bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation and Characterization of a Bioartificial Polymeric Material: Bilayer of Cellulose Acetate-PVA
Authors: Bernal-Ballén Andrés , Kuritka Ivo , Saha Petr
Published: May 2016

A new bioartificial polymeric material consisting of a bilayer of cellulose acetate and poly(vinyl alcohol) was successfully obtained by casting method. The material was characterized by Fourier transform infrared spectroscopy, contact angle, scanning electron microscopy, differential scanning calorimetry, gas permeability, water vapor permeability, and mechanical properties. The characterization indicates that two distinct and well-differentiated surfaces were achieved without detriment to the bulk properties. The interaction between natural and synthetic polymers indeed enhanced the gas permeability as well as the water vapor permeability in comparison to the original components, although mechanical properties were not substantially boosted by the combination of both. Moreover, beyond the interface, there were no detected interactions between the polymers as can be evidenced by the presence of a uniqueTgin the bilayer. The amalgamation of the relatively good mechanical properties with the two differentiated surfaces and the improvement of the permeability properties could indicate the potential of the material for being used in medicine.
Cardioprotective Potentials of Plant‐Derived Small Molecules against Doxorubicin Associated Cardiotoxicity
Authors: Ojha Shreesh , Al Taee Hasan , Goyal Sameer , Mahajan Umesh B. , Patil Chandrgouda R. , Arya D. S. , Rajesh Mohanraj
Published: May 2016

Doxorubicin (DOX) is a potent and widely used anthracycline antibiotic for the treatment of several malignancies. Unfortunately, the clinical utility of DOX is often restricted due to the elicitation of organ toxicity. Particularly, the increased risk for the development of dilated cardiomyopathy by DOX among the cancer survivors warrants major attention from the physicians as well as researchers to develop adjuvant agents to neutralize the noxious effects of DOX on the healthy myocardium. Despite these pitfalls, the use of traditional cytotoxic drugs continues to be the mainstay treatment for several types of cancer. Recently, phytochemicals have gained attention for their anticancer, chemopreventive, and cardioprotective activities. The ideal cardioprotective agents should not compromise the clinical efficacy of DOX and should be devoid of cumulative or irreversible toxicity on the naïve tissues. Furthermore, adjuvants possessing synergistic anticancer activity and quelling of chemoresistance would significantly enhance the clinical utility in combating DOX‐induced cardiotoxicity. The present review renders an overview of cardioprotective effects of plant‐derived small molecules and their purported mechanisms against DOX‐induced cardiotoxicity. Phytochemicals serve as the reservoirs of pharmacophore which can be utilized as templates for developing safe and potential novel cardioprotective agents in combating DOX‐induced cardiotoxicity.
Omega-3 Fatty Acids: Possible Neuroprotective Mechanisms in the Model of Global Ischemia in Rats
Authors: Nobre Maria Elizabeth Pereira , Correia Alyne Oliveira , Mendonça Francisco Nilson Maciel , Uchoa Luiz Ricardo Araújo , Vasconcelos Jessica Tamara Nunes , de Araújo Carlos Ney Alencar , Brito Gerly Anne de Castro , Siqueira Rafaelly Maria Pinheiro , Cerqueira Gilberto dos Santos , Neves Kelly Rose Tavares , Arida Ricardo Mário , Viana Glauce Socorro de Barros
Published: May 2016

Background. Omega-3 (ω3) administration was shown to protect against hypoxic-ischemic injury. The objectives were to study the neuroprotective effects ofω3, in a model of global ischemia.Methods. Male Wistar rats were subjected to carotid occlusion (30 min), followed by reperfusion. The groups were SO, untreated ischemic and ischemic treated rats withω3 (5 and 10 mg/kg, 7 days). The SO and untreated ischemic animals were orally treated with 1% cremophor and, 1 h after the last administration, they were behaviorally tested and euthanized for neurochemical (DA, DOPAC, and NE determinations), histological (Fluoro jade staining), and immunohistochemical (TNF-alpha, COX-2 and iNOS) evaluations. The data were analyzed by ANOVA and Newman-Keuls as thepost hoctest.Results. Ischemia increased the locomotor activity and rearing behavior that were partly reversed byω3. Ischemia decreased striatal DA and DOPAC contents and increased NE contents, effects reversed byω3. This drug protected hippocampal neuron degeneration, as observed by Fluoro-Jade staining, and the increased immunostainings for TNF-alpha, COX-2, and iNOS were partly or totally blocked byω3.Conclusion. This study showed a neuroprotective effect ofω3, in great part due to its anti-inflammatory properties, stimulating translational studies focusing on its use in clinic for stroke managing.
Newly Developed Topical Cefotaxime Sodium Hydrogels: Antibacterial Activity andIn VivoEvaluation
Authors: Zakaria Azza S. , Afifi Samar A. , Elkhodairy Kadria A.
Published: May 2016

In an attempt to reach better treatment of skin infections, gel formulations containing Cefotaxime (CTX) were prepared. The gel was formulated using Carbopol 934 (C934), Hydroxypropyl Methylcellulose 4000 (HPMC 4000), Carboxymethylcellulose Sodium (Na CMC), Pectin (PEC), Xanthan Gum (XG), or Guar Gum (GG). Thirteen different formulas were prepared and characterized physically in terms of color, syneresis, spreadability, pH, drug content, and rheological properties. Drug-excipients compatibility studies were confirmed by FTIR and thenin vitrodrug release study was conducted.In vitroandin vivoantibacterial activities of CTX were studied against wound pathogens such as,Staphylococcus aureus(S. aureus),Escherichia coli(E. coli), andPseudomonas aeruginosa(P. aeruginosa), using either pure drug or Fucidin® cream as control. F13 provides better spreadability compared to F1 (XG) or F11 (HPMC). Moreover, the release of the drug from hydrogel F13 containing C934 was slower and sustained for 8 h. Stability study revealed that, upon storage, there were no significant changes in pH, drug content, and viscosity of the gels. Also, F13 showed the larger inhibition zone and highest antibacterial activity among other formulations. Histological analysis demonstrated that after single treatment with F13 gel formulation, a noticeable reduction in microbial bioburden occurred in case of both Gram positive and Gram negative bacterial isolates.
Circulating Omentin-1 Levels Are Decreased in Dilated Cardiomyopathy Patients with Overt Heart Failure
Authors: Huang Ying , Lin Yingzhong , Zhang Shumin , Wang Zhijian , Zhang Jianwei , Chang Chao , Liu Ling , Ji Qingwei , Liu Xiaofei
Published: May 2016

Background. Recent evidence demonstrated that the circulating levels of omentin-1 are related to the presence of ischemic heart disease and heart failure. However, omentin-1 plasma levels in patients with nonischemic dilated cardiomyopathy (DCM), which is the most common etiology of heart failure, have yet to be investigated.Methods. Plasma levels of omentin-1 and adiponectin were measured in 100 patients with DCM and 45 healthy controls.Results. Plasma omentin-1 levels significantly decreased in DCM patients compared with the control group, whereas adiponectin levels significantly increased in DCM patients compared with the control group. Plasma omentin-1 levels were negatively correlated with adiponectin (R=-0.376,P=0.005), C-reactive protein (CRP) (R=-0.320,P=0.001), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (R=-0.365,P=0.000) levels as well as left ventricular end-diastolic diameter (LVEDD) (R=-0.200,P=0.046) but were positively correlated with left ventricular ejection fraction (LVEF) (R=0.496,P=0.000). Plasma adiponectin levels were positively correlated with CRP (R=0.273,P=0.006) and NT-proBNP (R=0.329,P=0.001) levels but were negatively correlated with fasting glucose (R=-0.218,P=0.029) and LVEF (R=-0.615,P=0.000) levels. Furthermore, omentin-1 (OR 0.983, 95% CI 0.970 to 0.996;P=0.008) levels were independently associated with the presence of DCM before NT-proBNP was added.Conclusions. Omentin-1 is a novel biomarker of DCM.
Extraction and Hydrophobic Modification of Cotton Stalk Bark Fiber
Authors: Li Ya-Yu , Du Guang-Ming , Feng Xin-Jie , Mu Ya-Wei , Li De-Qiang
Published: May 2016

Cotton stalk bark fiber (CSBF) was extracted at high temperature and under high pressure, under the condition of the alkali content of 11 wt%. Experimental results proved that the extraction yield of CSBF was 27.3 wt%, and the residual alkali concentration was 2.1 wt%. Then five kinds of modifiers including methyl methacrylate (MMA), MMA plus initiator, epoxy propane, copper ethanolamine, and silane coupling agent were chosen to modify the surface of CSBF. It was found by measuring water retention value (WRV) that these five kinds of modifiers were all effective and the silane coupling agent was best modifier among all. The optimal modifying conditions of silane coupling agent were obtained: modifier concentration was 5%, the mixing temperature was 20°C, the mixing time was 1 h, and vacuum drying time was 1 h. Under the optimal condition, the WRV of the modified CSBF was 89%. It is expected that these modified CSBF may be a filler with strengthening effect in wood plastic composites (WPC) fields.
A Novel EGFR Extracellular Domain Mutant, EGFRΔ768, Possesses Distinct Biological and Biochemical Properties in Neuroblastoma
Authors: Keller James , Nimnual Anjaruwee S. , Varghese Mathew S. , VanHeyst Kristen A. , Hayman Michael J. , Chan Edward L.
Published: May 2016

EGFR is a popular therapeutic target for many cancers. EGFR inhibitors have been tested in children with refractory neuroblastoma. Interestingly, partial response or stable disease was observed in a few neuroblastoma patients. As EGFR mutations are biomarkers for response to anti-EGFR drugs, primary neuroblastoma tumors and cell lines were screened for mutations. A novel EGFR extracellular domain deletion mutant, EGFRΔ768, was discovered and the biologic and biochemical properties of this mutant were characterized and compared with wild-type and EGFRvIII receptors. EGFRΔ768 was found to be constitutively active and localized to the cell surface. Its expression conferred resistance to etoposide and drove proliferation as well as invasion of cancer cells. While EGFRΔ768 had similarity to EGFRvIII, its biologic and biochemical properties were distinctly different from both the EGFRvIII and wild-type receptors. Even though erlotinib inhibited EGFRΔ768, its effect on the mutant was not as strong as that on wild-type EGFR and EGFRvIII. In addition, downstream signaling of EGFRΔ768 was different from that of the wild-type receptor. In conclusion, this is the first study to demonstrate that neuroblastoma express not only EGFRvIII, but also a novel EGFR extracellular domain deletion mutant, EGFRΔ768. The EGFRΔ768 also possesses distinct biologic and biochemical properties which might have therapeutic implications for neuroblastoma as well as other tumors expressing this novel mutant.

Implications: Neuroblastoma expressed a novel EGFR mutant which possesses distinct biologic and biochemical properties that might have therapeutic implications. Mol Cancer Res; 14(8); 740–52. ©2016 AACR.
Effects of Walnut Consumption on Colon Carcinogenesis and Microbial Community Structure
Authors: Nakanishi Masako , Chen Yanfei , Qendro Veneta , Miyamoto Shingo , Weinstock Erica , Weinstock George M. , Rosenberg Daniel W.
Published: May 2016

Walnuts are composed of a complex array of biologically active constituents with individual cancer-protective properties. Here, we assessed the potential benefit of whole walnut consumption in a mouse tumor bioassay using azoxymethane. In study 1, a modest reduction (1.3-fold) in tumor numbers was observed in mice fed a standard diet (AIN-76A) containing 9.4% walnuts (15% of total fat). In study 2, the effects of walnut supplementation was tested in the Total Western Diet (TWD). There was a significant reduction (2.3-fold; P < 0.02) in tumor numbers in male mice fed TWD containing 7% walnuts (10.5% of total fat). Higher concentrations of walnuts lacked inhibitory effects, particularly in female mice, indicating there may be optimal levels of dietary walnut intake for cancer prevention. Since components of the Mediterranean diet have been shown to affect the gut microbiome, the effects of walnuts were therefore tested in fecal samples using 16S rRNA gene sequencing. Carcinogen treatment reduced the diversity and richness of the gut microbiome, especially in male mice, which exhibited lower variability and greater sensitivity to environmental changes. Analysis of individual operational taxonomic units (OTU) identified specific groups of bacteria associated with carcinogen exposure, walnut consumption, and/or both variables. Correlation analysis also identified specific OTU clades that were strongly associated with the presence and number of tumors. Taken together, our results indicate that walnuts afford partial protection to the colon against a potent carcinogenic insult, and this may be due, in part, to walnut-induced changes to the gut microbiome. Cancer Prev Res; 9(8); 692–703. ©2016 AACR.
Effector Regulatory T Cells Reflect the Equilibrium between Antitumor Immunity and Autoimmunity in Adult T-cell Leukemia
Authors: Ureshino Hiroshi , Shindo Takero , Nishikawa Hiroyoshi , Watanabe Nobukazu , Watanabe Eri , Satoh Natsuko , Kitaura Kazutaka , Kitamura Hiroaki , Doi Kazuko , Nagase Kotaro , Kimura Hiromi , Samukawa Makoto , Kusunoki Susumu , Miyahara Masaharu , Shin-I Tadasu , Suzuki Ryuji , Sakaguchi Shimon , Kimura Shinya
Published: May 2016

The regulatory T cells (Treg) with the most potent immunosuppressive activity are the effector Tregs (eTreg) with a CD45RA–Foxp3++CCR4+ phenotype. Adult T-cell leukemia (ATL) cells often share the Treg phenotype and also express CCR4. Although mogamulizumab, a monoclonal antibody to CCR4, shows marked antitumor effects against ATL and peripheral T-cell lymphoma, concerns have been raised that it may induce severe autoimmune immunopathology by depleting eTregs. Here, we present case reports for two patients with ATL who responded to mogamulizumab but developed a severe skin rash and autoimmune brainstem encephalitis. Deep sequencing of the T-cell receptor revealed that ATL cells and naturally occurring Tregs within the cell population with a Treg phenotype can be clearly distinguished according to CADM1 expression. The onset of skin rash and brainstem encephalitis was coincident with eTreg depletion from the peripheral blood, whereas ATL relapses were coincident with eTreg recovery. These results imply that eTreg numbers in the peripheral blood sensitively reflect the equilibrium between antitumor immunity and autoimmunity, and that mogamulizumab might suppress ATL until the eTreg population recovers. Close monitoring of eTreg numbers is crucial if we are to provide immunomodulatory treatments that target malignancy without severe adverse events. Cancer Immunol Res; 4(8); 644–9. ©2016 AACR.
Impaired Intestinal Gas Clearance during Marked Hyperglycemia in Patients with Functional Abdominal Bloating
Authors: Hernando-Harder Ana Cristina , Riddinger Frank , Krammer Heinz-Juergen , Brade Joachim , Singer Manfred Vincenz , Harder Hermann
Published: May 2016

Background: Especially in patients with functional intestinal disorders, impaired intestinal gas transit can be involved in abdominal symptom generation. We have previously demonstrated an acceleration of intestinal gas clearance in health during acute fasting hyperglycemia and hypothesize that in patients with functional abdominal bloating this mechanism may fail. Methods: In 14 healthy subjects and 14 patients with functional abdominal bloating we compared effects of acute fasting hyperglycemia (∼12 mmol/l) and during euglycemia (control studies) on intestinal gas dynamics. Gas was infused into the jejunum (12 ml/min) for 120 min while rectal gas evacuation was continuously measured; perception and abdominal girth changes were separately evaluated. Results: Marked hyperglycemia accelerated gas evacuation (–98 (53) ml 1 h intestinal gas retention) in health. In patients with functional abdominal bloating, marked hyperglycemia failed to accelerate gas transit and intestinal gas retention developed (421 (116) ml 1 h intestinal gas retention, p < 0.05 vs. health) which results in increased abdominal symptoms (perception score >3) and abdominal distension (>3 mm girth increment) as compared with control subjects (p < 0.05 for both). Conclusion: Intestinal gas clearance is delayed in patients with functional abdominal bloating and the increase in gas clearance during acute hyperglycemia in healthy volunteers does not occur in these patients.
Celecoxib Inhibits Cdx2 Expression and Prevents Gastric Cancer in Helicobacter pylori-Infected Mongolian Gerbils
Authors: Futagami Seiji , Suzuki Kenji , Hiratsuka Tetsuro , Shindo Tomotaka , Hamamoto Tatsuhiko , Tatsuguchi Atsushi , Ueki Nobue , Shinji Yoko , Kusunoki Masanori , Wada Ken , Miyake Kazumasa , Gudis Katya , Tsukui Taku , Sakamoto Choitsu
Published: May 2016

Background/Aim: The aim of this study was to see whether administration of celecoxib, a selective COX-2 inhibitor, prior to the appearance of intestinal metaplasia could prevent the development of gastric cancer in Helicobacter pylori-infected Mongolian gerbils. Methods:Fifty-two Mongolian gerbilswere divided into 3 groups and given 5 biweekly doses of N-methyl-N-nitrosourea (MNU; 30 ppm). At week 12, group 2 (n = 20) and group 3 (n = 22) gerbils were then given an injection of H. pylori, while group 1 controls (n = 10) received Brucella broth alone. In addition, 7 weeks after H. pylori inoculation, at week 19, group 3 gerbils also received a 36-week administration course of celecoxib (1,500 ppm) in their diet. The incidence of gastric adenocarcinoma was determined at week 54 by histological analysis. COX-2 and Cdx2 protein expression and COX activity were evaluated for each group. The extent of intestinal metaplasia, Cdx2 and MUC2 expression, and the apoptotic index were evaluated semi-quantitatively by immunohistochemistry. Results: The incidence of gastric adenocarcinoma was: group 1, 0% (0/10); group 2, 65% (13/20), and group 3, 23% (5/22; p < 0.05). Continuous celecoxib administration significantly reduced COX activity and COX-2 protein expression, Cdx2 and MUC2 protein immunoreactivity, and the extent of Alcian blue periodic acid-Schiff-positive intestinal metaplasia in H. pylori-infected gerbils. Celecoxib also induced apoptosis in these gerbils. Significant inhibition of Cdx2 expression in group 3 gerbils was also shown by Western blot analysis. Conclusions: Prior to the first appearance of intestinal metaplasia, timely administration of celecoxib prevents gastric cancer occurrence by disrupting the progression of intestinal metaplasia into gastric carcinoma through its inhibition of Cdx2 expression in MNU-pretreated H. pylori-infected Mongolian gerbils.
SEN and Hepatitis Virus Infections in Nontransfused Children and Pediatric Thalassemia Patients with Multiple Transfusions in Taiwan
Authors: Chiou Shyh-Shin , Huang Jee-Fu , Chang Tai-Tsung , Hsieh Ming-Yen , Dai Chia-Yen , Yu Ming-Lung , Chang Wen-Yu , Chuang Wan-Long
Published: May 2016

Background: SouthernTaiwan is a hepatitis B and C viruses (HBV, HCV) endemic area. SEN virus (SENV) infection has been suggested as transfusion-related hepatitis. Two variants of SENV (SENV-D and SENV-H) have been studied in non-transfused children and transfusion-dependent thalassemia patients. Methods: Sera of 67 non-transfused children and 55 pediatric thalassemia patients with multiple transfusions were tested for SENV-D and SENV-H DNAs, liver function, iron status, HBV and HCV markers. Results: The prevalence of SENV (D or H), SENV-D, SENV-H infection, and SENV-D/H coinfection was significantly lower in nontransfused children than in thalassemia patients (22.4, 20.9, 5.0 and 1.5%, respectively, versus 67.3, 52.7, 40.0 and 25.5%, respectively, p < 0.001). The serum alanine aminotransferase (ALT) levels in thalassemia patients with SENV infection alone were significantly lower than levels in patients with SENV/HCV co-infection (p < 0.05), but not different when compared with those without SENV/HCV infection. SENV viremia was not associated with elevated ALT levels in thalassemia patients. SENV viremia did not increase the risk of HCV infection in thalassemia patients. Conclusions: SENV infection is high among non-transfused controls in Taiwan. Transfusion significantly increases the relevance of SENV infection. SENV viremia was not associated with the ALT levels in thalassemia patients.
Time-Kill Kinetics of Streptococcus pneumoniae with Reduced Susceptibility to Telithromycin
Authors: Al-Lahham Adnan , Reinert Ralf René
Published: May 2016

Background: Telithromycin is a new ketolide increasingly used in Europe and the United States. Only very few telithromycin-resistant isolates have been described to date. Methods: The anti-pneumococcal activity of telithromycin was determined against four clinical isolates of Streptococcus pneumoniae with reduced susceptibility to telithromycin by time-kill methodology. Results: All four telithromycin non-susceptible strains had the constitutive macrolide-lincosamide-streptogramin B phenotype and the ermB genotype. Pneumococcal strains had telithromycin minimum inhibitory concentrations (MICs) ranging between 2 and 8 µg/ml. Mulitlocus sequence typing and serotyping showed three isolates to harbour the identical serotype (serotype 14) and sequence type (sequence type 143) indicating a genetic relatedness of strains. Telithromycin was only bactericidal against the isolates with telithromycin resistance, with 4–8 times the MIC after 24 h. Conclusion: The killing by telithromycin of S. pneumoniae isolates having an ermB resistance determinant and a telithromycin MIC of ≧2 µg/ml is slow. Achievable concentrations in serum, alveolar macrophages and epithelial lining fluid are below the concentrations which are necessary for bactericidal killing of highly telithromycin-resistant strains.
A Case of Auditory Agnosia with Impairment of Perception and Expression of Music: Cognitive Processing of Tonality
Authors: Satoh Masayuki , Takeda Katsuhiko , Kuzuhara Shigeki
Published: May 2016

There is fairly general agreement that the melody and the rhythm are the independent components of the perception of music. In the theory of music, the melody and harmony determine to which tonality the music belongs. It remains an unsettled question whether the tonality is also an independent component of the perception of music, or a by-product of the melody and harmony. We describe a patient with auditory agnosia and expressive amusia that developed after a bilateral infarction of the temporal lobes. We carried out a detailed examination of musical ability in the patient and in control subjects. Comparing with a control population, we identified the following impairments in music perception: (a) discrimination of familiar melodies; (b) discrimination of unfamiliar phrases, and (c) discrimination of isolated chords. His performance in pitch discrimination and tonality were within normal limits. Although intrasubject statistical analysis revealed significant difference only between tonality task and unfamiliar phrase performance, comparison with control subjects suggested a dissociation between a preserved tonality analysis and impairment of perception of melody and chords. By comparing the results of our patient with those in the literature, we may say that there is a double dissociation between the tonality and the other components. Thus, it seems reasonable to suppose that tonality is an independent component of music perception. Based on our present and previous studies, we proposed the revised version of the cognitive model of musical processing in the brain.
Cerebrospinal Fluid IgM Index Correlates with Cranial MRI Lesion Load in Patients with Multiple Sclerosis
Authors: Jongen Peter J.H. , Lycklama a Nijeholt Geert , Lamers Karel J.B. , Doesburg Wim H. , Barkhof Frederik , Lemmens Wim A.J.G. , Klasen Ina S. , Hommes Otto R.
Published: May 2016

In multiple sclerosis intrathecal IgM synthesis correlates with an unfavourable disease course. Whether this reflects a pathogenic role of IgM, possibly in conjunction with complement, is a matter of debate. In a cross-sectional study we measured intrathecal synthesis of IgM and the complement component C3, and on cranial MRI lesion load and central brain atrophy in clinically active patients, 17 relapsing-remitting, 16 secondary progressive. Correlative analysis showed that in relapsing-remitting patients CSF IgM index correlated with cranial MRI T2 and T1 lesion load, and central brain atrophy; and the C3 index correlated with T2 lesion load. In secondary progressive patients CSF IgM index correlated with periventricular T2 lesion load. Our data are in favour of a pathogenic role of IgM in multiple sclerosis.
A Comparison of Clinically Atypical with Typical Chronic Inflammatory Demyelinating Polyradiculoneuropathy
Authors: Misra U.K. , Kalita J. , Yadav R.K.
Published: May 2016

Background: There is a paucity of prospective studies evaluating the atypical features of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Aims: To compare clinical and electrodiagnostic features of clinically typical and atypical CIDP patients. Methods: The patients with typical and atypical CIDP diagnosed according to the European Federation of Neurological Societies/Peripheral Nerve Society were included. The disability was graded on a 0–10 scale. Neurophysiological study included motor and sensory nerve conduction and F wave studies of both upper and lower limbs. The patients were treated with prednisolone with or without azathioprine. The outcome was evaluated at 6 months and improvement was defined as at least 2 grades improvement. Results: Eight out of 37 CIDP patients had atypical features, which included asymmetry in 2, dysautonomia in 3 and pure motor weakness, amyotrophic-lateral-sclerosis-like syndrome and distal weakness in 1 patient each. Tendon reflexes were retained in 3 patients. The mean duration of symptoms was 43 weeks in the typical and 30 weeks in the atypical group. The age, sex, disability, therapeutic response and neurophysiological features were similar in the 2 groups. Conclusion: About one fifth of CIDP patients may have atypical clinical features; however, their electrodiagnostic features and response to treatment are no different from typical CIDP.
Quality of Life following Chemoradiation and Postoperative Radiation for Locally Advanced Head and Neck Cancer
Authors: Nguyen Nam P. , Vos Paul , Karlsson Ulf , Nguyen Phuc , Dutta Suresh , Lemanski Claire , Ludin Adir , Rose Sue , Nguyen Ly M. , Ward Harold , Huang Shawn , Sallah Sabah
Published: May 2016

Background: To evaluate the impact of chemoradiation and postoperative radiation on patients’ quality of life (QOL) in a single institution. Methods: A retrospective analysis of 101 patients who had treatment for locally advanced head and neck cancer in a single institution. Forty-seven patients had chemotherapy and radiation, 54 patients underwent postoperative radiation. QOL was assessed with the University of Washington (UW), and the Hospital Anxiety (HA) and Depression (HD) questionnaires. All patients were free of disease at the survey time. Results: Mean and median UW scores were not different between the 2 groups: chemoradiation (65/67), postoperative radiation (62/63). Mean and median HA scores were 7.6/7 (chemoradiation), and 8.3/8 (postoperative radiation). Mean and median HD scores were 6.7/7 (chemoradiation), and 7.1/7 (postoperative radiation). Forty-four patients developed complications, with mean/median UW, HA, and HD scores of 55/55, 9.9/8, and 8.9/9, respectively. These scores were significantly different compared to the 57 patients without complications: 70/70 (p = 0.0001), 6.5/6 (p = 0.001), and 8.9/9 (p = 0.0001). Conclusion: There was no significant difference in QOL between chemoradiation and postoperative radiation in this retrospective study with a relatively short follow-up in the chemoradiation group. In addition, there were more patients with resectable disease in the postoperative group which may explain the lack of difference in QOL between the two groups. Patients who developed complications following treatment experienced lower QOL, more anxiety and depression. Our study raised the need to conduct a prospective randomized study to assess the real impact of chemoradiation and postoperative radiation on patients’ QOL.
Postlaryngectomy Vocal Rehabilitation: Assessment Using a Validated Questionnaire in 51 Patients
Authors: Kazi R. , Singh A. , De Cordova J. , Al-Mutairy A. , O’Leary L. , Nutting C.M. , Clarke P. , Rhys-Evans P. , Harrington K.J.
Published: May 2016

Background: This study aimed to assess valved speech and related issues in total laryngectomy patients with the help of the validated Voice Prosthesis Questionnaire (VPQ). Patients and Methods: We identified 61 patients who had undergone a surgical voice restoration with a valve following total laryngectomy and who were sent the VPQ by mail. Results: Fifty-one patients (37 males) completed the questionnaire giving a response rate of 83.6%. Fifty-three percent of the patients (n = 27) were fully aware of the dimensions of their valve including the length and diameter, whilst 25% (n = 13) were aware of only one of the two. There was a strong correlation between the patient’s perception of tone and their gender with the tone scores significantly lower in women as compared to men (Mann-Whitney test, p = 0.04). Ten patients (19.6%) had had leakage-related issues during the previous 7 days. Conclusions: This questionnaire provided a significant amount of valuable data. Based on our experience, we recommend the VPQ for prospective use in the serial monitoring and audit of total laryngectomy patients.
Effects of Rapamycin on Active Heymann Nephritis
Authors: Naumovic Radomir , Jovovic Djurdjica , Basta-Jovanovic Gordana , Miloradovic Zoran , Mihailovic-Stanojevic Nevena , Aleksic Tamara , Jovanovic Dijana
Published: May 2016

Background/Aim: The effects of rapamycin (RAPA) were examined in active Heymann nephritis (HN), an experimental model of human membranous nephropathy (MN). Current opinion on the therapy of MN is controversial, and medications used for its treatment have not yielded the expected results. Methods: In a two-part study, we examined the effects of RAPA (1.5 mg/kg/day) during the induction phase of HN and on the evolving disease. In both parts, control groups of immunized rats not treated with RAPA and control groups of unimmunized rats were observed and sacrificed concurrently with the treated groups. Results: During the induction phase no significant changes in proteinuria were observed in the group treated with RAPA, in comparison to those in the untreated group (p < 0.001). During the evolving disease RAPA significantly lowered proteinuria (p < 0.001). The characteristic pathohistologic changes and IgG depositions along the glomerular basement membrane were considerably diminished, and infiltration of CD8+ cells completely prevented. Conclusion: RAPA demonstrated beneficial effects on disease progression, given either in the induction phase or during evolving HN. It would be desirable to investigate the effect of RAPA on patients with MN.
A Phase II Study of Weekly Docetaxel for Patients with Advanced or Recurrent Cancer of the Cervix
Authors: Pearl Michael L. , Johnston Carolyn M. , McMeekin D. Scott
Published: May 2016

Background/Aims: A phase II study was conducted to assess the activity and toxicity of weekly docetaxel in patients with advanced or recurrent cancer of the cervix. Methods: Eligible patients were required to have measurable disease with adequate performance status, bone marrow, renal and hepatic function. Patients were allowed to receive chemosensitization and not more than one prior chemotherapy regimen excluding taxanes. Docetaxel 35 mg/m2 was administered intravenously weekly for 3 weeks followed by 1 week off until disease progression or adverse effects prohibited further therapy. Results: Ten patients were entered into this study, all of who were evaluable for toxicity and response. A median of 2 cycles (range 2–6) were administered. The most frequent drug-related toxicities were anemia and fatigue. There were no objective responses. Three patients had stable disease up to 6 cycles. One patient died of exsanguination from a known vaginal metastasis after completing her second cycle. The median progression-free interval was 1.7 months (range 0.9–5.8) and overall survival was 6.9 months (1.6–23.7). Conclusions: Docetaxel has limited activity in patients with recurrent cancer of the cervix at the dose and schedule tested.
Age-Related Changes in Antral Follicle Count among Women with and without Polycystic Ovaries
Authors: Al-Sunaidi Mohammed , Al-Mahrizi Sharifa , Tan Seang Lin , Tulandi Togas
Published: May 2016

Background/Aims: To evaluate follicular phase antral follicle count (AFC) in women of different ages with and without polycystic ovaries (PCO) and to correlate it with early follicular phase serum follicle stimulating hormone (FSH), estradiol, and ovarian volume. Methods: Retrospective analysis of 1,003 patients’ medical records at McGill Reproductive Center. AFC, ovarian volume, serum FSH and estradiol were evaluated and analyzed. Results: The mean numbers of AFC in women without PCO in the age-groups 19–24, 25–29, 30–34, 35–39, 40–44 years were 16, 13, 13, 10, and 6, and in those with MCO 41, 38, 33, 33 and 34 respectively. In women without MCO, AFC was associated with the strongest correlation with age (r: –0.50, p < 0.0001), followed by basal FSH (r: 0.33, p <0.0001). The correlations in women with PCO were less pronounced (AFC, r: –0.24, p < 0.0001; basal FSH, r: 0.17, p < 0.004). Conclusions: Compared to women without PCO, age-related decreases in AFC and changes in ovarian volume and FSH levels in women with PCO are less pronounced.
The Influence of Chemokine Receptor CCR2 Genotypes in the Route to Cervical Carcinogenesis
Authors: Coelho Ana , Matos Ana , Catarino Raquel , Pinto Daniela , Sousa Hugo , Pereira Deolinda , Medeiros Rui
Published: May 2016

Invasive squamous cell carcinomas of the cervix arise from earlier, reversible precursor lesions called low- and high-grade squamous intraepithelial lesions (LSIL and HSIL, respectively). The aim of our study was to analyse the influence of the CCR2-64I polymorphism in the development of SIL due to its preponderant role in the cervical carcinogenesis and in the progression of these lesions to invasive cervical carcinoma. We conducted a case-control study, analyzing 565 Caucasian women from the north of Portugal. The CCR2-64I polymorphism was analysed through polymerase chain reaction followed by restriction fragment length polymorphism. The frequency of GG, GA and AA genotypes was 76.5, 23.5 and 0.0% respectively, in HSIL patients, and 87.8, 11.1 and 1.1% respectively, in the control group. The G allele frequency was 88.2% in the HSIL group and 93.4% in the control group. Regarding the A allele frequency, it was 11.8% in the HSIL group and 6.6% in the control group. Overall, the frequency of A carrier genotypes was higher in HSIL patients than in the control group (p = 0.013; OR = 2.21; 95%CI: 1.17–4.15), suggesting that CCR2-64I polymorphism might contribute to the establishment of HSIL, through the disruption of the naturally fragile immune response directed towards human papillomavirus infection.
Genetically Identified Complete Hydatidiform Mole Coexisting with a Live Twin Fetus: Comparison with Conventional Diagnosis
Authors: Sumigama Seiji , Itakura Atsuo , Yamamoto Toshimichi , Nagasaka Tetsuro , Yamamoto Eiko , Ino Kazuhiko , Kikkawa Fumitaka
Published: May 2016

Twin pregnancy consisting of a complete hydatidiform mole (CHM) along with a live co-existing fetus is a rare entity and difficult to diagnose. A 37-year-old Japanese woman demonstrated a living fetus, a placenta and a multicystic mass within one gestational sac on ultrasound at 10 weeks. Termination of the pregnancy was performed, and the specimen was classified as partial mole by macro- and microscopic findings. The karyotype of the molar tissue was 46XX. DNA polymorphism analysis demonstrated that fetal DNA showed bi-parental origin while molar DNA showed paternal origin only. Thus, this case was erroneously classified by ultrasonography, macroscopic and pathologic findings, then correctly diagnosed as a twin pregnancy with a CHM and co-existing normal twin fetus by DNA polymorphism analysis. Immunohistochemistry of p57KIP2, the paternally imprinted and maternally expressed gene, supported the genetic diagnosis. This case suggested that conventional diagnostic methods were inadequate for accurate diagnosis of CHM with a co-existing fetus. DNA polymorphism analysis should be requested for the diagnosis of hydatidiform mole, especially in cases where it is difficult to discriminate between partial hydatidiform mole and CHM with a co-existing fetus.
Placental Overexpression of Transforming Growth Factor-β3 in the HELLP Syndrome
Authors: Emanuelli M. , Giannubilo S.R. , Landi B. , Sartini D. , Pierella F. , Corradetti A. , Tranquilli A.L.
Published: May 2016

Objective: To evaluate the placental expression of transforming growth factor-β3 (TGF-β3) in patients with HELLP syndrome and pre-eclampsia compared to controls, and its correlation to Doppler velocimetry analysis of the utero-placental blood flow. Study Design: Real-time PCR analysis was performed, after cesarean section, in placental samples from 10 women affected by HELLP syndrome, 10 women with pre-eclampsia and 10 controls. Pulsatility indices on Doppler waveform analysis from uterine and umbilical arteries were measured. Results: The mean TGF-β3 expression was significantly higher in patients with HELLP syndrome compared with the control group (p < 0.001), and no difference was observed in the pre-eclampsia group. TGF-β3 expression correlated positively with umbilical PI (p < 0.001). Conclusions: TGF-β3 may play a key role as regulator of a variety of cellular events occurring during HELLP syndrome, high local expression of this growth factor may be responsible for remodeling of the placental structure, which results in the dysfunction of maternal-fetal circulation.
Bartholin’s Gland Hyperplasia in a Young Woman
Authors: Ben-Harosh Shani , Cohen Itzhak , Bornstein Jacob
Published: May 2016

Background: Tumors arising from the Bartholin’s gland are very rare; the majority are benign. As most instances of swelling in the Bartholin’s gland area represent a duct cyst, clinicians tend to perform incision and drainage, rather than excision of the tumor. Case: A young woman with prolonged dyspareunia underwent total excision of the Bartholin’s gland because it felt firm and irregular. Histological examination revealed a well-circumscribed lesion containing an increased number of acini with a preserved tubular/acinar ratio – findings were consistent with nodular hyperplasia. Conclusion: Bartholin’s gland hyperplasia may be a cause of swelling in the gland area and dyspareunia. We recommend that whenever the gland feels firm or enlarged, total excision be considered, rather than drainage.
Delivery by Cesarean Section after Embolization for Vaginal Arteriovenous Malformation
Authors: Hasegawa Toru , Yamakawa Yoshihiro , Ota Satoshi , Kamei Tetsuya , Tateno Masaya
Published: May 2016

Vaginal arteriovenous malformation (AVM) can lead to life-threatening complications on delivery. No deliveries have been reported after selective embolization for a vaginal AVM. A 34-year-old nulliparous woman was found to have an arterial pulsatile mass on the left vaginal wall. The findings of magnetic resonance imaging and magnetic resonance angiography were consistent with an AVM. Selective transcatheter embolization for the AVM was done and, afterwards, the patient was found to be pregnant. The prenatal course was uneventful and the patient underwent elective cesarean delivery at term. Vaginal AVM can be successfully treated with selective embolization, with a good obstetric outcome.
Chronic Administration of Visfatin Ameliorated Diabetic Nephropathy in Type 2 Diabetic Mice
Authors: Kang Young Sun , Lee Mi Hwa , Song Hye Kyoung , Kim Jung Eun , Ghee Jung Yeon , Cha Jin Joo , Lee Ji Eun , Kim Hyun Wook , Han Jee young , Cha Dae Ryong
Published: May 2016

Background/Aims: Visfatin is a known adipokine which may improve insulin resistance in obesity and have an anti-diabetic effect via the insulin receptor. We studied the effects of visfatin on diabetic nephropathy in type 2 diabetic mice. Methods: Diabetic male db/db mice were treated with intraperitoneal injections of visfatin. Basal parameters were measured in all mice and glucose tolerance test (GTT) and insulin tolerance test (ITT) were performed in diabetic mice. The histopathological and molecular changes were evaluated in diabetic nephropathy. Results: Visfatin treatment had no effect on body weight, water and food intake, urinary volume, blood glucose, and HbA1c level. However, visfatin improved HOMA-IR, GTT, ITT and decreased plasma insulin and visfatin level, but not adiponectin level. Plasma cholesterol and triglyceride level were also improved by visfatin treatment. Significantly, visfatin decreased albuminuria in diabetic mice. Glomerulosclerotic change and mesangial expansion in the kidneys were significantly reduced. In addition, visfatin inhibited the expression of proinflammatory and profibrotic cytokines such as MCP-1, TGFβ1, type IV collagen, and PAI-1. The enzymes related to lipid metabolism in the kidney, HMG-CoAR was suppressed by visfatin treatment, whereas FXR and ABCA1 were significantly elevated by treatment. Conclusion: Visfatin might have a protective effect in diabetic nephropathy without the hypoglycemic effect.
Spontaneous Corneal Clearance in the Presence of a Partially Detached Graft after Non-Descemet Stripping Automated Endothelial Keratoplasty
Authors: Droutsas Konstantinos , Lazaridis Apostolos , Koutsandrea Chrysanthi , Chatzistefanou Klio I. , Moschos Marilita M. , Sekundo Walter
Published: May 2016

Purpose: To report the explantation of a detached and opaque donor disc as an alternative to secondary keratoplasty in a case of persistent graft detachment followed by spontaneous clearance of the recipient cornea after non-Descemet stripping automated endothelial keratoplasty (non-DSAEK). Methods: A 57-year-old man with cataract and bullous keratopathy after herpes simplex virus endotheliitis of the right eye and best spectacle-corrected visual acuity (BSCVA) of 0.1 underwent simultaneous phacoemulsification and non-DSAEK. Due to early detachment of the donor disc, two additional intracameral air injections were necessary in order to achieve graft attachment. However, the donor disc gradually detached and became fibrotic while the recipient cornea anterior to the detached graft became transparent and without any edema. Therefore, a mere explantation of the DSAEK graft was performed. Results: Four months after graft explantation, BSCVA was 0.5 and endothelial cell density (ECD) was 1,221 cells/mm2. After 13 months, BSCVA was still 0.6 while ECD had fell to 800, and 2 years later, the endothelium decompensated. BSCVA was 0.3 and ECD was not measurable. Conclusions: To our knowledge this is the first report of explantation of an endothelial graft as an alternative to re-keratoplasty in a case of spontaneous corneal clearance. This minimally invasive treatment may be considered in similar cases. However, due to the ongoing loss of endothelial cells after endothelial keratoplasty, a re-keratoplasty may still be needed in the long term.
A Late Case of Ischemic Cerebral Event after Resection of a Left Atrial Myxoma
Authors: Lafleur Reginald , Watkowska Justyna , Zhou Guoping , Alcide Phenix , Saint-Jacques Henock
Published: May 2016

Atrial myxoma is one of the most common primary cardiac tumors reported in the literature. In very rare instances, stroke has been the sequelae after a myxomatous tumor resection. We report this unique case of late ischemic cerebral event in a 46-year-old female some days after resection of a left atrial myxoma.
Minimally Invasive Surgery for Pancreatic Disease - Current Status
Authors: Alsfasser G. , Hermeneit S. , Rau B.M. , Klar E.
Published: May 2016

Laparoscopic procedures have advanced to represent the new gold standard in many surgical fields. Although application in pancreatic surgery is hampered by the friable nature of the gland and the difficulty of its exposure, advanced technology and surgeons' experience are leading to an expansion of minimally invasive pancreatic surgery. Addressing the whole range of main operative procedures, this review analyzes the literature data so far to give an overview about the current status of minimally invasive pancreatic surgery, its indications and limitations. In acute pancreatitis, a step-up approach from percutaneous drainage to retroperitoneoscopic necrosectomy seems beneficial. Transgastric necrosectomy also preserves the retroperitoneal compartment in contrast to the laparoscopic approach, which has widely been abandoned. In tumor pathology, laparoscopic access is adequate for small benign lesions in the pancreatic tail and body. Oncological outcome shows to be at least equal to the open procedure. Concerning laparoscopic pancreaticoduodenectomy, there is no evidence for a patients' benefit currently although several studies prove that it can be done.
The Learning Curve in Robotic Pancreaticoduodenectomy
Authors: Napoli N. , Kauffmann E.F. , Palmeri M. , Miccoli M. , Costa F. , Vistoli F. , Amorese G. , Boggi Ugo
Published: May 2016

Background/Purpose: Few data are available on the learning curve (LC) in robot-assisted pancreaticoduodenectomy (RAPD) and no study specifically addresses the LC of a single surgeon. Methods: The LC of a single surgeon in RAPD was determined using the cumulative sum method, based on operative time (OT). Data were extracted from a prospectively maintained database and analyzed retrospectively considering all events occurring within 90 days of index operation. Results: Seventy RAPD were analyzed. One operation was converted to open surgery (1.4%). One patient died within 30 days (1.4%) and one within 90 days (2.8%). Postoperative complications occurred in 53 patients (75.7%) and exceeded Clavien-Dindo grade IIIb in 7 patients (10%). OT dropped after 33 operations from a mean of 564 ± 101.7 min to a mean of 484.1 ± 77.9 min (p = 0.0005) and was associated to reduced incidence of delayed gastric emptying (72.7 vs. 48.7%; p = 0.039). The rate of hospital readmission improved after 40 operations from 20.0 (8 of 40) to 3.3% (1 of 30) (p = 0.04). Conclusions: RAPD was safely feasible in selected patients. OT dropped after the first 33 operations and was associated with reduced rate of delayed gastric emptying. Readmission rate improved after 40 operations.
Artery-First Distal Pancreatectomy
Authors: Takaori Kyoichi , Uemoto Shinji
Published: May 2016

Artery-first pancreatectomy is a technique to ligate the feeding artery before the division of the pancreas with intents to reduce the blood loss and to perform more oncologic resection; for example, the splenic artery (SA) is ligated first for artery-first distal pancreatectomy (DP). Potential merits of artery-first DP include early determination of resectability in the setting of pancreatic cancer with possible involvement of SA and/or celiac artery. However, due to difficulties in exposing the origin of SA, especially in open surgery, artery-first DP has been rarely performed. Through the experience of laparoscopic DP, we have developed a technique of artery-first DP by the ‘Tora-no-Ana' approach, which consists of posterior dissection of the pancreatic body thorough a division of the ligament of Treitz. A hanging maneuver of the pancreatic parenchyma with SA and vein is another key for a successful artery-first DP. By the hanging maneuver, the origin of SA is well visualized and clearly identified either by open, laparoscopic or robotic approach so that oncologic resection can be achieved. In conclusion, artery-first DP is safe and feasible if the surgical principals by the Tora-no-Ana approach and hanging maneuver of the pancreatic body are adhered.