Insight into thyroid-stimulating autoantibody interaction with the thyrotropin receptor N-terminus based on mutagenesis and re-evaluation of ambiguity in this region of the receptor crystal structure.

Background: Thyroid-stimulating autoantibodies (TSAb) bind to the thyrotropin receptor (TSHR) extracellular domain, or ectodomain (ECD), comprising a leucine-rich repeat domain (LRD) linked by a hinge region to the transmembrane domain (TMD). The LRD (residues 22-260; signal peptide 1-21) contains two disulfide-bonded loops at its N-terminus. In the crystal structure of the isolated LRD complexed with human TSAb monoclonal antibody (mAb) M22, N-terminal disulfide loop 1 (residues 22-30) could not be determined because of crystal disorder.

Mesenchymal stem cell delivery into rat infarcted myocardium using a porous polysaccharide-based scaffold: a quantitative comparison with endocardial injection.

The use of mesenchymal stem cells (MSCs) for tissue regeneration is often hampered by modest engraftment in host tissue. This study was designed to quantitatively compare MSCs engraftment rates after delivery using a polysaccharide-based porous scaffold or endocardial (EC) injection in a rat myocardial infarction model. Cellular engraftment was measured by quantitative reverse transcription-polymerase chain reaction using MSCs previously transduced with a lentiviral vector that expresses green fluorescent protein (GFP).

Causes of traumatic brain injury in patients admitted to Rafidia, Al-Ittihad and the specialized Arab hospitals, Palestine, 2006?2007.

Primary Objective: The eruption of Al-Aqsa Intifada created a war situation in Palestine, increasing the number of firearms injuries caused by occupying Israeli forces as well as disabling head injuries. No data were available to the Palestinian Ministry of Health and other health organizations on traumatic brain injury (TBI) in Palestine. This study, therefore, sought to determine the causes and outcomes of TBI in patients who were admitted to three hospitals in Nablus, Palestine.

Monocytic cells derived from human embryonic stem cells and fetal liver share common differentiation pathways and homeostatic functions.

The early emergence of macrophages and their large pattern of tissue distribution during development suggest that they may play a critical role in the initial steps of embryogenesis. In the present study, we show that monocytic cells derived from human embryonic stem cells (hESCs) and from fetal liver follow a differentiation pathway different to that of adult cells, leading to specific functions. Embryonic and fetal monocytic cells differentiated from a CD14(low)CD16(-) precursor to form CD14(high)CD16(+) cells without producing the CD14(high)CD16(-) cell population that predominates in adult peripheral blood.

Relationship between thyrotropin receptor hinge region proteolytic posttranslational modification and receptor physiological function.

The glycoprotein hormone receptor hinge region is the least conserved component and the most variable in size; the TSH receptor (TSHR) being the longest (152 amino acids; residues 261-412). The TSHR is also unique among the glycoprotein hormone receptor in undergoing in vivo intramolecular cleavage into disulfide-linked A- and B-subunits with removal of an intervening 'C-peptide' region. Experimentally, hinge region amino acids 317-366 (50 residues) can be deleted without alteration in receptor function.

Variable suppression of serum thyroxine in female mice of different inbred strains by triiodothyronine administered in drinking water.

Background: Recombinant-inbred mouse strains differ in their susceptibility to Graves'-like hyperthyroidism induced by immunization with adenovirus expressing the human thyrotropin (TSH) receptor. Because one genetic component contributing to this susceptibility is altered thyroid sensitivity to TSH receptor agonist stimulation, we wished to quantify thyroid responsiveness to TSH. For such studies, it is necessary to suppress endogenous TSH by administering L-3,5,3′-triiodothyronine (L-T3), with the subsequent decrease in serum thyroxine (T4) reflecting endogenous TSH suppression.

Antibodies to thyroid peroxidase arise spontaneously with age in NOD.H-2h4 mice and appear after thyroglobulin antibodies.

Hashimoto's thyroiditis, a common autoimmune disease, is associated with autoantibodies to thyroglobulin (Tg) and thyroid peroxidase (TPO). TPO, unlike abundant and easily purified Tg, is rarely investigated as an autoantigen in animals. We asked whether antibodies (Abs) develop to both TPO and Tg in thyroiditis that is induced (C57BL/6 and DBA/1 mice) or arises spontaneously (NOD.

Rare case of pediatric cecal volvulus.

An 11-year-old female child presented with abdominal pain, vomiting and constipation. An exploratory laparotomy revealed a cecal volvulus due to a congenital band and malfixation of the cecum. This was treated by excision of the band, derotation and decompression of cecum though an appendiceal stump suction.

Asthma and pulmonary arterial hypertension: do they share a key mechanism of pathogenesis?

Although largely distinct and seemingly unrelated, asthma and pulmonary arterial hypertension (PAH) have important pathological features in common, including inflammation, smooth muscle contraction and remodelling. We hypothesised that these common features could be explained by one shared mechanism of pathogenesis: activation of the transcription factor NFAT (nuclear factor of activated T-cells). If this concept is validated, it could lead to the introduction of novel therapeutic strategies against both lung disorders.

The case for regulatory reform in the business and healthcare environments.

Government regulations affect corporations and consumers on a daily basis. For example, environmental and safety regulations in the workplace are administrated by the Occupational Safety and Health Administration (OSHA) under the Department of Labor. OSHA sets and enforces standards in work environment to ensure the safety and health of workers.

Short term effects of spironolactone on blood lipid profile: a 3-month study on a cohort of young women with hirsutism.

Aims: To investigate the effects of spironolactone on serum lipids in women with hirsutism over a 3-month period.

Methods: In a prospective setting, 27 hirsute women (20 with polycystic ovary syndrome and seven with idiopathic hirsutism) with a mean age of 23.0 +/- 5.

Changes in growth hormone and insulin-like growth factor-I levels in the acute stage after open heart surgery and at the time of discharge.

Introduction: Stress conditions are known to disturb the axis of growth hormone (GH)/insulin-like growth factor-I (IGF-I), but there is little data on this topic after open heart surgery. This study aimed to investigate changes in GH/IGF-I axis in adults undergoing open heart surgery.

Methods: A total of 162 adult patients admitted for elective major cardiac surgery were studied in a prospective setting.

Rational use effects of implementing an essential medicines list in West Bank, Palestinian Territories.

The Palestinian Ministry of Health introduced an essential medicines list (EML) in 2000 to improve rational use of medicines and contain costs. We have examined the effects of the EML in the Palestinian healthcare public sector. We obtained data on prescription patterns for medicines from 3570 prescriptions given during outpatient visits in 17 healthcare facilities in the West Bank from 1997 to 2003.

Anatomy of the transarcuate approach to the petrous apex.

Objective: Determine the dimensions of the approach to the petrous apex through the crura of the superior semicircular canal (SSC).

Study Design: Measurements obtained from high-resolution computed tomography (HRCT) images.

Subjects And Methods: One hundred ninety-two HRCTs were screened and 58 temporal bones with pneumatized posterior petrous apex cell tracts in 39 patients were identified and reviewed.

Insulin resistance is an independent correlate of increased urine albumin excretion: a cross-sectional study in Iranian Type 2 diabetic patients.

Aims: To assess the association of insulin resistance with increased urinary albumin excretion (UAE) in a cohort of Iranian Type 2 diabetic patients.

Methods: Three hundred and sixty-one men and 472 women with Type 2 diabetes were enrolled from three different outpatient clinics (Tehran, Iran) during the period 2005-2008. Patients with obstructive uropathy, severe heart failure, liver disease, cancer, autoimmune disease and macroalbuminuria were not included.

Post-operative pain relief following intrathecal injection of acetylcholine esterase inhibitor during lumbar disc surgery: a prospective double blind randomized study.

Background: As spinal cholinergic receptors participate in the control of somatic pain, this effect could be potentiated by intrathecal injection of a cholinesterase inhibitor, neostigmine.

Objective: This study was designed to evaluate the effectiveness of intrathecal administration of neostigmine on pain relief after single level lumbar disectomy.

Methods: Sixty-six patients with unilateral extruded lumbar disc were randomly allocated into two groups, neostigmine ('N'), and control ('C'); the former received 100 microg of neostigmine methylsulphate, whereas the latter received placebo intrathecally after termination of the surgery.

Rapid, direct fabrication of antireflection-coated microlens arrays by photoembossing.

Photoembossing is a rapid, low cost process to create surface relief structures in polymer thin films via a reaction/diffusion mechanism. It is demonstrated that this technique can be used to create a microlens array of which the focal length can be easily controlled by tuning the processing parameters. In addition, the technique is shown to be particularly interesting since it does not require any physical contact during the development of the microlens array.

Avicenna's treatise on otology in Medieval Persia.

Avicenna (AD 980-1037) was one of the best-known physicians of his time. Born in Persia, he gained notoriety both in the local and international scenes. Avicenna's best-known book, Canon of Medicine, was the standard textbook of medicine for more than five centuries in Europe and the Persian Empire.

Albuminuria and its correlates in an Iranian type 2 diabetic population.

Objective: To study the prevalence and correlates of increased urinary albumin excretion (UAE) in an Iranian type 2 diabetic population.

Methods: Over a one year period since October 2002, 400 consecutive type 2 diabetic patients referred to an outpatient diabetes clinic, were enrolled in a cross sectional study. Subjects had no history of renal impairment or overt proteinuria.

Implementing an essential medicines list: effects on pricing and utilization in West Bank, Palestine.

The purpose of this article is to examine the effects of implementing an essential medicines list (EML) on medicine prices, utilization and aggregate cost savings in the public sector of West Bank, Palestine. The Palestinian Ministry of Health (MOH) introduced an EML to contain escalating costs and improve appropriate utilization within the public sector. To assess the effects of the EML implementation, we obtained price and utilization data for 76 medicine groups for 1997-2003.

Thyroid autoimmunity and recurrent spontaneous abortion in Iran: a case-control study.

Objective: To determine the association of thyroglobulin antibodies (TG-Ab) and thyroid peroxidase antibodies (TPO-Ab) with recurrent spontaneous abortion in a euthyroid, nonpregnant population of women in Iran.

Methods: In this case-control study conducted between November 2003 and September 2006 in Tehran, Iran, nonpregnant women with a history of 3 or more consecutive pregnancy losses and age-matched, healthy parous women without a history of reproductive problems were assessed. Thyroid function tests were performed, which included assessment of thyroid-stimulating hormone, triiodothyronine, thyroxine, and the presence of TG-Ab and TPO-Ab.

Enhancement of pulmonary vascular remodelling and inflammatory genes with VIP gene deletion.

The pathogenesis of idiopathic pulmonary arterial hypertension (PAH) remains poorly understood. The present authors recently reported that mice with vasoactive intestinal peptide (VIP) gene disruption show a spontaneous phenotype of PAH, with pulmonary vascular remodelling and lung inflammation. To explore the underlying molecular mechanisms in this model, it was examined whether absence of the VIP gene might alter the expression of additional genes involved in the pathogenesis of PAH, as single-gene deletions, in the absence of hypoxia, rarely result in significant pulmonary vascular remodelling.

Distribution of solitary parathyroid adenoma over the parathyroid glands and its surgical management.

Objective: To determine the distribution of solitary parathyroid adenoma over the parathyroid glands in a group of patients with primary hyperparathyroidism Design: A case-series.

Place And Duration Of Study: Departments of Surgery and Pathology at Shariati Hospital, Tehran, Iran, between the years 1981 and 2003.

Patients And Methods: A retrospective review of surgery reports of 118 patients with primary hyperparathyroidism was performed.

Craniopagus, Laleh and Ladan twins, sagital sinus.

Adult craniopagus twins aged 29 years who succumbed to the surgical separation are being presented posthumously. Neuroimaging studies had revealed a total type 3 craniopagus with a common superior sagittal sinus beginning at its distal half and draining into a common Torcular Herophili. In July 2003, neurosurgeons at Singapore embarked on the mission to tackle the separation of the most complex and challenging adult craniopagus of the present millennium, unfortunately ending up with devastating results.

A study of middle cranial fossa anatomy and anatomic variations.

We conducted a study to establish standardized measurements of the common anatomic landmarks used during surgery via the middle cranial fossa approach. Results were based on high-resolution computed tomography (CT) images of 98 temporal bones in 54 consecutively presenting patients. Measurements were obtained with the assistance of the standard PACS (picture archiving and communication system) software.