Decompressive surgery for treating nerve damage in leprosy. A Cochrane review.

OBJECTIVE: Decompressive surgery is used for treating nerve damage in leprosy. We assessed the effectiveness of decompressive surgery for patients with nerve damage due to leprosy. METHODS: A broad search strategy was performed to find eligible studies, selecting randomised controlled trials (RCTs) comparing decompressive surgery alone or plus corticosteroids with corticosteroids alone, placebo or no treatment. Two authors independently assessed quality and extracted data. Where it was not possible to perform a meta-analysis, the data for each trial was summarised. RESULTS: We included two randomised controlled trials involving 88 people. The trials examined the added benefit of surgery over prednisolone for treatment of nerve damage of less than 6 months duration. After 2 years follow-up there was no significant difference in nerve function improvement between people treated with surgery plus prednisolone or with prednisolone alone. Adverse effects of decompression surgery were not adequately described. CONCLUSIONS: Evidence from randomised controlled trials does not show a significant added benefit of surgery over steroid treatment alone. Well-designed randomised controlled trials are needed to establish the effectiveness of the combination of surgery and medical treatment compared to medical treatment alone

Exchange of functional domains between a bacterial conjugative relaxase and the integrase of the human adeno-associated virus

Endonucleases of the HUH family are specialized in processing single-stranded DNA in a variety of evolutionarily highly conserved biological processes related to mobile genetic elements. They share a structurally defined catalytic domain for site-specific nicking and strand-transfer reactions, which is often linked to the activities of additional functional domains, contributing to their overall versatility. To assess if these HUH domains could be interchanged, we created a chimeric protein from two distantly related HUH endonucleases, containing the N-terminal HUH domain of the bacterial conjugative relaxase TrwC and the C-terminal DNA helicase domain of the human adeno-associated virus (AAV) replicase and site-specific integrase. The purified chimeric protein retained oligomerization properties and DNA helicase activities similar to Rep68, while its DNA binding specificity and cleaving-joining activity at oriT was similar to TrwC. Interestingly, the chimeric protein could catalyse site-specific integration in bacteria with an efficiency comparable to that of TrwC, while the HUH domain of TrwC alone was unable to catalyze this reaction, implying that the Rep68 C-terminal helicase domain is complementing the TrwC HUH domain to achieve site-specific integration into TrwC targets in bacteria. Our results illustrate how HUH domains could have acquired through evolution other domains in order to attain new roles, contributing to the functional flexibility observed in this protein superfamily.This work was supported by the Medical Research Council (MRC) grant MR/N022890/1 to EH and grant 1001764 to RML; National Institutes of Health (NIH) grant RO1-GM09285 to CRE; Spanish Ministry of Economy and competitiveness (MINECO) grant BIO2013-46414-P to ML and AFM is supported by a Doc.Mobility fellowship from the Swiss National Science Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

A Clinical Instrument for Combined Raman Spectroscopy-Optical Coherence Tomography of Skin Cancers

Background and Objective: The current standard for diagnosis of skin cancers is visual inspection followed by biopsy and histopathology. This process can be invasive, subjective, time consuming, and costly. Optical techniques, including Optical Coherence Tomography (OCT) and Raman Spectroscopy (RS), have been developed to perform non-invasive characterization of skin lesions based on either morphological or biochemical features of disease. The objective of this work is to report a clinical instrument capable of both morphological and biochemical characterization of skin cancers with RS-OCT. Materials and Methods: The portable instrument utilizes independent 785 nm RS and 1,310 nm OCT system backbones. The two modalities are integrated in a 4 ''(H) x 5 ''(W) x 800 ''(L) clinical probe. The probe enables sequential acquisition of co-registered OCT and RS data sets. The axial response of the RS collection in the skin was estimated using scattering phantoms. In addition, RS-OCT data from patients with cancerous and non-cancerous lesions are reported. Results: The RS-OCT instrument is capable of screening areas as large as 15 mm(transverse) by 2.4 mm(in depth) at up to 8 frames/second with OCT, and identifying locations to perform RS. RS signal is collected from a 44 mu m transverse spot through a depth of approximately 530 mu m. RS-OCT data sets from a superficial scar and a nodular BCC are reported to demonstrate the clinical potential of the instrument. Conclusion: The RS-OCT instrument reported here is capable of morphological and biochemical characterization of cancerous skin lesions in a clinical setting. OCT can visualize microstructural irregularities and perform an initial morphological analysis of the lesion. The images can be used to guide acquisition of biochemically specific Raman spectra. The two data sets can then be evaluated with respect to one another to take advantage of the mutually complimentary nature of RS and OCT. Lasers Surg. Med. 43:143-151, 2011. (C) 2011 Wiley-Liss, In

Incomplete and irregular annual replacement of secondaries in Eurasian Golden Plovers, Pluvialis apricaria

In most waders (Charadrii) replacement of old by new feathers during moult of primaries occurs in a fixed order and in such a way that flight capacities are maintained. Moult of the secondaries of the Eurasian Golden Plover Pluvialis apricaria deviates from this general pattern. The sequence of secondary moult is irregular and – in most cases – asymmetric between wings. In addition, only about half the secondaries are renewed every year. Secondary moult is arrested in October and not resumed in spring. This can be deduced from the moult scores of >900 adults that were caught in autumn and spring when staging in the Netherlands, and from inspection of three birds caught on their nests in Iceland. It is also confirmed by the moult scores of seven birds (from a group of about 1,500) that were recaptured after their first complete moult. As their juvenile secondaries had been marked with picric acid the year before, all non-dyed secondaries had evidently been renewed – and all dyed ones were old. As irregular moult of the secondaries also occurs in other Charadriidae plovers, this characteristic might have originated from a common ancestor. Irregular and incomplete secondary moult may be explained by birds avoiding the costly moult of feathers that experience little wear. With most moult studies focusing on primary moult, this aspect of secondary moult has previously remained undiscovered

Incomplete and irregular annual replacement of secondaries in Eurasian Golden Plovers, <i>Pluvialis apricaria</i>

In most waders (Charadrii) replacement of old by new feathers during moult of primaries occurs in a fixed order and in such a way that flight capacities are maintained. Moult of the secondaries of the Eurasian Golden Plover Pluvialis apricaria deviates from this general pattern. The sequence of secondary moult is irregular and – in most cases – asymmetric between wings. In addition, only about half the secondaries are renewed every year. Secondary moult is arrested in October and not resumed in spring. This can be deduced from the moult scores of &gt;900 adults that were caught in autumn and spring when staging in the Netherlands, and from inspection of three birds caught on their nests in Iceland. It is also confirmed by the moult scores of seven birds (from a group of about 1,500) that were recaptured after their first complete moult. As their juvenile secondaries had been marked with picric acid the year before, all non-dyed secondaries had evidently been renewed – and all dyed ones were old. As irregular moult of the secondaries also occurs in other Charadriidae plovers, this characteristic might have originated from a common ancestor. Irregular and incomplete secondary moult may be explained by birds avoiding the costly moult of feathers that experience little wear. With most moult studies focusing on primary moult, this aspect of secondary moult has previously remained undiscovered.</p