bluuebunny/crossref_metadata_2025 huggingface dataset:
Lack of Keratinocyte Growth Factor Retards Angiogenesis in Cutaneous Wounds
Authors: Peng C , He Q , Luo C
Published: February 2013

This study investigated the effects of keratinocyte growth factor (KGF) on wound healing. Full-thickness excisional dorsal wounds were created on KGF knockout mice (KGF KO, n = 12) and wild-type C57BL/6 mice (WT, n = 12), and wound closure rates were measured. Immunohistochemical staining was used to investigate cell proliferation and blood vessel density by assessing Ki67 and CD31 protein levels, respectively, and real-time reverse transcription—polymerase chain reaction was used to measure vascular endothelial growth factor (VEGF) mRNA levels. No differences in the rate of wound closure were found between KGF KO and WT mice, however the KGF KO mice showed decreased proliferation of keratinocytes, angiogenesis and VEGF mRNA levels in vivo. These results suggest that KGF may play an important role in the regulation of VEGF gene expression and angiogenesis during wound healing.
Evaluation of the Clinical Significance of Classification of Traumatic Anterior Shoulder Instability Using Double-Contrast Computed Tomography Arthrography
Authors: Hao YD , Cui F , Zhu WH , Lu LY , Wang YB
Published: February 2013

This study evaluated the clinical significance of traumatic anterior shoulder instability (TASI) classification using double-contrast computed tomography (CT) arthrography. Patient were randomly assigned to two groups: group 1 ( n = 62); and group 2 ( n = 63). TASI symptom severity in group 1 was assessed using physical signs of shoulder trauma and conventional X-ray, CT and magnetic resonance imaging; these patients received either conservative management (with physical rehabilitation) or standard surgery. Group 2 underwent double-contrast CT arthrography to classify TASI; its findings formed the basis of subsequent management. At 24 months post-therapy, significant improvements in clinical outcomes were observed in group 2: Constant scores were higher and Western Ontario Shoulder Instability Index scores were lower. At 24 months, recurrence rates were 21.0% (13/62) in group 1 and 7.9% (5/63) in group 2. Findings suggested that TASI classification using double-contrast CT arthrography provided meaningful information thereby improving treatment efficacy.
Acute Rejection Correlates with Expression of Major Histocompatibility Complex Class I Antigens on Peripheral Blood CD3+CD8+ T-Lymphocytes following Skin Transplantation in Mice
Authors: Zhou YX , Zhao SM , Lu N , Yang XJ , Zhang Y , Li YJ , Zou X
Published: February 2013

This study investigated major histocompatibility complex class I (MHC-I) antigen expression on peripheral blood T-cells after transplantation to assess its potential as an early marker of acute graft rejection (AGR). Using a mouse model with or without immunosuppressive treatment, the expression of MHC-I antigens on CD3+CD8+ T-lymphocytes was assessed by flow cytometry following syngeneic graft ( n = 138) or allograft ( n = 138) skin transplantation. The occurrence of AGR was assessed by examining the degree of lymphocyte and monocyte infiltration in transplant biopsies. During AGR, expression of MHC-I antigens increased significantly compared with pre-transplant levels in the allograft group, even with immunosuppressive treatment. The highest expression of MHC-I antigens occurred 5 – 6 days before macroscopic rejection. These results suggest that expression of MHC-I antigens on peripheral blood CD3+CD8+ T-lymphocytes could be used as an early marker for predicting AGR.
Humoural Immune Responses to a Recombinant 16-kDa–38-kDa—ESAT-6 Mycobacterial Antigen in Tuberculosis
Authors: Wu L , Zhang M , Sun M , Jia B , Wang X
Published: February 2013

The present study investigated the diagnostic value of a recombinant 38-kDa–16-kDa—early secreted antigenic target of 6 kDa (ESAT-6) Mycobacterium tuberculosis (MTB) fusion antigen in 105 patients with tuberculosis (TB), 25 non-TB pulmonary disease patients and 20 healthy individuals. Its diagnostic value was compared with the commercially available enzyme-linked immunosorbent assay kit, the TB-directly observed therapy (DOT) kit. In the controls, the rate of positive antibody response to the TB-DOT kit was significantly higher than that of the recombinant antigen. The area under the receiver operating characteristic curve was 0.751, and the optimum sensitivity and specificity for detecting antibody responses to the recombinant antigen were 65.4% and 84.8%, respectively. The recombinant 38-kDa–16-kDa—ESAT-6 MTB antigen was more effective than the TB-DOT kit in distinguishing between TB patients and controls, and may be an optimal combination of antigens to provide a useful tool for the sensitive and specific diagnosis of patients with TB.
Cyclin-Dependent Kinase-Associated Protein Cks2 is Associated with Bladder Cancer Progression
Authors: Chen R , Feng C , Xu Y
Published: February 2013

In this observational retrospective study, expression of possible cancer-related genes was measured in patients with a pathological diagnosis of superficial bladder cancer. Further measurements were made in those who subsequently developed muscle-invasive cancer. Seven of the 45 patients with superficial bladder cancer progressed to muscle-invasive cancer. Expression of fatty acid binding protein 5 ( FABP5), poly(A) binding protein cytoplasmic 1 ( PABPC1), DEAD box polypeptide 5 ( DDX5), splicing factor 3b subunit 1 ( SF3B1), murine mammary tumour integration site 6 ( EIF3S6), tropomyosin 2β ( TPM2), transgelin ( TAGLN) and cyclin-dependent kinase-associated protein ( Cks2) genes was measured in bladder samples using real-time reverse transcription—polymerase chain reaction. FABP5, PABPC1, DDX5, SF3B1, EIF3S6 and Cks2 expression levels were significantly increased, and TPM2 and TAGLN were significantly decreased, in superficial bladder cancer compared with normal bladder tissue. In patients who developed muscle-invasive cancer, the Cks2 gene showed significantly increased expression after, compared with before, invasion. The Cks2 gene may have potential as a biomarker for predicting superficial bladder cancer progression to muscle-invasive cancer.
Sildenafil for Erectile Dysfunction in the Middle East: Observational Analysis of Patients with Diabetes and/or Hypertension Treated in the Clinical Practice Setting
Authors: El-Sakka AI , Anis T , Khadr N , Ismail TA , Hegazy AM , Fekry O , Youseif E
Published: February 2013

The effectiveness and tolerability of 12 weeks of open-label treatment with sildenafil citrate for erectile dysfunction (ED) associated with a diagnosis of diabetes mellitus and/or hypertension were assessed in clinical practice in three Middle Eastern countries. The dose was initially 50 mg and was adjusted by the physician as needed (permissible dose range 25 – 100 mg). Total mean ± SD score on the five-item version of the International Index of Erectile Function (severe ED, score 0 – 7; no ED, score 22 – 25) was 13.6 ± 5.7 at baseline (4556 patients) and increased significantly to 21.7 ± 4.1 at week 12. Global effectiveness was rated as good or very good by 91.4% of patients, 93.9% rating their sexual activity as spontaneous and 91.4% as natural. Discontinuation of sildenafil due to adverse events was infrequent (0.5%). Tolerability was rated as good or very good by 95.7% of patients. It is concluded that sildenafil was a well-tolerated and highly effective treatment of ED in outpatients with diabetes and/or hypertension from the three Middle Eastern countries studied.
Intervertebral Disc Changes after 1 h of Running: A Study on Athletes
Authors: Dimitriadis AT , Papagelopoulos PJ , Smith FW , Mavrogenis AF , Pope MH , Karantanas AH , Hadjipavlou AG , Katonis PG
Published: February 2013

The lumbar spines of 25 long-distance runners were examined using an upright magnetic resonance imaging scanner. All volunteer runners were scanned before and after running for 1 h. Scanning was performed with the runners seated upright (neutral), leaning forwards (flexion) and leaning backwards (extension). All measured discs showed a reduction in disc height after 1 h of running. A significant reduction in disc height was observed in all three body positions (neutral, flexion and extension) after 1 h of running. The results showed that, in flexion, extension and neutral positions, intervertebral discs undergo significant strain after 1 h of running. The lowest disc-height reduction was found at the L5 – S1 space in the neutral position; the same space had the highest percentage of disc degeneration.
Epidemiological Findings and Clinical and Magnetic Resonance Presentations in Subacute Sclerosing Panencephalitis
Authors: Cece H , Tokay L , Yildiz S , Karakas O , Karakas E , Iscan A
Published: February 2013

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, inflammatory neurodegenerative disease. This study investigated the relationships of clinical stage with epidemiological and magnetic resonance imaging (MRI) findings in SSPE by retrospective review of 76 cases (57 male) diagnosed by typical periodic electroencephalographic features, clinical symptoms and elevated measles antibody titre in cerebrospinal fluid. Clinical stage at diagnosis was I or II in 48 patients, III in 25 and IV in three. Prominent findings at presentation were atonic/myoclonic seizures (57.9%) and mental deterioration with behaviour alteration (30.3%). Frequent MRI findings (13 – 32 patients) were subcortical, periventricular and cortical involvement and brain atrophy; the corpus callosum, basal ganglia, cerebellum and brainstem were less frequently involved. Five patients had pseudotumour cerebri. Cranial MRI at initial diagnosis was normal in 21 patients (19 stage I/II, two stage III/IV). Abnormal MRI findings were significantly more frequent in the later stages, thus a normal initial cranial MRI does not exclude SSPE, which should, therefore, be kept in mind in childhood demyelinating diseases even when the presentation is unusual.
A 24-h Work Shift in Intensive Care Personnel: Biological Pathways between Work Stress and Ill Health
Authors: Matejovic M , Chvojka J , Sykora R , Krouzecky A , Radej J , Parizkova R , Dostal P , Novak I , Cerny V
Published: February 2013

This study evaluated inflammatory, coagulation and microvascular responses to a continuous 24-h work day in 13 healthy intensive care physicians. Inflammatory markers (interleukin [IL]-2, IL-6, IL-10, tumour necrosis factor-α, matrix metalloproteinase [MMP]-9 and adiponectin), adhesion molecules (vascular cellular adhesion molecule-1 and intercellular adhesion molecule-1 [ICAM-1]), coagulation parameters (thrombin—anti thrombin, von Willebrand factor and tissue factor) and sublingual micro circulation were assessed before and after a 24-h work shift. The 24-h work shift had no effect on inflammatory markers and ICAM-1. Direct visualization of microcirculation did not reveal stress-related perfusion abnormalities. A 24-h work shift in the intensive care unit was associated with significantly increased plasma levels of tissue factor — a potentially important mechanism linking acute job strain, haemostasis and atherosclerosis. The long-term consequences warrant further evaluation.
Skewing the Balance of Regulatory T-Cells and T-Helper 17 Cells in Breast Cancer Patients
Authors: Wang J , Cai D , Ma B , Wu G , Wu J
Published: February 2013

This study investigated the distribution of interleukin (IL)-17-producing CD4+ T-cells (T-helper [Th17] cells) in relation to CD4+CD25+CD127− cells (regulatory T-cells [Treg]) in tumour-infiltrating lymphocytes (TILs) and peripheral blood mononuclear cells (PBMCs) from breast cancer patients. The Th17 and Treg cells were evaluated by flow cytometry and reported as a percentage of total CD4+ cells. In TILs from early breast cancer patients ( n = 12), the frequency of Th17 cells was significantly higher than in PBMCs (14.5 ± 7.2% versus 6.9 ± 2.1%). In TILs from patients with advanced breast cancer ( n = 15), the frequency of Th17 cells was also significantly higher than that in PBMCs (9.1 ± 5.7% versus 3.2 ± 2.3%) but lower compared with early disease. The Th17/Treg ratio in TILs was markedly increased in early versus advanced disease. In conclusion, Th17 and Treg cell accumulation in the tumour microenvironment of breast cancer occurred in early disease; Th17 cell infiltration gradually decreased and Treg cells accumulated with disease progression.
Expression of Aquaglyceroporins in Epithelial Ovarian Tumours and Their Clinical Significance
Authors: Yang JH , Yan CX , Chen XJ , Zhu YS
Published: February 2013

Protein levels of aquaglyceroporins AQP3, AQP7 and AQP9 were measured by immunohistochemistry and Western blotting in epithelial ovarian tumour tissue from 98 patients and in normal ovary tissue from 20 persons with uterine myoma. AQP3 and AQP9 proteins were detected immunohistochemically in the basolateral membranes of benign and borderline tumour cells and were found to be distributed throughout the plasma membranes of malignant tumour cells. AQP7 protein was localized in the plasma membranes of benign tumour cells but, in borderline and malignant tumour cells, it was selectively stained in the nuclear membrane. Western blotting showed significantly higher AQP7 and AQP9 protein expression in malignant and borderline tumours than in benign tumour and normal ovarian tissue. AQP9 expression level was positively and significantly correlated with tumour grade and histological type. It was concluded that a high level of aquaglyceroporin expression may be an important factor in ovarian carcinogenesis.
Identification of High-Risk Human Papillomavirus (hrHPV)-Associated Genes in Early Stage Cervical Squamous Cell Carcinomas
Authors: Hu Y , Liu Y , Liu C-B , Ling Z-Q
Published: February 2013

This retrospective study investigated gene expression in tumour samples from 38 patients with early stage human papillomavirus (HPV)-associated cervical squamous cell carcinoma (CSCC). The patients were divided into two groups based on the presence of viral markers of HPV16 or HPV18 infection. Gene expression profiles of tumour samples and the corresponding normal cervical epithelium were analysed using cDNA microarrays. Several genes showed differential expression between the two groups of HPV-infected CSCC patients, although seven genes showed similar changes in both groups. The four genes encoding cyclin-dependent kinase inhibitor 2A, matrix metallopeptidase 9, laminin γ-1, and epidermal growth factor receptor were up-regulated, and the three genes encoding transforming growth factor β receptor 1, interleukin-1α and insulin-like growth factor-binding protein 6 were down-regulated, in both HPV16+ and HPV18+ CSCC. These proteins are involved in cell proliferation, cell structure and cell attachment, so their expression might be involved in the mechanism of HPV-induced carcinogenesis. A clearer understanding of HPV type-specific gene expression might aid diagnosis and treatment.
Comparison of the Predictability, Uniformity and Stability of a Laser in Situ Keratomileusis Corneal Flap Created with a VisuMax Femtosecond Laser or a Moria Microkeratome
Authors: Yao P , Xu Y , Zhou X
Published: February 2013

This prospective study compared the predictability, uniformity and stability of laser in situ keratomileusis corneal flap thickness created by a femtosecond laser or a classic microkeratome. Twenty-five femtosecond laser (VisuMax, Carl Zeiss Meditec) flaps and 38 microkeratome (Moria M3) flaps were measured using anterior segment optical coherence tomography at 1 week, 1 month and 6 months postoperatively. Flap thickness at seven points on each of the four meridians was calculated. At 6 months, VisuMax flaps showed better prediction than Moria flaps for central flap thickness. The standard deviation within individual flaps was smaller for VisuMax flaps and their index of symmetry was better. The mean thicknesses among the four eccentricities in the VisuMax flaps were the same, while Moria flaps were thicker at the 3-mm radius compared with the centre. The VisuMax femtosecond laser created corneal flaps with better predictability and uniformity, and similar reproducibility and stability, compared with the microkeratome.
Restless Legs Syndrome in Behçet's Disease
Authors: Ediz L , Hiz O , Toprak M , Ceylan MF , Yazmalar L , Gulcu E
Published: February 2013

The prevalence of restless legs syndrome (RLS) and its association with the clinical features of Behçet's disease (BD) has not previously been elucidated. The inflammatory character, central nervous system involvement and neuropathies of BD led to this investigation of RLS risk in BD patients. A total of 116 BD patients and 104 healthy control subjects were included; seven BD patients were excluded because of concurrent diseases, pregnancy or alcohol misuse that might cause RLS symptoms, and the remaining 109 BD patients were included in the analysis. The prevalence of RLS was significantly higher in patients with BD (32/109; 29.4%) than in controls (5/104; 4.8%). No significant differences were found between BD patients with and without RLS with regard to the clinical features of BD. RLS severity positively correlated with age in BD patients. In conclusion, BD-related RLS should be considered in symptomatic RLS secondary to rheumatological disorders and BD patients should be examined for RLS. Further studies are needed to clarify the pathogenetic mechanisms underlying BD-related RLS.
The Role of Serum Osteoprotegerin and S-100 Protein Levels in Patients with Acute Ischaemic Stroke: Determination of Stroke Subtype, Severity and Mortality
Authors: Üstündağ M , Orak M , Güloğlu C , Tamam Y , Sayhan MB , Kale E
Published: February 2013

This study investigated correlations between mortality, stroke subtype and stroke severity with serum osteoprotegerin (OPG) and S-100 protein levels prior to the treatment of patients admitted to the emergency department and diagnosed with ischaemic stroke. Pretreatment serum samples were collected from patients ( n = 90) to determine OPG and S-100 protein levels. Age- and sex-matched healthy individuals ( n = 16) served as controls. Compared with controls, OPG and S-100 protein levels were significantly higher in the cardioembolic and atherothrombotic stroke groups. Within the stroke group, OPG levels were significantly higher in the cardioembolic and atherothrombotic stroke groups compared with the transient ischaemic attack (TIA) group. S-100 protein levels were significantly higher in the atherothrombotic stroke group than in the lacunar stroke and TIA groups, and in the cardioembolic stroke group compared with the lacunar stroke group. Serum OPG and S-100 protein levels were significantly higher in patients who died compared with survivors. In predicting stroke subtype and severity, although both OPG and S-100 protein levels were indicators, S-100 protein was more valuable for mortality prediction.
Low-Dose Captopril Inhibits Wear Debris-Induced Inflammatory Osteolysis
Authors: Zhang Wei , Zhao Han , Peng Xiaochun , Cheng Tao , Zhang Xianlong
Published: February 2013

The role of captopril in titanium alloy particle-induced inflammatory osteolysis was investigated. BALB/c mice ( n = 32) were divided into four groups, an untreated control group and three treatment groups given 12.5, 25 or 50 mg/kg per day captopril. Intraperitoneal injections of either 0.9% saline (control) or captopril began 2 days before the introduction of titanium alloy particles and calvaria bone from a syngeneic mouse into established air pouches. Mice were sacrificed 10 days after bone/titanium alloy implantation, and pouch membranes and implants were collected for histological and molecular analysis. Low-dose captopril (12.5 mg/kg per day) was found to inhibit titanium particle-induced tissue inflammation and inflammatory osteolysis. Pouch membrane thickness and inflammatory cellular infiltration were significantly reduced relative to controls. Captopril also inhibited production of the inflammatory cytokines tumour necrosis factor-α, interleukin-1β and receptor activator of nuclear factor-κB ligand compared with controls. This study provides evidence that a low-dose of captopril can inhibit titanium particle-induced inflammatory osteolysis.
Biochemical Markers Comparison of Dynamic Hip Screw and Gamma Nail Implants in the Treatment of Stable Intertrochanteric Fracture: A Prospective Study of 60 Patients
Authors: Song W , Chen Y , Shen H , Yuan T , Zhang C , Zeng B
Published: February 2013

This prospective study compared the extent of surgical trauma following dynamic hip screw (DHS) or Gamma nail (GN) implantation in 60 patients (≥ 60 years old) with stable intertrochanteric fracture. Levels of the biochemical markers creatinine kinase (CK) and C-reactive protein (CRP) were measured pre- and postoperatively. CRP levels were statistically significantly lower on postoperative days 1 and 2 in patients in the DHS versus the GN group; no other differences were observed. Surgical procedures for DHS implantation were considered less invasive than those for GN implantation, although the degree of muscle damage was similar in both groups. The degree of bone and bone marrow damage, rather than muscle tissue damage, may be crucial for determining the CRP response during the operative period. It is concluded that DHS implantation may be described as a more ‘systemically’ minimally invasive procedure than GN implantation.
Modified Thoracoscopic versus Minimally Invasive Oesophagectomy in Curative Resection of Oesophageal Cancer
Authors: Yuan YC , Xia ZK , Yin N , Yin BL , Hu JG
Published: February 2013

Conventional thoracoscopic oesophagectomy is time-consuming and requires sophisticated endoscopic skills. To reduce these problems we have modified the operating procedure, first by anastomosis of the oesophagus with the tubular stomach pulled up via the retrosternal route, followed by thoracoscopic oesophagectomy (modified thoracoscopic oesophagectomy). Outcomes were compared between the modified procedure and minimally invasive oesophagectomy. There were no significant differences in general preoperative clinical characteristics between the two patient groups. The modified thoracoscopic oesophagectomy group had significantly lower hospitalization expenses, significantly shorter operation times and significantly more lymph nodes removed compared with the minimally invasive oesophagectomy group, but there were no significant group differences in lengths of hospital and intensive care unit stays, morbidity and mortality. These results indicate that modified thoracoscopic oesophagectomy is feasible, simplifies operating procedures and reduces hospitalization expenses with acceptable morbidity.
Association between ABO Blood Groups and Osteoporosis Severity in Chinese Adults Aged 50 Years and over
Authors: Lu B-B , Li K-H
Published: February 2013

This study investigated whether the ABO blood groups contributed to the severity of osteoporosis in 1452 community-dwelling Chinese adults aged 50 – 85 years. Osteoporosis severity was scored as: F0, no osteoporosis; F1, osteopenia; F2, osteoporosis; and F3, severe osteoporosis. The proportions of adults with a non-O blood group were 55.0%, 62.0%, 70.8% and 72.6% for the groups with F0, F1, F2 and F3 osteoporosis scores, respectively. Having a non-O blood group was associated with an increased severity of osteoporosis, even after adjustment for gender, age and cigarette consumption (odds ratio 1.8; 95% confidence interval 1.0, 2.9). This study demonstrated that having a non-O blood group was an independent risk factor for the progression of osteoporosis in Chinese adults with osteoporosis aged ≥ 50 years.
Comparative Evaluation of the Microcolumn Gel Card Test and the Conventional Tube Test for Measurement of Titres of Immunoglobulin G Antibodies to Blood Group A and Blood Group B
Authors: Cheng D , Hao Y
Published: February 2013

The conventional tube test (CTT) and microcolumn gel card test (MG) were used to measure immunoglobulin G (IgG) antibody titres to blood group A (anti-A) and blood group B (anti-B) in 288 serum samples. Diagnostic concordance and correlations between the two methods were analysed. MG was more sensitive than CTT in the detection of both anti-A and anti-B IgG. Correlation coefficients for the two methods for the titration of anti-A and anti-B were 0.8470 and 0.8336, respectively. The regression equation representing the relationship between the two methods was calculated and used to convert critical values for anti-A and anti-B IgG antibodies determined by CTT to critical values for MG titration. Analyses showed 86.8% and 89.9% diagnostic concordant rates for the detection of anti-A and anti-B IgG, respectively. It was concluded that titration results obtained by MG correlate well with those obtained by CTT, but critical values determined by CTT need to be converted into corresponding MG values.
Comparison of Coronary Artery Calcification and Some Coronary Artery Calcification Risk Factors in Patients on Haemodialysis and in Patients with Type 2 Diabetes
Authors: Krajnc M , Pečovnik-Balon B , Hojs R , Rupreht M
Published: February 2013

Patients on haemodialysis (HD) and patients with type 2 diabetes are at high-risk for coronary artery calcification (CAC). The coronary artery calcium score (CACS), quantified by computed tomography, cannot be completely explained by traditional cardiovascular disease risk factors. CAC was measured in 45 non-diabetic chronic kidney disease patients on HD and in 45 matched type 2 diabetes patients without diabetic nephropathy. Serum calcium, phosphate, 25-hydroxyvitamin D (25[OH]D), alkaline phosphatase, intact parathyroid hormone (iPTH), fetuin-A, high-sensitivity C-reactive protein (hsCRP), albumin, homocysteine, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides and femoral neck bone mineral density were also measured. No differences were observed in patient distribution across the CACS risk categories between the two groups. Significant differences were observed in serum calcium, phosphate, 25(OH)D, alkaline phosphatase, iPTH, fetuin-A, hsCRP, homocysteine and triglycerides between the two patient groups. Further research into the diverse, numerous and often interlinked factors that influence CAC in different groups of patients is warranted.
Anxiety and Depression during Hospital Treatment of Exacerbation of Chronic Obstructive Pulmonary Disease
Authors: Regvat J , Žmitek A , Vegnuti M , Košnik M , Šuškovič S
Published: February 2013

This study investigated the prevalence, risk factors and rate of recognition of anxiety and depression in 50 patients hospitalized for exacerbation of chronic obstructive pulmonary disease (COPD). Using the Primary Care Evaluation of Mental Disorders questionnaire, 13 patients were identified as having depression, four had anxiety and eight had a combination of the two. Patients with anxiety and/or depression had a significantly higher partial pressure of oxygen and pH, and a lower partial pressure of carbon dioxide, in arterial blood on admission, more severe dyspnoea after a 6-min walk test and less improvement of dyspnoea from admission to discharge than COPD patients without anxiety and/or depression. Two patients were referred to a mental health specialist during their hospitalization, indicating a low rate of recognition. The results suggest that patients with mental disorders are referred and admitted to hospital earlier in the course of a COPD exacerbation due to earlier and more intense perception of dyspnoea.
Diagnosing Mitral Valve Prolapse by Improving the Predictive Power of Classifiers
Authors: Dinevski D , Mertik M , Kokol P
Published: February 2013

Mitral valve prolapse (MVP) has been described as one of the most common cardiac valvular abnormalities in industrialized countries, and can result in sudden death. This study focused on various feature selection mechanisms that might improve the predictive power of a classifier to diagnose MVP. The experiment included selection mechanisms using classical greedy feature selection approaches (forward selection and backward elimination), a genetic algorithm (GA) approach and a cellular automaton (CA) approach. The main aim of this latest approach is to use CA with GA for the data transformation phase of the knowledge discovery process. The CA—GA approach produced better results than the classical greedy approaches. The subsets of features produced by the GA and CA approaches were most appropriate for the decision tree classifier, for diagnosing MVP with the highest overall class accuracy. More importantly, the CA and GA approaches were also capable of generalizing some important knowledge concerning MVP diagnosis.
High-Dose Cholecalciferol Supplementation for Vitamin D Deficiency in Haemodialysis Patients
Authors: Jakopin E , Balon B Pecovnik , Ekart R , Gorenjak M
Published: February 2013

Vitamin D deficiency, which is a recognized problem in haemodialysis (HD) patients, has been associated with higher all-cause mortality. There are no guidelines concerning vitamin D supplementation in HD patients. This study aimed to assess the effects of once-monthly supplementation with high-dose cholecalciferol (vitamin D3) in HD patients. Patients with 25-hydroxyvitamin D (25[OH]D) levels of < 75 nmol/l received 40 000 IU of cholecalciferol once-monthly for 3 months in succession. Every 4 months, 25(OH)D levels were measured and, based on the findings, cholecalciferol therapy was continued for another cycle if necessary. Six cycles were completed in the 24-month study period. The majority of HD patients had mild or severe vitamin D deficiency at baseline. Monthly supplementation with cholecalciferol at 40000 IU was well tolerated, safe and inexpensive. The treatment regime was effective for vitamin D insufficiency but did not prove to be enough to restore 25(OH)D levels in HD patients with mild or severe vitamin D deficiency.
Expert Panel Consensus Recommendations for the Pharmacological Treatment of Acute Pain in the Middle East Region
Authors: Ayad AE , Ghaly N , Ragab R , Majeed S , Nassar H , Al Jalabi A , Al Shoaibi A , Noor S El , Salti A , Costandi J , Zeidan AZ , Schug SA
Published: February 2013

The findings of an expert panel convened to review critically how best to apply evidence-based guidelines for the treatment of acute pain in the Middle East region are presented. The panel recommended a three-step treatment protocol. Patients with mild-to-moderate levels of acute pain should be treated with paracetamol (step 1). If analgesia is insufficient after 1 – 2 days, a selective cyclo-oxygenase-2 inhibitor or, if gastrointestinal safety and bleeding risk are not an issue, a non-specific nonsteroidal anti-inflammatory drug, should be used (step 2). If analgesia remains inadequate, treatment with tramadol, or paracetamol plus codeine/tramadol is recommended (step 3). Patients reporting severe pain should be referred to a pain clinic or specialist for opioid analgesic treatment. Measures of pain and functioning that have been validated in Arabic, with culturally appropriate and easy to understand descriptors, should be used. Early and aggressive acute pain management is important to reduce the risk of pain becoming chronic, especially in the presence of neuropathic features.
The Relationship between Diabetic Autonomic Neuropathy and Diabetic Risk Factors in a Taiwanese Population
Authors: Hsiao J-Y , Tien K-J , Hsiao C-T , Weng H-H , Chung T-C , Hsieh M-C
Published: February 2013

This study looked at spectral analysis of heart rate variability (HRV) between patients with type 2 diabetes mellitus (DM) and healthy controls. The association between diabetic autonomic neuropathy (DAN) with HRV parameter changes and DM risk factors (including nephropathy) was investigated. HRV parameters were compared between 271 patients with DM and 160 controls. A statistically significant difference was found between the two groups for each parameter. Patients with DM were then divided into three groups by the levels of individual risk factors: body mass index, total cholesterol, 2-h postprandial plasma glucose concentration, glycosylated haemoglobin, duration of DM and the albumin—creatinine ratio. HRV parameters decreased significantly in patients with DM as the risk factor level progressed. This study identified previously known and new potential risk factors for the development of DAN, which may be important for the development of risk reduction strategies.
Preoperative Insertion of an Intra-Aortic Balloon Pump Improved the Prognosis of High-Risk Patients Undergoing Off-Pump Coronary Artery Bypass Grafting
Authors: Shi M , Huang J , Pang L , Wang Y
Published: February 2013

This study investigated the efficacy and safety of preoperative insertion of an intra-aortic balloon pump (IABP) in high-risk coronary atherosclerotic disease patients undergoing off-pump coronary artery bypass grafting (OPCAB). A total of 232 patients were recruited to the study, of whom 107 underwent percutaneous insertion of an IABP prior to OPCAB. The remaining 125 patients underwent OPCAB alone. Pre-, peri- and postoperative parameters were compared between the two groups. Preoperative insertion of an IABP was associated with a shorter stay in intensive care, decreased incidence of postoperative dialysis and acute heart failure, and a reduction in postoperative mortality compared with OPCAB alone. There were no between-group differences in terms of haematocrit level, number of distal anastomoses, volume of postoperative drainage or incidence of reoperation for bleeding and postoperative stroke/cerebrovascular accident. In conclusion, preoperative insertion of an IABP improved the prognosis of high-risk CAD patients undergoing OPCAB.
The Role of Hepatic Liver X Receptor α-and Sterol Regulatory Element Binding Protein-1c-Mediated Lipid Disorder in the Pathogenesis of Non-Alcoholic Steatohepatitis in Rats
Authors: Ai Z-L , Zhu C-H , Min M , Wang J , Lan C-H , Fan L-L , Sun W-J , Chen D-F
Published: February 2013

Liver X receptor α (LXRα) and sterol regulatory element binding protein-1c (SREBP-1c) were studied in rats with non-alcoholic steatohepatitis (NASH) induced by a high-fat diet. Forty 5-week-old rats were fed either a high-fat diet ( n = 30) or a normal diet ( n = 10) for 9, 13 or 17 weeks. The mRNA and protein levels for LXRα and SREBP-1c were measured at each time point, as was fatty acid synthase (FAS) activity and the serum levels of free fatty acid (FFA) and triglyceride (TG). The mRNA and protein levels for LXRα and SREBP-1c, FAS activity and serum levels of FFA and TG all significantly increased from week 9 in the high-fat diet rats versus controls. In conclusion, a high-fat diet upregulates LXRα which, in turn, upregulates SREBP-1c, increasing the activity of FAS and FFA and accumulation of TG in hepatocytes. Thus, LXRα and SREBP-1c contribute to the development of NASH.
Association of Interleukin-11 with Mortality in Patients with Spontaneous Basal Ganglia Haemorrhage
Authors: Tu CJ , Liu WG , Dong XQ , Liu JS , Song DG , Yu WH , Zhang ZY , Zhen G , Luo HM
Published: February 2013

This study evaluated interleukin (IL)-11 as an independent prognostic marker of mortality following intracerebral haemorrhage (ICH). Plasma IL-11 levels in patients with ICH were significantly higher than in healthy controls. Multivariate analysis indicated that plasma IL-11 level was an independent predictor for mortality within 1 week of ICH onset and was positively associated with haematoma volume. Receiver operating characteristic curve analysis identified that a baseline plasma IL-11 level > 20.9 pg/ml predicted mortality within 1 week of ICH onset with 81.2% sensitivity and 74.1% specificity. The area under the curve for IL-11 level was significantly smaller than that for the Glasgow Coma Scale score, but similar to that for haematoma volume. IL-11 did not, however, significantly improve the predictive value of the Glasgow Coma Scale or haematoma volume. Thus, IL-11 may be considered as a new independent prognostic marker of mortality and an additional valuable tool for risk stratification and decision-making in the acute phase of ICH.
Improvements in the Establishment of a Rat Myocardial Infarction Model
Authors: Hou Y , Huang C , Cai X , Zhao J , Guo W
Published: February 2013

Coronary artery ligation is widely used for myocardial infarction (MI) induction in rats but produces a large variation in infarct size — a major determinant of mortality. Accurate control of infarct size is critically important for the establishment of a useful animal model. This study determined the anatomical course of the left anterior descending coronary artery (LAD) by direct visualization in order to locate precisely the position of ligation. MI was induced by conventional methods (control group) or using a detailed anatomical knowledge of the LAD (experimental group). Triphenyltetrazolium chloride (TTC) staining was performed to compare infarct size, and electrocardiogram (ECG) changes were observed. The rate of MI induction was significantly higher in the experimental group than in the control group (89.5% vs 65.6%) and the size of infarction was more consistent in the experimental group. Direct visualization of the rat LAD allowed accurate identification of the ligation site, thereby controlling infarct size and improving the success rate of the rat model.
Ginsenoside Rg1 Enhances Endothelial Progenitor Cell Angiogenic Potency and Prevents Senescence In Vitro
Authors: Shi A-W , Gu N , Liu X-M , Wang X , Peng Y-Z
Published: February 2013

This study investigated the effect of ginsenoside Rg1 on the functions of ex vivo cultivated endothelial progenitor cells (EPCs) and whether ginsenoside Rg1 prevented EPC senescence. EPCs isolated from peripheral blood from healthy volunteers were incubated with different concentrations of ginsenoside Rg1 and the effects were observed at different time points. Cell proliferation and in vitro vasculogenesis were assayed and flow cytometry was used to determine the effects of ginsenoside Rg1 on the cell cycle. Senescence and telomerase activity in EPCs were also assayed. It was found that ginsenoside Rg1 promoted EPC proliferation and vasculogenesis in dose-and time-dependent manners. Cell-cycle analysis showed that ginsenoside Rg1 increased the proliferative phase and decreased the resting phase of EPCs. β-Galactosidase and telomerase activities increased. These results support the view that ginsenoside Rg1 induces EPC proliferation and angiogenesis, and inhibits EPC senescence.
Effect of Single-Injection versus Continuous Local Infiltration Analgesia after Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Study
Authors: Zhang S , Wang F , Lu ZD , Li YP , Zhang L , Jin QH
Published: February 2013

In this randomized, double-blind, placebo-controlled, single-centre study, 80 patients (American Society of Anesthesiologists physical status I — III) received postoperative single-injection local infiltration analgesia (SLIA), continuous local infiltration analgesia (CLIA) or placebo (control group). Intravenous patient-controlled morphine was used as rescue analgesia. The CLIA group showed lower postoperative visual analogue scale (VAS) pain scores from 8 to 48 h at rest and from 16 to 48 h during activity compared with the SLIA group. The CLIA group also had significantly lower consumption of morphine from 24 to 48 h postoperatively versus the SLIA group. Patient satisfaction was higher, and maximum flexion of the knee on postoperative days 7 and 90 was greater, in the CLIA group compared with the SLIA group. CLIA provided prolonged superior analgesia and was associated with more favourable functional recovery and patient satisfaction compared with SLIA.
Effects of an Angiotensin 2 Receptor Blocker plus Diuretic Combination Drug in Chronic Heart Failure Complicated by Hypertension
Authors: Suzuki O , Ishii H , Kobayashi S
Published: February 2013

The effects of 24 weeks' treatment with an angiotensin 2 receptor blocker (ARB)/diuretic combination drug were investigated in an open-label study of 61 patients with stabilized chronic heart failure. Renin—angiotensin—aldosterone system inhibitors were replaced with a tablet containing hydrochlorothiazide 6.25 mg plus candesartan 8 mg, administered orally, once daily, in patients with systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg while under optimal treatment. Both SBP and DBP declined significantly during the ARB/diuretic combination treatment. Diuretics administered previously were discontinued during the study period in 15 patients, decreasing the number of drugs being taken. During ARB/diuretic combination treatment, the blood urea nitrogen level worsened but no significant changes were noted in potassium or estimated glomerular filtration rate, which had been a matter of concern. Additionally, the level of brain natriuretic peptide, an indicator of the severity of heart failure, was improved, indicating effectiveness and safety of the ARB/diuretic combination drug.
Pineal Parenchymal Tumours: Minimum Apparent Diffusion Coefficient in Prediction of Tumour Grading
Authors: Zhu L , Ren G , Li K , Liang ZH , Tang WJ , Ji YM , Li YX , Cheng HX , Geng DY
Published: February 2013

Retrospective assessment was performed of the minimum apparent diffusion coefficient (minADC) together with quantitative assessment of the histopathological features of resected tumour tissue and the Ki-67 labelling index (LI) for predicting pineal parenchymal tumour (PPT) grade. Magnetic resonance images of tumours from 26 male and female patients (mean age 27.7 years) with pathologically confirmed PPTs, comprising 10 pineocytomas (PCs), seven pineal parenchymal tumours of intermediate differentiation (PPTIDs) and nine pineoblastomas (PBs), were reviewed retrospectively. Using ADC maps derived from isotropic diffusion-weighted images, the minADC value of each tumour was determined postoperatively from several regions of interest defined in the tumour, excluding cystic, necrotic, haemorrhagic or calcified components. Surgical intervention was undertaken in all cases. The Ki-67 LI was measured in surgical specimens. Mean minADC and Ki-67 LI showed significant differences among PCs, PPTIDs and PBs, and minADC was negatively correlated with Ki-67 LI. It is concluded that the minADC of PPTs provide useful additional information when predicting tumour grading.
Predictive Value of Penile Dynamic Colour Duplex Doppler Ultrasound Parameters in Patients with Post-Traumatic Urethral Stricture
Authors: Chen L , Hu B , Feng C , Sun X-J
Published: February 2013

This study evaluated dynamic colour duplex Doppler ultrasound (D-CDDU) for the assessment of erectile function in patients with post-traumatic urethral stricture. In total, 44 patients with urethral stricture secondary to trauma were recruited between January 2009 and June 2010. Peak systolic velocity of the cavernosal artery was measured before and after intracavernosal injection (ICI) of 20 mg papaverine and 1 mg phentolamine. Cavernosal artery end-diastolic velocity and resistance index (RI) were evaluated after ICI. Patients with RI ≥ 0.8 had significantly shorter strictures than those with RI < 0.8 after ICI only in cases of posterior urethral stricture. Patients with RI ≥ 0.8 were significantly younger than those with RI < 0.8. Urethral stricture length was negatively correlated with RI ( r = −0.375). Cavernosal artery RI after ICI is a reliable predictor of erectile function in patients with urethral stricture, especially posterior stricture. The patient's age should be considered when using this parameter.
Predictive Value of Doppler Ultrasound in Childhood Pneumonia
Authors: Yekeler E , Ucar A , Yilmaz R , Yilmaz E , Cheikahmad I , Sharifov R , Somer A
Published: February 2013

This study aimed to determine the predictive value of intercostal and pulmonary artery Doppler flow patterns in the outcome of childhood pneumonia. Pneumonia was classified according to type of pleural effusion and the ultrasound features of consolidations. Doppler flow patterns of intercostal and pulmonary arteries were analysed and correlated with pneumonia type and hospital stay. Of 83 pneumonia cases, 55 were uncomplicated and 28 were complicated. Pleural effusion was present in 54 cases, with 29 non-septated and 25 septated cases. Patients with uncomplicated pneumonia did not have abnormal Doppler flow patterns, compared with 64% (18 of 28) of patients with complicated pneumonia. Doppler ultrasound patterns in childhood pneumonia were correlated with pneumonia type and may be predictive of pneumonia outcome.
Pseudoangiosarcomatous Squamous Cell Carcinoma of the Lung
Authors: Kong M , Ren X , You Q , Yao H , Teng X
Published: February 2013

Pulmonary pseudoangiosarcomatous squamous cell carcinoma (PSCC) is a rare aggressive variant of squamous cell carcinoma. Histopathologically, PSCC is characterized by interanastomosing cords and channels, lined by atypical cells, with spaces containing erythrocytes or floating tumour cells. PSCC mimics angiosarcoma, so careful attention should be paid to immunohistochemical differences. Two PSCC cases are described here: in a 79-year-old male, bronchoscopy revealed mucosal swelling and hypertrophy and an adrenal mass was found 1 month later; in a 76-year-old male, computed tomography revealed rib destruction due to a non-calcified soft-tissue tumour and, although the tumour resembled an angiosarcoma, endothelial markers were negative and cytokeratin and p63 markers were positive. Immunohisto chemical analyses may be helpful in establishing an accurate diagnosis. PSCC had a progressive course in both patients, who died ≤ 3 months postdiagnosis.
Management of Psoriasis in Africa and the Middle East: A Review of Current Opinion, Practice and Opportunities for Improvement
Authors: Abdulghani M , Al Sheik A , Alkhawajah M , Ammoury A , Behrens F , Benchikhi H , Benkaidali I , Doss N , Gendy A El , Mokhtar I , Odendaal D , Raboobee N , Thaçi D , Weiss R , Whitaker D
Published: February 2013

Psoriasis is a common, chronic, systemic, inflammatory disease of the skin that is often associated with inflammatory musculoskeletal disease. Psoriasis impacts on affected individuals and on society at many levels, being associated with considerable economic burden and impaired quality of life. This article aims to provide dermatologists and their allied healthcare professionals, particularly those practicing in Africa and the Middle East, with a review of the current understanding of psoriasis, its treatment and impact, as a backdrop for further discussion of the management of psoriasis in these regions. Insight into the real-life, day-to-day challenges and unmet needs currently facing dermatologists in Africa and the Middle East is provided by the authors, most of whom are experienced dermatologists practicing in this region.
Hyperoxygenated Solutions in Clinical Practice: Preventing or Reducing Hypoxic Injury
Authors: Xu H , Li Y , Gao W , Zhang H , Xu L-X
Published: February 2013

In cases of hypoxia, oxygen can be supplied via a number of methods including face masks, nasal cannulae, hyperoxygenated oxygen chambers and mechanical ventilation. Administering oxygen via the respiratory tract is, however, limited in respiratory diseases such as pulmonary fibrosis, pneumoconiosis and severe acute respiratory syndrome, or following the inhalation of asphyxiating poisons. This has led to research into new methods of supplying oxygen that bypass the lungs. Research has investigated the efficacy of intravenous hyperoxygenated solutions (HOS) as auxiliary oxygen supplies in several hypoxic states including cardiopulmonary resuscitation, respiratory failure, cerebrovascular disease, myocardial ischaemia, severe acute respiratory syndrome, poisoning, neonatal hypoxia, altitude sickness, large burns and traumatic haemorrhagic shock. Much of the research has taken place in China and more than 3.5 million hypoxic patients have received HOS, with good therapeutic effects. This review summarizes the literature supporting the use of this novel treatment.