and Sc131 white varieties) and (Sc166, Sc176, Sc186 yellow varieties) that cultivated in summer corn season in 2014 at Experimental farm, Faculty of Agriculture, Benha University (Qalubiyah governorate) exposed to different infestation of Ostrinia nubilalis (Hubn.). Data demonstrated that corn variety of Sc 168 recorded the lowest mean of larvae number and stem bores, followed by variety of Sc 176 that recorded the lowest mean of infested ears and broken tassel. While, variety of Sc 128 recorded the highest increase in dry ears yield (13.70 Ardab/faddan) followed by variety of Sc 176 (12.18 Ardab/faddan). All the infestation symptoms by the insect were recorded in the field during the whole season. The data revealed that ascorbic acid oxidase in corn seed and leaves of tested varieties had negative correlation with all infestation symptoms of O. nubilalis. On the contrary, it caused positive correlation with weights of dry ears yield .On the other hand, alfa esterase enzyme in tested corn seed and leaves showed positive correlation with all infestation symptoms of O. nubilalis and negative correlation with dry ears yield. Current results demonstrated that biochemical constituents with defense enzyme as ascorbic acid oxidase plays an important role in seeds and continue in leaves for plants resistance against O. nubilalis infestation.

Hepatitis B virus (HBV) infection is a global health problem. The mechanisms of immune tolerance in HBV infection are still unclear. The host immune response plays a critical role in determining the outcome of HBV infection. Human leucocyte antigen-G (HLA-G) is involved in immunotolerogenic process and infectious diseases. This study aimed to explore the implication of soluble HLA-G (sHLA-G) and its isoforms in HBV infection. Total sHLA-G (including shedding HLA-G1 and HLA-G5) was analysed by ELISA in 95 chronic HBV patients, 83 spontaneously resolvers and 100 healthy controls (HC). To explore the presence of sHLA-G dimers, we performed an immunoprecipitation and a Western blot analysis on positive samples for sHLA-G in ELISA. The serum levels of sHLA-G were significantly increased in patients with chronic HBV patients compared to spontaneously resolvers and HC (P

The cotton leaf worm Spodoptera littoralis (Biosd) treated as 4th instar larvae by LC50 of some plant oil formulations as neem, jojoba and orange oils to study the histopathological changes in male testes and female ovaries of adult moths. The experiments started by some biological studies on the 4th instar S. littoralis larvae, the results showed that all the tested plant oil formulations achieved the greatest percent of adult malformations. Also, the previous formulations caused strongest effect in the adult fecundity and fertility reduction. This was followed by toxic impact studies on 4th instar S. littoralis larvae that fed on castor bean leaves treated by a series of successive concentrations of each formulate to determine LC50 and LT50 and calculated toxicity index for each formulate. The results concerning neem force (neem oil) was found to be the most effective plant oil formulate that recorded LC50 (0.095%) and the shortest LT50 (2.88 days). The results could be summarized as follows: 1) Neem oil formulation: Testicular follicle were indistinguishable, the contents of male testes separated from the epithelial membrane, in addition, sperm bundles were degenerated and scattered in testes compared with the control. Also, it reduced the size of female ovaries and appeared as clustered, while the nurse cell nucleus was dissolved or absent, the ovarian vacuoles appeared in the shrinkage oocyte compared with normal female ovaries. 2) Jojoba oil formulation: The histopathological effects were clearly observed in male testes and female ovaries of moths. Complete necrosis of all zones and germ cells became indistinct and the vacuoles were clearly seen along the whole testes. Also, ovaries exhibited different shapes and sizes. On the other hand, small vacuoles were found. Moreover, some oocytes nurse cells and their nuclei were shrinkage compared with male testes and female ovaries of the control. 3) Orange oil formulation: The epithelial membrane was separated from testes and became unclear as compared to some sperm bundles degenerated and the rest become scattered. While, the follicular epithelial of female ovaries were completely separated more than oocytes and the nurse cells were absent with abnormal oocyte shape. Also, the ovaries appeared in abnormal shape.

The present work aimed to study the toxic and antifeeding activities of certain plant extracts against Spodoptera littoralis (Boisd.) The extracts of lantana and lemongrass leaves were applied at 5 & 10% concentrations, against 2nd and 4th instars larvae of S. littoralis under laboratory conditions 27 ± 2 °C and 55 – 65% relative humidity. Results showed that the lemongrass extract in water at 10% conc. on the 2nd larval instar and lantana extract in water at 10% conc. on 4th larval instar were the highest in efficacy as antifeedants. Regarding, conversion of ingested and digested food (ECI) & (ECD) lantana extract in water 10% had the least effect. The highest mortality percentage was attained from the lemongrass extract in acetone 10% and lantana extract in water 5% treatments against both the 2nd and 4th larval instars, respectively. Data showed that all the plant extracts caused significant reductions in respect of larval and pupal durations, pupal weight and % of adult emergence compared with the untreated check. The plant extracts had a clear effect on the carbohydrates hydrolysis enzymes as amylase and trehalse

The effect of different concentrations for both of water flae-bane leaves and mango seed plant extracts were studied especially their biological and biochemical effects on the 4th larval instar of Agrotis ipsilon using toxic baits. The results clearly demonstrated that the tested extracts achieved significant increase in the pupal longevity and significant reduction in the larval longevity and pupal weight besides the percentage of pupation. Also, on the adult longevity for either male or female. There was remarkable significant increase in the percentage of malformation for both pupae and adults. The best treatment among all the tested extracts was water mango seed extract at 5% concentration followed by water flae-bane leaves at the same concentration. The biochemical studies proved that water mango seed extract caused increase in the secretion of both of glucsidase and Trehalse enzymes, and decrease in the secretion of acetyl choline esterase. While, water flae-bane leaves extract caused increase in the secretion of acetyl choline esterase. From this point of view, may be the extracts had an effect on the rate of glucose absorption in the blood.

Pulp of sour orange fruit; Citrus aurantium v. amara extracted in water and petroleum ether, leaves of lantana; Lantana salvifolia extracted in acetone and leaves of Herb Robert; Geranium robertianum extracted in water at different concentrations 3, 4 and 5% were tested under laboratory conditions against Citrus mealy bug Planococcus citri (Risso) (Pseudococcidae: Homoptera) which is one of the most wide spread insects infesting horticulture crops either inside or outside greenhouses. Data demonstrated that sour orange extracted in petroleum ether the highest reduction in the population of the different stages of the mealy bug being 97.01% after 8 days from treatment with the assayed materials at 5% concentration. While lantana extract in acetone, pulp of sour orange and leaves of Herb Robert extracted in water achieved intermediate reductions in bug population. Also, LT50 values were determined for the different treatments and it ranged from 2.32 to 3.75 days for leaves of Herb Robert extracted in water and pulp of sour orange extracted in water, respectively.

Leaves of lemongrass and Pigeon berry belonging to two different plant families were extracted in water, petroleum ether and acetone, in addition, to two biopesticides, a bacterial one (Dipel 2X) and entomopathogenic fungi (Biofly) and their mixtures with the two plants used extracted in water in controlling the pink stem borer Sesamia cretica Led. in maize fields during the early summer plantation 2010 season. Data demonstrated that both of lemongrass extract in water, acetone and their mixtures with Biofly achieved the highest reduction percentages in egg-masses. Also, extract of Pigeon berry in acetone showed the highest reduction percentages in the two symptoms of infestation (perforated leaves and dead hearts), the same percentages were obtained either from Pigeon berry with Dipel or Dipel 2X alone in the dead heart cases. (The harvest maize yield was calculated after 120 days from sowing as ardab / feddan). Data obtained from laboratory tests was almost in the same trend as those obtained in the field in which the shortest LT50 values at 5% concentration were calculated for all the treatmnets. It could be concluded that plant extracts which resulted in the highest reduction percentage in egg-masses, larvae and dead heart cases were the same in obtaining the heaviest yield besides decreasing the environment pollution and definitely more save for farmers in comparison with the recommended chemical pesticide.

Four ornamental plants Lantana salvifolia, Lantana (Verbeneceae), Geranium columbinam Pigeon's foot and Geranium robertianum Herb Robert (Geraniaceae) were intercropped with maize plants during early summer seasons plantation mid of April 2009 & 2010 using two nursery methods (alternative hills – alternative rows), aiming to study the effect of essential volatile oils scattered around maize plants against Sesamia cretica Led.. Results demonstrated that the nursery of Lantana and Sweat basil had the highest effect during the two seasons on number and vital of egg-masses and subsequently on number of larvae, number of plants containing perforated leaves and dead hearts. Also, the effect on dry ears weight was estimated. Generally, intercropping using the alternative hills was the best method of nursing. While nursery of Pigeon's foot ranked the third in this respect. However, nursery of Herb Robert was the least among all the ornamental plants used during the two seasons.

The efficiency of water and acetone extracts of radish Raphanus raphanistrum L. and turnip Brassica rape were tested separately and their mixtures with some hiopestiddes (Protecto Siosect) and an insect growth regulator (Runner) agnist 5asamia crelica throughout early summer season 2009. Data demonstrated that treatment with Runner alone, mixture of water radish extract and Protects achieved the highest percentage reduction in number of Sesanda aenea egg-masses, number of larvae, also the for mentioned treatments achieved the highest percentage reduction of plants containing perforated leaves and dead hearts. In addition the highest yield was obtained as a result of treating plants with the previously mentioned treatments. Data showed that there were significant negative correlation between yield and each of 5. o-ebrca traits.

Dodonia leaves and Sour orange (water and acetone extracts) in addition to some compounds derived from plant origin were eva-luated in controlling Sesamia cretica throughout early summer sea-son 2009. The treatments which caused the best results against S. cretica egg-masses, larv ae, number of dead hearts were Natcom 40 (jojoba oil) and Tresser, water dodonia extract and sour orange extracted in petrolum ether. Subsequently, gained the highest yield of 26.7 ardab / feddan. Data showed that a significant negative correlation between yield and each of S. cretica traits. The compo-sition of the experimental plants were obtained from some scientific sites on the wide world web.

The influence of some plant extracts belonging to different families using different polarity solvents on certain biological aspects of 2 nd larval instar of S. cretica larvae was investigated under laboratory conditions of 31 °C & 60 R.H.. The extracted plants were tooth pick, Ammi visnaga Lam (Family: Umbelliferae), coffee tree, Coffea arabica (L. Rubiaceae) , pomegranate Punica granalum L. (Punicaceae) and taro Arum colocasia (Araceae). Data obtained showed that acetone pomegranate extract and hexan tooth pick extract caused the highest mortality percentage (88% & 85% than control). In addition, acetone coffee, acetone pomegranate and hexan tooth pick extracts caused shorter mean of larval duration, 22, 22 and 23 days, respectively. The shortest pupal duration 7 days was due to hexan tooth pick and acetone coffee extract treatments. While the shortest adult longevity (8 days) due to the treatment of hexan tooth pick extract. Also, some deformations were found in S. cretica larvae and pupae as a result of treatment with acetone coffee extract (30 and 33%, respectively). The composition of the tested plants were obtained from some scientific sites on the wide world web. From the previous results, it could be concluded that plant extracts proved to be a safe alternative pest control trend rather than tradional pesticides.

The aim of this study was to characterize the antigenic profile of blasts in acute lymphoblastic leukaemia (ALL) and to determine possible phenotypic aberrancies in a series of 152 patients with acute leukaemia diagnosed non myeloid leukaemia in cytology. Samples were analyzed by EPICS XL flow cytometer (Beckman Coulter) after staining with monoclonal antibodies(Beckman Coulter). Based on criteria of EGIL (European Group of Immunological Leukaemia), cases were classified as: acute lymphoblastic leukaemia (ALL, 52,6%); 75% cases of ALL belong to lymphoid B lineage. 80% of ALL B were CD10 positive, marker of best prognosis. In 10,5% of cases, biphenotypic leukaemia is diagnosed (lymphoid/myeloid). In 25% of cases aberrancies in phenotype were found. Flow cytometry has wide field of applications to characterize blast cells from patients with acute leukaemia: to establish diagnosis of lineage responsible in proliferation, to determine the stage of maturation, to predict prognosis for a better adaptation of adequate treatment, to follow evolution of disease after chemotherapy and to study minimal residual disease.

The effects of Natcom oil (40% Jojoba oil + 59% mineral oil 1% garlic oil) and Adhatoda vasica leaves (water, ethanol, hexane and acetone) extracts were evaluated on hatchability of Spodoptera littoralis eggs at different ages (1 & 5 days) under laboratory conditions 27 ± 2 °C and 70 ± 5 RH.It was found that Natcom 40 at the different tested concentration had the highest effect against all the tested ages of egg, unless the lowest concentration 1% had the best effect of all, causing 94% and 87.4% reduction for 1 and 5 days old of eggs, respectively.Adahatoda vasica leaves water and ethanol extracts showed also high effect on eggs compared with the remaining solvents (Acetone and Hexane).Generally, Preparation of plant extracts were relatively more effective against eggs 5 day old than the ones of 1 day old.

There is currently no known genetic disease linked to prolactin (Prl) or its receptor (PrlR) in humans. Given the essential role of this hormonal system in breast physiology, we reasoned that genetic anomalies of Prl/PrlR genes may be related to the occurrence of breast diseases with high proliferative potential. Multiple fibroadenomas (MFA) are benign breast tumors which appear most frequently in young women, including at puberty, when Prl has well-recognized proliferative actions on the breast. In a prospective study involving 74 MFA patients and 170 control subjects, we identified four patients harboring a heterozygous single nucleotide polymorphism in exon 6 of the PrlR gene, encoding Ile 146 →Leu substitution in its extracellular domain. This sole substitution was sufficient to confer constitutive activity to the receptor variant (PrlR I146L ), as assessed in three reconstituted cell models (Ba/F3, HEK293 and MCF-7 cells) by Prl-independent ( i ) PrlR tyrosine phosphorylation, ( ii ) activation of signal transducer and activator of transcription 5 (STAT5) signaling, ( iii ) transcriptional activity toward a Prl-responsive reporter gene, and ( iv ) cell proliferation and protection from cell death. Constitutive activity of PrlR I146L in the breast sample from a patient was supported by increased STAT5 signaling. This is a unique description of a functional mutation of the PrlR associated with a human disease. Hallmarks of constitutive activity were all reversed by a specific PrlR antagonist, which opens potential therapeutic approaches for MFA, or any other disease that could be associated with this mutation in future.

Resume But Plusieurs tests de laboratoire sont disponibles pour le controle de qualite des concentres plaquettaires. Dans le cadre de controle de qualite des concentres plaquettaires standard (CP), nous avons mesure les gaz de sang et le degre d’activation plaquettaire. Materiels et methodes Les CP sont prepares par la methode de plasma riche en plaquette. Soixante-cinq CP (45 a j1 de vie et 20 a j5 de vie) ont ete etudies. Le pH, la PO 2 , la PCO 2 et la concentration des HCO 3 −, ont ete mesures par un appareil de gaz de sang. L’activation plaquettaire a ete evaluee en mesurant le pourcentage de plaquettes exprimant a leur surface le CD62p et le pourcentage de complexe leucoplaquettaire (% CLP). Resultats Le pH de tous les CP etait compris entre 7,0 et 7,6. Le pH des CP a j1 etait significativement plus eleves que celui des CP a j5 (7,5 ± 0,05 versus 7,3 ± 0,14 ; p p = 0,052). Le pourcentage de CLP etait plus bas dans les CP a j5 par comparaison aux CP a j1. Cette difference etait egalement non significative (22,2 ± 7,5 % versus 17,9 ± 8,0 % ; p = 0,23). Conclusion Le pH et le degre d’activation plaquettaire mesures sont compatibles avec une bonne viabilite plaquettaire. Notre etude est la premiere a evaluer le pourcentage des CLP dans les CP. D’autres etudes sont necessaires pour apprecier l’impact des CLP sur le rendement transfusionnel.

The effect of water extracts of six plants as a toxic activity on Spodoptera littoralis 2'4 & 4°5 larvae was investigated under controlled laboratory condition of 27 °C and 55 — 65% R.H. These plants were leaves of Dodonaea, Dodonaea viscoza, (family: Sapindaceae), pulps and seeds of sour orange Citrus aurantium v. 81778M (family: Rutaceae), (midrib of cabbage leaf), Biassica oleracea v. capitata, (family: Crudferae), (turnip), Brassica raga v. esculenta (family: Crudferae) and (Mango-singara) MangAva domestics (family: Anacardiaceae). Data obtained revealed that Dodonaea-water extract and pulp of sour orange water-extract caused the highest mortality and reduction percentages (80 & 75% than control in 2°I instar larvae and 80 & 81.3% than control in 4m instar larvae, respectively). In addition, pulp of sour orange extract manifested effects since it caused shorter mean of larval duration (13.5 days), longer mean of pupal duration (15 days) and lowest mean of pupal weight (0.1485 gm). Meanwhile, shorter mean of adult longevity (4.3 days) was due to Dodonaea leaves extract. Bioassay data were observable in which the shortest LTso values (4.46 and 3.59 days) for 2"`f and 4m instars larvae treated with Dodonaea extract at 10% concentration, respectively.

Chronic hepatitis B virus (HBV) infection occurs in association to a deregulation of immune system. Human leukocyte antigen E (HLA-E) is an immune-tolerant nonclassical HLA class I molecule that could be involved in HBV progression. To measure soluble (s) HLA-E in patients with chronic HBV hepatitis (CHB). We tested the potential association of HLA-E*01:01/01:03 AG gene polymorphism to CHB. Our cohort consisted of 93 Tunisian CHB patients (stratified in CHB with high HBV DNA levels and CHB with low HBV DNA levels) and 245 healthy donors. Plasma sHLA-E was determined using enzyme-linked immunosorbent assay (ELISA). Genotyping was performed using polymerase chain reaction sequence-specific primer. No association between HLA-E*01:01/01:03 AG polymorphism and HBV DNA levels in CHB patients was found. G/G genotype is less frequent in CHB patients without significance. sHLA-E is significantly enhanced in CHB patients compared with healthy controls (P = 0.0017). Stratification according to HBV DNA levels showed that CHB patients with low HBV DNA levels have higher sHLA-E levels compared with CHB patients with high HBV DNA levels. CHB patients with G/G genotype have enhanced sHLA-E levels compared with other genotypes (P = 0.037). This significant difference is maintained only for CHB women concerning G/G genotypes (P = 0.042). Finally, we reported enhanced sHLA-E in CHB patients with advanced stages of fibrosis (P = 0.032). We demonstrate, for the first time, the association of sHLA-E to CHB. Owing to the positive correlation of HLA-E*01:01/01:03 AG polymorphism and the association of sHLA-E to advanced fibrosis stages, HLA-E could be a powerful predictor for CHB progression. Further investigations will be required to substantiate HLA-E role as a putative clinical biomarker of CHB.

Implementation of multicenter and/or longitudinal studies requires an effective quality assurance program to identify trends, data inconsistencies and process variability of results over time. The Diabetes Control and Complications Trial (DCCT) and the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study represent over 30 years of data collection among a cohort of participants across 27 clinical centers. The quality assurance plan is overseen by the Data Coordinating Center and is implemented across the clinical centers and central reading units. Each central unit incorporates specific DCCT/EDIC quality monitoring activities into their routine quality assurance plan. The results are reviewed by a data quality assurance committee whose function is to identify variances in quality that may impact study results from the central units as well as within and across clinical centers, and to recommend implementation of corrective procedures when necessary. Over the 30-year period, changes to the methods, equipment, or clinical procedures have been required to keep procedures current and ensure continued collection of scientifically valid and clinically relevant results. Pilot testing to compare historic processes with contemporary alternatives is performed and comparability is validated prior to incorporation of new procedures into the study. Details of the quality assurance plan across and within the clinical and central reading units are described, and quality outcomes for core measures analyzed by the central reading units (e.g. biochemical samples, fundus photographs, ECGs) are presented.

Background. – Recent epidemiological studies in Europe and in USA using antigliadin antibodies and antiendomysium antibodies for initial screening have shown that the overall prevalence of celiac disease (CD) is about 1:200 (0.5%). Aim. – To screen for CD in healthy blood donors in Tunisia. Patients and methods. – Sera from 2500 healthy blood donors (median age: 21 years, 70% men and 30% women) were screened for IgG-antigliadin antibodies and IgA-antigliadin antibodies with an enzyme-linked immunosorbent assay. All sera with positive antigliadin antibodies were tested for antiendomysium antibodies using human umbilical cord cryosections as substrate. Results. – Seven healthy blood donors (median age: 21 years; four men, three women) have antiendomysium antibodies. The prevalence of antiendomysium antibodies in healthy blood donors in Tunisia is 1:355 (0.28%). Conclusions. – On the basis of a high specificity of the antiendomysium antibodies, it is likely that the seven blood donors identified in this study have CD. These data suggest that CD is frequent in Tunisia.

Resume Objectif. – La technique du capitonnage de l'aisselle sans drainage semble une alternative valable au drainage aspiratif. Ce capitonnage peut etre musculaire ou aponevrotique. Nous rapportons ici une evaluation du capitonnage musculaire, sans drainage. La presentation de nos resultats sur le capitonnage musculaire a ete egalement l’occasion de faire le point sur les autres alternatives visant a reduire la morbidite du drainage aspiratif. Patientes et methodes. – Un capitonnage musculaire a ete realise de maniere prospective au Centre Rene-Huguenin sur 152 patientes avec huit chirurgiens differents. Le recul est de 3,5 ans. La douleur a ete evaluee de maniere comparative avec 30 patientes operees avec un drainage aspiratif. Resultats. – Cette technique est d’un apprentissage simple. Elle est reproductible, elle simplifie les suites operatoires en permettant toujours une sortie au deuxieme ou troisieme jour postoperatoire sans soins a domicile. Il n’y a aucune augmentation des sequelles tardives. En revanche, les douleurs postoperatoires sont deux fois plus importantes dans les premieres semaines par rapport au drainage aspiratif et le taux de seromes est augmente. Discussion et conclusion. – Malgre la tres bonne efficacite, cette majoration des douleurs nous est apparue comme un obstacle majeur a la diffusion du capitonnage musculaire. Recemment, une modification technique importante realisant un capitonnage aponevrotique a ete publiee. Elle semble avoir une bonne efficacite, avec moins de douleurs que le capitonnage musculaire. Elle est en cours d’evaluation et pourrait devenir une alternative valable au drainage. Les alternatives techniques sont discutees. Les etudes publiees manquent, pour la plupart, de comparaison avec le drainage et ne prennent pas suffisamment en compte le retentissement sur la qualite de vie. Des travaux evaluant mieux cette qualite de vie sont actuellement en cours et devraient permettre, a l’avenir, de faire des choix prenant mieux en compte cette dimension.

Fever-shivers reaction (FSR) is the most frequent transfusion immediate incident related to platelet transfusions. The aim of our prospective study was to assess the frequency of the different immediate incidents, especially the frequency and the causes of the FSR, observed during the transfusion of standard platelet concentrates (SPC). For each FSR, analysis of causes included: a bacterial culture of the implicated SPC, a blood culture and HLA antibody screening (lymphocytotoxicity assay) among the patients. In the study period, 34 patients were followed during 74 transfusions. Ten immediate incidents were noted; FSR: N = 8, erythema-urticaria: N = 1 and nausea-vomit: N = 1. The FSR was observed in 6 patients who received 56 SPC. Analysis of causes of this reaction revealed that: HLA antibodies were present in one patient; bacterial contamination was not found neither among the patients nor in the implicated SPC, and the risk of the FSR occurrence rose with increased storage time of the SPC transfused. Indeed, a significant difference was noted between the mean age of the SPC implicated in the FSR and the mean age of those not implicated (P = 0,0028). In conclusion, the FSR is a frequent incident observed during SPC transfusions. In the majority of cases, the cause of this reaction was not identified. Further studies will be necessary to better understand the physiological mechanisms of the FSR.

SummaryCryoprecipitate is the principal type of factor VIII (FVIII) concentrate used for treating haemophilia A in Tunisia. Allergic reactions, viral transmission, and inhibitor formation remain the most serious complications of FVIII therapy. The aims of the study presented here were to evaluate the efficacy of FVIII therapy, to investigate the inhibitor prevalence, and the factors which may affect inhibitor formation in our haemophilia A patients. Plasma samples were screened for FVIII inhibitors by the Bethesda method. 30 minutes FVIII recovery was also determined for each patient. In this prospective study, 18 previously treated haemophilia A patients, four with severe (FVIII concentration

Objectifs Les dossiers de sante electronique (DSE) sont devenus une necessite dans la pratique quotidienne des medecins. Il est recommande que les programmes de formation en soins de sante incluent les DSE dans leur curriculum afin de preparer les residents en formation a leurs experiences cliniques. La plupart des residents ne sont pas a jour avec les recentes lignes directrices sur la gestion des patients, comme ils depensent plus de 40 % de leur temps devant un ecran d’ordinateur remplissant les donnees DES. Methodes Plusieurs “Guidelines” internationaux en uro-oncologie ont ete encodees et integrees dans un assistant medical electronique avance (AME). Cela permet au logiciel de guider le stagiaire a travers plusieurs etapes afin de resoudre un cas clinique. Quand plusieurs modalite de traitement sont valable, le logiciel peut aider dans la decision clinique en fournissant des points favorables ou non favorables a un certain plan de gestion. Toutes les evaluations sont effectuees apres une analyse approfondie du DSE et en tenant compte du profil personnalise du patient et des co-morbidites. Resultats Cet article decrit un systeme de DSE entierement fonctionnel qui est avantageux pour l’education medicale en raison de ses qualites interactives. Comme le logiciel est encode avec des “Guidelines” internationaux et mis a jour d’une maniere reguliere, le logiciel aidera a eviter des erreurs de pratique medicale a maintenir les residents en formation a jour avec les developpements recents dans la pratique clinique ( Figure 1 , Figure 2 ). Conclusion L’utilisation d’un assistant electronique lors de la formation d’urologie est une innovation qui facilitera l’apprentissage en guidant les rencontres avec les patients et en assistant au plan de gestion. Une evaluation et une recherche complementaires sont en effet necessaires pour evaluer l’efficacite du programme dans la pratique quotidienne.

Identification of an HLA-G 14-bp Insertion/Deletion (Ins/Del) polymorphism at the 3' untranslated region of HLA-G revealed its importance in HLA-G mRNA stability and HLA-G protein level variation. We evaluated the association between the HLA-G 14-bp Ins/Del polymorphism in patients with chronic Hepatitis B virus (HBV) infection in a case-control study. Genomic DNA was extracted from 263 patients with chronic HBV hepatitis and 246 control subjects and was examined for the HLA-G 14-bp Ins/Del polymorphism by PCR. The polymorphic variants were genotyped in chronic HBV seropositive cases stratified according to HBV DNA levels, fibrosis stages and in a control population. There was no statistical significant association between the 14-bp Ins/Del polymorphism and increased susceptibility to HBV infection neither for alleles (P = 0.09) nor for genotypes (P = 0.18). The stratification of HBV patients based on HBV DNA levels revealed an association between the 14-bp Ins/Del polymorphism and an enhanced HBV activity with high HBV DNA levels. In particular, the Ins allele was significantly associated with high HBV DNA levels (P = 0.0024, OR = 1.71, 95% CI 1.2-2.4). The genotype Ins/Ins was associated with a 2.5-fold (95% CI, 1.29-4.88) increased risk of susceptibility to high HBV replication compared with the Del/Del and Ins/Del genotypes. This susceptibility is linked to the presence of two Ins alleles. No association was observed between the 14-bp Ins/Del polymorphism and fibrosis stage of HBV infection. We observed an association between the 14-bp Ins/Del polymorphism and high HBV replication characterized by high HBV DNA levels in chronic HBV patients. These results suggest a potential prognostic value for disease outcome evaluation.

Refractive error (RE) is a complex, multifactorial disorder characterized by a mismatch between the optical power of the eye and its axial length that causes object images to be focused off the retina. The two major subtypes of RE are myopia (nearsightedness) and hyperopia (farsightedness), which represent opposite ends of the distribution of the quantitative measure of spherical refraction. We performed a fixed effects meta-analysis of genome-wide association results of myopia and hyperopia from 9 studies of European-derived populations: AREDS, KORA, FES, OGP-Talana, MESA, RSI, RSII, RSIII and ERF. One genome-wide significant region was observed for myopia, corresponding to a previously identified myopia locus on 8q12 (p = 1.25×10-8), which has been reported by Kiefer et al. as significantly associated with myopia age at onset and Verhoeven et al. as significantly associated to mean spherical-equivalent (MSE) refractive error. We observed two genome-wide significant associations with hyperopia. These regions overlapped with loci on 15q14 (minimum p value = 9.11×10-11) and 8q12 (minimum p value 1.82×10-11) previously reported for MSE and myopia age at onset. We also used an intermarker linkage- disequilibrium-based method for calculating the effective number of tests in targeted regional replication analyses. We analyzed myopia (which represents the closest phenotype in our data to the one used by Kiefer et al.) and showed replication of 10 additional loci associated with myopia previously reported by Kiefer et al. This is the first replication of these loci using myopia as the trait under analysis. "Replication-level" association was also seen between hyperopia and 12 of Kiefer et al.'s published loci. For the loci that show evidence of association to both myopia and hyperopia, the estimated effect of the risk alleles were in opposite directions for the two traits. This suggests that these loci are important contributors to variation of refractive error across the distribution.

This article stems from a panel session at the 1997 Symposium on Software Reusability, and discusses open research issues, classified by goal and by approach. Software development cannot possibly become an engineering discipline so long as it has not perfected a technology for developing products from reusable assets in a routine manner, on an industrial scale. Software reuse cannot, in turn, achieve this status unless we make the following provisions: a sound scientific foundation that encompasses relevant design principles, widely acceptable engineering standards that compile these principles into working practical solutions, and coherent managerial standards that enable the deployment of these solutions under acceptable conditions of product quality and process maturity. Although successful software reuse experiments are increasingly common, success is not the norm, software reuse is not a matter of routine practice, the promises of software reuse remain for the most part unfulfilled, and a number of issues remain worthy of further research.

Background: Left ventricular assist devices (LVAD)-induced unloading appear to cause reverse cardiac remodeling. However, its effect on arrhythmogenicity is a controversial issue, and prospective data are lacking. We sought to investigate the impact of LVAD-induced unloading on the electrical properties of the failing heart. Methods We prospectively studied the effects of LVAD therapy on QRS, QT, and QTc durations and ventricular arrhythmias from electrocardiograms and 24-hour ambulatory electrocardiograms recorded before and during 6 months of mechanical support in 12 LVAD patients and 7 other patients with advanced nonischemic cardiomyopathy untreated with LVAD. Results After 1 week of LVAD support, QTc duration had decreased from 479 ± 79 ms to 411 ± 57 ms (p = 0.037), and QRS duration from 150 ± 46 ms to 134 ± 32 ms (p = 0.029). At 6 months, QTc was found to be 372 ± 56 ms (p = 0.046 versus baseline, 15% shortening) and QRS 118 ± 25 ms (p = 0.028 versus baseline, 11% shortening). A strong correlation was found between QTc shortening and increase in left ventricular ejection fraction and decrease in left ventricular filling pressures. After 2 months of LVAD support, premature ventricular contractions had decreased from 3,507 ± 4,252 to 483 ± 417 in 24 hours (p = 0.043), ventricular couplets from 82 ± 99 to 29 ± 25 in 24 hours (p = 0.05), and ventricular runs from 9 ± 8 to 10 ± 9 (not significant). No patient died suddenly or suffered a symptomatic arrhythmic event during follow-up. No significant electrocardiographic, functional, or hemodynamic change was observed in the 7 patients untreated with LVAD. Conclusions The LVAD support caused progressive shortening of QTc and QRS intervals, consistent with reverse remodeling of the failing heart's electrical properties, accompanied by a decrease in frequency of ventricular arrhythmias. © 2011 The Society of Thoracic Surgeons.

The aims of this flow cytometry study were to quantify B lymphoid precursors known as hématogones across age and clinical conditions and to study the immunophenotypic profile of these benign immature B cells. A total of 406 consecutive marrow specimens were analyzed for hématogones using 4-color flow cytometry during a 19 month period (60% males and 40% females). The age range was 3 months to 89 years. Hématogones were present in 80% of the specimens. Morphologic analysis of the smears from each patient showed small numbers of hématogones (13% of total cellularity). The B cell population was defined by CD19 + CD45 bright positivity, coexpression of other B lineage markers: CD20, CD22, CD10, CD29, CD38 and CD58 in addition to HLA-DR and CD34. In our study we found a significant decline in hématogones with increasing age but a broad range was found at all ages. Marrow from some adults contained relatively high numbers. Diagnosis in these patients included cytopenias, infections, and neoplastic diseases. Distinction of hématogones is critical for disease management particularly after therapy of paediatric B acute lymphoblastic leukaemia to monitor for minimal residual disease.