bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of bone erosions in knee osteoarthrosis by serum biomarkers
Authors: Zivanovic Sandra , Petrovic-Rackov Ljiljana , Jevtic Milorad
Published: April 2010

Introduction. Osteoarthrosis (OA) is a degenerative chronic disease characterized by destruction of joint articular cartilage and subchondral bone with formation of osteophytes and usuries on joint surface. Quantitative and dynamic changes in remodeling of joint tissue reflect matrix molecules that dismiss as fragments in joint liquid, blood and urine where they can be detected. Human cartilage glycoprotein (YKL-40) is synthesised by chondrocytes and synovial cells and plays a significant role in remodel tissue. Objective. The aim of the paper was the parallel analysis and determination of the degree of correlation between ultrasound indicators destruction of joints, bone erosion (usuries), and serum YKL-40 concentrations in patients with primary osteoarthrosis of the knee. Methods. The analysis included 88 patients with the diagnosis of knee OA. Ultrasound review of knees was done by two rheumatologists. The analysis of serum samples determined the concentration of YKL40 by ELISA method. Results. The average age of patients was 69.97?9.37 years, duration of knee OA 6.46?6.73 years. The mean value of age in 59 patients with usuries was 72.05?7.74, at 29 without usuries 65.75?11.00 (p=0.003). The average value (median) thickness cartilage in medial condyl femur (front access) in patients with usuries was 1.25 mm (1.12-1.36 mm), without usuries 1.35 mm (1.20-1.51 mm) (p=0.016). The central YKL40 value of biomarkers in the patients without usuries was 81 ng/ml (46.5-120.5 ng/ml), with usuries the medial condyil 138 ng/ml (89.5-175.0 ng/ml), the lateral 106 ng/ml (63.0-201.5 ng/ml) and both condyl 86 ng/ ml (69.75-140.5 ng/ml) (p=0.004). The central value YKL40 after 5 year-duration of disease was 83.68?33.65 ng/ml, after 10 years 138.22?48.88 ng/ml, after 15 years 209.30?79.36 ng/ml, and after 20 years 218.50?106.51 ng/ml (p=0.000). The biomarker YKL 40 may be a marker for usuries (area 0.691, p=0.004; confidence interval 0.574-0.808). If you took the optimal cut-off of 84.5 ng/ml, then YKL40 sensitivity to the usuries was 69.5%, and specificity 51.7%. Conclusion. Increased concentrations of biomarkers YKL40 may be an indicator of the degree of destructive changes in the knee osteoarthrosis.
An alternative approach for endocardial pacemaker lead implantation in patient with persistent left superior vena cava
Authors: Mitov Vladimir , Perisic Zoran , Kostic Tomislav , Stojkovic Aleksandar , Jolic Aleksandar , Aleksic Aleksandar , Milasinovic Goran
Published: April 2010

Introduction. Persistent left superior vena cava represents a congenital vascular defect of the venous system, which often makes standard 58 cm endocardial lead placement impossible. Case Outline. A right chamber approach by the left cephalic vein was tried. This was impossible because standard endocardial lead (SJM Isoflex S 1646T, bipolar lead, 58 cm in length, body diameter 7 French) was too short for this patient. A unipolar lead for coronary sinus (Medtronic ATTEIN 4193-88), 88 cm in length, body diameter 4 French, was placed in the posterior branch of the coronary sinus. With such positioning of the lead, a VVI pacemaker pacing was enabled. The operation lasted for 48 minutes, and the time of total X-ray exposure was 9.6 minutes. The values that were achieved were: threshold 0.3 V, pulse width 0.37 ms, maximum R 22.55 mV. Ten months after the implantation, the values were: thresh- old 0.3 V, maximum R 28.8 mV. Conclusion. Persistent left superior vena cava in some cases makes standard 58 cm endocardial lead placement impossible due to its joining to the right atrium over the dilated coronary sinus. Coronary sinus lead placement in the posterior or lateral coronary sinus branch represents an acceptable alternative approach for pacemaker lead placement in these patients.
Cholangiocellular carcinoma of the common hepatic duct causing obstructive jaundice in a patient with metastatic colonic carcinoma within liver
Authors: Colovic Radoje , Grubor Nikica , Radak Vladimir , Micev Marjan , Latincic Stojan
Published: April 2010

Introduction. Colorectal carcinoma, one of the most frequent carcinomas, produces liver metastasis very frequently. Surprisingly, those secondaries rarely cause obstructive jaundice. If it appears, it is usually caused by compression or infiltration of the major bile ducts close to the hepatic hilus, less frequently with bile duct obstruction by gelatinous mucus produced by the tumour, much rarer by the tumour growth within the, otherwise intact, common bile duct and very rarely by metastasis into the biliary tree. Case Outline. We present a 67-year-old man who had been submitted to left colectomy for sygmoid colon carcinoma four years earlier, now, admitted with an obstructive jaundice, along with a number of liver and lung secondaries. Obstructive jaundice was caused by the vegetative tumour of the proximal part of the common hepatic duct which was resected and anastomosed with a Roux-en-Y jejunal limb. The postoperative recovery was uneventful. The patient died 7 months later without jaundice due to liver and lung secondaries. Histological findings showed cholangiocellular carcinoma of the common hepatic duct, while the histological findings of the liver tumour specimen confirmed metastatic colonic carcinoma. Conclusion. In case of obstructive jaundice in patients with metastatic colonic carcinoma within liver, other aethiological factors of biliary obstruction can not be excluded and have to be taken into differential diagnosis.
Coeliac disease as the cause of resistant sideropenic anaemia in children with Down's syndrome: Case report
Authors: Pavlovic Momcilo , Radlovic Nedeljko , Lekovic Zoran , Berenji Karolina , Stojsic Zorica , Radlovic Vladimir
Published: April 2010

Introduction. Coeliac disease (CD) is a permanent intolerance of gluten, i.e. of gliadin and related proteins found in the endosperm of wheat, rye and barley. It is characterized by polygenic predisposition, autoimmune nature, predominantly asymptomatic or atypical clinical course, as well as by high prevalence in patients with Down's syndrome (DS) and some other diseases. Outline of Cases. We are presenting a girl and two boys, aged 6-7 (X=6.33) years with DS and CD recognized under the feature of sideropenic anaemia resistant to oral therapy with iron. Beside mental retardation, low stature and the morphological features characteristic of DS, two patients had a congenital heart disease; one ventricular septal defect and the other atrioventricular canal. In two patients, trisomy on the 21st chromosome pair (trisomy 21) was disclosed in all cells, while one had a mosaic karyotype. All three patients had classical laboratory parameters of sideropenic anaemia: blood Hb 77-89 g/l (X=81.67), HCT 0.26-0.29% (X=0.28), MCV 69-80 fl (X=73), MCH 24.3-30 pg (X=26.77) and serum iron 2-5 ?mol/L (X=4.0). Beside anaemia and in one patient a mild isolated hypertransaminasemia (AST 67 U/l, ALT 62 U/l), other indicators of CD were not registered in any of the children. In addition, in all three patients, we also detected an increased level of antibodies to tissue transglutaminase (atTG) of IgA class (45-88 U/l) so that we performed endoscopic enterobiopsy in order to reliably confirm the diagnosis of CD. In all three patients, the pathohistological finding of the duodenal mucosa specimen showed mild to moderate destructive enteropathy associated with high intraepithelial lymphocyte infiltration, cryptic hyperplasia and lympho-plasmocytic infiltration of the stroma. In all three patients, the treatment with a strict gluten-free diet and iron therapy applied orally for 3-4 months resulted in blood count normalization and the correction of sideropenia. Serum level of the atTG-IgA, repeated after a 12-month diet, was also normal. Conclusion. CD should be taken into consideration in all cases of sideropenic anaemia resistant to iron oral therapy in children with DS. The diagnosis of CD implicates corresponding pathohistological confirmation, while the treatment of sideropenic anaemia and its complications, beside iron preparations, also requires compliance with a gluten-free diet.
Hundred years of atrial fibrillation: Current knowledge and perspectives
Authors: Potpara Tatjana , Grujic Miodrag
Published: April 2010

Atrial fibrillation (AF) is the most common sustained arrhythmia in general population. AF in humans was first described in 1903. Gradually, it has been well appreciated that AF is not just an acceptable alternative for normal rhythm but rather a serious threat, related to increased mortality and cardiovascular morbidity. AF can precipitate or worsen pre-existing heart failure, may cause the development of tachycardiomyopathy and is an independent risk factor for thromboembolic events, most frequently stroke. It has long been believed that rhythm control is the best therapy for AF. Nowadays there is a clear scientific proof that rhythm control offers no benefit over frequency control, at least for older patients, even with advanced left ventricular dysfunction. However, optimal treatment for younger, highly symptomatic, otherwise healthy AF patients has not been designed. Available antiarrhythmics have considerable proarrhythmic potential or organ toxicity, and new safer drugs are under investigation. Nonpharmacological approaches, namely RF-catheter ablation, are rapidly developing. Prevention of thromboembolism is imperative, and new safer oral anticoagulants have been intensively investigated. Recent randomized studies (PIAF, RACE, STAF, AFFIRM, HOT-CAFE) did not solve the issue of optimal arrhythmia treatment, but they emphasized the prevention of thromboembolism based on risk factors, and not on AF type, mainly because asymptomatic episodes of AF may not be clinically recognized.
Pro-Inflammatory CD11c+CD206+ Adipose Tissue Macrophages Are Associated With Insulin Resistance in Human Obesity
Authors: Wentworth John M. , Naselli Gaetano , Brown Wendy A. , Doyle Lisa , Phipson Belinda , Smyth Gordon K. , Wabitsch Martin , O'Brien Paul E. , Harrison Leonard C.
Published: April 2010

OBJECTIVE

Insulin resistance and other features of the metabolic syndrome have been causally linked to adipose tissue macrophages (ATMs) in mice with diet-induced obesity. We aimed to characterize macrophage phenotype and function in human subcutaneous and omental adipose tissue in relation to insulin resistance in obesity.

RESEARCH DESIGN AND METHODS

Adipose tissue was obtained from lean and obese women undergoing bariatric surgery. Metabolic markers were measured in fasting serum and ATMs characterized by immunohistology, flow cytometry, and tissue culture studies.

RESULTS

ATMs comprised CD11c+CD206+ cells in “crown” aggregates and solitary CD11c−CD206+ cells at adipocyte junctions. In obese women, CD11c+ ATM density was greater in subcutaneous than omental adipose tissue and correlated with markers of insulin resistance. CD11c+ ATMs were distinguished by high expression of integrins and antigen presentation molecules; interleukin (IL)-1β, -6, -8, and -10; tumor necrosis factor-α; and CC chemokine ligand-3, indicative of an activated, proinflammatory state. In addition, CD11c+ ATMs were enriched for mitochondria and for RNA transcripts encoding mitochondrial, proteasomal, and lysosomal proteins, fatty acid metabolism enzymes, and T-cell chemoattractants, whereas CD11c− ATMs were enriched for transcripts involved in tissue maintenance and repair. Tissue culture medium conditioned by CD11c+ ATMs, but not CD11c− ATMs or other stromovascular cells, impaired insulin-stimulated glucose uptake by human adipocytes.

CONCLUSIONS

These findings identify proinflammatory CD11c+ ATMs as markers of insulin resistance in human obesity. In addition, the machinery of CD11c+ ATMs indicates they metabolize lipid and may initiate adaptive immune responses.
Cardiorespiratory Fitness and Insulin Sensitivity in Overweight or Obese Subjects May Be Linked Through Intrahepatic Lipid Content
Authors: Haufe Sven , Engeli Stefan , Budziarek Petra , Utz Wolfgang , Schulz-Menger Jeanette , Hermsdorf Mario , Wiesner Susanne , Otto Christoph , Haas Verena , de Greiff Armin , Luft Friedrich C. , Boschmann Michael , Jordan Jens
Published: April 2010

OBJECTIVE

Low cardiorespiratory fitness (CRF) predisposes one to cardiovascular disease and type 2 diabetes in part independently of body weight. Given the close relationship between intrahepatic lipid content (IHL) and insulin sensitivity, we hypothesized that the direct relationship between fitness and insulin sensitivity may be explained by IHL.

RESEARCH DESIGN AND METHODS

We included 138 overweight to obese, otherwise healthy subjects (aged 43.6 ± 8.9 years, BMI 33.8 ± 4 kg/m2). Body composition was estimated by bioimpedance analyses. Abdominal fat distribution, intramyocellular, and IHL were assessed by magnetic resonance spectroscopy and tomography. Incremental exercise testing was performed to estimate an individual's CRF. Insulin sensitivity was determined during an oral glucose tolerance test.

RESULTS

For all subjects, CRF was related to insulin sensitivity (r = 0.32, P < 0.05), IHL (r = −0.27, P < 0.05), and visceral (r = −0.25, P < 0.05) and total fat mass (r = −0.32, P < 0.05), but not to intramyocellular lipids (r = −0.08, NS). Insulin sensitivity correlated significantly with all fat depots. In multivariate regression analyses, independent predictors of insulin sensitivity were IHL, visceral fat, and fitness (r2 = −0.43, P < 0.01, r2 = −0.34, and r2 = 0.29, P < 0.05, respectively). However, the positive correlation between fitness and insulin sensitivity was abolished after adjustment for IHL (r = 0.16, NS), whereas it remained significant when adjusted for visceral or total body fat. Further, when subjects were grouped into high versus low IHL, insulin sensitivity was higher in those subjects with low IHL, irrespective of fitness levels.

CONCLUSIONS

Our study suggests that the positive effect of increased CRF on insulin sensitivity in overweight to obese subjects may be mediated indirectly through IHL reduction.
Estimated Average Glucose and Self-Monitored Mean Blood Glucose Are Discordant Estimates of Glycemic Control
Authors: Hempe James M. , Soros Arlette A. , Chalew Stuart A.
Published: April 2010

OBJECTIVE

The A1C-Derived Average Glucose study recommended reporting A1C in estimated average glucose (eAG) equivalents. We compared eAG with self-monitored mean blood glucose (MBG) to determine whether eAG is systematically biased due to biological variation in the relationship between MBG and A1C.

RESEARCH DESIGN AND METHODS

MBG and A1C were recorded from charts of 202 pediatric type 1 diabetic patients at 1,612 clinic visits. Patients were divided into groups with low, moderate, or high A1C bias based on a hemoglobin glycation index (HGI).

RESULTS

The mean ± SD values for MBG versus eAG were as follows: total population, 194 ± 34 vs. 196 ± 36 mg/dl; low-HGI group, 186 ± 31 vs. 163 ± 20 mg/dl; moderate-HGI group, 195 ± 28 vs. 193 ± 19 mg/dl; and high-HGI group, 199 ± 42 vs. 230 ± 31 mg/dl.

CONCLUSIONS

eAG underestimated MBG in low HGI patients and overestimated MBG in high HGI patients. Disagreement between eAG and MBG downloaded from patient glucose meters will cause confusion if eAG is implemented for clinical use.
Prediction of Incident Diabetic Neuropathy Using the Monofilament Examination
Authors: Perkins Bruce A. , Orszag Andrej , Ngo Mylan , Ng Eduardo , New Patti , Bril Vera
Published: April 2010

OBJECTIVE

To determine the specific monofilament examination score that predicts the subsequent 4-year incidence of diabetic neuropathy with the highest degree of diagnostic accuracy.

RESEARCH DESIGN AND METHODS

Longitudinal follow-up of 175 of 197 (89%) participants in the Toronto Diabetic Neuropathy Cohort without baseline neuropathy for incident neuropathy. We examined the baseline monofilament examination score (and other simple sensory screening tests) by receiver operating characteristic (ROC) curve analysis.

RESULTS

Incident diabetic neuropathy developed in 50 (29%) participants over a mean follow-up of 4.1 years (interquartile range 2.6–7.1 years). Although male sex, longer diabetes duration, taller height, and higher blood pressure at baseline were associated with incident neuropathy, the strongest association was with a lower baseline monofilament score (score out of 8 was 3.7 ± 2.5 for incident neuropathy vs. 5.7 ± 2.3 for those who did not develop neuropathy; P < 0.001). The optimal threshold score for risk of incident neuropathy was ≤5 sensate stimuli out of 8, with 72% sensitivity, 64% specificity, positive and negative likelihood ratios of 2.5 and 0.35, and positive and negative predictive values of 87 and 46%, respectively (χ2 = 20.7, P < 0.001). Area under the ROC curve was significantly greater for the monofilament examination compared with that for other simple sensory tests.

CONCLUSIONS

A simple threshold of ≤5 sensate stimuli out of 8 discriminates 4-year risk of diabetic neuropathy with acceptable operating characteristics. Although there are limitations in its specificity for prediction of future neuropathy onset, the monofilament examination is appropriate as a simple diabetic neuropathy screening instrument generalizable to the clinical setting.
Cytokine mRNA expressions after racing at a high altitude and at sea level in horses with exercise-induced pulmonary hemorrhage
Authors: Saulez Montague N. , Godfroid Jacques , Bosman Anamarie , Stiltner Jackie L. , Breathnach Cormac C. , Horohov David W.
Published: April 2010

Objective—To determine concentrations of cytokine mRNA in horses with exercise-induced pulmonary hemorrhage (EIPH) after racing.

Animals—97 Thoroughbreds.

Procedures—Following tracheobronchoscopy, the severity of EIPH was graded (scale of 0 to 4), and venous blood samples were collected from 10 horses in each grade. After RNA isolation and cDNA synthesis, real-time PCR assay was conducted to detect cytokinespecific mRNA for interleukin (IL)-1, IL-6, and IL-10; interferon (INF)-γ; and tumor necrosis factor (TNF)-α.

Results—Neither location nor grade of EIPH affected the expression of IL-1 and INF-γ. There was significantly greater overall expression of IL-6 mRNA at sea level, with significantly more IL-6 expressed in horses with grade 4 EIPH than in horses with grade 0, 1, or 2 EIPH. At a high altitude, no difference was detected for IL-6 expression among the various EIPH grades. There was significantly greater overall expression of TNF-α mRNA at a high altitude; however, there was no difference within the various grades of EIPH. Expression of IL-10 was significantly affected by grade of EIPH because horses with grade 3 EIPH expressed significantly more IL-10 mRNA than did horses with grade 0 or 2 EIPH; this expression was not affected by location.

Conclusions and Clinical Relevance—At sea level, increased IL-6 expression was associated with more severe EIPH, and altitude may affect gene expressions of the proinflammatory cytokine TNF-α and anti-inflammatory cytokine IL-6. Studies on protein concentrations of cytokine expression are needed. The pathophysiologic importance of these findings remains to be explained.
Transcriptional changes associated with recurrent airway obstruction in affected and unaffected horses
Authors: Venugopal Changaram S. , Mendes Luiz Claudio N. , Peiró Juliana R. , Laborde Susan S. , Stokes Ashley M. , Moore Rustin M.
Published: April 2010

Objective—To identify differentially expressed genes in pulmonary tissues of horses affected with summer pasture-associated obstructive pulmonary disease (SPAOPD), which is a form of recurrent airway obstruction (RAO), compared with those of unaffected horses.

Animals—6 horses with SPAOPD-RAO and 6 unaffected (healthy) horses.

Procedures—Horses were assigned to 2 groups on the basis of medical history, clinical score, and transpleural pressure. Total RNA from each of the 5 lung lobes of each of the 6 SPAOPD-RAO–affected horses was extracted and pooled. Similarly, total RNA from unaffected horses was pooled. Differential display (DD) PCR assay was performed, and differentially expressed bands were purified and cloned into a plasmid vector. Plasmids were extracted from recombinant colonies, and purified DNA was sequenced. Genes of interest for RAO pathogenesis were identified. Real-time PCR assay was performed to confirm findings for the DD PCR assay.

Results—18 differentially expressed genes (17 upregulated and 1 downregulated) were identified. Three genes of particular interest were found to be altered (2 upregulated and 1 downregulated) in horses with SPAOPD-RAO by use of real-time PCR assay, and these findings matched the differential expression found by use of the DD PCR assay.

Conclusions and Clinical Relevance—SPAOPD-RAO in horses is a multifactorial, complex disease involving several genes. Upregulated genes, particularly β2-microglobulin, and the downregulated secretoglobin gene can serve as marker genes that may help to identify SPAOPD-RAO at an early age.
Oligosaccharides induce changes in protein patterns of regenerating spruce protoplasts
Authors: Kákoniová Daniela , Hlinková Elena , Lišková Desana , Kollárová Karin
Published: April 2010

Galactoglucomannan oligosaccharides (GGMOs, d.p. 4–8 and fractions d.p. 3, 4, 5, 6–7), used in culture media for spruce protoplasts derived from callus cells showed a pleiotropic effect. They influenced both, quality and quantity of extracellular proteins in regenerating protoplasts. GGMOs d.p. 4, 5 at pH 6.0 and the mixture of d.p. 4–8 (pH 3.8 and 6.0) after 48 h of culture increased the amount of extra- and intracellular proteins and the viability of protoplasts. The most significant effect on protoplasts viability in the presence of GGMOs d.p. 4–8 without the growth hormone supplementation at pH 3.8, and with lower efficiency in the presence of NAA (1 mg/l) has been observed. The most significant differences were observed in the molecular mass intervals Mr∼17–21 kDa, 25–30 kDa, and 45–60 kDa. After 24 h of culture extracellular acid proteins with Mr∼30; 41; 68; and 90 in media supplemented with GGMOs d.p. 3, 4, 5, 6–7 (pH 6.0) with or without NAA were identified to belong to the group of β-1,3-glucanases. Extracellular proteins p27.5; 30; 41; 50; 52 and 90 exhibited chitinase activity after 24 h of protoplast cultivation. GGMOs probably fulfil a protective role in this process of spruce protoplast regeneration.
Hepatic mechanisms of the Walnut antidiabetic effect in mice
Authors: Kamyab Hanieh , Hejrati Shohreh , Khanavi Mahnaz , Malihi Farshad , Mohammadirad Azadeh , Baeeri Maryam , Esmaily Hadi , Abdollahi Mohammad
Published: April 2010

The present study was designed to explore the mechanism of action of walnut (the seed of Juglans regia) leaf and ridge on hepatic glucose metabolism in diabetic mice. Experimental diabetes was induced by intravenous administration of streptozotocin (60 mg/kg)and confirmed with an increase of blood glucose, 90–100% of the control, 72 hours later. Isolated extracts from walnut leaf and ridges were administered in a single effective dose of 400 mg/kg orally. Firstly, blood glucose was determined every 1 hour until 5 hours post administration of extracts. In the second experiment, the liver was surgically removed, 2 hours post treatment of diabetic animals with extracts, homogenized and used for measurement of key enzymes of glycogenolysis (glycogen phosphorylase, GP) and gluconeogenesis (phosphoenolpyruvate carboxykinase, PEPCK). Treatment by both leaf and ridge extracts decreased blood glucose and liver PEPCK activity and increased blood insulin and liver GP activity. It is concluded that walnut is able to lower blood glucose through inhibition of hepatic gluconeogenesis and secretion of pancreatic insulin.
Effect of Age and Sex on Histomorphometrical Characteristics of Two Muscles of Laticauda Lambs
Authors: Velotto Salvatore , Varricchio Ettore , Prisco Maria Rosa Di , Stasi Tommaso , Crasto Antonio
Published: April 2010

The aim of the present experiment was to determine the effect of sex and age on histochemical and morphometric characteristics of muscle fibres (myocytes) in lambs born by single, twin, triplet and quadruplet birth. Thirty lambs were slaughtered at 60 days of age; thirty were weaned at 60 days and fed until 120 days with flakes (60%) and food supplements, and then slaughtered. Muscle tissues were obtained from two muscles, namely m. semitendinosus and m. longissimus dorsi of all lambs. For each fibre type, area perimeter and diameter (maximum and minimum) were measured and slow-twitch oxidative fibres, fast-twitch glycolytic fibres, fast-twitch oxidative-glycolytic fibres were histochemically differentiated. The muscles were stained for myosin ATPase, and succinic dehydrogenase. At 60 days, females had fibres larger than males, whereas the opposite was observed at 120 days. Besides, at 60 days, the lambs born by single birth had fibres larger than those born by multiple birth, whereas the opposite was observed at 120 days. Single lambs were heavier than twin lambs and multiple lambs. Fast-twitch glycolytic fibres had the largest size, followed by slow-twitch oxidative and fast-twitch oxidative glycolytic fibres. The dimensions of fibre types in m. longissimus dorsi were larger than in m. semitendinosus (P < 0.001).These muscle fibre characteristics are thought to be important factors influencing meat quality, which is often related to metabolic and contractile properties as determined by the muscle fibre type distribution.
Angiogenic Effect of Leptin in the Quail Chorioallantoic Membrane
Authors: Výboh Pavel , Zeman Michal , Bilčík Boris , Šárniková Božena , Košťál Ľubor
Published: April 2010

Leptin, the product ofobgene, beside its key role in the control of body weight and food consumption, can be involved in the control of embryonic development. Leptin administrationin ovoaccelerated the embryonic and post-embryonic development in Japanese quail. Although the mechanisms of leptin effects on growth and development acceleration are not clear, stimulation of angiogenesis represents one of plausible explanations. Therefore, the aim of the present study was to investigate the pro-angiogenic effect of leptinin vivoin the quail chorioallantoic membrane (CAM). The recombinant murine leptin (10, 100, and 1000 ng) was applied eitherex ovoon the CAM surface ofex ovoincubated embryos at embryonic day 7 (ED7) orin ovointo the egg albumen at ED5. Changes in blood vessels were quantified by the fractal analysis providing the fractal dimension (Df) estimate. Leptin administeredin ovowas more efficient in stimulation of angiogenesis than theex ovotreatment, since 10 ng dose elicited significantly higher (P< 0.001) stimulation of vessel development of the CAM under the air cell than it did afterex ovocultivation. Our study confirmed that exogenously applied leptin was able to stimulate angiogenesis in CAM. Leptin-mediated stimulation of angiogenesis may improve nutrient utilization from the yolk and explain at least partially the accelerating effect of leptin on avian embryo growth and development.
Determination of Haptoglobin in Bovine Serum using Polyclonal and Monoclonal Anti-human Haptoglobin Antibodies
Authors: Jawor Paulina , Stefaniak Tadeusz , Kątnik-Prastowska Iwona
Published: April 2010

Two ELISA procedures to determine haptoglobin (Hp) in bovine serum were developed. Equine haemoglobin was used as the solid phase. Self-developed goat polyclonal antibody (variant I) and monoclonal antibody (variant II) raised against human Hp were used. The results were compared with the guaiacol method. High correlation was found (r = 0.96 and r = 0.90, respectively) based on the results of 548 bovine serum samples, of which 357 were from clinically healthy cows and 191 from cows and calves monitored during treatment for the most common diseases. The Hp detection limit of ELISA using polyclonal Ab was 0.1 mg/l and using MoAb 0.21 mg/l. The addition of 2% PEG 6000 at the antibody-binding steps enabled major shortening of the incubation periods. The relatively short time, low cost of reagents, and high correlation with the reference method support the use of these ELISA variants in bovine diagnostics.
Medical abortion in lactating women – low levels of mifepristone in breast milk
Authors: SÄÄV INGRID , FIALA CHRISTIAN , HÄMÄLÄINEN JONNA M , HEIKINHEIMO OSKARI , GEMZELL‐DANIELSSON KRISTINA
Published: April 2010

Objective. Medical abortion using mifepristone followed by misoprostol is increasingly used for termination of an unwanted pregnancy. Consequently, an increasing number of women undergo medical abortion while still breastfeeding from a previous pregnancy. But there are no data on mifepristone use during lactation. We studied the levels of mifepristone in breast milk collected from women undergoing medical abortion. Design and samples. Samples of milk were collected from 12 women during the first 7 days after intake of either 200 mg (n = 2) or 600 mg (n = 10) of mifepristone. In addition, serum samples were collected on day 3 (n = 4). Main outcome measures. The levels of mifepristone, quantified using radioimmunoassay. Results. The milk concentrations of mifepristone were highest in the first samples collected during the first 12 hours following drug intake, and ranged from undetectable (< 0.013 μmol/l) to 0.913 μmol/l. Thereafter, declining concentrations of mifepristone were detected up to 7 days. The lowest levels of mifepristone in milk were measured following ingestion of the 200 mg dose. The milk:serum ratio of mifepristone ranged from < 0.013:1 to 0.042:1 on day 3 (n = 4). The calculated relative infant dose (RID) was 1.5% at its highest. Conclusions. The levels of mifepristone in milk are low, especially when using the 200 mg dose. Breastfeeding can be safely continued in an uninterrupted manner during medical abortion of this kind.
Comparison Between Diclosulam- and Imazapic-Based Weed Control Systems in Peanut1
Authors: Brecke B. , Wehtje G. , Paudel K.
Published: April 2010

Field studies were conducted in Florida and Alabama in 1998 and 1999 to evaluate imazapic [70gai/ha preemergence (PRE) or early postemergence (EPOST)], diclosulam (18 or 26 g ai/ha PRE or 18 g/ha EPOST) or imazapic + diclosulam (35 + 13 g/ha PRE or 35 + 9 g/ha EPOST). These treatments were applied alone or supplemented with either a paraquat + bentazon tank mixture or 2,4-DB. The intent was to determine if diclosulam, which has a mode of action similar to imazapic and is less persistent and less costly, could be incorporated into systems with other herbicides and thereby offer an alternative to imazapic. Maximum yield and economic return were consistently associated with only two treatments, imazapic at 70 g/ha EPOST and imazapic + diclosulam at 35 + 9 g/ha EPOST. However, none of the diclosulam-based systems provided a more favorable economic return than imazapic applied alone due to poor sicklepod control with diclosulam. Sicklepod control with diclosulam was improved with the addition of either paraquat + bentazon or 2,4-DB, but control was less than that obtained with imazapic. Diclosulam-based systems could be identified that were as effective as imazapic alone in controlling Florida beggarweed (diclosulam 26 g/ha EPOST or imazapic + diclosulam PRE or EPOST), bristly starbur (diclosulam 18 g/ha PRE or imazapic + diclosulam PRE or EPOST) and yellow nutsedge (imazapic + diclosulam EPOST). Thus, diclosulam-based systems may offer an economic advantage over imazapic in areas void of sicklepod. Neither diclosulam nor imazapic adversely affected any of five runner-type peanut cultivars (Georgia Green, Southern Runner, ViruGuard, Florida MDR 98, or Florida C-99R) when applied at twice labeled rates.
Variation in Oil Content Among Mexican and Peruvian hirsuta Peanut Landraces and Virginia-Type hypogaea Lines1
Authors: Barrientos-Priego L. , Isleib T. G. , Pattee H. E.
Published: April 2010

Many consumers in the U.S. claim to prefer low fat foods, and this has encouraged the search for peanut (Arachis hypogaea L.) cultivars with low or reduced oil content. A collector's note on the low oil content of PI 576616, a Peruvian-type peanut (A. hypogaea subsp. hypogaea var. hirsuta Köhler) prompted screening of similar landraces from Mexico. PI 576633, PI 576634, PI 576635, PI 576636, PI 576637, and PI 576638 were collected in 1993 and imported to the U.S. for evaluation. In 1994, 120plants per landrace were planted in the field, using Peruvian hirsuta PI 501296 as a control. In 1995, 24 selections from each Mexican landrace, 10 selections from PI 501296, and North Carolina State Univ. (NCSU) breeding line N91026E were planted. Based on oil analysis of the lines tested in 1995, 23 low oil and eight high oil selections were planted with four NCSU virginia-type breeding lines (N91026E, N92038, N94006L, and N94014L) used as controls in 1993. Nuclear magnetic resonance (NMR) was used for oil content determination. From the 1994planting, selections from PI 576633 and PI 576638 had the lowest oil content. Five selections from PI 576634 and PI 576635 with low oil content also were identified. Earlier screening of 580 entries in the NCSU germplasm collection identified only three lines with similar oil contents. In 1995, significant (P ≤ 0.01) oil content differences were found between landraces collected from the states of Puebla and Guanajuato (482 vs. 504 g kg−1). Significant variation was found among Puebla landraces, but no differences were found among Guanajuato landraces. In 1996, significant year-to-year variation was found for some of the 31 selections. Low oil lines have been identified with the potential to be used as parents in breeding for reduced oil content.
Equivalence of fusion rates after rigid internal fixation of the occiput to C-2 with or without C-1 instrumentation
Authors: Hankinson Todd C. , Avellino Anthony M. , Harter David , Jea Andrew , Lew Sean , Pincus David , Proctor Mark R. , Rodriguez Luis , Sacco David , Spinks Theodore , Brockmeyer Douglas L. , Anderson Richard C. E.
Published: April 2010

Object

The object of this study was to assess a multiinstitutional experience with pediatric occipitocervical constructs to determine whether a difference exists between the fusion and complication rates of constructs with or without direct C-1 instrumentation.

Methods

Seventy-seven cases of occiput-C2 instrumentation and fusion, performed at 9 children's hospitals, were retrospectively analyzed. Entry criteria included atlantooccipital instability with or without atlantoaxial instability. Any case involving subaxial instability was excluded. Constructs were divided into 3 groups based on the characteristics of the anchoring spinal instrumentation: Group 1, C-2 instrumentation; Group 2, C-1 and C-2 instrumentation without transarticular screw (TAS) placement; and Group 3, any TAS placement. Groups were compared based on rates of fusion and perioperative complications.

Results

Group 1 consisted of 16 patients (20.8%) and had a 100% rate of radiographically demonstrated fusion. Group 2 included 22 patients (28.6%), and a 100% fusion rate was achieved, although 2 cases were lost to follow-up before documented fusion. Group 3 included 39 patients (50.6%) and demonstrated a 100% radiographic fusion rate. Complication rates were 12.5, 13.7, and 5.1%, respectively. There were 3 vertebral artery injuries, 1 (4.5%) in Group 2 and 2 (5.1%) in Group 3.

Conclusions

High fusion rates and low complication rates were achieved with each configuration examined. There was no difference in fusion rates between the group without (Group 1) and those with (Groups 2 and 3) C-1 instrumentation. These findings indicated that in the pediatric population, excellent occipitocervical fusion rates can be accomplished without directly instrumenting C-1.
Postoperative cerebellar mutism syndrome following treatment of medulloblastoma: neuroradiographic features and origin
Authors: Wells Elizabeth M. , Khademian Zarir P. , Walsh Karin S. , Vezina Gilbert , Sposto Richard , Keating Robert F. , Packer Roger J.
Published: April 2010

Object

The origin and long-term outcome of cerebellar mutism syndrome (CMS), a postoperative syndrome of diminished speech, hypotonia, and ataxia that affects approximately 25% of patients with medulloblastoma, is poorly elucidated. The current study was undertaken to determine factors associated with development of CMS, a means to determine its severity or cause, and outcomes of patients with this syndrome.

Methods

The study included 28 children with medulloblastoma who either underwent an operation or were referred to the authors' institution soon after surgery. Eleven (39%) of these children had CMS. The preoperative, immediate postoperative, and 1-year postoperative MR images were reviewed by a neuroradiologist blinded to diagnosis of CMS. The severity of mutism and neurological and neurocognitive outcomes were examined.

Results

Preoperative MR images showed no differences in tumor size, hydrocephalus, or peritumoral edema in patients with and without CMS. An association with brainstem invasion was significant (p < 0.05), and there was a trend toward an association with involvement of the cerebellomedullary angle (p = 0.08). Images obtained immediately postoperatively showed cerebellar edema in 92% of all patients; there were trends for more middle and superior cerebellar peduncle edema in patients with CMS (p = 0.05 and 0.07, respectively). At 1 year postoperatively, patients with CMS showed more moderate to severe atrophy/gliosis of total cerebellum (p < 0.01), vermis (p < 0.01), and brainstem (p < 0.05). Mean IQ was 16 points lower in patients with CMS (IQ = 84.2 ± 15.8) compared with those without CMS (IQ = 100.4 ± 17.4), with a trend toward significance (p = 0.07).

Conclusions

This study demonstrates that CMS is associated with postoperative damage to the cerebellum and brainstem, damage not predicted by immediate postoperative MR imaging, and with poorer associated functional outcome.
Insular epilepsy masquerading as multifocal cortical epilepsy as proven by depth electrode
Authors: Levitt Michael R. , Ojemann Jeffrey G. , Kuratani John
Published: April 2010

The insular cortex is an uncommon epileptogenic location from which complex partial seizures may arise. Seizure activity in insular epilepsy may mimic temporal, parietal, or other cortical areas. Semiology, electroencephalography, and even surface electrocorticography recordings may falsely localize other cortical foci, leading to inaccurate diagnosis and treatment. The use of insular depth electrodes allows more precise localization of seizure foci. The authors describe the case of a young girl with seizures falsely localized to the cortex, with foci arising from the insula, as proven by depth electrode recordings. Resection of the insula yielded seizure control.
Autosomal recessive osteopetrosis as an unusual cause of hydrocephalus, extensive calcification of tentorium cerebelli, and calvarial hyperostosis
Authors: Turgut Mehmet , Aral Yusuf Z. , Özsunar Yelda
Published: April 2010

Osteopetrosis is an uncommon congenital disorder characterized by defective osteoclastic resorption of bone that results in increased bone density. Clinical symptoms include anemia, hepatosplenomegaly, and cranial nerve and/or brainstem compression and hydrocephalus due to foraminal narrowing in the skull. The authors present an unusual case of a patient with autosomal recessive osteopetrosis associated with extensive calcification of the dura mater covering the brain as well as obstructive hydrocephalus. Ventriculoperitoneal shunt treatment was complicated by persistent overdrainage. It is suggested that chronic progressive triventricular hydrocephalus developed as a result of acquired aqueductal stenosis caused by extensive calcification of the tentorium cerebelli and calvarial hyperostosis. To the best of the authors' knowledge, this has not been described in the literature.
Fusiform dilation of the carotid artery following radical resection of pediatric craniopharyngiomas: natural history and management
Authors: Elliott Robert E. , Wisoff Jeffrey H.
Published: April 2010

Object

Fusiform dilation of the supraclinoid internal carotid artery (FDCA) is a reported occurrence following surgery for suprasellar tumors, in particular craniopharyngiomas. We report our experience of the incidence and natural history of FDCA following aggressive surgical resection of craniopharyngiomas in children.

Methods

Between 1986 and 2006, 86 patients under the age of 21 underwent radical resection of craniopharyngiomas at our institution. Ten cases with < 1 year of follow-up imaging (6), perioperative death (3), or nonsuprasellar tumors (1) were excluded. Data were retrospectively collected on the remaining 76 patients (43 male, 33 female; mean age 9.5 years; mean tumor size 3.3 cm) to determine the risk factors for and the rate and clinical significance of FDCA.

Results

Fifty patients had primary tumors and 26 patients received treatment before referral to our center. Sixty-six children (87%) had gross-total resection. At a mean follow-up time of 9.9 years, FDCA had developed in 7 patients (9.2%), all of whom had primary tumors and gross-total resection. The mean time to onset of FDCA was 6.8 months (range 3–11 months) with stabilization occurring at mean of 17.7 months (range 9–29.5 months). The mean size of the aneurysms was 9.1 mm (range 7.1–12 mm). After arrest, no lesions showed continued growth on serial imaging or produced symptoms or required treatment. There were no significant differences in age, sex, tumor size, pre- or retrochiasmatic location, extent of resection, or surgical approach (p > 0.05) between patients with and without FDCA.

Conclusions

Fusiform dilation of the supraclinoid internal carotid artery occurred in almost 10% of children following radical resection of craniopharyngiomas. In agreement with other reports, the authors concluded that FDCA probably occurs as a result of surgical manipulation of the supraclinoid carotid artery and should be managed conservatively because very few patients exhibit continued symptoms or experience growth or rupture of the lesion.
Radiation therapy for pediatric craniopharyngioma
Authors: Kiehna Erin N. , Merchant Thomas E.
Published: April 2010

Object

The treatment of craniopharyngioma is highly controversial. Continued advances in limited surgery and radiation therapy have maintained excellent local disease control while minimizing treatment-related sequelae. Further analyses of outcomes are necessary to characterize the long-term effects of radiation therapy.

Methods

An extensive literature review was performed for all studies including radiation therapy, with or without surgery, for pediatric craniopharyngioma.

Results

The authors identified 32 papers describing radiation therapy for treatment of pediatric craniopharyngioma, with disease control ranging from 44 to 100%. Modern studies report at least 90% disease control with 5-year follow-up. Fifteen studies reported outcomes, demonstrating that more than two-thirds of patients treated with surgery and radiation therapy have favorable outcomes, and this rate is more than 85% in the modern era.

Conclusions

Conservative surgery and radiation therapy results in long-term disease control in pediatric patients with craniopharyngioma that is comparable to results obtained with radical surgery alone. However, children with craniopharyngioma remain vulnerable to late treatment failures and side effects from radiation therapy, including endocrinopathies, vasculopathies, and secondary tumors, which may be detrimental to the quality of life. Long-term follow-up beyond 5–10 years is necessary to assess tumor control relative to functional outcomes.
Craniopharyngioma: a comparison of tumor control with various treatment strategies
Authors: Yang Isaac , Sughrue Michael E. , Rutkowski Martin J. , Kaur Rajwant , Ivan Michael E. , Aranda Derick , Barani Igor J. , Parsa Andrew T.
Published: April 2010

Object

Craniopharyngiomas have a propensity to recur after resection, potentially causing death through their aggressive local behavior in their critical site of origin. Recent data suggest that subtotal resection (STR) followed by adjuvant radiotherapy (XRT) may be an appealing substitute for gross-total resection (GTR), providing similar rates of tumor control without the morbidity associated with aggressive resection. Here, the authors summarize the published literature regarding rates of tumor control with various treatment modalities for craniopharyngiomas.

Methods

The authors performed a comprehensive search of the English language literature to identify studies publishing outcome data on patients undergoing surgery for craniopharyngioma. Rates of progression-free survival (PFS) and overall survival (OS) were determined through Kaplan-Meier analysis.

Results

There were 442 patients who underwent tumor resection. Among these patients, GTR was achieved in 256 cases (58%), STR in 101 cases (23%), and STR+XRT in 85 cases (19%). The 2- and 5-year PFS rates for the GTR group versus the STR+XRT group were 88 versus 91%, and 67 versus 69%, respectively. The 5- and 10-year OS rates for the GTR group versus the STR+XRT group were 98 versus 99%, and 98 versus 95%, respectively. There was no significant difference in PFS (log-rank test) or OS with GTR (log-rank test).

Conclusions

Given the relative rarity of craniopharyngioma, this study provides estimates of outcome for a variety of treatment combinations, as not all treatments are an option for all patients with these tumors.
Surgical nuances for removal of retrochiasmatic craniopharyngiomas via the transbasal subfrontal translamina terminalis approach
Authors: Liu James K. , Christiano Lana D. , Gupta Gaurav , Carmel Peter W.
Published: April 2010

Giant craniopharyngiomas in the retrochiasmatic space are challenging tumors, given the location and surrounding vital structures. Surgical removal remains the first line of therapy and offers the best chance of cure. For tumors with extension into the retrochiasmatic space, the authors use the translamina terminalis corridor via the transbasal subfrontal approach. Although the lamina terminalis can be accessed via anterolateral approaches (pterional or orbitozygomatic), the surgical view of the optic chiasm is oblique and prevents adequate visualization of the ipsilateral wall of the third ventricle. The transbasal subfrontal approach, on the other hand, offers the major advantage of direct midline orientation and access to the third ventricle through the lamina terminalis. This provides the significant advantage of visualization of both walls of the third ventricle and hypothalamus as well as inferior midline access to the interpeduncular cistern to permit safe neurovascular dissection and total tumor removal. In this report, the authors describe the transbasal subfrontal translamina terminalis approach, with specific emphasis on technical surgical nuances in removing retrochiasmatic craniopharyngiomas. An illustrative video demonstrating the technique is also presented.