bluuebunny/crossref_metadata_2025 huggingface dataset:
New Development of a Dural Arteriovenous Fistula (AVF) of the Superior Sagittal Sinus after Transvenous Embolization of a Left Sigmoid Sinus Dural AVF
Authors: Kurata A. , Suzuki S. , Iwamoto K. , Yamada M. , Fujii K. , Kan S.
Published: January 2017

Transvenous occlusion of an affected sinus has become a standardized curative treatment for dural sinus arteriovenous fistula. A 57-year-old man with a left sigmoid sinus isolated dural AVF was successfully treated with tansarterial followed by transvenous embolization. Follow-up angiography one year and two months thereafter showed complete disappearance of the dural AVF. However, one year later, superior parasagittal sinus dural arteriovenous fistula had newly developed, for which the etiology and a careful point for follow-up are here discussed.
N-Butyl Cyanoacrylate Proved Beneficial to Avoid a Nontarget Embolization of the Ophthalmic Artery in Endovascular Management of Epistaxis
Authors: Shuster A. , Gunnarsson T. , Klurfan P. , Larrazabal R.
Published: January 2017

Epistaxis is a common disorder affecting equally both genders. Posterior origin of epistaxis in some instances requires endovascular treatment. Anastomoses between external carotid artery and internal carotid or ophthalmic arteries heighten the risk of stroke or blindness, if particles of polyvinyl alcohol are used for embolization. We report a case of 90-year-old man for whom successful embolization with N-Butyl Cyanoacrylate glue was performed as an alternative treatment for recurrent epistaxis.
Stenting in the Remnant of the Third Aortic Arch in a Case of Post-Irradiation Occluded Internal Carotid Artery
Authors: Chen H.-C. , Lin C.-J. , Chang F.-C. , Luo C.-B. , Lai Y.-J. , Chang C.-Y.
Published: January 2017

Collateral networks between the external carotid artery and internal carotid arteries become crucial for cerebral perfusion after occlusion of internal carotid arteries. We report the first case of a patient who received percutaneous transluminal angioplasty and stenting in a collateral vessel between the external and internal carotid artery for treatment of radiation induced severe stenosis of the internal carotid artery in the context of a contralateral internal carotid artery occlusion.
Y-Stent-Assisted Coil Embolization of Wide-Neck Intracranial Aneurysms
Authors: Akgul E. , Aksungur E. , Balli T. , Onan B. , Yilmaz D.M. , Bicakci S. , Erman T.
Published: January 2017

This report evaluated the short and midterm results of the safety and effectiveness of the treatment technique with hybrid and non-hybrid Y-configured, dual stent-assisted coil embolization of wide-neck intracranial aneurysms, and reviewed the literature concerning this technique.

Nine patients, eight with unruptured and one with ruptured aneurysms were included in the study. Of aneurysms embolized with a hybrid (with two different stents) and non-hybrid (with two identical stents) technique, three were located in the anterior communicating artery, three at the tip and one at the distal site of basilar artery, and two in the middle cerebral artery. All aneurysms included the orifices of bifurcation vessels. All aneurysms were stented and embolized during the same session. While Neuroform and Enterprise stents were used in the hybrid technique, two Enterprise stents were used in the non-hybrid technique.

Dual Y-stent assisted coil embolization was performed successfully in eight of nine patients (88.9%), including five patients (55.6%) with hybrid and three patients (33.3%) with non-hybrid technique. No procedural complication, no mortality and no minor or major neurological complications were seen during the angiographic or clinical follow-up. When an attempt was made at passing the second stent through the first Enterprise stent, the stent protruded inside the aneurysm in one patient (11.1%).

Hybrid or non-hybrid dual Y-stent-assisted coil embolization in the treatment of ruptured or unruptured wide-neck and complex intracranial aneurysms is a safe and effective method from the viewpoint of short and midterm results.
Extruded Platinum Coils from Recurrent Previously Coiled Intracranial Aneurysms Discovered at the Time of Microsurgical Clip Ligation
Authors: Deshaies E.M.
Published: January 2017

CE of brain aneurysms is safer with better outcomes than microsurgical clip ligation. However, the higher recurrence rate may nullify the acute benefits of coiling. Reported here are three patients who underwent surgery to treat their recurrent, previously coiled aneurysm. Intraoperatively, coils were seen extruding from the recurrent regions of each aneurysm and adherent to the surrounding neurovascular structures. These interesting findings question the premise that observation of a recurrent aneurysm is safe.
Balloon-Assisted Rapid Intermittent Sequential Coiling (BRISC) Technique for the Treatment of Complex Wide-Necked Intracranial Aneurysms
Authors: Modi J. , Eesa M. , Menon B.K. , Wong J.H. , Goyal M.
Published: January 2017

We describe our experience with balloon-assisted rapid intermittent sequential coiling (BRISC) of complex wide-necked aneurysms as an alternative to stent-assisted coiling. We use this technique in patients with acutely ruptured aneurysms, where antithrombotic treatment prior to stent deployment may not be advisable, and where the vascular anatomy is unfavorable for stenting. This is a retrospective analysis of 11 wide-necked aneurysms treated with this technique from June 2008 to January 2010. Results were analyzed in terms of aneurysm occlusion, procedural complications like thromboembolism, dissection/vasospasm, groin hematoma and any recurrence on follow-up. Coiling was successfully attempted in all cases (100%). Immediate angiographic results showed complete occlusion (class 1) in 8/11, residual neck (class II) in 3/11 and no residual aneurysm (class III). Procedural complications were local thrombus formation in 3/11 procedures but no symptomatic thromboembolism, dissection in 1/11 and groin hematoma in 1/11. There was no morbidity or mortality. On follow-up study, there was one recurrence, which was subsequently coiled. In our opinion, this technique may provide an alternative to stent-assisted coiling in patients with ruptured aneurysm where antithrombotic treatment prior to stent deployment may not be advisable and in the presence of vascular anatomy unsuitable for stenting.
Endovascular Treatment of a Vertebral Artery Aneurysm via Puncture of the Surgically Exposed Vertebral Artery
Authors: Oka F. , Ishihara H. , Kato S. , Shinoyama M. , Suzuki M.
Published: January 2017

We describe a case of subarachnoid hemorrhage due to a ruptured right vertebral artery (VA) aneurysm where endovascular therapy via a trans-femoral route was not feasible. Therefore we surgically exposed the VA and directly punctured it at the C4 level, followed by successful coil embolization. Direct access to the vertebral artery using an anterior surgical approach is an alternative in cases where the proximal side of the artery is occluded.
Endovascular Treatment of Intracranial Ruptured Aneurysms Associated with Arteriovenous Malformations: A Clinical Analysis of 14 Hemorrhagic Cases
Authors: Yu J.-L. , Yang S. , Luo Q. , Wang H.-L. , Wang B. , Qu Y.-Y. , Xu K.
Published: January 2017

This study investigated and summarized endovascular therapeutic strategies for intracranial ruptured aneurysms associated with arteriovenous malformations (AVMs). Between June 2005 and June 2009, we identified 16 aneurysms in 14 hemorrhagic cases of intracranial AVM using digital subtraction angiography (DSA). Of the 16 aneurysms, 14 were ruptured and two were unruptured. Aneurysms were classified as types I to IV, and were treated. Aneurysm treatment was followed by AVM treatment via various therapies, including embolization, gamma knife radiotherapy, or follow-up and observation to reduce the risk of aneurysm rupture or intracranial hemorrhage. Over a follow-up period ranging from six months to one year, none of the patients had aneurysm ruptures or intracranial hemorrhage. Most (13/14) patients had a Glasgow Outcome Scale (GOS) score of 5, and one patient had a score of 4. Sixteen aneurysms were treated successfully, as confirmed by DSA examination, and no AVMs re-grew. Clinical therapeutic strategies for intracranial ruptured aneurysms associated with AVMs should include aneurysm treatment first to reduce the risk of rupture and intracranial hemorrhage, eventually leading to a better prognosis.
In Vivo Assessment of Chitosan/β-Glycerophosphate as a New Liquid Embolic Agent
Authors: Wang Y. , Xu N. , Luo Q. , Li Y. , Sun L. , Wang H. , Xu K. , Wang B. , Zhen Y.
Published: January 2017

We sought to assess the feasibility of using thermosensitive chitosan/β-glycerophosphate for embolotherapy. The renal arteries in nine rabbits were embolized with chitosan/β-glycerophosphate. The animals were studied angiographically and sacrificed at one week (n = 3), four weeks (n = 3), and eight weeks (n = 3) after embolotherapy. Histology was obtained at these three time points. Delivery of chitosan/β-glycerophosphate was successful in all cases. Complete occlusion was achieved in all cases. No recanalization was observed in the follow-up angiograms. No untoward inflammatory reactions were observed in the target renal arteries and infarcted kidneys during the histological examinations. Our preliminary feasibility evaluation in rabbit renal arteries indicates that C/GP is a satisfactory embolization agent.
Endovascular Management of Anterior Cranial Fossa Dural Arteriovenous Malformations
Authors: Mack W.J. , Gonzalez N.R. , Jahan R. , Vinuela F.
Published: January 2017

Dural arteriovenous fistulas (dAVFs) of the anterior cranial fossa have traditionally been treated by open surgical disconnection. Safe navigation through the ophthalmic artery or fragile cortical veins has historically provided a barrier to effective endovascular occlusion of these lesions. Using current microcatheter technology and embolic materials, safe positioning within the distal ophthalmic artery, beyond the origin of the central retinal artery, is achievable. We describe two cases in which anterior cranial fossa dAVFs were treated by exclusively endovascular strategies, and highlight the pertinent technical and anatomic considerations. We discuss the clinical symptoms resulting from the differing venous drainage patterns.
Development of Indirect Cavernous Dural Arteriovenous Fistula after Trapping for Direct Carotid Cavernous Fistula
Authors: Yoshino H. , Ishihara H. , Oka F. , Kato S. , Suzuki M.
Published: January 2017

A 60-year-old man with direct carotid cavernous fistula (CCF) due to a motor vehicle accident underwent internal carotid artery trapping following high-flow external carotid to internal carotid artery bypass (EC-IC bypass). Follow-up angiography revealed ipsilateral complex indirect cavernous arteriovenous fistula. Although the traumatic indirect CCF angioarchitecture differs from cavernous-sinus dural arteriovenous fistula (CS-DAVF), the present indirect fistula was similar to the latter. Complex indirect CCF can occur after treatment of direct CCF caused by severe head injury.
Transvenous Approach to Intracranial Dural Arteriovenous Fistula (Cognard V): A Treatment Option
Authors: Lorenzo S. Aixut , Weitz A. Tomasello , Andaluz J. Blasco , Manzanera L. Sanroman , Fernández J.M. Macho
Published: January 2017

The endovascular technique is the gold standard treatment in dural arteriovenous fistulas. Due to the limited number of series published it is difficult to create rigid guidelines in terms of the best endovascular treatment approach. Treatment must be tailored to each particular case, but it is important to keep in mind that the possibility of treating a type V dAVF by the transvenous approach should not be discarded. In selected cases the transvenous approach may be helpful to increase the chance of success in the endovascular treatment of type V dAVF.

We describe a patient in whom the first arterial treatment failed to achieve occlusion of the fistulous point with the glue. Clinical symptoms improved due to the diminished flow at the fistula after the first embolization but as soon as collateral arteries were recruited by the fistula, spinal cord venous drainage impairment led to symptoms recurrence. Transvenous access allowed us to close the fistula completely in one only session with a complete disappearance of the pathologically inverted perimedullary venous flow.
Serum Interleukin-18 in Children with Henoch-Schönlein Purpura: A Promising Marker of Disease Activity?
Authors: Rigante D. , Zampetti A. , Bersani G. , Candelli M. , Piras A. , Rendeli C. , Antuzzi D. , Feliciani C. , Stabile A.
Published: January 2017

Henoch-Schönlein purpura (HSp) is the most common systemic vasculitis of childhood with typical skin involvement and concurrent signs involving joints, gastrointestinal tract, and kidney. HSp pathogenesis is still far from being completely understood, though a knotty cytokine complex is believed to contribute to its intimate processes. The aim of our evaluation is to establish the relationship between serum levels of interleukin (IL)-18 and disease outcome and establish its feasibility to provide a marker of disease activity or even a prognostic tool in clinical practice. We examined clinical/laboratory variables and serum IL-18 in 17 children hospitalized during a year for HSp, diagnosed by EULAR/PRINTO/PRES criteria; the same patients were re-evaluated after 6 months. All results were compared with 25 age-matched healthy controls. IL-12 and IL-6 were also evaluated in a cohort of the same patients and compared with controls. General and clinical variables (sex, edema of the extremities, gastrointestinal or renal complications, relapses and renal involvement at 6 months) had no relationship with cytokine levels. Serum IL-18 and IL-6 levels were found significantly increased at diagnosis in HSp patients when compared with healthy controls. After 6 months, serum IL-18 and IL-12 levels were significantly decreased in patients, while IL-12 and IL-6 levels were significantly increased compared to healthy controls. Though preliminary and expecting further confirmation on a larger sample, our data support the conclusion that serum IL-18 levels reflect HSp activity.
Serum IgE for Bet v 1 in Patients Affected by Atopic Dermatitis
Authors: Ciprandi G. , De Amici M. , Berardi L. , Vignini M. , Marseglia G.
Published: January 2017

Atopic dermatitis (AD) is a common allergic disorder and may be associated with respiratory allergy. In this study serum levels of IgE specific for the major allergen of birch (Bet v 1) were measured in two groups of AD patients with specific IgE to birch: the first with associated respiratory birch allergy and the second with cutaneous symptoms alone. The results show that the patients suffering from AD associated with respiratory allergy had the highest serum levels of IgE specific for Bet v 1. In conclusion, this study shows that the measurement of serum specific IgE for a major allergen may be useful in common practice as high levels are associated with complicated pathology.
Side Effects of the Immune System: Lessons from Tuberculosis-Related Immune Reconstitution Inflammatory Syndrome
Authors: Buonsenso D. , Pirronti T. , Genovese O. , Gargiullo L. , Ranno O. , Valentini P.
Published: January 2017

Immune reconstitution inflammatory syndrome (IRIS) is a recently described syndrome among human immunodeficiency virus (HIV)-infected patients attributable to the recovery of the immune system during antiretroviral therapy. A growing number of researches on this syndrome have been conducted in recent years, but IRIS in children has not been widely studied. We report the case of a 4.5 month-old, tuberculosis (TB)-HIV co-infected girl who developed IRIS two months after beginning antiretroviral and anti-TB medications. We moreover review the immunopathogenesis of TB-HIV coinfection and IRIS, with particular regard to TB-related IRIS.
Calcium Ionophore A23187 and Compound 48/80 Induce PGD2 and Tryptase in Human Cord Blood-Derived Mast Cells: Lack of Effect of IL-18
Authors: Maccauro G. , Tripodi D. , Saggini A. , Conti F. , Cianchetti E. , Angelucci D. , Rosati M. , Toniato E. , Fulcheri M. , Tetè S. , Salini V. , Caraffa A. , Antinolfi P. , Frydas S. , Conti P. , Theoharides T.C.
Published: January 2017

Immunological and biochemical reactions associated with inflammation are elicited in response to a physical or immunological challenge. Early in inflammation there is mobilization and infiltration of neutrophils, mast cells and macrophages to the site of inflammation. These cells release pro-inflammatory compounds icluding cytokines, vasoactive peptides (eg., histamine), and eicosanoids. The release of prostaglandin D2 (PGD2) and tryptase induced by anti-IgE, A23187 and compound 48/80 were studied using in vitro a good and valid model of human cord blood-derived mast cells (HCBDMC). Tryptase is a mast cell product and enhances vasopermeability with anticoagulant activities. In this study we measure the release of PGD2 and tryptase on mast cells activate by anti-IgE, calcium ionophore A23187, polybasic compound 48/80 (an agent containing a cationic region adjacent to a hydrophobic moiety, which works by activating G proteins) and IL-18. The generation of PGD2 was measured by radioimmunoassay. Release of PGD2 was detectable (after 12 h) following challenge with anti-IgE, A23187 and compound 48/80. Our data show that mature HCBDMC produce proinflammatory PGD2 following triggering with anti-IgE and with IgE-independent agonists, such as calcium ionophore A23187 and polybasic compound 48/80, while IL-18 was unable to stimulate the release of PGD2 or tryptase on HCBDMC. Although a great deal has been learned about the mediators produced by mast cells, the ultimate biologic function(s) of mast cells remains a mystery.
Toll-like Receptor 4 Expression, Interleukin-6, -8 and Ccl-20 Release, and NF-KB Translocation in Human Periodontal Ligament Mesenchymal Stem Cells Stimulated with LPS-P. Gingivalis
Authors: Trubiani O. , Ballerini P. , Murmura G. , Pizzicannella J. , Giuliani P. , Buccella S. , Caputi S.
Published: January 2017

Periodontal diseases, the major public health problem of the oral cavity, are clinically characterized by inflammation of the periodontal connective tissue that ultimately induces the destruction of periodontal tissue and the loss of alveolar bone. In chronic periodontitis, as well as aggressive periodontitis, the anaerobic gram-negative bacterium Porphyromonas gingivalis (P. gingivalis) is implicated. The pathogenicity of P. gingivalis is exerted by a wide variety of factors, including lipopolysaccharides (LPSs). LPSs activate the innate immune response during Gram-negative bacterial infections through the Toll-like receptor 4 (TLR-4)/myeloid differentiation protein 2 (MD-2) complex. In this study, the expression of TLR-4, the cell growth, the cytokine release, and the nuclear factor-KB (NF-kB) transcription factor expression in response to LPS- P.Gingivalis (LPS-G) were examined in Human Periodontal Ligament Mesenchymal Stem Cells (PDL-MSCs). The results obtained demonstrate that, in basal conditions, human PDL-MSCs express high levels of TLR-4. In inflammatory conditions mimicked by LPS-G challenge, the MTT assay carried out at different treatment times demonstrated the decrease of the cell growth. Moreover, the recognition of P. gingivalis components by TLR-4 culminated with the activation of secretion of inflammatory mediators such as: IL-6, IL-8 and CCL-20, and with the up-regulation of NF-kB, which was translocated into the nucleus. Our data intended to specify that TLR-4 expressed by PDL-MSCs is functional and plays a key role in inflammation.
Histological Evaluation of Peri-Implant Soft Tissues in Immediately Loaded Implants Featuring Different Implant-Abutment Connections: A Preliminary Study
Authors: Guerra M. , Vozza I. , Quaranta A.
Published: January 2017

The aim of the present study is to evaluate the peri-implant soft tissues and the amount of inflammatory cells around two different implant-abutment connections (self-locking conical connection with platform switching and screwed connection with standard abutment and internal anti-rotational system). Histological analysis was made of 14 implants, 7 with self-locking Morse tapered connection (experimental group A) and 7 with screw-retained anti-rotational connection (control group B). Sixty days after non-functional immediate loading, peri-implant tissue biopsies were performed. In the samples taken from the experimental group the peri-implant connective tissue consisted of a greater density of collagen and fibroblasts compared to the connective tissue of the control group. The experimental group specimens showed less inflammatory infiltrate close to the self-locking tapered connection compared to the tissues around the screw-retained connection. The SEM observations showed less microgap in the self-locking conical connection than in the screw connections with standard abutment and internal anti-rotational system. The presence of connective tissue with few inflammatory cells and the absence of inflammatory infiltrate, in self-locking conical connection implants is due to the minimal size of the implant-abutment microgap that does not allow the passage of fluids and bacteria from the oral cavity to the implant thus preventing tissue inflammation.
Intratonsillar Abscess: Diagnosis and Treatment of a Rare Disease
Authors: Yang M-L. , Lee J-C. , Hsu C-H. , Kao C-H.
Published: January 2017

Intratonsillar abscess is a condition that has rarely been described. Herein we summarize our experience diagnosing and treating four patients with intratonsillar abscess. In all cases, the diagnosis was confirmed by computer tomography (CT) scanning, which revealed enlargement of the right palatine tonsil with an area of central hypodensity and rim enhancement. Successful treatment in each case involved aspiration of the abscess using an 18G needle and post-procedural antibiotics. Our cases highlight the usefulness of CT for diagnosis and needle aspiration for treatment of intratonsillar abscess.
Recurrent Drug-Induced Insulin Autoimmune Syndrome in a Patient with Premature Ovarian Failure
Authors: Krysiak R. , Okopien B.
Published: January 2017

Insulin autoimmune syndrome (IAS) is characterized by hypoglycemic attacks, very high insulin levels and the presence of circulating autoantibodies to insulin in patients who have not been treated with exogenous insulin. Approximately half of patients with insulin autoimmune syndrome have a medication history preceding hypoglycemic events. We present the case of a young woman with premature ovarian failure who developed IAS initially after treatment with methimazole and several years later after captopril, and because of coexistent premature ovarian failure was classified as having autoimmune polyglandular syndrome (APS) type 3. Termination of methimazole and Captopril treatment resulted in the disappearance of hypoglycemic episodes. We discuss diagnostic and treatment dilemmas associated with discovering and management of IAS and APS in this patient.
Retention of Flunisolide in Rat Lungs after Single Inhalation
Authors: Kantar A. , Carloni M. , Kulkarni N. , Fedeli D. , Falcioni G.
Published: January 2017

Flunisolide (6α-fluorine 11β, 16α, 17α, 21-tetrahydroxypregna-1, 4-diene-3.20-dione 16.17 acetonide) is a potent inhaled corticosteroid, as demonstrated by its anti-inflammatory activities. Clinical data have widely demonstrated that inhaled flunisolide administered twice daily is effective for the treatment of bronchial asthma. However, pharmacokinetic studies suggest that the high solubility rate of flunisolde in bronchial fluid reduces the residence time of the drug in the lungs to a few minutes. The aim of this study is to determine the concentration of flunisolide in lung tissue of rats after administration by inhalation at varying time periods. Male Wistar rats weighing approximately 300 g were divided into four groups and administered a single dose of 1 mg flunisolide via inhalation. Rats were sacrificed with the exposure to CO2 either immediately or 3,6,12 hours after inhalation. The whole lung was then surgically removed and analysed for flunisolide concentration using gas chromatography. The mean concentration (2 standard deviation) of flunisolide detected in the lung tissue at 0, 3, 6 hours after inhalation were 66.4 (11.9), 48.6 (5.9), 42.7 (8.1) ng/mg of proteins, respectively. No flunisolide was detected after 12 hours in lung tissue. We conclude that flunisolide is retained for long duration (more than 6 hours) in lung tissue. This finding partially explains the mechanisms of action of the drug.
Hepatitis C is Associated with High Levels of Circulating N-Terminal Pro-Brain Natriuretic Peptide and Interleukin-6
Authors: Antonelli A. , Ferri C. , Ferrari S.M. , Di Domenicantonio A. , Mancusi C. , Marchi S. , De Bortoli N. , Metelli M.R. , Bruschi F. , Fallahi P.
Published: January 2017

To our knowledge, no study has evaluated N-terminal pro-brain natriuretic peptide (NTproBNP) together with interleukin-6 (IL-6) and interferon (IFN)-gamma serum levels in a large series of patients with hepatitis C virus (HCV) as possible markers of cardiac dysfunction. NTproBNP and IL-6 serum levels were valued in 55 HCV-patients, and in 55 sex- and age-matched controls. HCV-patients showed significantly higher mean NTproBNP and IL-6 levels than controls ( P = 0.001); no significant difference was observed for IFN-gamma. By defining high NTproBNP level as a value higher than 300 pg/mL (that is used to rule out heart failure in patients under 75 years of age), 12% (6/49) of HCV-patients and 0 of controls had NTproBNP (χ2; P = 0.012). In conclusion, this study demonstrates high levels of circulating NTproBNP and IL-6 in HCV-patients. The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction. Further prospective studies quantifying symptoms and correlating these with echocardiography parameters are needed to confirm this association.
Third Molar Surgical Removal: A Possible Model of Human Systemic Inflammation? A Preliminary Investigation
Authors: Cei S. , D'Aiuto F. , Duranti E. , Taddei S. , Gabriele M. , Ghiadoni L. , Graziani F.
Published: January 2017

Accumulating evidence suggests that dental treatment is associated with systemic inflammation. We aimed to preliminarily study the impact of third molar removal on biomarkers of inflammation and oxidative stress. Ten consecutive subjects underwent the removal of third molars under local anaesthesia and provided blood samples before and 1, 7 and 60 days following therapy assessed for high-sensitivity serum concentrations of C-Reactive Protein (CRP), fibrinogen, white cell counts and a number of measures of oxidative stress (MDA, LOOH and FRAP). One week inflammatory response ensued with acute increases after 24 h of CRP (P<0.01), Fibrinogen (P<0.05) and white cell counts (P<0.05). Third molar removal may represent a useful model to investigate inflammation in humans.
Giant Cell Lesion or Langerhans' Cell Histiocytosis of the Mandible? A Case Report
Authors: Valentini V. , Terenzi V. , Cassoni A. , Bosco S. , Brauner E. , Shahinas J. , Pompa G.
Published: January 2017

Langerhans' cell histiocytosis (LCH), formerly known as histiocytosis X, is characterized by cell proliferation. The leading clinical symptom of LCH within mandibular and maxillary bones is pain and it may resemble periodontal diseases, apical cysts, ameloblastoma, central giant cell granuloma, vascular malformation, osteomyelitys, bone metastasis and malignancies. In this paper we present the case of a mandibular histiocytosis misdiagnosed as a reparative giant cell granuloma at the first and as an aggressive giant cell tumor at the second biopsy. Definitive diagnosis was made only after examination of surgical specimens following hemimandibulectomy.
Integration of local and central laboratory functions in a worldwide multicentre study: Experience from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study
Authors:   HAPO Study Cooperative Research Group, Nesbitt G Selby , Smye Michael , Sheridan Brian , Lappin Terence RJ , Trimble Elisabeth R
Published: January 2017

Background Measurement of glucose in multiple Field Laboratories requires rigorous standardization when patients and caregivers are masked, unless predefined thresholds are met. Local misclassification of participants at the thresholds can introduce recruitment bias and adversely affect the integrity of study findings.

Purpose To describe the challenges and the approach to meeting them in measuring glucose, HbA1c, and C-peptide in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. HAPO is an observational epidemiologic study of 25 000 pregnant women from 15 centres in 10 countries, designed to clarify unanswered questions on associations of maternal glycemia, less severe than overt diabetes mellitus, with risks of adverse pregnancy outcome.

Methods Glucose tolerance (75 g two-hour OGTT) is assessed locally at 24-32 weeks’ gestation, with results masked if fasting and two-hour plasma glucose are ≤5.8 mmol/L and ≤11.1 mmol/L, respectively. For analysis of outcomes HAPO utilizes measurements of glucose, C-peptide, and HbA1c on frozen samples in a Central Laboratory; measurement of HbA1c on stored, frozen blood also creates special challenges. A common external quality assessment scheme was used to standardize glucose measurements between Field Centre and Central Laboratories before and during data collection.

Results Agreement between Field Centres and the Central Laboratory in rates above the masking thresholds has been excellent (Kappa = 0.79, P < 0.001), with rates of 1.8 and 1.7% respectively. Percent technical error for Central Laboratory OGTT measurements of glucose, C-peptide, and HbA1c, were 2.0, 4.2, and 2.0, respectively.

Limitations It is not possible to assess if comparable results could have been obtained with a less rigorous approach to standardization.

Conclusions HAPO has been successful in ensuring comparability of glucose measurement between its Central Laboratory and Field Centre laboratories and in measuring its key metabolites with accuracy and precision. Recruitment bias based on glucose measurement has been avoided.
A noninvasive diagnostic model to assess nonalcoholic hepatic steatosis in patients with chronic hepatitis B
Authors: Ou Hongjie , Cai Shaohang , Liu Ying , Xia Muye , Peng Jie
Published: January 2017

Objective:

The objective of this study was to develop a noninvasive diagnostic test for nonalcoholic hepatic steatosis in patients with chronic hepatitis B (CHB) by using routinely available clinical markers.

Methods:

A retrospective study of patients with CHB, with or without hepatic steatosis (fatty change) who were diagnosed with controlled attenuation parameter (CAP) measured by transient elastography were included. Patient information was analyzed on lifestyle; laboratory tests, including serum lipid levels; blood pressure; blood uric acid; and medical history of type 2 diabetes mellitus (T2DM).

Results:

A total of 1312 patients were included in the study; 618 patients had confirmed hepatic steatosis. The CAP levels were significantly correlated with patient height ( p < 0.001), weight ( p < 0.001), waistline measurement ( p < 0.001), hipline measurement ( p < 0.001), and diastolic blood pressure (DBP) ( p < 0.001). Multivariate logistic regression analysis resulted in the development of an equation for the diagnostic of simple steatosis: the fatty liver (FL) test. The area under the receiver operating characteristic (AUROC) curve of the FL test was 0.79 ( p < 0.001) in the training group and 0.82 in the validation group. When the FL test was >−0.425, the sensitivity, specificity, positive likelihood ratio (LR) and negative LR were 74.72%, 72.12%, 2.68, and 0.35 respectively. The average FL test result was −0.54 ± 1.26 in patients with CHB without hypertension, and 0.42 ± 1.35, 1.12 ± 1.65, and 1.98 ± 1.22 in patients with hypertension grade 1, 2, and 3, respectively ( p < 0.001).

Conclusion:

This study has demonstrated a noninvasive test for hepatic steatosis in patients with CHB.
Differences in the prognosis of early gastric cancer according to sex and age
Authors: Suh Do Dam , Oh Seong Tae , Yook Jeong Hwan , Kim Byung-Sik , Kim Beom Su
Published: January 2017

Background:

Few studies have compared early gastric cancer (EGC) outcomes according to sex and age.

Methods:

We retrospectively reviewed 2085 patients who underwent curative gastrectomy for EGC between 1989 and 2000. Prognosis and risk factors for nodal involvement were evaluated according to sex and age.

Results:

Male sex and age were independent prognostic factors for overall survival (OS) but not relapse-free survival (RFS). In young (⩽55 years) patients, there were no significant differences in RFS and OS between men and women. However, older (>55 years) men had a poorer OS and older women had a poorer RFS. Young female patients had a higher proportion of gastric cancer-related death than young male patients. Female sex was an independent risk factor for nodal involvement in younger patients.

Conclusions:

Young women with EGC should be more intensively treated and monitored than other patient groups and should not be treated by endoscopic resection.
Levodopa-carbidopa enteral suspension in advanced Parkinson’s disease: clinical evidence and experience
Authors: Virhammar Johan , Nyholm Dag
Published: January 2017

The duration of action of oral levodopa becomes shorter as Parkinson’s disease (PD) progresses. Patients with advanced PD may develop potentially disabling motor fluctuations and abnormal involuntary movement (dyskinesia), which cannot be managed with optimized oral or transdermal PD medications. The progressively worsening symptoms can have a substantial impact on the patient quality of life (QoL). Levodopa–carbidopa intestinal gel (LCIG) is delivered continuously via a percutaneous endoscopic gastrostomy with a jejunal extension (PEG-J). LCIG is licensed for the treatment of levodopa-responsive advanced PD in individuals experiencing severe motor fluctuations and dyskinesia when available combinations of antiparkinsonian medications have not given satisfactory results. Initial evidence for the efficacy and tolerability of LCIG came from a number of small-scale studies, but recently, three prospective studies have provided higher quality evidence. A 12-week double-blind comparison of LCIG with standard levodopa therapy, a 52-week open-label study extension of the double-blind study, and a 54-week open-label safety study, demonstrated significant improvements in ‘off’ time and ‘on’ time without troublesome dyskinesia, and QoL measures that were maintained in the longer term. There are also observations that LCIG may be effective treatment for nonmotor symptoms (NMS) although the evidence is limited. There is a need for further research on the efficacy of LCIG in reducing NMS, dyskinesia and improving QoL. This review surveys the clinical evidence for the effectiveness and tolerability of LCIG in the management of advanced PD and highlights some practical considerations to help optimize treatment.
Interactions among COX-2, GPIIIa and P2Y1 variants are associated with aspirin responsiveness and adverse events in patients with ischemic stroke
Authors: Yi Xingyang , Han Zhao , Zhou Qiang , Lin Jing , Wang Chun
Published: January 2017

Background:

The effect of gene variants and their interactions on response to aspirin and clinical adverse outcomes after an acute ischemic stroke (IS) is not fully understood. The aim of this study was to investigate the association of aspirin-relevant gene variants and their interactions with clinical adverse outcomes in IS patients taking aspirin.

Methods:

A total of 14 variants from six genes encoding COX enzymes ( COX-1, COX-2), platelet membrane receptors ( TXAS1, P2Y1, P2Y12) and glycoprotein receptor (GPIIIa) were examined in 850 acute IS patients. Gene–gene interactions were analyzed using generalized multifactor dimensionality reduction (GMDR) analysis. All patients were followed up for 1 year after admission. Primary outcome was a composite of recurrent ischemic stroke (RIS), myocardial infarction (MI) and death.

Results:

The primary outcome occurred in 112 (13.5%) patients (81 RIS, 16 MI and 15 deaths). There were no significant differences in the frequencies of the genotypes of the 14 variants between the patients with and without primary outcome using single-locus analytical approach. However, there was significant gene–gene interaction among rs20417, rs1371097 and rs2317676. The high-risk interactive genotypes of rs20417, rs1371097 and rs2317676 were independently associated with primary adverse outcome of RIS, MI, and death after acute IS.

Conclusion:

The three-loci interactions are associated with sensitivity of IS patients to aspirin and aspirin-induced adverse clinical events. The combinatorial analysis used in this study may be helpful to elucidate complex genetic risk of aspirin resistance (AR).

Clinical trial registration:

The study described here is registered at http://www.chictr.org/ (unique identifier: ChiCTR-OCH-14004724).
Using Humor or Fear Appeal: The Moderating Role of the Source's Attractiveness and the Source's Communication Habits in an Electoral Campaign
Authors: Capelli Sonia , Sabadie William , Trendel Olivier
Published: January 2017

This research compares the impact of two advertising tactics, humor versus fear appeals, according to the moderating effects of two characteristics of the source: Attractiveness and communication habits. A set of hypotheses is proposed and tested using a between-subject experiment in the context of the 2007 French presidential election. Results show a moderating effect of source attractiveness on attitude toward the ad. Humor should be favored over fear when the message targets undecided voters or supporters, whereas fear should be favored when the message targets opponents. Perceived communication habits - perceived previous use of the advertising tactic by the candidate – also moderate message effectiveness such as humor is more effective when it is seldom used by the candidate, whereas fear is more effective when it is used on a regular basis.
The Role of Bundling in Firms' Marketing Strategies: A Synthesis
Authors: Chiambaretto Paul , Dumez Hervé
Published: January 2017

Bundling and unbundling, i.e., selling by combining a number of products into a package or by separating them, are central elements of corporate strategies. Most existing research papers, in various fields, offer a fragmented analysis of these phenomena. This paper puts these contributions into perspective so as to gain a broader understanding of the advantages of bundling and unbundling in marketing strategy.
Legacy of the Two Crises: The Case of Malaysia
Authors: Kim Jangryoul
Published: January 2017

This paper examines the long-run effects of the two crises, that is, the Asian currency crisis and the subprime financial crisis, on the Malaysian GDP. Using a Markov-switching unobserved components model, we decompose the Malaysian GDP into the permanent and transitory components which are subject to possible shifts around the two crises periods. According to the estimation results with the quarterly GDP over 1986:Q1 to 2011:Q1, the output loss caused by the two crises was moderate in the sense that the trend output did not decrease even in the midst of the two crisis-driven recessions, despite the sharp declines in actual GDP. Also, comparison of the actual and trend growth rates across the pre-, inter-, and post-crises periods strongly suggests that the growth potential of the Malaysian economy has declined after the two crises.
Is AFTA a Desirable Regional Trade Agreement for ASEAN?
Authors: Park Innwon
Published: January 2017

This study evaluates the effectiveness of the Association of Southeast Asian Nation (ASEAN) in liberalizing trade and investment through regional economic cooperation. We test whether the ASEAN Free Trade Area (AFTA) satisfies necessary conditions for a trade bloc to generate a positive and sufficient net trade creation effect by calculating trade-related indices introduced by the theory of economic integration. We find that ASEAN economies might not satisfy most of the conditions for creating positive welfare gains from AFTA. Moreover, in order to search for a desirable regional trade agreement (RTA) in the East Asian region, this study considers alternative strategies beyond AFTA, such as the currently implemented ASEAN hub (three sets of ASEAN+1: ASEAN+China, ASEAN+Japan, and ASEAN+Korea) RTA and a proposed ASEAN+3 (including ASEAN, China, Japan, and Korea) RTA. Although the ASEAN hub RTA appears to be a better policy option for ASEAN, it is not necessarily desirable for the region when we consider the neighboring countries in Northeast Asia as spokes. Therefore, we propose that the ASEAN+3 RTA, covering 10 ASEAN member countries and the three Northeast Asian countries, is a more desirable RTA in East Asia.
An Analysis of Economic Impacts of FTAs on Strategic Industries in Jordan
Authors: Kang Moonsung
Published: January 2017

This paper analyzes the economic impacts of Jordan's regional trade agreements on its major strategic industries. We calculate each individual industry's revealed comparative advantage (RCA) index to identify Jordan's strategic industries showing comparative advantages. And then we analyze each individual industry's export performance before and after its regional trade agreements have entered into force. This paper found that the bilateral free trade agreement (FTA) between Jordan and the United States has shown a positive impact on the Jordanian export performance, mainly in the textiles and clothing industry. However, it has not been quite as effective in enhancing Jordanian export opportunities in other industries, such as chemicals, vegetable products, paper and paperboard, and prepared foodstuffs, although there has been a growing positive impact on precious stones. The positive impacts of the FTA with the United States on Jordan's textiles and clothing industry have been heavily dependent upon its initiatives and programs of QIZs. Pan Arab Free-Trade Area (PAFTA) has shown a relatively positive impact on several industries, such as chemicals, vegetable products, paper and paperboard, precious stones, and prepared foodstuffs, although chemicals and vegetable products have shown a steady export performance no matter whether PAFTA enters into force. However, the bilateral FTA with the EC has failed to show any significant impact on the Jordanian export performances of its strategic industries having comparative advantages.
How Does Corporate Structure Affect the Value of Firms in Emerging Markets? Evidence from Korea
Authors: Baek Jae-Seung
Published: January 2017

In this paper, we examine the time varying effect of corporate structure on firm value in an emerging market using Korean firms. We find that during a good economic situation (a good state from January 2000 to March 2001; a bad state from October 2001 to April 2002), firms recover (suffer) from external shocks and have a much brighter (darker) prospect of investment opportunities and firms with poor corporate structure experience a bigger (smaller) rebound in their share values. These results are robust for different measures of corporate structure and hold when we control for a variety of variables that affect firm performance during these periods. Our evidence suggests that the role of corporate structure has been changed following macroeconomic situations such as stock market index or economic index.
RhoA regulates actin network dynamics during apical surface emergence in multiciliated epithelial cells
Authors: Sedzinski Jakub , Hannezo Edouard , Tu Fan , Biro Maté , Wallingford John B.
Published: January 2017

Homeostatic replacement of epithelial cells from basal precursors is a multistep process involving progenitor cell specification, radial intercalation and, finally, apical surface emergence. Recent data demonstrate that actin-based pushing under the control of the formin protein Fmn1 drives apical emergence in nascent multiciliated epithelial cells (MCCs), but little else is known about this actin network or the control of Fmn1. Here, we explore the role of the small GTPase RhoA in MCC apical emergence. Disruption of RhoA function reduced the rate of apical surface expansion and decreased the final size of the apical domain. Analysis of cell shapes suggests that RhoA alters the balance of forces exerted on the MCC apical surface. Finally, quantitative time-lapse imaging and fluorescence recovery after photobleaching studies argue that RhoA works in concert with Fmn1 to control assembly of the specialized apical actin network in MCCs. These data provide new molecular insights into epithelial apical surface assembly and could also shed light on mechanisms of apical lumen formation.
Successful Post-Pancreatitis Pseudoaneurysm Coagulation by Percutaneous Computed Tomography (CT)-Guided Thrombin Injection
Authors: Spezia Laura , Sozzi Carlo , Contro Alberto , Mansueto Giancarlo
Published: January 2017

Background: Pseudoaneurysm is a rare but potentially life-threatening vascular complication of acute pancreatitis, with a mortality rate of 20–43% in untreated patients. The treatment usually involves trans-arterial embolization or surgical resection.

Case Report: A 44-year-old man with a history of acute pancreatitis developed a pseudoaneurysm of the pancreatic tail, diagnosed as a splenic artery pseudoaneurysm by CT. Selective arteriography performed with the purpose of embolization did not reveal the pseudoaneurysm. The day after, under CT guidance, human thrombin (1,000 IU) was injected inside the aneurysmatic sac with its complete occlusion. A control MRI 6 months later confirmed a complete resolution of the pseudoaneurysm.

Conclusions: Percutaneous coagulation of a post-pancreatitis pseudoaneurysm is a relatively easy and safe procedure, and it can be considered as an alternative to trans-arterial embolization when the pseudoaneurysm cannot be visualized on selective arteriography.
A voltage-dependent fluorescent indicator for optogenetic applications, archaerhodopsin-3: Structure and optical properties from in silico modeling
Authors: Nikolaev Dmitrii M. , Emelyanov Anton , Boitsov Vitaly M. , Panov Maxim S , Ryazantsev Mikhail N.
Published: January 2017

It was demonstrated in recent studies that some rhodopsins can be used in optogenetics as fluorescent indicators of membrane voltage. One of the promising candidates for these applications is archaerhodopsin-3. However, the fluorescent signal for wild-type achaerhodopsin-3 is not strong enough for real applications. Rational design of mutants with an improved signal is an important task, which requires both experimental and theoretical studies. Herein, we used a homology-based computational approach to predict the three-dimensional structure of archaerhodopsin-3, and a Quantum Mechanics/Molecular Mechanics (QM/MM) hybrid approach with high-level multireference ab initio methodology (SORCI+Q/AMBER) to model optical properties of this protein. We demonstrated that this methodology allows for reliable prediction of structure and spectral properties of archaerhodopsin-3. The results of this study can be utilized for computational molecular design of efficient fluorescent indicators of membrane voltage for modern optogenetics on the basis of archaerhodopsin-3.
Alport syndrome: facts and opinions
Authors: Kashtan Clifford
Published: January 2017

In this commentary, I review recent advances in Alport syndrome genetics, diagnostics, and therapeutics. I also offer some opinions regarding strategies to optimize the early identification of affected individuals to promote early therapeutic intervention.