bluuebunny/crossref_metadata_2025 huggingface dataset:
E-063 Endovascular treatment of fusiform intracranial vertebral artery aneurysms using reconstructive techniques: single center experience
Authors: Dabus G , Samaniego E , Linfante I
Published: July 2012

Objective

Fusiform intracranial aneurysms are challenging lesions that occur secondary to atherosclerosis or dissection. Although unclear, the prognosis of patients with fusiform aneurysms seems to be poor. We report our single center experience in the treatment of fusiform aneurysms involving the intracranial vertebral arteries using reconstructive endovascular techniques.

Method

The neurointerventional database of our institution was retrospectively reviewed from June of 2010 to February of 2012. Patients who underwent endovascular treatment of fusiform intracranial vertebral artery aneurysms using reconstructive techniques were included in the analysis. Patients treated with parent vessel sacrifice (deconstructive technique) were excluded. Clinical presentation, size, reconstructive technique used, procedural complication, clinical and angiographic follow-ups were included in the analysis.

Results

Seven patients met the inclusion criteria in our study. There were four men and three women with a mean age of 56 years (range 41–76 years). Two patients (two women) presented with acute subarachnoid hemorrhage (SAH) and were treated with stent assisted coil embolization (SACE). Five patients had unruptured aneurysms; four patients were treated with SACE; the other patient had a partially thrombosed aneurysm and was treated with stent-reconstruction with deployment of two stents (no coiling). The mean of the largest diameter of the lesions was 8.7 mm. There was one asymptomatic procedural complication (non-flow-limiting cervical dissection). All patients had good clinical outcomes (mRS <2) with no late hemorrhage at a mean clinical follow-up of 12 months. One patient that presented with SAH was lost to angiographic follow-up; for all other six patients angiographic follow-up was obtained (mean of 9.6 months). Of these patients, five demonstrated aneurysm occlusion with complete vessel reconstruction in the follow-up. One patient that presented with SAH and was treated with SACE had aneurysm regrowth at 1 month and was retreated with further coil embolization and deployment of a 3rd stent with no complications.

Conclusions

The use of reconstructive techniques in the endovascular treatment of unruptured fusiform intracranial vertebral artery aneurysms is feasible, safe and effective in the mid-term. In patients presenting with SAH, however, the safety and effectiveness of these techniques remain unclear.

Competing interests

G Dabus: Codman Neurovascular. Surpass Medical. E Samaniego: None. I Linfante: Codman Neurovascular. Surpass Medical.
E-064 Endovascular treatment of acute vertebro-basilar occlusion with self-expandable stents: single center experience
Authors: Dabus G , Samaniego E , Linfante I
Published: July 2012

Objective

The rate of death or disability associated with acute basilar artery occlusion (BAO) is as high as 80%–90% with standard medical therapy. We report our single center experience in the treatment of acute BAO with self-expandable stents (SES).

Method

The stroke database of our institution was retrospectively reviewed from June of 2008 to February of 2012. Patients with angiographic evidence of symptomatic BAO in whom SES were attempted to deploy as acute endovascular intervention were included in the analysis. Good outcome was defined as a modified Rankin Scale ≤2 on follow-up.

Results

Ten patients with acute BAO in whom stents were attempted to deploy were identified. Median National Institute of Health Stroke Scale score on admission was 18. The average of time from symptom onset to endovascular treatment was 11 h after any vertebro-basilar ischemic symptoms had started. Pre-procedure, all patients had a TIMI score of 0. Stents were successfully deployed in 90% (9/10) of cases. One stent was not deployed due to severe vessel tortuosity. Twelve stents were deployed in nine subjects. Seven out of 10 patients (70%) had a TIMI score of 3 at the end of the procedure. The rate of procedural complications was 20% (2/10). Two patients developed intracerebral hemorrhage due to wire perforations. Fifty percent patients (5/10) achieved good outcome (mRS ≤2) on follow-up. Four patients died and one had severe disability.

Conclusions

The use of SES in this small cohort of patients with acute BAO is technically feasible with high recanalization rates. The safety and efficacy of the procedure need to be addressed in larger randomized controlled study.

Competing interests

G Dabus: Codman Neurovascular. Surpass Medical. E Samaniego: None. I Linfante: Codman Neurovascular. Surpass Medical.
E-065 Diagnosis and management of intracranial hypotension: a case review: Abstract E-065 Figure 1
Authors: Bourgeois A , Kvamme P , Chang T , Laing G
Published: July 2012

Purpose

Headache remains one of the top three most common indications for neurologic imaging. Intracranial hypotension is one causative etiology of headache, which although rare, carries considerable morbidity and potential mortality. Initial misdiagnosis is very common despite the presence of a unique and well-defined constellation of imaging findings. This case-based review examines the mechanisms of pathogenesis, common clinical features, and imaging findings associated with seven recent cases of intracranial hypotension. Interventional management of symptomatic intracranial hypotension includes epidural blood patching, percutaneous placement of fibrin sealant, and surgical CSF leak repair. However, outcomes and treatment strategies remain poorly studied. This review also discusses various treatment strategies utilizing our own experience, in order to better manage intracranial hypotension.

Methods

Following IRB approval, a retrospective chart review was performed from the time period of January 1, 2009–October 1, 2011. Symptomatic patients with low intracranial pressures (<15 cm H2O) as demonstrated by lumbar puncture and with correlating cross sectional imaging within 1 month of the diagnostic lumbar puncture were included.

Results

Each of the seven patients displayed at least one classic imaging feature of intracranial hypotension:

Downward displacement of the brain through the incisura or “slumping of the midbrain”.

Diffuse dural thickening and enhancement.

Venous and dural sinus distension.

Subdural hygromas/hematomas.

Perineural root sleeve cysts.

Epidural contrast collections.

Flaring or other bizarre root sleeve morphology.

Abnormal nerve root morphology and epidural fluid/contrast collections were the most common imaging abnormalities. CT guided percutaneous, multilevel epidural patching using own blood or synthetic patch material were utilized for treatment. Five of the seven patients required a repeat procedure.

Conclusion

Recognition of the common findings of intracranial hypotension is important as this diagnosis is often not considered, potentially leading to more invasive and ineffective therapies. When detected, successful treatment can be achieved utilizing several techniques although repeat treatments are often necessary.

Competing interests

None.

References

1.Rabin,Barry,et al.Spontaneous intracranial hypotension: spinal MR findings.Am J Neuroradiol1998;19:1034–9.

2.Farb RJ,et al.The venous distension sign: a diagnostic sign of intracranial hypotension at MR imaging of the brain.AJNR Am J Neuroradiol2007;28:1489–93.

3.Schievink,Wouter. Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension.JAMA2006;295:2286–96.

4.Schievink,Wouter,et al.Diagnostic criteria for spontaneous spinal CSF leaks and intracranial hypotension.Am J Neuroradiol2008;29:853–6.

Abstract E-065 Figure 1
E-066 A favorable profile for selecting acute ischemic stroke patients for thrombolytic therapy: Abstract E-066 Table 1
Authors: Moradzadeh N , Sharma J , Vargas E , Jung R , Koo B , Blackham K
Published: July 2012

Background

There is currently an intense interest in defining predictive profiles from MRI based diffusion/perfusion information for acute ischemic stroke patients. Perfusion/diffusion ratio (mismatch ratio) and penumbra volumes are factors used to select patients for thrombolysis. The current literature considers a mismatch ratio of 1.2 as the minimum for thrombolysis. There is much debate, however, as to how mismatch ratios and penumbra volumes affect patient outcome.

Methods

31 acute ischemic stroke patients were selected at random and had their presenting acute stroke-protocol MRI processed through OLEA Medical's PerfScape, which calculated the penumbral volume and mismatch ratio, using a Tmax of 4 s. A mismatch ratio of 1.2–4.5 with a penumbra volume >80 cc was labeled as a Favorable Profile (FP). NIHSS scores were collected both at stroke presentation and at time of discharge. An improvement of NIHSS ≥4 at time of discharge was considered a good outcome.

Results

Eight patients were found to have a FP with a mismatch ratio between 1.2 and 4.5 and a penumbra volume >80 cc. Twenty-three patients did not have an FP. Of the eight patients with an FP, all 8 had an improvement of ≥4 in their NIHSS score. Of the 23 patients who did not have an FP, 7 had an improvement of ≥4 in their NIHSS score, while 16 had no improvement or an improvement of <4 in their NIHSS score, (p=0.0008). Furthermore, a homogenous subset of patients (N=20) who underwent thrombolytic therapy and achieved TIMI 2 or greater recanalization, showed similar findings (p=0.02)

Conclusion

This small study demonstrates that our definition of a favorable MRI perfusion profile in ischemic stroke patients (mismatch ratio of 1.2–4.5 and a penumbra volume >80 cc) was associated with a good outcome at discharge, for all patients as well as an endovascularly treated homogeneous subset. Furthermore, the clinical application of this upper limit of 4.5 for the mismatch ratio warrants further investigation.

Abstract E-066 Table 1

Favorable profile and NIHSS improvement

NIHSS improvement ≥4NIHSS improvement <4Favorable Profile (Mismatch ratio of 1.2–4.5 and penumbra volume >80 cc)80Not a Favorable Profile716

Competing interests

None.
E-068 CT angiography in the diagnosis of non-aneurysmal spontaneous subarachnoid hemorrhage: a meta-analysis
Authors: Jethwa P , Punia V , Gandhi C , Prestigiacomo C
Published: July 2012

Introduction

Modern CT angiography (CTA) has shown high sensitivity for detecting a ruptured aneurysm in the setting of acute subarachnoid hemorrhage (SAH). Patients with SAH and no aneurysm found on CTA pose a diagnostic dilemma for treating physicians. These patients traditionally undergo digital subtraction angiography (DSA) in search of an occult aneurysm; however, this practice has recently been called into question. We performed a meta-analysis of the current literature to assess the role of CTA in the diagnosis of non-aneurysmal SAH (NASAH).

Methods

A systematic review of the literature was performed to find articles comparing the sensitivity of CTA to DSA for diagnosing aneurysms in the setting of acute SAH. Based on clinical relevance, only studies performed with 16-slice CT scanners or greater were included in the analysis. Data from these studies were combined with our own institutional data to create an overall 2×2 table, from which descriptive statistics were generated.

Results

After an extensive literature review, 22 studies were included in the final analysis. The total number of true positive, false positive, true negative, and false negative CT angiograms were 3046, 7, 737, and 33, respectively. The overall sensitivity and specificity were 98.9% (98.4–99.2) and 99.1% (98.0–99), respectively. The positive and negative predictive values were 99.8% (99.5–99.9) and 95.7% (94.0–97.0), respectively. There was a trend toward higher sensitivity with 32- and 64-slice CT scanners when compared with 16-slice scanners, but this difference was not statistically significant.

Conclusions

The results of this analysis demonstrate the high sensitivity of 16-slice or greater CTA in detecting aneurysms in acute SAH. Therefore, the vast majority of patients with negative CTA requires no further workup and needs not be subjected to the risks of DSA. DSA should be reserved only for patients exhibiting a clinical exam incongruent with NASAH, which has a typically benign course.

Competing interests

None.
E-007 Urgent recanalization with stent for severe intracranial stenosis in patients with transient ischemic attack or minor stroke
Authors: Lee T , Song S , Lee S
Published: July 2012

Background and purpose

Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients.

Methods

Between June 2009 and November 2011, stent-assisted angioplasty by using stent for intracranial severe stenosis (>70%) was performed in nine patients after TIA (12 stenotic lesions) and 19 patients after minor stroke (21 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed.

Results

Stenting was successful in all 28 patients. The mean time interval from stroke symptom onset to stenting was 4.2 days (1∼13 days). The mean pre-procedural stenosis was 83.3% (range 70%–95%), and the mean stenosis immediately after stent placement was 4.2%. In-stent thrombosis occurred in three lesions (n=3, 9.1%), and was lysed with abciximab. Procedure-related asymptomatic dissection occurred in one lesion (n=1, 3.0%), and was solved by implanting a second stent. No intracranial hemorrhage or vessel perforation occurred in any patient. During the mean follow-up period of 14.4 months (range, 2–31 months), one patient had a symptomatic in-stent restenosis (80%) after 6 months of stent placement.

Conclusion

Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of ≥70%.

Competing interests

None.
E-071 CT perfusion as a tool to predict the risk of hemorrhagic transformation in ischemic stroke treated with tissue plasminogen activator: a single center experience
Authors: Kass-Hout T , Kass-Hout O , Al Masry M , Mokin M , Wack D , Nourollahzadeh E , Siddiqui A , Levy E , Synder K
Published: July 2012

Objective

To use the CT Perfusion (CTP) parameters at the time of hospital admission, including Cerebral Blood Volume and Permeability Surface area product (PS), to identify patients with higher risk to develop hemorrhagic transformation in the setting of acute stroke therapy with intravenous thrombolysis.

Methods

Retrospective study that compared admission CTP variables between patients with Hemorrhagic Transformation (HT) acute stroke and those with no hemorrhagic transformation. Both groups received standard of care intravenous thrombolysis with tPA. Twenty patients presented to our stroke center between the years 2007 and 2011 within 3 h after stroke symptoms onset. All patients underwent two-phase 320 slice CTP which creates Cerebral Blood Volume and PS measurements. Patients were divided into two groups according to whether or not they had HT on a follow-up CT head without contrast, done within 36 h of the thrombolysis therapy. Clinical, demographic and CTP variables were compared between the HT and non-HT groups using logistic regression analyses.

Results

HT developed in 8 (40%) patients. Patients with HT had lower ASPECT score (p=0.03), higher NIHSS on admission (p=0.01) and worse outcome (p=0.04) compared to patients who did not develop HT. Baseline blood flow defects were comparable between the two groups. The mean PS for the HT group was 0.53 ml/min/100 g brain tissue, which was significantly higher than that for the non-HT group of 0.04 ml/min/100 g brain tissue (p<0.0001). The mean area under the curve was 0.92 (95% CI). The PS threshold of 0.26 ml/min/100 g brain tissue had a sensitivity of 80% and a specificity of 92% for detecting patients with high risk of hemorrhagic transformation after intravenous thrombolysis.

Conclusions

Admission CTP measurements might be useful to predict patients who are at higher risk to develop hemorrhagic transformation after acute ischemic stroke therapy.

Competing interests

T Kass-Hout: Genentech. O Kass-Hout: None. M Al Masry: None. M Mokin: None. D Wack: None. E Nourollahzadeh: None. A Siddiqui: NINDS 1R01NS064592-01A1, University at Buffalo. Shurtleff, Inc, Concentric Medical, ev3/Covidien Vascular Therapies, GuidePoint Global Consulting, Penumbra. Codman & Shurtleff, Inc, Genentech. Hotspur, Intratech Medical, StimSox, Valor Medical. Abbott Vascular, American Association of Neurological Surgeons, Neocure Group LLC, an Emergency Medicine Conference. E Levy: Codman & Shurtleff, Inc, ev3/Covidien Vascular Therapies, Boston Scientific. TheraSyn Sensors, Inc. Medical Ltd., Mynx/Access Closure. Boston Scientific. K Synder: Toshiba and ev3.
E-076 Imaging to endovascular recanalization in less than an hour is feasible
Authors: Almekhlafi M , Eesa M , Menon B , Demchuk A , Goyal M
Published: July 2012

Introduction

The shorter the time from core estimation by imaging to recanalization, the more likely that core expansion is minimized. We aimed to assess the feasibility of achieving an ultra-short imaging to recanalization time in the routine practice setting.

Methods

This is a prospective, single-operator, case series of acute ischemic stroke patients treated with endovascular therapy in a tertiary center where imaging to recanalization of <60 min was achieved.

Results

Imaging to recanalization time <60 min was accomplished in 38% (11 patients) of treated patients. The median imaging to recanalization time was 47 min. The median 24-h NIHSS scale was 1 (range 0–11). Upon discharge, 82% of patients achieved a modified Rankin scale score of 1 or less.

Conclusions

An imaging to recanalization time under 60 min is feasible and may be associated with better functional outcome.

Competing interests

None.
E-078 Acute stroke intervention with solitaire stent: a meta-analysis
Authors: Dumont T , Kass-Hout T , Eller J , Siddiqui A , Levy E
Published: July 2012

Introduction

Based on promising revascularization results in the SWIFT trial (83% revascularization), FDA approval of the Solitaire stent for acute stroke intervention is anticipated. The Solitaire stent has been used extensively in Europe for acute stroke intervention. This important real-world use case experience provides insight into the applicability of Solitaire for post-market use. The purpose of this study is to review existing case series of stroke intervention with Solitaire to evaluate efficacy in revascularization and outcomes.

Method

A meta-analysis of existing case series with acute stroke intervention employing the Solitaire stent was performed. Case series were identified using a thorough literature review. All case series (including case reports) were included. Endpoints including recanalization and Modified Rankin Score on discharge were noted.

Results

Twelve studies were identified with at least one acute stroke intervention with the Solitaire stent. These studies included a total of 205 patients. Revascularization was successfully performed in 182 patients (89%). Acceptable outcomes (MRS 0–2) were reported for 100 patients (49%).

Conclusions

With the anticipated approval of the Solitaire stent for publication of the SWIFT trial in a few months, “real world” case series such as this will soon be of less relevance. In itself, this relatively small series has little to offer in comparison to the similar reports cited. In addition, several more similar case series have been published since the writing of this manuscript (by my count at least seven more series are available on PubMed). At the very least, these articles should be considered in a revision prior to re-submission.

Competing interests

T Dumont: None. T Kass-Hout: None. J Eller: None. A Siddiqui: Grants: University at Buffalo, National Institutes of Health (not for this study). Codman & Shurtleff, Concentric Medical, ev3/Covidien Vascular Therapies, GuidePoint Global Consulting, Penumbra;. Financial interests: Hotspur, Intratech Medical, StimSox, Valor Medical; Speakers' Bureaus: Codman & Shurtleff, Genentech; Honoraria: Abbott Vascular, Genentech, Neocure Group, Annual Peripheral Angi. E Levy: Grant, other research support, research support: Codman & Shurtleff, Inc., ev3/Covidien Vascular Therapies. consultant/advisory board: Codman & Shurtleff, Inc.; Consultant per project and/or per hour: Codman & Shurtleff; ev3/Covidien Vascular Therapies, TheraSyn Sensors. ownership interests: Intratech Medical, Mynx/Access Closure; honoraria: Boston Scientific; fees for carotid stent training: Abbott Vascular, ev3/Covidien Vascular Therapies. Receives no consulting salary.
E-079 Redefining endovascular access for treatment of intracranial aneurysms
Authors: Grobelny T
Published: July 2012

Introduction/Purpose

The Penumbra Coil 400 (PC 400) is a new generation of platinum coils with a larger primary diameter (0.020″) than conventional embolic coils (0.010″–0.015″), requiring a larger diameter microcatheter for delivery. The Penumbra PX 400 Microcatheter has a 0.025″ ID lumen and 2.8F distal OD. This is somewhat larger than microcatheters that have been conventionally used to access aneurysms and deliver embolic coils (up to 0.021″ ID lumen and 2.3F distal OD). Compared with conventional microcatheters which use stainless steel reinforcement, the PX400 has a Nitinol coil reinforcement and, in addition, has a softer polymer construction at the distal tip. The PX400 takes advantage of the softness of Nitinol. These innovations combine to produce a catheter which is very soft yet very stable within an aneurysm. The goal of this investigation was to compare the properties of the PX 400 with conventional microcatheters for embolization of intracranial aneurysms.

Materials and Methods

The PX 400 Microcatheter was used in eight endovascular cases for Penumbra coil delivery for treatment of intracranial vascular lesions by a single operator with 15 years of neuroendovascular experience. This includes one post-traumatic CCF and seven brain aneurysms. In the aneurysm group, there were two basilar aneurysms, one vertebral aneurysm, two A-comm aneurysms, one MCA aneurysm, and one P-comm aneurysm. In our series, balloon remodeling was used in one case; two cases required a Neuroform stent used with a microcatheter being advanced through the stent, and in two cases an Enterprise stent was used with a PX 400 catheter being jailed. The standard 014 wire was used for all cases, SilverSpeed (ev3/Covidien) or Syncro2wire (Boston Scientific). A two-guide support system was used, a 6F Chaperon (Microvention) and an 8F Neuron MAX (Penumbra).

Results

In all cases, the PX 400 Microcatheter reached its intended target, and the coil delivery was uneventful. The catheter crossed a Neuroform stent without difficulty. Jailing technique with an Enterprise stent was favored, but a Neuron Max had to be used to fit a Prowler Plus and a PX 400 together. The overall responsiveness and tractability as well as stability of the new catheter are excellent even in a very tortuous anatomy.

Conclusion

Results confirmed that the larger PX 400 microcatheter had tracking, aneurysm entry, coil delivery, stability, and safety characteristics very similar to conventional microcatheters used for the embolization of intracranial aneurysms. Thus, the technology and material engineering represented in the PX 400 redefines microcatheters for treatment of aneurysms and may enable a significant advancement not previously possible with conventional coil treatment.

Competing interests

None.
Acute effects of Achilles tendon vibration on soleus and tibialis anterior spinal and cortical excitability
Authors: Lapole Thomas , Deroussen François , Pérot Chantal , Petitjean Michel
Published: July 2012

Prolonged vibration is known to alter muscle performance. Attenuation of Ia afferent efficacy is the main mechanism suggested. However, changes in motor cortex excitability could also be hypothesized. The purpose of the present study was therefore to analyze the acute and outlasting effects of 1 h of Achilles tendon vibration (frequency, 50 Hz) on the soleus (SOL) and tibialis anterior (TA) neuromuscular excitability. Spinal excitability was investigated by means of H-reflexes and F-waves while cortical excitability was characterized by motor evoked potentials (MEPs) obtained by transcranial magnetic stimulation. Twelve subjects performed the experimental procedures 3 times: at the beginning of the testing session (PRE), immediately after 1 h of Achilles tendon vibration (POST), and 1 h after the end of vibration (POST-1H). Prolonged vibration led to acute reduced H-reflex amplitudes for SOL only (46.9% ± 7.7% vs. 32.8% ± 7%; p = 0.006). Mainly presynaptic inhibition mechanisms were thought to be involved because of unchanged F-wave persistence and amplitude mean values, suggesting unaffected motoneuronal excitability. While no acute effects were reported for SOL and TA cortical excitability, both muscles were characterized by an outlasting increase in their MEP amplitude (0.64 ± 0.2 mV vs. 0.43 ± 0.18 mV and 2.17 ± 0.56 mV vs. 1.26 ± 0.36 mV, respectively; p < 0.05). The high modulation of Ia afferent input by vibration led to changes in motor cortex excitability that could contribute to the enhancement in muscular activation capacities reported after chronic use of tendon vibration.
Results from the Active Healthy Kids Canada 2011 Report Card on Physical Activity for Children and Youth
Authors: Barnes Joel D. , Colley Rachel C. , Tremblay Mark S.
Published: July 2012

The Active Healthy Kids Canada 2011 Report Card on Physical Activity for Children and Youth assesses how Canada is doing as a country at promoting and facilitating physical activity opportunities for children and youth. The aim of this brief communication is to provide a summary of the results. Twenty-three physical activity indicators were graded. The physical activity levels indicator received an “F” for the fifth consecutive year, and little improvement was seen across most indicators.
Effects of an in-patient treatment program based on regular exercise and a balanced diet on high molecular weight adiponectin, resistin levels, and insulin resistance in adolescents with severe obesity
Authors: Gueugnon Carine , Mougin Fabienne , Simon-Rigaud Marie-Laure , Regnard Jacques , Nègre Véronique , Dumoulin Gilles
Published: July 2012

Adiponectin, the most abundant hormone produced by adipose tissue, circulates in 3 isoforms, including high molecular weight (HMW) adiponectin. The latter has been suggested to be a better predictor of metabolic disturbances and insulin resistance associated with obesity. This study investigated changes in total and HMW adiponectin, resistin, and homeostasis model assessment (HOMA) during a 9-month in-patient treatment program based on physical exercise and a balanced diet in 32 severely obese adolescents. Total and HMW adiponectin, resistin, and HOMA were measured at baseline (month 0) and during the program (months 3, 6, 9). In addition, a control group of 15 teenagers served as a reference for the baseline assessments. At baseline, HMW adiponectin was more markedly decreased in obese adolescents than total adiponectin, and both were lower than in controls. Conversely, resistin and HOMA were higher in obese adolescents. During the program, there was a significant change in body composition and improved insulin sensitivity among obese teenagers. In addition, HMW adiponectin and the ratio of HMW-to-total adiponectin increased throughout the study, whereas total adiponectin only increased up until the sixth month. On the contrary, resistin did not show any significant change. In obese adolescents, a long-term combination of aerobic exercise and a balanced diet, inducing change in body composition and improved insulin sensitivity, markedly increased HMW adiponectin compared with total adiponectin, without any change in resistin concentrations. Our results thus suggest that the determination of HMW adiponectin could be more useful than measurement of total adiponectin in clinical settings.
Effect of aerobic training status on both maximal lactate steady state and critical power
Authors: Greco Camila Coelho , Caritá Renato Aparecido Corrêa , Dekerle Jeanne , Denadai Benedito Sérgio
Published: July 2012

This study aimed at assessing the sensitivity of both maximal lactate steady state (MLSS) and critical power (CP) in populations of different aerobic training status to ascertain whether CP is as sensitive as MLSS to a change in aerobic fitness. Seven untrained subjects (UT) (maximal oxygen uptake = 37.4 ± 6.5 mL·kg–1·min–1) and 7 endurance cyclists (T) (maximal oxygen uptake = 62.4 ± 5.2 mL·kg–1·min–1) performed an incremental test for maximal oxygen uptake estimation and several constant work rate tests for MLSS and CP determination. MLSS, whether expressed in mL·kg–1·min–1 (T: 51.8 ± 5.7 vs. UT: 29.0 ± 6.1) or % maximal oxygen uptake (T: 83.1 ± 6.8 vs. UT: 77.1 ± 4.5), was significantly higher in the T group. CP expressed in mL·kg–1·min–1 (T: 56.8 ± 5.1 vs. UT: 33.1 ± 6.3) was significantly higher in the T group as well but no difference was found when expressed in % maximal oxygen uptake (T: 91.1 ± 4.8 vs. UT: 88.3 ± 3.6). Whether expressed in absolute or relative values, MLSS is sensitive to aerobic training status and a good measure of aerobic endurance. Conversely, the improvement in CP with years of training is proportional to those of maximal oxygen uptake. Thus, CP might be less sensitive than MLSS for depicting an enhancement in aerobic fitness.
Systematic review of sedentary behaviour and health indicators in the early years (aged 0–4 years)
Authors: LeBlanc Allana G. , Spence John C. , Carson Valerie , Connor Gorber Sarah , Dillman Carrie , Janssen Ian , Kho Michelle E. , Stearns Jodie A. , Timmons Brian W. , Tremblay Mark S.
Published: July 2012

Accumulating evidence suggests that young children spend excessive time being sedentary. The purpose of this systematic review was to determine the relationship between sedentary behaviours and health indicators during the early years (ages 0–4 years). Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework, this review aimed to present the best available evidence on the threshold of sedentary behaviour associated with healthy measures of adiposity, bone health, motor skill development, psychosocial health, cognitive development, and cardiometabolic health indicators in infants, toddlers, and preschoolers. Online databases, personal libraries, and government documents were searched for relevant studies. Studies that included an intervention (or experimental) group or prospective analysis were included. Twenty-one unique studies, representing 23 papers and 22 417 participants, met inclusion criteria; 7 studies included information on infants, 13 on toddlers, and 10 on preschoolers. Of these, 11, 6, and 8 studies reported data on adiposity, psychosocial health, and cognitive development, respectively. No included study reported on motor skill development, bone, or cardiometabolic health indicators. In conclusion, this review found low- to moderate-quality evidence to suggest that increased television viewing is associated with unfavourable measures of adiposity and decreased scores on measures of psychosocial health and cognitive development. No evidence existed to indicate that television viewing is beneficial for improving psychosocial health or cognitive development. In several instances a dose–response relationship was evident between increased time spent watching television and decreased psychosocial health or cognitive development. This work may be used as evidence to inform public health guidelines. (PROSPERO registration: CRD4011001280.)
Cell-to-cell contact dependence and junctional protein content are correlated with in vivo maturation of pancreatic beta cells
Authors: Santos-Silva Junia Carolina , Carvalho Carolina Prado de França , de Oliveira Ricardo Beltrame , Boschero Antonio Carlos , Collares-Buzato Carla Beatriz
Published: July 2012

In this study, we investigated the cellular distribution of junctional proteins and the dependence on cell–cell contacts of pancreatic beta cells during animal development. Fetus and newborn rat islets, which display a relatively poor insulin secretory response to glucose, present an immature morphology and cytoarchitecture when compared with young and adult islets that are responsive to glucose. At the perinatal stage, beta cells display a low junctional content of neural cell adhesion molecule (N-CAM), α- and β-catenins, ZO-1, and F-actin, while a differential distribution of N-CAM and Pan-cadherin was seen in beta cells and nonbeta cells only from young and adult islets. In the absence of intercellular contacts, the glucose-stimulated insulin secretion was completely blocked in adult beta cells, but after reaggregation they partially reestablished the secretory response to glucose. By contrast, neonatal beta cells were poorly responsive to sugar, regardless of whether they were arranged as intact islets or as isolated cells. Interestingly, after 10 days of culturing, neonatal beta cells, known to display increased junctional protein content in vitro, became responsive to glucose and concomitantly dependent on cell–cell contacts. Therefore, our data suggest that the developmental acquisition of an adult-like insulin secretory pattern is paralleled by a dependence on direct cell–cell interactions.
Mepivacaine-induced contraction is attenuated by endothelial nitric oxide release in isolated rat aorta
Authors: Sung Hui-Jin , Choi Mun-Jeoung , Ok Seong-Ho , Lee Soo Hee , Hwang Il Jeong , Kim Hee Sook , Chang Ki Churl , Shin Il-Woo , Lee Heon-Keun , Park Kyeong-Eon , Chung Young-Kyun , Sohn Ju-Tae
Published: July 2012

Mepivacaine is an aminoamide-linked local anesthetic with an intermediate duration that intrinsically produces vasoconstriction both in vivo and in vitro. The aims of this in-vitro study were to examine the direct effect of mepivacaine in isolated rat aortic rings and to determine the associated cellular mechanism with a particular focus on endothelium-derived vasodilators, which modulate vascular tone. In the aortic rings with or without endothelium, cumulative mepivacaine concentration–response curves were generated in the presence or absence of the following antagonists: Nω-nitro-l-arginine methyl ester [l-NAME], indomethacin, fluconazole, methylene blue, 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one [ODQ], verapamil, and calcium-free Krebs solution. Mepivacaine produced vasoconstriction at low concentrations (1 × 10−3 and 3 × 10−3 mol/L) followed by vasodilation at a high concentration (1 × 10−2 mol/L). The mepivacaine-induced contraction was higher in endothelium-denuded aortae than in endothelium-intact aortae. Pretreatment with l-NAME, ODQ, and methylene blue enhanced mepivacaine-induced contraction in the endothelium-intact rings, whereas fluconazole had no effect. Indomethacin slightly attenuated mepivacaine-induced contraction, whereas verapamil and calcium-free Krebs solution more strongly attenuated this contraction. The vasoconstriction induced by mepivacaine is attenuated mainly by the endothelial nitric oxide – cyclic guanosine monophosphate pathway. In addition, mepivacaine-induced contraction involves cyclooxygenase pathway activation and extracellular calcium influx via voltage-operated calcium channels.
Activation of Ca2+-activated Cl–channels by store-operated Ca2+entry in arterial smooth muscle cells does not require reverse-mode Na+/Ca2+exchange
Authors: Angermann Jeff E. , Forrest Abigail S. , Greenwood Iain A. , Leblanc Normand
Published: July 2012

The main purpose of this study was to characterize the stimulation of Ca2+-activated Cl–(ClCa) by store-operated Ca2+entry (SOCE) channels in rabbit pulmonary arterial smooth muscle cells (PASMCs) and determine if this process requires reverse-mode Na+/Ca2+exchange (NCX). In whole-cell voltage clamped PASMCs incubated with 1 μmol/L nifedipine (Nif) to inhibit Ca2+channels, 30 μmol/L cyclopiazonic acid (CPA), a SERCA pump inhibitor, activated a nonselective cation conductance permeable to Na+(ISOC) during an initial 1–3 s step, ranging from–120 to +60 mV, and Ca2+-activated Cl–current (ICl(Ca)) during a second step to +90 mV that increased with the level of the preceding hyperpolarizing step. Niflumic acid (100 μmol/L), a ClCachannel blocker, abolished ICl(Ca)but had no effect on ISOC, whereas the ISOCblocker SKF-96365 (50 μmol/L) suppressed both currents. Dual patch clamp and Fluo-4 fluorescence measurements revealed the appearance of CPA-induced Ca2+transients of increasing magnitude with increasing hyperpolarizing steps, which correlated with ICl(Ca)amplitude. The absence of Ca2+transients at positive potentials following a hyperpolarizing step combined with the observation that SOCE-stimulated ICl(Ca)was unaffected by the NCX blocker KB-R7943 (1 μmol/L) suggest that the SOCE/ClCainteraction does not require reverse-mode NCX in our conditions.
Effect of phosphatidylinositol 3-kinase-γ inhibitor CAY10505 in hypertension, and its associated vascular endothelium dysfunction in rats
Authors: Tyagi Sandeep , Sharma Saurabh , Budhiraja Ramji Dass
Published: July 2012

This study has been designed to investigate the role of phosphatidyl-inositol 3-kinase-γ (PI3Kγ) in deoxycorticosterone acetate salt (DOCA) hypertension induced vascular endothelium dysfunction. Wistar rats were uninephrectomised and DOCA (40 mg·(kg body mass)−1, subcutaneous injection) was administered twice weekly for 6 weeks to produce hypertension. Rats with mean arterial blood pressure ≥ 140 mm Hg (1 mm Hg = 133.322 Pa) were selected as hypertensive. Vascular endothelium dysfunction was assessed in terms of attenuation of acetylcholine-induced endothelium-dependent relaxation (isolated aortic ring preparation), decrease in serum nitrate and (or) nitrite level, as well as reduced level of glutathione and disruption of integrity of vascular endothelium (histopathology). Five weeks of DOCA administration were followed by 7 days of daily administration of PI3Kγ inhibitor (5-[[5-(4-fluorophenyl)-2-furanyl]methylene]-2,4-thiazolidinedione (CAY10505), 0.6 mg·kg−1, per os (p.o.)), atorvastatin (30 mg·kg−1, p.o.), and losartan (25 mg·kg−1, p.o.) (positive control of hypertension), which significantly improved acetylcholine-induced endothelium dependent relaxation, serum nitrate and (or) nitrite level, glutathione level, and the vascular endothelial lining in hypertensive rats.Therefore, it may be concluded that CAY10505, a specific inhibitor of PI3Kγ, improves hypertension-associated vascular endothelial dysfunction. Thus, inhibition of PI3Kγ might be a useful approach in the therapeutics of vascular endothelium dysfunction.
Effects of an aqueous extract of North American ginseng on MOG(35–55)-induced EAE in mice
Authors: Bowie Laura E. , Roscoe Wendi A. , Lui Ed M.K. , Smith Robin , Karlik Stephen J.
Published: July 2012

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system, in which the release of reactive oxygen species by infiltrating immune cells contributes to demyelination. American ginseng ( Panax quinquefolius ) is a natural health product with numerous beneficial properties, including anti-inflammatory and anti-oxidant effects. The purpose of this study was to determine whether ginseng could influence the course of the disease experimental autoimmune encephalomyelitis (EAE), an animal model of MS. C57BL/6J mice were immunized with MOG(35–55) peptide to induce EAE. After clinical disease appeared, mice received either oral doses of an aqueous extract of ginseng (150 mg/kg body mass), or the vehicle. Clinical symptoms were recorded, and spinal cord tissue samples were analyzed for pathological signs of disease. The aqueous extract of ginseng significantly decreased (i) clinical signs of EAE, (ii) levels of circulating TNF-α, and (iii) central nervous system immunoreactive iNOS and demyelination scores, without a change in other neuropathological measures. This study shows that an aqueous extract of ginseng may be able to attenuate certain signs of EAE, suggesting that it may be a useful adjuvant therapy for MS.
Bone morphogenetic protein 7 polarizes THP-1 cells into M2 macrophages
Authors: Rocher Crystal , Singla Reetu , Singal Pawan K. , Parthasarathy Sampath , Singla Dinender K.
Published: July 2012

It was hypothesized that monocyte treatment with bone morphogenetic protein 7 (BMP7) would significantly enhance monocyte polarization into M2 macrophages as well as increasing the levels of anti-inflammatory cytokines. In a cell culture system using monocytes (human acute monocytic leukemia cell line THP-1), we studied the effects of BMP7 on monocytes polarizing into M2 macrophages. The data demonstrate that THP-1 cells contain a BMP type II receptor (BMPR2), and that its activation is significantly (p < 0.05) increased following treatment with BMP7. Furthermore, there was an increase of M2 macrophages, BMPR2, and anti-inflammatory cytokines interleukin (IL)-10 and IL-1ra compared with the respective controls. Moreover, treatment with BMP7 caused a significant (p < 0.05) decrease in the levels of pro-inflammatory cytokines IL-6, tumour necrosis factor (TNF-α), and monocyte chemotactic protein-1 (MCP-1), compared with the controls. In conclusion, we suggest for the first time that BMP7 has a unique potential to polarize monocytes into M2 macrophages, required for tissue repair, which will have significant applications for the treatment of atherosclerosis.
FRACTAL MODEL OF FISSION PRODUCT RELEASE IN NUCLEAR FUEL
Authors: STANKUNAS GEDIMINAS
Published: July 2012

A model of fission gas migration in nuclear fuel pellet is proposed. Diffusion process of fission gas in granular structure of nuclear fuel with presence of inter-granular bubbles in the fuel matrix is simulated by fractional diffusion model. The Grunwald–Letnikov derivative parameter characterizes the influence of porous fuel matrix on the diffusion process of fission gas. A finite-difference method for solving fractional diffusion equations is considered. Numerical solution of diffusion equation shows correlation of fission gas release and Grunwald–Letnikov derivative parameter. Calculated profile of fission gas concentration distribution is similar to that obtained in the experimental studies. Diffusion of fission gas is modeled for real RBMK-1500 fuel operation conditions. A functional dependence of Grunwald–Letnikov derivative parameter with fuel burn-up is established.
EMINENT PAPER SERIES — WHY DO INVENTORIES RISE WHEN DEMAND FALLS IN HOUSING AND OTHER MARKETS?
Authors: LAZEAR EDWARD P.
Published: July 2012

Inventories and price changes are correlated. The inverse relation is most obvious in housing where inventories build in low-demand markets and shrink in high-demand markets. This is a puzzle. Symmetry of information among buyers and sellers would seem to imply that sellers would change their reservation value by the amount that buyers change their offers. Because there is heterogeneity among buyers in the valuation of a given house, sellers set prices strategically. When demand falls, sellers rationally lower their prices, but not by enough to keep the probability of sale constant. As a result, inventories grow.
FINANCIAL STRESS IN ASEAN-5 ECONOMIES FROM THE ASIAN CRISIS TO THE GLOBAL CRISIS
Authors: TNG BOON HWA , KWEK KIAN TENG , SHENG ANDREW
Published: July 2012

We construct four market-specific Financial Stress Indices (FSIs) and overall FSIs for the ASEAN-5 economies from 1997 to 2009. Using the FSIs, we establish stylized features of financial stress and characterize the connectivity of financial markets. The results show that stress was most severe during the Asian Crisis, followed by the Tech Burst and the recent Global Crisis. Principal component analysis (PCA) demonstrates that regional connectivity is strongest in equity markets, implying their predominant role in the transmission of stress within the region. Meanwhile, Singapore possesses the lowest connectivity within the ASEAN cluster, but the highest to international markets.
MULTIPLE SOLITON SOLUTIONS FOR THREE SYSTEMS OF BROER–KAUP–KUPERSHMIDT EQUATIONS DESCRIBING NONLINEAR AND DISPERSIVE LONG GRAVITY WAVES
Authors: WAZWAZ ABDUL MAJID
Published: July 2012

Three systems of Broer–Kaup–Kupershmidt (BKK) equations, that describe nonlinear and dispersive long gravity waves, are investigated. The simplified form of the Hirota's bilinear method is employed for a reliable treatment of these three systems. Multiple soliton solutions are formally derived for each system.
KNOTTED 2-SPHERES IN TUBES IN Z4
Authors: SOTEROS C. E. , SUMNERS D. W. , WHITTINGTON S. G.
Published: July 2012

We prove a pattern theorem for 2-spheres in tubes in Z4and use this to prove that all except exponentially few 2-spheres in a tube in Z4are knotted. We sketch how the argument can be applied to prove the same result for p-spheres in a tube in Zp+2, p > 2.
A LOCAL VARIATIONAL PRINCIPLE FOR RANDOM BUNDLE TRANSFORMATIONS
Authors: MA XIANFENG , CHEN ERCAI
Published: July 2012

We introduce local topological entropy [Formula: see text] and two kinds of local measure-theoretic entropy [Formula: see text] and [Formula: see text] for random bundle transformations. We derive a variational inequality of random local entropy for [Formula: see text]. As an application of such relation we prove a local variational principle in random dynamical system.
CONE STRUCTURE OF L2-WASSERSTEIN SPACES
Authors: TAKATSU ASUKA , YOKOTA TAKUMI
Published: July 2012

The aim of this paper is to obtain a better understanding of the geometric structure of quadratic Wasserstein spaces over separable Hilbert spaces. For this sake, we focus on their cone and product structures, and prove that the quadratic Wasserstein space over any separable Hilbert space has a cone structure and splits the underlying space isometrically but no more than that. These are shown in more general settings, and one of our main results is that the quadratic Wasserstein space over a Polish space has a cone structure if and only if so does the underlying space.
Propagation of Computer Virus under Human Intervention: A Dynamical Model
Authors: Gan Chenquan , Yang Xiaofan , Liu Wanping , Zhu Qingyi , Zhang Xulong
Published: July 2012

This paper examines the propagation behavior of computer virus under human intervention. A dynamical model describing the spread of computer virus, under which a susceptible computer can become recovered directly and an infected computer can become susceptible directly, is proposed. Through a qualitative analysis of this model, it is found that the virus‐free equilibrium is globally asymptotically stable when the basic reproduction number R0 ≤ 1, whereas the viral equilibrium is globally asymptotically stable if R0 > 1. Based on these results and a parameter analysis, some appropriate measures for eradicating the spread of computer virus across the Internet are recommended.
The Development of Executive Function in Autism
Authors: Pellicano Elizabeth
Published: July 2012

Autism is a common and often highly debilitating neurodevelopmental condition, whose core behavioral features are believed to be rooted in disrupted neurocognitive processes, including especially “executive function.” Researchers have predominantly focused upon understanding the putative causal relationship between difficulties in EF and autistic symptomatology. This paper suggests, however, that the effects of individual differences in EF should be more far-reaching, playing a significant part in the real-life outcomes of individuals with autism, including their social competence, everyday adaptive behavior, and academic achievement. It further considers the nature of the EF-outcome relationship, including the possible determinants of individual differences in EF, and makes several recommendations for future research.