True aneurysmal disease in the carotid arteries is very uncommon, but individuals with this pathology face the grave risk of thromboembolism, which may consequently lead to cerebrovascular accidents. Clinical knowledge remains relatively limited owing to its rarity. We present the case of a 41-year-old obese female with a type II right extracranial internal carotid artery aneurysm incidentally found during imaging work-up. She underwent open surgical reconstruction with an autologous interposition graft from the common carotid artery to the internal carotid artery at the base level of the skull. Her postoperative period was uneventful, and the patient was discharged on postoperative day five with aspirin. At 12 months of follow-up, the patient remained symptom-free without complications.

True aneurysmal disease in the carotid arteries is very uncommon, but individuals with this pathology face the grave risk of thromboembolism, which may consequently lead to cerebrovascular accidents. Clinical knowledge remains relatively limited owing to its rarity. We present the case of a 41-year-old obese female with a type II right extracranial internal carotid artery aneurysm incidentally found during imaging work-up. She underwent open surgical reconstruction with an autologous interposition graft from the common carotid artery to the internal carotid artery at the base level of the skull. Her postoperative period was uneventful, and the patient was discharged on postoperative day five with aspirin. At 12 months of follow-up, the patient remained symptom-free without complications.

Background: Pectin is a pharmaceutically relevant excipient that can be upcycled from selected Philippine fruit peel wastes. Method optimization of pectin extraction leads to maximizing yields from limited resources, while also reducing environmental wastes, and providing local alternative sources. Objectives: This study aimed to optimize the method of extracting pectin from selected Philippine fruit peel wastes using the Box-Behnken design, by varying the acid extraction solvent, treatment time, and working temperature. Methodology: The three-level (-1, 0, 1) Box-Behnken design (15 set-ups) was used to optimize the pectin extraction in each of the fruit peel samples (C. maxima; A. heterophyllus; ripe and unripe M. indica; D. zibethinus; and H. undatus). The three experimental factors were the type of 3N acid used as extracting solvent (HNO₃, H₂SO₄, and HCl); duration of treatment in minutes (60, 90, and 120); and temperature of treatment in C 60, 75, and 90). The %yield was computed in each set-up, and the projected yields were generated using multiple linear regression. The pectin samples obtained from the optimized conditions were subjected to the physicochemical characterization, with apple pectin as the standard. Degree of esterification (DE), equivalent weight (EW), methoxy content (MC), alkalinity of ash (AA), and anhydrouronic acid content (AUA) were performed. Results: Maximum yields were extracted from C. maxima (28.96%), A. heterophyllus (20.12%), ripe M. indica (26.23%), and unripe M. indica (25.89%), using 3N H₂SO₄, for a treatment duration of 60 minutes, at a working temperature of 90 C, and H. undatus (25.03%) at 60 C, for a treatment duration of 120 minutes. Conclusion Optimum conditions were identified to extract pectin in each of the fruit peel samples. The 3N H₂SO₄ produced the highest pectin yields in all of the set-ups, while the treatment time and working temperature vary per fruit peel sample. Pectin extract from C. maxima, A. heterophyllus, and M. indica was comparable to the standard.
Pectins

BACKGROUND: Pectin is a heteropolysaccharide used in pharmaceutical formulations as a binding agent. Importation of pectin costs billions of Philippine pesos, but the local laboratory-scale production of this excipient from fruit peel wastes is estimated to be cheaper by 80%.

OBJECTIVE: To address economic and environment concerns associated with pectin production, this study aimed to optimize the isolation and purification of pharmaceutical grade pectin from pomelo (Citrus maxima Merr.) fruit peel as basis for commercial-scale production.

METHODS: Pectin was extracted from pomelo using different solvents: 6.2% w/w citric acid, 1N acetic acid, 3N hydrochloric acid, 3N nitric acid, and 3N sulfuric acid. Temperatures for extracting pectin were explored at 40°C, 60°C, and 90°C. Obtained pectin samples were characterized based on the following parameters: equivalent weight (EW), methoxyl content (MC), ash content (AC), anhydrouronic acid content (AUA), and degree of esterification (DE).

RESULTS: Highest pectin yield (9.25%) was obtained using 3N nitric acid and 3N sulfuric acid at 90°C.Based from the pharmacopeial standards (MC ? 6.7, AUA ? 74.0), all the samples did not pass the parameters, except the pectin extracted using 3N sulfuric acid at 90°C (MC = 6.76, AUA = 74.61).

CONCLUSION: Among the different solvents used for extraction, 3N sulfuric acid produced the highest percent yield of pharmaceutical grade pectin from pomelo fruit peel. Its optimum temperature for extraction was at 90°C. The sample passed the USP standards of MC values not less than 6.76 and AUA values not less than 74. Under the following conditions, pomelo fruit peel have the potential for commercial-scale production of pharmaceutical grade pectin.

BACKGROUND: This study was conducted to characterize and compare the physicochemical and pharmacopoeial properties of starches isolated from the seeds of Artocarpus odoratissimus Blanco (marang), Nephelium lappaceum L. (rambutan), and unripe green Mangifera indica L. (mango) with corn starch, as possible sources of pharmaceutical grade starch.

METHODS: The starch from the seeds of these fruits was isolated and characterized through their physicochemical (organoleptic characteristics, percent yield, amylose-amylopectin ratio, bulk density, tapped density, compressibility index, Hausner ratio, angle of repose, solubility, swelling power, and viscosity) and pharmacopoeial properties (identification test, pH, loss on drying, and limit of iron). Morphology of the granules was also assessed.

RESULTS: The physicochemical properties showed that amylose content of the seed starches was significantly lower (p=0.001) and amylopectin content significantly higher (p=0.001) than the native high amylose corn starch. The lower values of bulk and tapped densities, and high values in compressibility index and Hausner ratio of the seed starches compared to corn starch may be due to their smaller particles. The results of the pharmacopoeial characterization showed compliance with the United States Pharmacopeia's (USP) acceptable limits, except for the pH of marang seeds.

CONCLUSION: The starches isolated from the fruit seeds have unique properties, but only rambutan seed starch has the most desirable physicochemical and pharmacopoeial properties that is comparable with corn starch. Rambutan seeds could be utilized as a source of starch for pharmaceutical applications.

BACKGROUND/AIMS: The development of therapeutic strategies for the treatment of cirrhosis has become an important focus for basic and clinical researchers. Adrenergic receptor antagonists have been evaluated as antifibrotic drugs in rodent models of carbon tetrachloride (CCl4)-induced cirrhosis. The aim of the present study was to evaluate the effects of carvedilol and doxazosin on fibrosis/cirrhosis in a hamster animal model. METHODS: Cirrhotic-induced hamsters were treated by daily administration of carvedilol and doxazosin for 6 weeks. Hepatic function and histological evaluation were conducted by measuring biochemical markers, including total bilirubin, aspartate aminotransferase, alanine aminotransferase and albumin, and liver tissue slices. Additionally, transforming growth factor beta (TGF-beta) immunohistochemistry was analyzed. RESULTS: Biochemical markers revealed that hepatic function was restored after treatment with doxazosin and carvedilol. Histological evaluation showed a decrease in collagen type I deposits and TGF-beta-secreting cells. CONCLUSIONS: Taken together, these results suggest that the decrease in collagen type I following treatment with doxazosin or carvedilol is achieved by decreasing the profibrotic activities of TGF-beta via the blockage of alpha1- and beta-adrenergic receptor. Consequently, a diminution of fibrotic tissue in the CCl4-induced model of cirrhosis is achieved.
Adrenergic alpha-1 Receptor Antagonists/*pharmacology ; Alanine Transaminase/blood ; Animals ; Aspartate Aminotransferases/blood ; Bilirubin/blood ; Carbazoles/*pharmacology ; Carbon Tetrachloride ; Collagen Type I/drug effects/metabolism ; Cricetinae ; Doxazosin/*pharmacology ; Liver/metabolism/pathology ; Liver Cirrhosis/blood/chemically induced/*drug therapy ; Liver Function Tests ; Propanolamines/*pharmacology ; Serum Albumin/analysis ; Transforming Growth Factor beta/blood/*drug effects

Recently, porous titanium granules (PTGs) have been indicated for the preservation of the dimensions of post-extraction sockets, as a filler in sinus lift procedures and for the treatment of peri-implant and periodontal defects, based on the osteoconductivity and dimensional stability of the titanium granules. However, there is a lack of information regarding the use of this material in larger defects and in conjunction with membranes. The objective of this study is to test the behavior of PTGs used to fill critical size defects in rabbit tibiae, with and without membranes. Critical defects were created in both tibiae of rabbits, divided randomly into three groups: Group A (defect filled with PTG), Group B (defect filled with PTG+collagen membrane) and a control group (empty defect). After six weeks, histomorphometric analysis was performed. The results showed more defect closures at the cortical area (87.37%±2.2%) and more bone formation at the marrow area (57.6%±1.3%) in Group B, in comparison with the other groups (P<0.05); the use of membranes improved the material stability expressed as more percentages of the original material when membranes were used (P<0.05). Finally, inflammatory reactions were observed when the granules were not protected by membranes. In spite of the limitations of this animal study, it may be concluded that PTG particles are osteoconductive and allow bone growth. The PTG particles must be covered by a membrane, especially when grafting larger defects, in order to control particle migration, promote clot stabilization and separate the PTG graft from undesired soft tissue cells.
Animals ; Male ; Membranes, Artificial ; Rabbits ; Tibia ; abnormalities ; Titanium ; chemistry

In this article we introduce modern statistical machine learning and bioinformatics approaches that have been used in learning statistical relationships from big data in medicine and behavioral science that typically include clinical, genomic (and proteomic) and environmental variables. Every year, data collected from biomedical and behavioral science is getting larger and more complicated. Thus, in medicine, we also need to be aware of this trend and understand the statistical tools that are available to analyze these datasets. Many statistical analyses that are aimed to analyze such big datasets have been introduced recently. However, given many different types of clinical, genomic, and environmental data, it is rather uncommon to see statistical methods that combine knowledge resulting from those different data types. To this extent, we will introduce big data in terms of clinical data, single nucleotide polymorphism and gene expression studies and their interactions with environment. In this article, we will introduce the concept of well-known regression analyses such as linear and logistic regressions that has been widely used in clinical data analyses and modern statistical models such as Bayesian networks that has been introduced to analyze more complicated data. Also we will discuss how to represent the interaction among clinical, genomic, and environmental data in using modern statistical models. We conclude this article with a promising modern statistical method called Bayesian networks that is suitable in analyzing big data sets that consists with different type of large data from clinical, genomic, and environmental data. Such statistical model form big data will provide us with more comprehensive understanding of human physiology and disease.
Bayes Theorem ; Behavioral Sciences ; Computational Biology ; Data Interpretation, Statistical ; Dataset ; Gene Expression ; Humans ; Learning ; Logistic Models ; Machine Learning* ; Models, Statistical ; Physiology ; Polymorphism, Single Nucleotide ; Statistics as Topic* ; Systems Biology