bluuebunny/crossref_metadata_2025 huggingface dataset:
The Dual Catheter Technique for Coiling of Wide-Necked Cerebral Aneurysms: An Under-Reported Method
Authors: Horowitz M. , Gupta R. , Jovin T.
Published: January 2017

Aneurysms with wide necks can be difficult to manage due to inability to contain the coil mass within the lesion. When standard devices will not suffice the use of two catheters delivering coils simultaneously into the aneurysm can often provide excellent results in terms of aneurysm obliteration.

We report two cases of wide-necked aneurysms coiled successfully using the dual catheter technique.

Both aneurysms were successfully treated using the dual catheter technique with coil retention within the aneurysm fundus and excellent flow throngh the afferent and efferent vessels.

The dual catheter technique is an under-reported method for treating wide-necked aneurysms. Successful performance, however, relies upon considerations of coil type and delivery, coil deployment, catheter removal, and anticoagulation therapy.
Spinal Epidural Haemangioma Associated with Extensive Gastrointestinal Haemangiomas
Authors: Cheng L. T. E. , Lim W. E. H.
Published: January 2017

A case of spinal epidural cavernous haemangioma associated with gastrointestinal haemangiomas is discussed. The patient was a young Chinese female presenting with chronic lower back pain. She had a history of extensive gastric and small bowel haemangiomas. Lumbar spine MRI showed a heterogeneously enhancing epidural mass infiltrating the paravertebral muscles. Open biopsy confirmed an epidural cavernous haemangioma. To our knowledge, an association between spinal epidural cavernous haemangiomas and gastrointestinal haemangiomas has not been reported.
Traumatic Carotid-Cavernous Fistula: Endovascular Treatment with Onyx and Coils
Authors: Baccin C.E. , Campos C.M.S. , Abicalaf R. , Kanashiro L.H.T. , Bolcato M.R. , Lima S.S. , Piske R. L.
Published: January 2017

Carotid cavernous fistulas (CCF) are mostly post-traumatic and are due to a tear of the internal carotid artery (ICA) inside the cavernous sinus. The improvement of endovascular techniques with venous approach enables the preservation of internal carotid artery patency in most cases when detachable balloons fail in order to reconstruct and repair the tear in the ICA. The case described here has a giant aneurysmatic dilatation of the cavernous sinus and inferior petrosal sinus. We associate coils and Onyx to occlude the lesion preserving and repairing the large hole of the fistula.
Growth and Rupture Mechanism of Partially Thrombosed Aneurysms
Authors: Krings T. , Alvarez H. , Reinacher P. , Ozanne A. , Baccin C.E. , Gandolfo C. , Zhao W.-Y. , Reinges M.H.T. , Lasjaunias P.
Published: January 2017

Within the group of giant and large aneurysms the subgroup of the so-called “partially thrombosed” aneurysms can be differentiated according to clinical and neuroimaging findings. The present study was carried out to determine the site of bleeding of these aneurysms and what implications concerning their pathomechanism can be drawn from these findings.

Twenty patients aged two to 77 (mean 44) years who exhibited a partially thrombosed aneurysm that had recently bled were included. Images (MRI including T1 pre- and postcontrast and T2 weighted images in multiple planes, CT and digital subtraction angiography) and patients' charts were reviewed.

MRI showed an onion-skin appearance of the thrombus in 19 patients, rim enhancement of the aneurysm wall (either partial or complete) in 17, and a perifocal edema in 16 patients. The acute hemorrhage was typically crescent-shaped and located at the periphery of the aneurysm, distant from the perfused lumen of the aneurysm within the thrombosed part of the aneurysm.

The current denomination “partially thrombosed” intracranial arterial aneurysms leads to the presumption that thrombus is present endoluminal whereas in fact the site of hemorrhage is within the vessel wall. A more accurate nomination would, therefore, be “aneurysms with intra mural hemorrhage”. The enhancing wall and the edematous reaction of the adjacent brain parenchyma might be a sign for an inflammatory pathomechanism which is reinforced by histological and pathophysiological studies. This disease should be regarded as a clinical entity separate from saccular or non-thrombosed giant or large aneurysms.
Intracerebral Hemorrhage after Carotid Artery Stenting without Evidence of Hyperperfusion in Positron Emission Tomography
Authors: Shindo A. , Kawai N. , Kawakita K. , Kawanishi M. , Tamiya T. , Nagao S.
Published: January 2017

A 75-year-old man with a recent history of transient left hemiparesis and dysarthria was referred to our hospital. Angiography showed right internal carotid artery (ICA) occlusion and left ICA 89% stenosis. Positron emission tomography (PET) showed decreased cerebral blood flow (CBF), and increased oxygen extraction fraction (OEF) and cerebral blood volume (CBV) in the right hemisphere.

In the left hemisphere, CBV was increased, but CBF and OEF remained normal. One month after the transient ischemic attack, left carotid artery stenting (CAS) was performed without complications. Diffusion-weighted magnetic resonance imaging (MRI) on the day after CAS showed no fresh ischemic lesion. PET on the second day after CAS showed increased CBF and decreased OEF and CBV in the right hemisphere as compared with those before CAS. In the left hemisphere, decreased CBV was observed and CBF was slightly increased as compared with those before CAS.

The postoperative course was uneventful, but on the fifth day after CAS, the patient suddenly showed a focal seizure and right motor weakness. Emergency computed tomography scanning showed massive intracranial hemorrhage with severe brain edema in the left hemisphere. Although CBF study is useful to predict the hyperperfusion syndrome, we cannot disregard the possibility of intracerebral hemorrhage after CAS for carotid artery stenosis when there is no evidence of hyperperfusion on postoperative CBF study.
Endovascular Treatment of a Ruptured Blood Blister-Like Aneurysm with a Flow-Diverting Stent
Authors: Rasskazoff S. , Silvaggio J. , Brouwer Pa. , Kaufmann A. , Nistor A. , Iancu D.
Published: January 2017

Treatment of BBAs is currently challenging and remains difficult despite improvement of microsurgical technique and advancement in endovascular technologies. Therapeutic options are reconstructive and deconstructive open surgeries or endovascular procedures. However, there is a lack of consensus about optimal treatment. We report a case of 38-year old woman with subarachnoid hemorrhage due to a ruptured BBA successfully treated with placement of an endovascular flow-diverting stent.
Provocation Lumbar Diskography at Previously Fused Levels
Authors: Dulai H.S. , Bartynski W.S. , Rothfus W.S. , Gerszten P.C.
Published: January 2017

Recurrent or persistent low back pain (LBP) after lumbar fusion can be related to many factors. We reviewed the provocation lumbar diskogram (PLD) features and redo-fusion outcome in our patients evaluated for recurrent/persistent LBP after technically successful fusion. LD was performed in 27 patients with recurrent/persistent LBP after prior successful lumbar surgical fusion (31 fused levels: single-level fusion-23; two-level fusion-4). PLD response and imaging characteristics at fused and non-fused levels were assessed including: intra-diskal lidocaine response, diskogram-image/post-diskogram CT appearance, presence/absence of diskographic contrast leakage, and evidence of fusion integrity or hardware failure. Outcomes in patients having redo-fusion were assessed.

Concordant pain was encountered at 15 out of 23 (65%) single-level fusions, non-concordant pain in one fusion with non-painful response in seven. Adjacent-level concordant pain was identified in seven out of 23 (30%) patients (three of 15 with painful fused levels; four of seven with non-painful fusions). In two-level fusions, concordant pain was encountered at one fused level in each patient. In painful fused levels, leaking and contained disks were encountered with partial or complete pain elimination after intra-diskal lidocaine injection. In anterior fusions, space or contrast surrounding the cage was noted at five of 11 levels. Pseudoarthrosis was noted only with trans-sacral screw fusions. Redo-fusion in 13 patients resulted in significant improvement in nine and moderate improvement in one.

Patients with recurrent/persistent LBP after technically successful fusion may have a diskogenic pain source at the surgically fused or adjacent level confirmed by lidocaine-assisted PLD.
Otorrhagia from the “Aberrant Internal Carotid” Artery in the Middle Ear
Authors: Söderman M. , Moersdorf M. , Lysdahl M. , Mendel L.
Published: January 2017

Agenesis of the cervical portion of the internal carotid artery (ICA) may result in blood supply to the ipsilateral cerebral hemisphere being provided by an enlarged inferior tympanic branch of the ascending pharyngeal artery. This enlarged vessel, passing through Jacobson's canal and anastomosing with the likewise enlarged caroticotympanic branch of the ICA in front of the promontorium, may simulate a middle ear mass.

We present five patients with this unusual anatomical variant, three of which underwent biopsy of what was believed to be a middle ear tumour.

One patient experienced rupture of an arterial aneurysm in the middle ear successfully treated with endovascular application of detachable platinum coils.

It is mandatory for ENT-surgeons and radiologists who perform head-and-neck examinations to recognize this anatomical variant, not mistaking it for a tumour, since biopsy of a large artery supplying the brain may have disastrous consequences.

In patients with otorrhagia, an arterial aneurysm must be considered as a possible source of bleeding, in some cases amenable for treatment with an endovascular technique.

The diagnosis of “aberrant internal carotid artery” is usually made with CT of the temporal bone or MR of the skull base. Cerebral angiography is in most cases not necessary, unless an endovascular procedure is planned.
Embolisation of Branches of the Ophthalmic Artery
Authors: Matsumaru Y. , Alvarez H. , Rodesch G. , Lasjaunias P.L.
Published: January 2017

Nine patients presenting various orbital and skull base pathologies embolised through the ophthalmic artery are reported.

All cases were catheterised beyond the bend around the optic nerve (second portion of the intraorbital ophthalmic artery). Embolisation was carried in all with n-butyl cyano-acrylate without post interventional visual disturbance.

Relying on the classic description as well as previous personal work on the ophthalmic artery anatomy and angiographic anatomy, all procedures were performed under general anaesthesia without functional testing. The central retinal artery and the long ciliary arteries arise from the first or second portion of the ophthalmic artery. For embryological reasons no branch to the visual tract can arise from the ophthalmic trunk distal to the origin of the superficial recurrent meningeal artery or the lacrimal artery.

Therefore distal catheterisation at least beyond the second portion, (and injection without reflux) makes safe embolisation possible in all variations of internal carotid origin of the ophthalmic stem.

Independent from the expected goal of the embolisation, the use of particles in this territory should in our opinion be discouraged.
Predilation technique with balloon angioplasty to facilitate percutaneous groin access of large size sheath through scar tissue
Authors: Pecoraro Felice , Krishnaswamy Mayur , Steuer Johnny , Puippe Gilbert , Mangialardi Nicola , Pfammatter Thomas , Rancic Zoran , Veith Frank J , Cayne Neal S , Lachat Mario
Published: January 2017

Purpose

Percutaneous remote access for endovascular aortic repair is an advantageous alternative to open access. Previous surgery in the femoral region and the presence of synthetic vascular grafts in the femoral/iliac arteries represent major limitations to percutaneous remote access. The aim of this study was to evaluate an original technique used for enabling percutaneous remote access for thoracic or abdominal endovascular aortic repair in patients with scar tissue and/or a vascular graft in the groin.

Methods

Twenty-five consecutive patients with a thoracic (11/25; 44%) or an aortic aneurysm (14/25; 66%) and with a synthetic vascular graft in the groin (16/25; 64%) or a redo groin access (9/25; 36%) were managed through the percutaneous remote access. In all patients, a percutaneous transluminal angioplasty balloon was used to predilate the scar tissue and the femoral artery or the synthetic vascular graft after preclosing (ProGlide®; Abbott Vascular, Santa Clara, CA, USA). In 10 patients, requiring a 20 Fr sheath, a 6 mm percutaneous transluminal angioplasty balloon was used; and in the remaining 15, requiring a 24 Fr sheath, an 8 mm percutaneous transluminal angioplasty balloon. Preclosing was exclusively performed using ProGlide®. Mean follow-up was 15 months.

Results

In all cases, stent-graft deployment was successful. There was one surgical conversion (4%; 1/25) due to bleeding from a femoral anastomosis. Two cases required additional percutaneous maneuvers (postclosing with another system in one patient and endoluminal shielding with stent-graft in the other patient). No pseudoaneurysm or access complication occurred during the follow-up.

Conclusions

Percutaneous access in redo groins with scar tissue and/or synthetic vascular graft using ultrasound-guided punction, preclosing with ProGlide® system and predilation with percutaneous transluminal angioplasty balloon to introduce large size sheath as used for endovascular aortic repair showed to be feasible, safe and with few local complications.
The Effects of Long-Term Treatment by Immunotherapy and Fluticazone on Broncial Hyperreactivity
Authors: Ilonidis G. , Anogianakis G. , Trakatelli Chr. , Anogeianaki A. , Giavazis J. , Trakatellis M. , Michalis I.
Published: January 2017

Thirty subjects (20 female and 10 male), all allergic to the mites D. Pteronyssinus and D. Farinae, participated in the present study which covered a period of four years. The subjects were randomly divided in two groups. Group I included 10 female and 5 male subjects, with an average age of 25.8 (+/− 3.5) years who received immunotherapy only. Group II had an average age of 31.5 (+/− 4) years and they received immunotherapy along with fluticazone propionate (1000mcg/day). The protocol for immunotherapy was the same for both groups. The basis FEV1 was determined for each subject of both Groups I and II and afterwards they were subjected to provocation tests of nebulized methacholine solution administered in consecutively larger concentrations until a drop in FEV1 >20 % (PC20), was observed. Three years later, when their therapy was completed, all subjects were subjected to the same provocation test and a significant reduction in bronchial hyperactivity was documented for both groups. In particular, for Group I, the percentage of change in FEV1 values was 27.25 +/- 5.23 % and PC20 5.11 +/− 2.64 mg/ml before immunotherapy, while after immunotherapy the same indicators were 22.22 +/- 7.08 % (P<0.05) and 6.85 +/− 4.03 mg/ml, (P<0.05) respectively. For Group II, the percentage of change in FEV1 values was 26.28 +/− 2.5 % and PC20 5.42 +/− 2.5 mg/ml before immunotherapy, while after immunotherapy the same indicators were 12.27 +/- 2.49 % (P<0.01)and 11.64 +/− 5.14 mg/ml, P<0.01 respectively. It is concluded that although significant reduction in hyperreactivity can be achieved through immunotherapy, the combination of immunotherapy with daily fluticazone propionate administration shows the most promising results.
Evaluation of “Steroid-Sparing” Effects of Xanthena® Cream in Patients with Mild to Moderate Atopic Dermatitis
Authors: Cassano N. , Amoruso A. , Masci S. , De Paola S. , Salvatori S. , Agnusdei C. P. , Calabretta S. , Callea A. , Cellini F. , Centofanti S. , Cuomo M. , Curia S. , Dattola S. , De Caro C. , Del Brocco L. , Donato L. , Ferrari A. , Lopreiato R. , Puglisi A. , Ruggiero G. , Russo F.M. , Valenti G. , Vernaci R. , Verrina F. , Liotti G. , Vena G.A.
Published: January 2017

Emollients play an important role in the management of atopic dermatitis (AD). The aim of this study was to evaluate the efficacy and the “steroid-sparing” activity of an emollient cream (Xanthena® cream) in patients with mild to moderate AD. Patients were asked to apply twice a day for 7 days a cream containing hydrocortisone butyrate on the lesionai skin and then to apply Xanthena® cream only on the left side of affected areas. During the 2-month study period, the use of the corticosteroid cream was resumed in case of flare-up in any side.

The results obtained show significant differences of both the total severity score and the intensity of each symptom and sign of AD between the skin areas treated with Xanthena® cream and the control areas (P<0.05); a relevant reduction of steroid requirement was also noted in correlation with the use of this emollient cream (P<0.05). A significant improvement was observed even after the first month of therapy for most symptoms, except for excoriations/fissuring, oozing/crusting and burning which improved only at 2 months. Treatment was well-tolerated by the majority of patients; adverse local reactions, mostly transient and of mild intensity, were observed in 7% of cases.
An Open Randomized Controlled Study on the Efficacy of Low-Sodium Water Intake Evaluated by Non-Invasive Methods in Patients with Cellulite
Authors: Puddu P. , Ventrice C. , Pennasilico G. , Guarnaccia G. , Ruffelli M. , Di Pietro A. , De Pità O.
Published: January 2017

Cellulite is the result of complex physiological changes of the subcutaneous fat layer and of microcirculation, clinically manifesting as orange peel skin especially in women and involving thighs, buttocks, and abdomen. An adequate water intake has been suggested to be helpful in controlling the development and worsening of the disease. An open randomized controlled study has been performed to evaluate modification induced by an adequate diet associated to low-sodium or high-sodium water intake on some clinical features of patients affected with mild to moderate cellulite.

Non-invasive instrumental investigations (Bioelectrical Impedance Analysis (BIA), thermography and skin echography) were used before and after dietary treatment. A significant improvement of the disease, in terms of weight loss, cutaneous microcirculation and reduction of subcutaneous fat layer, was observed in the group of patients who underwent low-sodium water intake. An adequate dietary treatment associated to a low-sodium water intake is able to efficiently controll some biological and clinical parameters of mild to moderate cellulite.
Neurotoxicity Assessment of Chemicals on Exposed Workers — A Review of Neurobehavioral and Neurophysilogical Tests
Authors: Niu Q.
Published: January 2017

With the wide utilization of neurotoxic substances, more and more people are exposed to them occupationally or environmentally. Neurotoxicity has been defined as any adverse effect on the structure or function of the central and /or peripheral nervous system by biological, chemical and physical agent. Neurotoxic effect may be permanent or reversible, caused by neuropharmacological or neurodegenerative properties of a neurotoxicant. The nervous system is very sensitive and fragile to chemicals. The early adverse effects should be detected as early as possible because they are reversible, functional and chemical, not structural. A multidisciplinary approach is necessary to assess neurotoxicity because of the complexity and diverse functions of the nervous system. Many of the relevant effects can be measured directly by neurochemical, neurophysiological, and neuropathological techniques, whereas, others must be inferred from observed behavior and psychic performance. Neurotoxicity in humans is most commonly measured by relatively noninvasive neurophysiological and neurobehavioral methods that assess cognitive, affective, sensory, and motor function. The biomarker assay can be complement. In general, due to the speciality and difficult accessibility, the biomarkers that manifest the neurotoxicity of chemicals in nervous system are difficult to obtain, but a number of biochemical and molecular parameters similar to those involved as toxicity targets in the nervous system are also present in more easily accessible tissues, such as cerebrospinal fluid (CSF), blood, plasma and peripheral blood cells. These tissues can be surrogate indicators. With the multidisciplinary approach, the neurotoxicity of chemicals can be assessed or screened sensitively and practically.
Mediators of Inflammation in Children with Inflammatory Bowel Disease
Authors: Hatzistilianou-Sidiropoulou M. , Nousia-Arvanitakis S. , Galli-Tsinopoulou A. , Agguridaki C. , Xefteri M. , Tsavdaridou V.
Published: January 2017

Inflammatory bowel disease (IBD) in children remains a challenging problem. Crohn disease and ulcerative colitis are characterized by an activation of intestinal mononuclear cells and T-cells within the inflammed lesions. In the present study, we determined whether circulating inflammatory mediators, such as interleukins and adhesion molecules, may represent useful markers of immune activation in vivo. Serum concentrations of IL-2, IL-6, IL-8, IL-10, sIL-2R, sICAM-1 and sVCAM-1 were measured by a quantitative enzyme-linked immunosorbent assay (ELISA) in 18 patients with IBD and 25 healthy subjects matched for age and sex (control group). According to our results, all the inflammatory mediators are significantly increased in patients with IBD as compared to the control group. Pro-inflammatory mediators (IL-6, IL-8, IL-10) are elevated in the serum of patients with active disease, suggesting that they act as naturally occuring initiators of the acute inflammatory process. Increased IL-2 and sIL-2R levels reflect T-cell activation. Increased circulating sICAM-1 and sVCAM-1 levels may reflect increased adhesiveness and signal transmission across cells, probably as a result of shedding of the parent molecule during local cellular immunoresponses in vivo. The measurement of inflammatory mediators may be a useful adjunct to the clinical assessment and to the routine laboratory testing of IBD pediatric patients.
Distal Mucosal Site Stimulation by Kefir and Duration of the Immune Response
Authors: Vinderola C. G. , Duarte J. , Thangavel D. , Perdigon G. , Farnworth E. , Matar C.
Published: January 2017

Kefir is a fermented milk (drink) produced by the action of lactic acid bacteria, yeasts and acetic acid bacteria. We recently reported a comparative study on the effect of kefir containing viable or non-viable bacteria by studying their modulatory activity on the intestinal immune response. A functional dose was established in a murine model and the pattern of regulatory and pro-inflammatory cytokines induced was also studied. The existence of a common mucosal immune system implies that the immune cells stimulated in one mucosal tissue can spread and relocate through various mucosal sites. The aim of this work was to determine the effect of an oral administration of kefir on the duration of the intestinal mucosa immune response and the modulatory activity in distal mucosal sites, specifically in the peritoneal and pulmonary macrophages and in the bronchial tissue. BALB/c mice were fed with kefir or pasteurized kefir at doses previously determined as functional for intestinal mucosa immunomodulation. Kefir feeding was stopped and the number of IgA, IgG, IL-4, IL-6, IL-10, IIFNγ and TNFα producing cells was determined in the lamina propria of small intestine immediately, and after 2 and 7 days of kefir withdrawal. IgA producing cells were also measured in the bronchial tissue of lungs immediately and 2 and 7 days after kefir withdrawal. Phagocytic activity of peritoneal and pulmonary macrophages was also determined. The oral administration of kefir or pasteurized kefir increased the number of IgA+ cells not only in the gut lamina propria, but also in the bronchial tissue, supporting the concept of local antibody secretion after remote-site stimulation in the intestinal tract. Both peritoneal and pulmonary macrophages were activated by kefir or pasteurized kefir feeding. Peritoneal macrophages were stimulated faster than pulmonary macrophages (for kefir). The enhanced phagocytic activity achieved by kefir or pasteurized kefir lasted longer for the peritoneal than for the pulmonary macrophages. Due to the increased bronchial IgA and phagocytic activity of pulmonary macrophages after kefir feeding observed in this study, the oral administration of kefir could act as a natural adjuvant for enhancing the specific immune response against respiratory pathogens. The parameters studied returned to control values within a week of cessation of kefir administration. This would suggest that there is a low risk of overstimulating the gut mucosal immune system during periodic consumption of kefir.
Prevalence of Chlamydia Trachomatis Infections in Symptomatic Patients in Bulgaria
Authors: Ouzounova V. , Haralambieva J. , Mitov I.
Published: January 2017

The aim of the study was to investigate the prevalence of C. trachomatis infection in symptomatic patients and to compare our data with similar studies made in Bulgaria. 822 patients were included in the study with a diagnosis suggestive of Chlamydial infection: urethritis, prostatitis, Reiter syndrome, cervicitis, salpingitis, pelvic inflammatory disease, ectopic pregnancy, infertility, etc. The samples were cell cultured on McCoy and detected by immunofluorescence with anti-lipopolysaccharide monoclonal antibody. The prevalence of C. trachomatis infection in symptomatic patients was about 37% in the investigated 822 urogenital samples (568 women and 254 men). Active infection with C. trachomatis was detected in 39% of the women and in 33% of the men. Our study shows a relatively high prevalence of C. trachomatis infection in symptomatic patients; a lower prevalence of the infection in comparison with other Bulgarian studies, using different methods for detection. The results prove the high sensitivity and specificity of the cell-culture method for the detection of Chlamydial infections and the need for screening of the symptomatic patients and their sexual partners for Chlamydial infection.
Heat Shock Proteins (HSP): Future Trends in Cancer Immunotherapy
Authors: Deepak P. , Kumar S. , Acharya A.
Published: January 2017

Heat Shock Proteins (HSPs) are a large family of highly conserved proteins involved in assisting protein folding and unfolding in the cells. HSPs are expressed constitutively as well as inducibly and, interacting with antigen presenting cells, induce the expression of various cytokines and chemokines as well as the maturation and migration of dendritic cells, thus acting themselves as cytokines. HSP-chaperoned antigenic peptides are also generated within the tumor cells. Such chaperoned peptides are released in the extra cellular medium with an association of HSPs by cell stress, death or tumor cell lyses. HSP-peptide complexes from extra cellular medium are taken up by antigen presenting cells through CD91 receptor and are represented or cross-presented by their MHC class I molecules for specific anti-tumor immune response. In addition, HSPs expressed on the cell surface of tumor cells stimulate αβ T-cells and γδ T-cells as well as natural killer (NK) cells that are first-line defense mechanisms. In this manner, HSPs have the ability to stimulate both arms of the effecter mechanism of the immune system. These unique immunological attributes of HSPs are presently becoming the basis for tumor immunotherapy. Tumor-derived HSP-peptide complexes have been demonstrated to serve as anti-tumor vaccines. To date various approaches of vaccination using HSPs have been developed and tested clinically. These HSP-based vaccine approaches can be combined with hyperthermia and CTLA-4 blockade to enhance their anti-tumor potentiality.
Immunomodulatory and Anti-Inflammatory Activity Induced by Oral Administration of a Probiotic Strain of Lactobacillus Casei
Authors: Bonet M. E. Bibas , Chaves A. S. , Mesón O. , Perdigón G.
Published: January 2017

The aim of this work was to study the effect of the long-term cyclic administration of the probiotic strain of Lactobacillus ( L.) casei CRL 431 as a mucosal immunomodulator of the immune cells associated with the lamina propria of the small intestine, bronchus and other immune cells not associated with mucosal tissues, such as peritoneal macrophages. BALB/c mice were orally administered with a suspension of Lc 109 cfu/day/animal in non-fat milk (NFM) 10% for two consecutive days, the optimal dose selected in previous studies to reach protective immunity. This administration was repeated cyclically every 5 days for 98 days. Mice in the control group received only NFM 10%. Samples were taken after two days of L. casei administration and every 14 days until day 98. The small intestine and lungs were removed for histological slices preparation. Haematoxilin-eosin stains were made for histological studies of the small intestine. The number of IgA producing cells in the lamina propria of the small intestine and in bronchus was determined by immunofluorescence assays. Regulatory (IL-4, IL-10) and proinflammatory (TNF-α, INF-γ) cytokines were measured in the gut. Peritoneal macrophages were collected during the same periods for phagocytosis assays. We determined an increase in the number of IgA+ cells in the lamina propria of the small intestine in all the periods assayed and in BALT only until day 28. The cytokines studied (IL-10, IL-4, TNF-α and INF-γ) increased in most of the periods assayed, the effect being more remarkable for the anti-inflammatory cytokines such as IL-4 and IL-10. INF-γ was also increased but no modifications in the histological studies of the small intestine were observed, suggesting other roles for this cytokine The phagocytic activity of PM increased for most of the periods assayed. We demonstrated that long-term cyclic oral L. casei administration favors mucosal immunity and modulates the immune response to maintain the homeostasis at the mucosal level.
Detection of Antibodies to Human Herpesvirus 8 (HHV-8) among Women of Child-Bearing Age in the Apulia Region (South-Eastern Italy)
Authors: Fiore J.R. , Volpe A. , Di Stefano M. , Vimercati A. , Tateo M. , Cantatore S. , Ingrassia F. , Greco P. , Pastore G. , Dentico P.
Published: January 2017

In this study the authors investigated the presence of serum antibodies to Human Herpesvirus 8 (HHV-8) in a group of women of child-bearing age in the Apulia region (South Eastern Italy). A seroprevalence of 16.8% was observed, increasing, although non significantly, with the age of the women (10.6% in women between 19 and 25 years, 25.3% in women aging more than 35 years). The presence of antibodies to Hepatitis C Virus (HCV) was significantly associated to the detection of antibodies to HHV-8. Possible mother-to-child transmission of HHV-8 as well as the outcome of fetuses or children born to HHV-8 positive mothers are still a matter of debate. This study, showing the wide diffusion of HHV-8 infection in healthy women of child-bearing age in our geographical area, highlights the urgency of studies aimed to better clarify these relevant topics.
Pathogens and Dead Cells Cooperate with Cytokines in Activating the Innate and Adaptive Response
Authors: Belizário J.E.
Published: January 2017

After microbial invasion and tissue damage, a set of cytokines, including interleukin-1α (IL-1α), IL-1β, IL-6, IL-18 and tumor necrosis factor-α (TNF-α), and microbial and endogenous molecules named pathogen-associated molecular pattern (PAMPs) and damage-associated molecular pattern (DAMPs), are released from activated leukocytes and dead cells and bind to immune receptors to induce the innate and adaptive response. The intracellular signals induced by the multiprotein complex formed by the Toll-like receptors/IL-1 receptors (TLRs), NOD-like receptors (NLRs) and tumor necrosis factor-α receptors (TNFRs) and their ligands and downstream effectors lead to the activation of NF-κB (NFkappaB) and the interferon regulatory factor (IRF) transcription factors and thereby the synthesis of pro- and anti-inflammatory genes as well as pro- and anti-cell death genes. Depending on cell-intrinsic and extrinsic biochemical events elicited by an inflammatory response, the cells die via apoptosis, necrosis, pyroptosis or autophagy cell death program. This article resumes our current understanding of these processes and how they influence inflammation.
Anti-Inflammatory Activity of the Marine Cyanobacterium Trichodesmium Erythraeum against Carrageenan-Induced Paw Oedema in Wistar Albino Rats
Authors: Silambarasan G. , Ramanathan T. , Nabeel M.A. , Kalaichelvan V.K. , Kathiresan K. , Balasubramanian T.
Published: January 2017

Inflammatory diseases, including rheumatic, diseases are a major cause of morbidity of the working force throughout the world. Inflammation is a tissue reaction to infection. The effects are redness (erythema), swelling (oedema) and pain, to the area that can result in loss of function. Cyanobacteria are photosynthetic prokaryotic organisms which are potentially useful in pharmaceuticals, industrial chemicals, and restriction enzymes. Trichodesmium species are non-heterocystous cyanobacteria, commonly found in tropical and subtropical oligotrophic oceans. They occur in filaments of 20–200 cells which often congregate to form larger colonies called blooms that can be seen and often form dense blooms covering vast areas in sub-tropical regions. The present study tested the anti-inflammatory effect of the marine cyanobacterium, Trichodesmium erythraeum in carrageenan-induced inflammation in rats. The aqueous extract showed anti-inflammatory activity at a high dosage (500 mg/kg) and this effect was on par with the commercial drug, indomethacin. The inhibition of inflammation volume was 57.5±5.5 % and 47.5±4.7% respectively, at higher and lower dosages, in 30 minutes of treatment. The control group without any treatment exhibited an increase in the paw volume. This is the first report on the anti-inflammatory effect of marine-derived Trichodesmium erythraeum.
Prognostic Value of Urokinase Plasminogen Activator Receptor (Upar) and Neutrophil CD64 Expression in Acute Respiratory Distress Syndrome Patients
Authors: Hassan H. , Attia A. , Raslan H. , Shorman M. , Zaytoun T. , Elsammak M.
Published: January 2017

The outcome of acute respiratory distress syndrome (ARDS) may vary from complete recovery to multiorgan failure and death. The current study evaluates the prognostic performance of plasma uPAR and Neutrophil expression of CD64 in patients with ARDS of different etiologies and tests the possible correlation with other prognostic markers, namely APACHE-II score and serum CRP. The current study included 2 groups: 68 patients with ARDS and 25 age- and sex-matched, randomly selected, healthy control subjects. Blood samples were taken for routine laboratory tests on admission to ICU. Plasma uPAR was measured using a commercially available ELISA kit, and neutrophil CD64 expression was measured using flow cytometry. Plasma uPar was significantly higher in bacteremic ARDS patients than those without bacteremia. There was also a significant increase in plasma uPAR in ARDS survivors than in those who died. CD64 expression showed a similar pattern of increase in bacteremic ARDS. Using ROC curves plasma uPAR outperformed CD64 expression and CRP as a prognostic indicator in the studied ARDS patients. A cut-off value for plasma uPAR which almost always predicted mortality was 15.1 ng/ml with PPV of 100% and NPV 97%. Plasma uPAR is significantly elevated in ARDS patients and has a superior prognostic value to both neutrophil CD64 expression and scrum CRP in ARDS patients. A plasma uPAR cutoff value of 15.1 ng/ml has a PPV of 100% and NPV of 97% in predicting mortality in the ARDS patient included in the current study.
Tooth Orthodontic Movement after Maxillofacial Surgery
Authors: Lucchese A. , Gherlone E. , Portelli M. , Bertossi D.
Published: January 2017

The purpose of this study is to compare the rate of orthodontic tooth movement in regenerated bone, created after mandibular Distraction Osteogenesis (DO), with the rate of orthodontic tooth movement in patients who had extractions. The sample group (treated subjects) was composed of 14 Class II patients (5 males and 9 females, mean age 25.0±1.1years) treated with a Distraction Osteogenesis appliance; the control group (extraction cases) was composed of 14 subjects (mean age 21.9±3.1 years). Both groups were followed by conventional orthodontic treatment for space closure. Teeth movements (amount and fate) were evaluated by measuring the distance between the distal wing of the canine bracket and the mesial wing of the first or the second premolar bracket, depending on the group, using Vernier callipers (Dentaurum). Readings were noted every 2 weeks until space closure was completed. In this study the mean duration of the post-distraction orthodontic treatment was 12±0.3 months. Our study showed that the space created by distraction was closed in 10±1 months; while with conventional orthodontic treatment the average time to complete space closure was 5.90±0.9 months. The average space closure was 6.50±0.10 mm with conventional orthodontic treatment and 7.90±0.38 mm in the patients treated with DO. The mean rate of tooth movement was 1.27±0.23 mm/month in the group with conventional orthodontic treatment and 0.68±0.20 mm/month in the group treated with DO. Unpaired t test showed a significant difference between tooth movement in the study sample and in the control group (p<.05). As suggested by most scientific literature, in our sample dental movement was started at the end of the consolidation phase. However, the rate of space closure in the distraction area was higher than with conventional orthodontic treatment. Undoubtedly, this approach can be used for the treatment of very severe skeletal malocclusions and maxillofacial deformities, but it cannot be considered an alternative to conventional orthodontic surgery to accelerate treatment because tooth movement in edentulous spaces created by osteodistraction requires more time.
Innate Lymphoid Cells: Immunoregulatory Cells of Mucosal Inflammation
Authors: Kumar V.
Published: January 2017

Inflammation is a very complex immunopathological process occurring due to exaggerated activation of immune system in response to various inflammatory stimuli (i.e. bacterial, viral, fungal or parasitic antigens, xenobiotics, autoantigens and sterile inflammation of unknown cause (i.e. tumor associated inflammation), traumatic inflammation or allergic inflammation etc.). Innate lymphoid cells (ILCs) are particular newly discovered immune cells, which have characteristics of both innate and adaptive immune cells. These cells have shown very significant roles in the pathogenesis of inflammatory disorders at mucosal surfaces (i.e. respiratory tract, gastrointestinal tract and mucosal skin surfaces or barriers). The present review, explores their role in pathogenesis of inflammation at mucosal sites.
Enhanced Anti-Diabetogenic Effect of Intravenous Immune Globulin Modified by Ferrous Ion Exposure
Authors: Pavlovic S. , Zdravkovic N. , Pejnovic N. , Djoumerska-Aleksieva I.K. , Arsenijevic N. , Vassilev T.L. , Lukic M.L.
Published: January 2017

The aim of this study was to investigate the immunomodulatory capacity of native and Fe(II)-exposed intravenous immune globulin (IVIg) in multiple low dose streptozotocin-induced diabetes and to delineate the mechanisms of their influence on immune cell functions. Optimal doses (200–600mg/kg) of IVIg prevented the development of hyperglycemia, glycosuria and attenuated mononuclear cell infiltration in pancreatic islets. Fe(II) exposure of IVIg decreased their optimal therapeutic dose to 100mg/kg which significantly decreased the serum levels of proinflammatory cytokines compared to the same dose of native IVIg. This was accompanied by lower numbers of TNF-α, IFN-γ and IL-17 producing CD4+ T cells and increased frequencies of CD4+IL-10+ and CD4+IL-4+ T cells in the pancreatic lymph nodes and islets on day 16 after diabetes induction. Ferrous ion-exposed IVIg enhanced the bias towards Th2 response while the regulatory Foxp3+ T cells were not affected.
Identification of Tumorigenesis from the Specific Coupling of Cyclooxygenase-2 with Microsomal Prostaglandin E2 Synthase-1 in vivo
Authors: Chillar A. , So S-P. , Tang N. , Ruan K-H.
Published: January 2017

A newly created hybrid enzyme (COX-2-10aa-mPGES-1), which mimics the specific biosynthesis of the inflammatory PGE2 through COX-2's coupling to mPGES-1, was stably expressed in HEK293 cells. The stable cell line, which consistently expresses the superior triple catalytic (Trip-Cat) activities from COX-2 and mPGES-1, was able to directly convert arachidonic acid into the pathogenic PGE2 and distinguish it from other PGE2 synthesizing pathways, as confirmed by enzyme immunoassay, LC/MS analysis and a specific [14C]-AA (arachidonic acid) metabolite analysis approach. A competitive assay confirmed that the endogenous cPGES and mPGES-2 in the HEK293 cells had little involvement in the presence of the expressed COX-2-10aa-mPGES-1 for the synthesis of pathogenic PGE2. Furthermore, subcutaneous injection of the stable cell lines into nu/nu mice revealed 100% (10 out 10) occurrence of tumor mass formation beginning on Day 7 and a continuous progression of the masses to the maximal size which required sacrificing the mice. In contrast, only 10% occurrence of tumor masses, though smaller and with slower growth rates, were observed for the group of vector-transfected HEK293 control cells expressing only endogenous cPGES and/or mPGES-2. The PGE2 produced from multiple pathways by the HEK293 cells co-expressing the individual wild type COX-2 and mPGES-1, and in the presence of endogenous cPGES and mPGES-2, showed also a significantly increased tumor occurrence rate to 30%, which confirmed that the sole coupling of COX-2 to mPGES-1 is a powerful tumor-advancing factor. This result implies that the engineered COX-2-10aa-mPGES-1 could be a promising molecule as a drug developing target against the pathway of COX-2 coupled to mPGES-1 to treat inflammatory diseases and cancers.
Reciprocal Action of Pentraxin-3 and CRP in Women with Polycystic Ovary Syndrome
Authors: Güdücü N. , Görmüş U. , Alp E. , Kavak Z.N. , Dünder İ.
Published: January 2017

The aim of this study was to investigate the relationship between pentraxin-3 and other biochemical parameters in women with polycystic ovary syndrome (PCOS). We compared 58 women with PCOS to 34 body mass index- and age-matched normally menstruating healthy controls. Women with PCOS had significantly higher DHEA-S, free testosterone, LH and FAI, but lower pentraxin-3 levels when compared to healthy controls (0.86±0.21 and 0.91±0.14 respectively, p=0.014). Levels of CRP and lipoprotein-a were higher in the PCOS group. Overweight PCOS had significantly higher insulin, HOMA-IR, FAI, free testosterone and CRP and statistically significantly lower HDL and SHBG levels when compared to controls. Pentraxin-3 levels of obese and normal weight PCOS were similar. CRP and pentraxin-3 might contribute reciprocally to metabolic events and chronic low-grade inflammation in women with PCOS.
Effect of Thermosetting Gel with Doxycycline Hyclate 3% + Ketorolac Tromethamine 0.5% on Postoperative Discomfort after Third Molar Surgery: A Prospective Randomized Study
Authors: Farronato G. , Cossellu G. , Miani A. , Ceschel G. , Tremolati M. , Picozzi V. , Angiero F.
Published: January 2017

This study compared the analgesic and anti-inflammatory efficacy of intra-alveolar administration of a thermosetting gel containing Doxycycline Hyclate 3% + Ketorolac Tromethamine 0.5% (Tg-DHKT) (Thermosetting gel, Monteresearch, Bollate, Italy) on patient discomfort after third molar surgery. This study was a single-blind, randomized clinical trial, including two study groups of 39 and 41 patients each, who required surgical removal of a single mandibular impacted third molar. After the extraction the test group received an intra-alveolar injection with Tg-DHKT and the second group a thermosetting gel containing only Doxycycline Hyclate 3% (Tg-DH). Each patient's symptoms (pain, swelling, reddening, bleeding and body temperature) was assessed with a follow-up questionnaire (PoSSe scale). Nimesulide 100 mg, a painkiller, every 8 hours was prescribed to the Control and Test groups if necessary (maximum 3 doses); if they needed to assume it they were asked to mark it on the questionnaire. Results showed that on the second day after surgery pain, oedema and reddening decreased faster in the Control group (Tg-DH). There was no difference between the two groups when postoperative bleeding was evaluated. In both groups bleeding decreased in the same way, probably due to the mechanical characteristics of the gel itself. 46% of patients of the Test group did not require to take any painkiller at home. Our data demonstrate that the use of Tg-DHKT is less effective in the prevention of postoperative symptoms after third molar extraction compared to Tg-DH. However, almost half of patients in the Test group did not need to take more pain medication at home, suggesting that a single postoperative local administration of Tg-DHKT is a safe and effective concept for controlling pain, oedema and inflammation after third molar extraction.
Inhibition of Cxcr 1 and 2 Delays Preterm Delivery and Reduces Neonatal Mortality in a Mouse Model of Chorioamnionitis
Authors: Kamity R. , Patel H. , Younis S. , Nasim M. , Miller E. , Ahmed M.
Published: January 2017

Intrauterine infection is one of the main etiologies associated with preterm delivery. Cytokines involved in chorioamnionitis, including IL-1, TNF-α, IL-6, IL-8, and MCP1, activate different pathways that lead to preterm delivery. Antileukinate (AL) is a potent selective IL-8 inhibitor that binds to CXC receptors 1&2 on neutrophils, thereby inhibiting IL-8-induced neutrophil chemotaxis and degranulation. Since CXC receptors 1&2 are critically involved in the pathology of chorioamnionitis, their inhibition with AL may have therapeutic potential. Four timed-pregnant C57BL6 mice groups were studied. LPS group received LPS intraperitoneally on gestational day (GD) 15. The AL group received LPS on GD15 followed immediately by intraperitoneal AL injection and repeated on GD16, and 17. Control groups received either saline, or no injections. In the LPS group, 90% delivered within 24 hours after LPS administration compared to 20% in the AL group. The LPS group had 85% stillborn compared to 15% in the AL group. Uterine histopathology AL group showed evidence of less inflammatory reaction compared to the LPS group. Uterine tissue and serum from the AL group had a significant reduction of inflammatory cytokines compared with the LPS group. Cytokine levels in brain and lung tissues from surviving pups were not significantly different between the AL and control groups. Our data show that antileukinate significantly delays preterm delivery in a mouse model of chorioamnionitis, and reduces neonatal mortality and morbidity.