bluuebunny/crossref_metadata_2025 huggingface dataset:
NO-1886 suppresses diet-induced insulin resistance and cholesterol accumulation through STAT5-dependent upregulation of IGF1 and CYP7A1
Authors: Li Qinkai , Yin Weidong , Cai Manbo , Liu Yi , Hou Hongjie , Shen Qingyun , Zhang Chi , Xiao Junxia , Hu Xiaobo , Wu Qishisan , Funaki Makoto , Nakaya Yutaka
Published: October 2009

Insulin resistance and dyslipidemia are both considered to be risk factors for metabolic syndrome. Low levels of IGF1 are associated with insulin resistance. Elevation of low-density lipoprotein cholesterol (LDL-C) concomitant with depression of high-density lipoprotein cholesterol (HDL-C) increase the risk of obesity and type 2 diabetes mellitus (T2DM). Liver secretes IGF1 and catabolizes cholesterol regulated by the rate-limiting enzyme of bile acid synthesis from cholesterol 7α-hydroxylase (CYP7A1). NO-1886, a chemically synthesized lipoprotein lipase activator, suppresses diet-induced insulin resistance with the improvement of HDL-C. The goal of the present study is to evaluate whether NO-1886 upregulates IGF1 and CYP7A1 to benefit glucose and cholesterol metabolism. By using human hepatoma cell lines (HepG2 cells) as an in vitro model, we found that NO-1886 promoted IGF1 secretion and CYP7A1 expression through the activation of signal transducer and activator of transcription 5 (STAT5). Pretreatment of cells with AG 490, the inhibitor of STAT pathway, completely abolished NO-1886-induced IGF1 secretion and CYP7A1 expression. Studies performed in Chinese Bama minipigs pointed out an augmentation of plasma IGF1 elicited by a single dose administration of NO-1886. Long-term supplementation with NO-1886 recovered hyperinsulinemia and low plasma levels of IGF1 suppressed LDL-C and facilitated reverse cholesterol transport by decreasing hepatic cholesterol accumulation through increasing CYP7A1 expression in high-fat/high-sucrose/high-cholesterol diet minipigs. These findings indicate that NO-1886 upregulates IGF1 secretion and CYP7A1 expression to improve insulin resistance and hepatic cholesterol accumulation, which may represent an alternative therapeutic avenue of NO-1886 for T2DM and metabolic syndrome.
Catch-up growth after dexamethasone withdrawal occurs in cultured postnatal rat metatarsal bones
Authors: Chagin Andrei S , Karimian Elham , Sundström Katja , Eriksson Emma , Sävendahl Lars
Published: October 2009

Children exposed to systemic glucocorticoids often exhibit growth retardation and after the cessation of therapy catch-up growth occurs in many, but not all patients. The developmental regulation and underlying cellular mechanisms of catch-up growth are not fully understood. To clarify this issue, we established an in vitro model of catch-up growth. Here we present a protocol for the long-term culture (up to 160 days) of fetal (E20) as well as postnatal (P8) rat metatarsal bones which allowed us to characterize ex vivo the phenomenon of catch-up growth without any influence by systemic factors. The relevance of the model was confirmed by the demonstration that the growth of fetal and postnatal bones were stimulated by IGF1 (100 ng/ml) and inhibited by dexamethasone (Dexa; 1 μM). We found that the capacity to undergo catch-up growth was restricted to postnatal bones. Catch-up growth occurred after postnatal bones had been exposed to Dexa for 7 or 12 days but not after a more prolonged exposure (19 days). Incomplete catch-up growth resulted in compromised bone length when assessed at the end of the 4-month period of culture. While exposure to Dexa was associated with decreased chondrocyte proliferation and differentiation, catch-up growth was only associated with increased cell proliferation. We conclude that the phenomenon of catch-up growth after Dexa treatment is intrinsic to the growth plate and primarily mediated by an upregulation of chondrocyte proliferation.
Hormesis Against Aging and Diseases: Using Properties of Biological Adaptation for Health and Survival Improvement
Authors: Yashin A. I.
Published: October 2009

The idea of using hormesis for postponing aging and improving human health has been recently discussed in scientific literature. This paper shows that redundancy in renewal capacity, some portion of which become activated and manifested in hormesis effects, may originate as a result of interaction between living organisms and their environment. It is shown that such redundancy may normally exist for organisms in the wild, and not only in domesticated and laboratory animals. Further development of the hormesis idea requires: (i) investigating regularities of response to multiple stimuli; (ii) studying slow-time responses (e.g., physiological adaptation) to repeated stimuli; (iii) studying connection between slow and fast (e.g., developing at the cellular and sub-cellular levels) stress responses; (iv) translating knowledge accumulated in studies of animal model systems to humans; (v) evaluating unrealized potential for improving health and longevity using hormetic mechanisms. The use of mathematical and computer modeling for translating experimental knowledge about hormesis effects to humans, as well as connection between studying hormetic mechanisms and analyses of the age trajectories of physiological and biological indices affecting U-shapes curves of morbidity-mortality risks using longitudinal data on aging, health, and longevity are discussed.
Infants Born Preterm Exhibit Different Patterns of Center-of-Pressure Movement Than Infants Born at Full Term
Authors: Dusing Stacey C. , Kyvelidou Anastasia , Mercer Vicki S. , Stergiou Nick
Published: October 2009

Background

Infants born preterm are at risk for developmental impairments related to postural control.

Objective

The purpose of this study was to determine whether infants born preterm and infants born at full term differed in postural control at 1 to 3 weeks after term age.

Design

This study included 17 infants born preterm (mean gestational age=31.9 weeks, range=25.0–34.6) and 15 infants born at full term (mean gestational age=38.9 weeks, range=37.3–40.6). All infants were without diagnosed neurological or genetic conditions.

Measurement

Center-of-pressure (COP) data were recorded at 5 Hz while each infant was positioned supine on a pressure-sensitive mat in an alert behavioral state. Root mean square (RMS) displacement and approximate entropy (ApEn) were used to describe the COP movement variability in the time series. Differences between groups were identified using independent t tests.

Results

The COP time series were found to be deterministic, suggesting order in the time series. Infants born preterm exhibited significantly larger RMS values in the caudal-cephalic direction than infants born at full term (1.11 and 0.83 cm, respectively; t=−2.6, df=30, P=.01). However, infants born at full term had significantly larger ApEn values in the caudal-cephalic direction (1.19 and 1.11, respectively; t=2.4, df=30, P=.02). The 2 groups did not differ in RMS or ApEn values in the medial-lateral direction or the resultant.

Conclusions

Infants born at full term exhibited COP displacements in the caudal-cephalic direction that were smaller in amplitude, but may be considered more complex or less predictable, than those of infants born preterm. One explanation is that infants born preterm exhibited more stereotypic patterns of movement, resulting in large, but repetitive, COP excursions. A combination of linear and nonlinear measures may provide insight into the control of posture of young infants.
Social and Community Participation of Children and Youth With Cerebral Palsy Is Associated With Age and Gross Motor Function Classification
Authors: Palisano Robert J. , Kang Lin-Ju , Chiarello Lisa A. , Orlin Margo , Oeffinger Donna , Maggs Jill
Published: October 2009

Background

Through social and community participation, children and youth with cerebral palsy (CP) form friendships, gain knowledge, learn skills, express creativity, and determine meaning and purpose in life.

Objective

The purposes of this study were: (1) to determine whether social and community participation of children and youth with CP differ based on age, sex, and gross motor function, and (2) to identify the types of activities in which social and community participation are highest.

Design and Methods

A prospective cross-sectional analytic design was used. The participants were a sample of convenience of 291 children (6–12 years of age) and 209 youth (13–21 years of age) with CP (55.4% males, 44.6% females) receiving services from 7 children's hospitals. Participants completed the Children's Assessment of Participation and Enjoyment (CAPE) by structured interview. Gross Motor Function Classification System (GMFCS) level was determined by the researchers.

Results

Youth did a higher percentage of activities with friends and others and outside the home than children. Children and youth in level I did a higher percentage of activities with friends and others compared with children and youth in levels II and III and in levels IV and V. Children and youth in level I and in levels IV and V did a higher percentage of activities outside the home than children and youth in levels II and III. Differences were not found between females and males. The percentage of activities done with friends and others and outside the home was highest for physical and skill-based activities.

Limitations

Findings cannot be attributed only to GMFCS level.

Conclusions

The ability to walk without restrictions is desirable for social and community participation. For children and youth with CP who have limitations in mobility, physical therapists have roles as consultants for accessibility, activity accommodations, and assistive technology and as advocates for inclusive environments.
Turkish Delightin Vienna: Art, Islam, and European Public Culture
Authors: Göle Nilüfer
Published: October 2009

This article focuses on the ways in which the European aesthetic realm becomes a battleground of intercultural and intercivilizational conflicts as well as a domain of borrowings and mixings between “native” and “Islamic” values, thereby creating a transnational public sphere. Through a two-way interpretation of a controversial statue depicting a naked woman with headscarf, entitled Turkish Delight and exhibited in a public garden in front of the Kunsthalle Museum in Vienna in 2007 before it was wrenched from its pedestal and left lying on the ground, the author examines how the artistic scene as an interactive space between art and politics, between cultures and publics, participates in the elaboration of a bond between Muslims and Europeans, a bond not without elements of confrontation and violence. It is argued that while the statue violates the intimacy and piety of a Muslim woman by exposing her nakedness to the public gaze, it also seeks ways to relate to the familiar other, Turkish migrants in Europe, albeit in a provocative manner. The purpose of this analysis is to demonstrate how the public space is not fixed once and for all but is always being recreated anew and inhabited through performativity, conflict and confrontation.
Class Struggle and Displacement: Slavoj Žižek and Film Theory
Authors: Flisfeder Matthew
Published: October 2009

In the following, I argue against cognitivist film scholars, such as David Bordwell and Noël Carroll, for the relevance of Slavoj Žižek in the field of film criticism and theory. I argue that Žižek's work presents a wholly new mode of criticism which focuses on the ideological displacement of class struggle in cinema. Class struggle, according to Žižek, represents the social Real, in the Lacanian sense. By focusing on the Lacanian Real, as opposed to the Imaginary or the Symbolic, Žižek accomplishes what early film theorists were only too eager (but unable) to develop: a psychoanalytic theory of film. However, rather than focus on film spectatorship, I claim that Žižek's work is useful in critiquing the content of films. The focus, here, begins with an examination of early film theory and the critique thereof by cognitivist film scholars. Žižek's exegetic use of films is then examined before considering the concept of the Real in psychoanalysis. After considering the function of the Real in political analysis, I conclude by looking at the displacement of class struggle as the social Real in films.
A unique experiment in neurological surgery: intracerebral injection of antitoxin for tetanus
Authors: Patel Neal B. , Pendleton Courtney , Quiñones-Hinojosa Alfredo , Cohen-Gadol Aaron A.
Published: October 2009

The discipline of neurological surgery was considered primarily “hopeless” and, at best, experimental in the late 19th century. Harvey Cushing's efforts during his initial uncharted voyage through the surgery of the human cranium were rudimentary and exploratory. A direct review of his available patient records from early in his career provides the opportunity to look back at Cushing as a physician-scientist, uncovering work that demonstrates that he was at the forefront of neurosurgical intervention in avenues that have been largely overlooked. The authors present Cushing's notes pertaining to a case of tetanus. This case represents the intersection of neurosurgery and tetanus treatment in Dr. Cushing's intracerebral injection of antitoxin to treat generalized tetanus.
Intraoperative computed tomography angiography with computed tomography perfusion imaging in vascular neurosurgery: feasibility of a new concept
Authors: Schichor Christian , Rachinger Walter , Morhard Dominik , Zausinger Stefan , Heigl Thomas J. , Reiser Maximilian , Tonn Jörg-Christian
Published: October 2009

Object

In vascular neurosurgery, there is a demand for intraoperative imaging of blood vessels as well as for rapid information about critical impairment of brain perfusion. This study was conducted to analyze the feasibility of intraoperative CT angiography and brain perfusion mapping using an up-to-date multislice CT scanner in a prospective pilot series.

Methods

Ten patients with unruptured aneurysms underwent intraoperative scanning with a 40-slice sliding-gantry CT scanner. Multimodal CT acquisition was obtained in 8 patients consisting of dynamic perfusion CT (PCT) scanning followed by intracranial CT angiography. Two of these patients underwent CT angiography and PCT 2 times in 1 session as a control after repositioning cerebral aneurysm clips. In another 2 patients, CT angiography was performed alone. The quality of all imaging obtained was assessed in a blinded consensus reading performed by an experienced neurosurgeon and an experienced neuroradiologist. A 6-point scoring system ranging from excellent to insufficient was used for quality evaluation of PCT and CT angiography.

Results

In 9 of 10 PCT data sets, the quality was rated excellent or good. In the remaining case, the quality was rated insufficient for diagnostic evaluation due to major streak artifacts induced by the titanium pins of the head clamp. In this particular case, the quality of the related CT angiography was rated good and sufficient for intraoperative decision making. The quality of all 12 CT angiography data sets was rated excellent or good. In 1 patient with an anterior communicating artery aneurysm, PCT scanning led to a repositioning of the clip because of an ischemic pattern of the perfusion parameter maps due to clip stenosis of an artery. The subsequent PCT scan obtained in this patient revealed an improved perfusion of the related vascular territory, and follow-up MR imaging showed only minor ischemia of the anterior cerebral artery territory.

Conclusions

Intraoperative CT angiography and PCT scanning were shown to be feasible with short acquisition time, little interference with the surgical workflow, and very good diagnostic imaging quality. Thus, these modalities might be very helpful in vascular neurosurgery. Having demonstrated their feasibility, the impact of these methods on patients' outcomes has now to be analyzed prospectively in a larger series.
A C-fiber–mediated neuropathic brachioradial pruritus
Authors: De Ridder Dirk , Hans Guy , Pals Philippe , Menovsky Tomas
Published: October 2009

A 56-year-old man presented to the outpatient clinic with a 3-year history of itch within the innervation territory of C-6 of the left arm. Sudden neck movements induced intermittent paresthesias in the same dermatome. No dermatological diseases, allergies, or trauma to the affected extremity or the spine or a history of familial pruritus were reported.

Neurological physical examination and electromyography revealed normal findings. Quantitative sensory testing demonstrated selective C-fiber dysfunction at C6–8 on the left, and cervical MR imaging revealed multilevel degenerative cervical spine pathology with neuroforaminal stenoses. Brachioradial neuropathic pruritus caused by cervical neuroforaminal stenosis was the final diagnosis. Treatment consisted of 2 cervical epidural steroid applications that resulted in clinical disappearance of the itch and improvement in C-fiber function on quantitative sensory testing.
A proposed classification system that projects outcomes based on preoperative variables for adult patients with glioblastoma multiforme
Authors: Chaichana Kaisorn , Parker Scott , Olivi Alessandro , Quiñones-Hinojosa Alfredo
Published: October 2009

Object

Glioblastoma multiforme (GBM) is the most common and aggressive type of primary brain tumor in adults. Although the average survival is ~ 12 months, individual survival is heterogeneous. The ability to predict short- and long-term survivors is limited. Therefore, the aims of this study were to ascertain preoperative risk factors associated with survival, develop a preoperative prognostic grading system, and evaluate the utility of this grading system in predicting survival for patients undergoing resection of a primary intracranial GBM.

Methods

Cases involving adult patients who underwent surgery for an intracranial primary (de novo) GBM between 1997 and 2007 at The Johns Hopkins Hospital, an academic tertiary-care institution, were retrospectively reviewed. Multivariate proportional hazards regression analysis was used to identify preoperative factors associated with survival, after controlling for extent of resection and adjuvant therapies. The identified associations with survival were then used to develop a grading system based on preoperative variables. Survival as a function of time was plotted using the Kaplan-Meier method, and survival rates were compared using Log-rank analysis. Associations with p < 0.05 were considered statistically significant.

Results

Of the 393 patients in this study, 310 (79%) had died as of most recent follow-up (median time from surgery to death 11.9 months). The preoperative factors, independent of extent of resection and adjuvant therapies (carmustine wafers, temozolomide, and radiation), found to be negatively associated with survival were: age > 60 years (p < 0.0001), Karnofsky performance status score ≤ 80 (p < 0.0001), motor deficit (p = 0.02), language deficit (p = 0.001), and periventricular tumor location (p = 0.04). Patients possessing 0–1, 2, 3, and 4–5 of these variables were assigned a preoperative grade of 1, 2, 3, and 4, respectively. Patients with a preoperative grade of 1, 2, 3, and 4 had a median survival of 16.6, 10.2, 6.8, and 6.1 months, respectively.

Conclusions

The present study found that older age, poor performance status, motor deficit, language deficit, and periventricular tumor location independently predicted poorer survival in patients undergoing GBM resection. A grading system based on these factors was able to identify 4 distinct groups of patients with different survival rates. This grading system, based only on preoperative variables, may provide patients and physicians with prognostic information that may guide medical and surgical therapy before any intervention is pursued.
Mechanical characteristics and surface elemental composition of a Yasargil titanium aneurysm clip after long-term implantation
Authors: Otawara Yasunari , Ogasawara Kuniaki , Kashimura Hiroshi , Kubo Yoshitaka , Ogawa Akira , Watanabe Kouichi
Published: October 2009

The mechanical properties of titanium-alloy aneurysm clips after long-term implantation in the human cranium are unclear. The characteristics of a Yasargil titanium aneurysm clip were evaluated after long-term implantation for 12 years in a patient with a cerebral aneurysm. The closing forces of the retrieved clip before and after implantation were approximately equal. The bending test showed no differences between the retrieved and control clips. Titanium oxide and calcium were identified on the surface of the retrieved clip, which indicated the formation of corrosion-resistant layers. Titanium-alloy clips retain their mechanical properties in the human cranium for a long time.
Delayed administration of erythropoietin reducing hippocampal cell loss, enhancing angiogenesis and neurogenesis, and improving functional outcome following traumatic brain injury in rats: comparison of treatment with single and triple dose
Authors: Xiong Ye , Mahmood Asim , Meng Yuling , Zhang Yanlu , Qu Changsheng , Schallert Timothy , Chopp Michael
Published: October 2009

Object

This efficacy study was designed to investigate traumatic brain injury (TBI) in rats treated with delayed erythropoietin (EPO) administered in a single dose compared with a triple dose.

Methods

Young adult male Wistar rats were randomly divided into the following groups: 1) sham group (6 animals); 2) TBI/saline group (6 animals); 3) TBI/EPO×1 group (6 animals); and 4) TBI/EPO×3 group (7 animals). Traumatic brain injury was induced by controlled cortical impact over the left parietal cortex. Erythropoietin (5000 U/kg) or saline was administered intraperitoneally on Day 1 (EPO×1 group) or on Days 1, 2, and 3 (EPO×3 group) postinjury. Neurological function was assessed using a modified neurological severity score, foot-fault, and Morris water maze tests. Animals were killed 35 days after injury and brain sections were stained for immunohistochemistry.

Results

Compared with the saline treatment, EPO treatment in both the EPO×1 and EPO×3 groups significantly reduced hippocampal cell loss, enhanced angiogenesis and neurogenesis in the injured cortex and hippocampus, and significantly improved neurological functional outcome. The EPO×3 group exhibited significantly improved functional and histological outcomes compared with the EPO×1 group.

Conclusions

These data demonstrate that delayed posttraumatic administration of EPO significantly improved histological and long-term functional outcomes in rats after TBI. The triple doses of delayed EPO treatment produced better histological and functional outcomes in rats, although a single dose provided substantial benefits compared with saline treatment.
Sustainability: Environmental Studies and Public Health
Authors: Scholz Miklas
Published: October 2009

This special issue ‘Sustainability: Environmental Studies and Public Health’ is part of the internationally leading 'International Journal of Environmental Research and Public Health’. I was invited to be the guest editor, and to oversee the refereeing process and subsequent selection of timely, relevant and high quality papers highlighting particularly novel aspects concerned with sustainability issues in environmental studies. [...]
(S*)-2,7,8-Trihydroxychroman-4-one
Authors: Cheng Ming-Jen , Lo Wen-Li , Yeh Hung-Chun , Chen Chung-Yi
Published: October 2009

Reticumanone (1), a new chromanone, isolated from the leaves of Cinnamomum reticulatum Hay (Lauraceae), has been characterized as (S*)-2,7,8-trihydroxychroman-4-one, by means of spectroscopic methods.
3,6-Bis(5’-bromo-3’-indolyl)-1,4-dimethypiperazine-2,5-dione
Authors: Crooke Stephen , Davis-McGibony Michele , Whitlock Christine
Published: October 2009

The one-pot synthesis of 3,6-bis(5’-bromo-3’-indolyl)-1,4-dimethylpiperazine- 2,5-dione is reported. Sarcosine anhydride is brominated and immediately reacted with 5-bromoindole to produce the product, which is characterized by 1H NMR, MS and microanalysis.
An Efficient Method for the N-Bromosuccinimide Catalyzed Synthesis of Indolyl-Nitroalkanes
Authors: Kuo Chun-Wei , Wang Chun-Chao , Fang Hu-Lin , Raju B. Rama , Kavala Veerababurao , Habib Pateliya Mujjamil , Yao Ching-Fa
Published: October 2009

An efficient and practical method for the synthesis of indolyl-nitroalkane derivatives catalyzed by N-bromosuccinimide is described. The generality of this method was demonstrated by synthesizing an array of diverse 3-substituted indole derivatives by the reaction of different β-nitrostyrenes with various substituted indoles. Simple reaction conditions accompanied by good yields of indolyl-nitroalkanes are the merits of this methodology.
Evaluation of Antioxidant and Antibacterial Activities of Aqueous, Methanolic and Alkaloid Extracts from Mitragyna Speciosa (Rubiaceae Family) Leaves
Authors: Parthasarathy Suhanya , Bin Azizi Juzaili , Ramanathan Surash , Ismail Sabariah , Sasidharan Sreenivasan , Said Mohd I.  Mohd. , Mansor Sharif  Mahsufi
Published: October 2009

Studies on the antioxidant and antimicrobial activities of Mitragyna speciosa leaf extracts are lacking. In this study the antioxidant properties of water, methanolic and alkaloid M. speciosa leaf extracts were evaluated using the DPPH (2,2-diphenyl-1- picrylhydrazyl) radical scavenging method. The amount of total phenolics and flavanoid contents were also estimated. The DPPH IC50 values of the aqueous, alkaloid and methanolic extracts were 213.4, 104.81 and 37.08 μg/mL, respectively. The total phenolic content of the aqueous, alkaloid and methanolic extracts were 66.0 mg, 88.4, 105.6 mg GAE/g, respectively, while the total flavanoid were 28.2, 20.0 and 91.1 mg CAE/g respectively. The antioxidant activities were correlated with the total phenolic content. This result suggests that the relatively high antioxidant activity of the methanolic extract compared to aqueous and alkaloid extract could be possibly be due to its high phenolic content. The aqueous, alkaloid and methanolic extracts were screened for antimicrobial activity. The extracts showed antimicrobial activity against Salmonella typhi and Bacillus subtilis. The minimum inhibitory concentrations (MICs) of extracts determined by the broth dilution method ranged from 3.12 to 6.25 mg/mL. The alkaloid extract was found to be most effective against all of the tested organisms.
Coupled Atmosphere‐Wildland Fire Modelling
Authors: Baptiste Filippi Jean , Bosseur Frédéric , Mari Céline , Lac Christine , Le Moigne Patrick , Cuenot Bénédicte , Veynante Denis , Cariolle Daniel , Balbi Jacques‐Henri
Published: October 2009

Simulating the interaction between fire and atmosphere is critical to the estimation of the rate of spread of the fire. Wildfire's convection (i.e., entire plume) can modify the local meteorology throughout the atmospheric boundary layer and consequently affect the fire propagation speed and behaviour. In this study, we use for the first time the Méso‐NH meso‐scale numerical model coupled to the point functional ForeFire simplified physical front‐tracking wildfire model to investigate the differences introduced by the atmospheric feedback in propagation speed and behaviour. Both numerical models have been developed as research tools for operational models and are currently used to forecast localized extreme events. These models have been selected because they can be run coupled and support decisions in wildfire management in France and Europe. The main originalities of this combination reside in the fact that Méso‐NH is run in a Large Eddy Simulation (LES) configuration and that the rate of spread model used in ForeFire provides a physical formulation to take into account the effect of wind and slope. Simulations of typical experimental configurations show that the numerical atmospheric model is able to reproduce plausible convective effects of the heat produced by the fire. Numerical results are comparable to estimated values for fire‐induced winds and present behaviour similar to other existing numerical approaches.
Fibromyalgia Syndrome Module at OMERACT 9: Domain Construct
Authors: MEASE PHILIP , ARNOLD LESLEY M. , CHOY ERNEST H. , CLAUW DANIEL J. , CROFFORD LESLIE J. , GLASS JENNIFER M. , MARTIN SUSAN A. , MOREA JESSICA , SIMON LEE , STRAND C. VIBEKE , WILLIAMS DAVID A.
Published: October 2009

The objective of the module was to (1) establish a core domain set for fibromyalgia (FM) assessment in clinical trials and practice, (2) review outcome measure performance characteristics, (3) discuss development of a responder index for assessment of FM in clinical trials, (4) review objective markers, (5) review the domain of cognitive dysfunction, and (6) establish a research agenda for outcomes research. Presentations at the module included: (1) Results of univariate and multivariate analysis of 10 FM clinical trials of 4 drugs, mapping key domains identified in previous patient focus group: Delphi exercises and a clinician/researcher Delphi exercise, and breakout discussions to vote on possible essential domains and reliable measures; (2) Updates regarding outcome measure status; (3) Update on objective markers to measure FM disease state; and (4) Review of the issue of cognitive dysfunction (dyscognition) in FM. Consensus was reached as follows: (1) Greater than 70% of OMERACT participants agreed that pain, tenderness, fatigue, patient global, multidimensional function and sleep disturbance domains should be measured in all FM clinical trials; dyscognition and depression should be measured in some trials; and stiffness, anxiety, functional imaging, and cerebrospinal fluid biomarkers were identified as domains of research interest. (2) FM domain outcome measures have generally proven to be reliable, discriminative, and feasible. More sophisticated and comprehensive measures are in development, as is a responder index for FM. (3) Increasing numbers of objective markers are being developed for FM assessment. (4) Cognitive dysfunction assessment by self-assessed and applied outcome measures is being developed. In conclusion, a multidimensional symptom core set is proposed for evaluation of FM in clinical trials. Research on improved measures of single domains and composite measures is ongoing.
Measures of Response in Clinical Trials of Systemic Sclerosis: The Combined Response Index for Systemic Sclerosis (CRISS) and Outcome Measures in Pulmonary Arterial Hypertension Related to Systemic Sclerosis (EPOSS)
Authors: KHANNA DINESH , DISTLER OLIVER , AVOUAC JEROME , BEHRENS FRANK , CLEMENTS PHILIP J. , DENTON CHRISTOPHER , FOELDVARI IVAN , GIANNINI EDWARD , HUSCHER DOERTE , KOWAL-BIELECKA OTYLIA , LOVELL DANIEL , MATUCCI-CERINIC MARCO , MAYES MAUREEN , MERKEL PETER A. , NASH PETER , OPITZ CHRISTIAN F. , PITTROW DAVID , RUBIN LEWIS , SEIBOLD JAMES R. , STEEN VIRGINIA , STRAND C. VIBEKE , TUGWELL PETER S. , VARGA JOHN , ZINK ANGELA , FURST DANIEL E.
Published: October 2009

There have been steady efforts to develop a combined response index for systemic sclerosis (CRISS). A parallel and equally successful effort has been made by an Expert Panel on Outcome Measures in PAH related to Systemic Sclerosis (EPOSS) to measure effect in treatment of pulmonary arterial hypertension of systemic sclerosis (PAH-SSc). CRISS conducted a Delphi process combined with expert review to identify 11 candidate domains for inclusion in a core set of outcomes for SSc clinical trials: soluble biomarkers, cardiac, digital ulcers, gastrointestinal, global health, health related quality of life (HRQOL) and function, musculoskeletal, pulmonary, Raynaud’s, renal, and skin. Tools within domains were also agreed upon. Concentrating on one aspect of disease, PAH, EPOSS also conducted a Delphi process and judged the following domains as the most appropriate for randomized controlled trials in PAH-SSc: lung vascular/pulmonary arterial pressure, cardiac function, exercise testing; severity of dyspnea, discontinuation of treatment; quality of life/activities of daily living; global state; and survival. Possible useful tools within each domain were also agreed on. Patient derived, physician derived, and objective measures of response will be included and combined with the idea that each reflects different aspects of PAH (EPOSS) and overall disease (CRISS) although this assumption may not prove true and can be separated if statistically and clinically valid to do so. In either case, prospective studies will require measurement of all domains, and tools are required and will be developed to define appropriate combined measures of response. CRISS and EPOSS are being developed through the OMERACT process. Through Delphi process and literature review significant progress has been made for both indices, and prospective data are being collected.
Comparison of diagnostic accuracy between USG and MRCP in biliary and pancreatic pathology
Authors: Bhatt C , Shah PS , Prajapati HJ , Modi J
Published: October 2009

OBJECTIVE :- To evaluate the diagnostic accuracy between USG & MRCP in the patients suspected of biliary and pancreatic pathology.
MATERIAL & METHODS : Fifty patients attending the hospital of all age groups and both sexes, suspected of biliary and pancreatic pathology, were examined first by USG and followed by MRCP, and findings were correlated with ERCP and biopsy report.
RESULTS :- Out of 50 patients 38 patients had biliary pathology and 12 patients had pancreatic pathology. Out of this, MRCP was 98 % accurate in diagnosis when results were compared in all cases. USG didn′t help in case of CBD stricture, in evaluating Pancreatic duct into Chronic pancreatitis and in lower end of CBD pathology.
CONCLUSION :- USG is the cheap and easily available modality so, it is the primary investigative modality for suspected patients of biliary and pancreatic pathology, but MRCP has high diagnostic value.
Role of ultrasonography and computed tomography in the evaluation of focal splenic lesions
Authors: Shetty CM , Lakhkar BN , Pereira NM , Koshy SM
Published: October 2009

OBJECTIVE: To study the role of ultrasonography and computed tomography in the evaluation of focal splenic lesions, to compare their diagnostic accuracies, to study the differential diagnosis of focal splenic lesions, to evaluate the imaging features of common lesions and to calculate the incidence of focal splenic involvement in lymphomas.
MATERIALS AND METHODS: A prospective study of 46 patients was undertaken in whom focal lesions in the spleen were detected on USG, CT or both. In all patients, USG was done and images were stored. Five mm thick contiguous sections were obtained from the spleen before and after injection of intravenous contrast material in the portovenous phase.
RESULTS: Of the focal splenic lesions 28 (60.8%) were benign and 18 (39.2%) were malignant. The spectrum of benign lesions included cysts (4), infarcts (10), abscesses (9) HIV+ve cases with focal hypodense splenic lesions (5) and a case of inflammatory pseudotumour. Malignant lesions included 6 cases each of Hodgkin′s and non-Hodgkin′s lymphoma and 6 cases of metastatic deposits in the spleen. Diagnostic accuracy of plain CT was 78.7%, of USG 87.2% and of CECT was 100%. Lesion detection was significantly improved by contrast enhancement. NHL, especially the high grade lymphomas presented with large nodular pattern of involvement of spleen whereas Hodgkin′s lymphoma presented in majority of cases with small nodular pattern of involvement. Imaging features of infarcts corresponded to the classic wedge shaped peripheral pattern in a majority,(80%) and were extensive with hilar sparing in 20%.
CONCLUSION: We concluded that contrast enhanced CT is the ideal modality for detection of focal splenic lesions, with USG being used mainly for follow up. The spectrum of differentials of focal splenic lesions in our study corresponded with reports in literature.
The Role of cardiac MRI in congenital heart disease
Authors: Sree Ram MN , Sreedhar CM , Alam A , Indrajit IK
Published: October 2009

Cardiac MRI is a valuable and an accurate modality used in the evaluation of structure and function of the heart. It is increasingly considered as a useful non invasive examination in management of cardiovascular conditions, a situation resulting from significant advances in MR technologies. Evaluation of congenital heart disease is an important application of Cardiac MRI since the morphological details of chambers, septum, defects and anomalous connections are depicted accurately. Additionally, flow information across valves, chambers, outflow tracts and shunts are also provided. Its utility is further increased especially during follow up of patients after corrective surgery. This article reviews current state-of-the-art MRI application in common congenital heart diseases.
Incidence and implications of a left inferior vena cava on IVC filter placement
Authors: Kalyanpur A , Pollak JS
Published: October 2009

Objective: To assess the prevalence and ability to detect a left inferior vena cava (IVC) during venography prior to filter placement and its implications for device implantation.
Materials and Methods : Over 58 months, patients referred for an IVC filter were prospectively evaluated for a left IVC by performing cavography injecting into the left iliac vein, left renal venography, or CT scan correlation. Additionally, cavograms of patients receiving filters over the four previous years were reviewed to assess the adequacy of detecting these anomalies based on the degree of opacification of the left iliac vein in relation to the position of the catheter tip.
Results: Prospective evaluation for a left IVC was adequate in 477 of 503 patients. Retrospective evaluation using CT scans was possible in another 14. Left IVCs were detected in 5 patients (1%). Three patients with duplications were managed with either 2 filters, a suprarenal filter, or a bird′s nest filter straddling both cavas. Two patients with isolated left IVCs received a single filter. Of 62 retrospectively reviewed cavograms, the left iliac vein was inadequately opacified in 69% when the catheter was in the low IVC (53 patients) and 71% when it was in the right iliac vein (7 patients).
Conclusions: Low caval or right iliac vein injections infrequently provide sufficient reflux into the left iliac vein to assess for a left IVC. Left iliac vein catheterization is easy and will readily provide this information. Modifications in filter placement technique may be necessary when caval anomalies are present.
Structural brain lesions in schizophrenia -magnetic resonance imaging on a mid field magnet
Authors: Parkar S R , Seethalakshmi R , Shah H
Published: October 2009

Objectives : The brain damage associated with schizophrenia has been established beyond doubt; however, what remains unexplored is the biological nature of transcultural variations. An important reason for this was the lack of mid and high field scanners in developing countries like India.
Material and Methods : We undertook a pilot study using a 0.5 Tesla MRI scanner (General Electric Signa Contour) to explore identifiable structural brain lesions in ten randomly selected individuals with schizophrenia.
Results: Nine of the ten participants in the series had structural brain changes. The most common findings were ventricular dilatation and prominent cerebral cortical sulci and cerebellar folia. Additionally non-focal white matter lesions were observed in three patients and small right hippocampus was noted in one participant.
Conclusions : The study discusses that establishing structural brain lesions with mid field scanners is indeed feasible. The small study sample and heterogeneity of schizophrenia however made it difficult to establish any definite associations
Ellis-Van creveld′s syndrome (a case rreport)
Authors: Sharma O P , Saraf R , Gupta B
Published: October 2009

A 13 years old male patient had stunted growth, bilateral polydactyly, fusion of capitate and hamate on right side, incomplete duplication of 1st metacarpal at its proximal end, poorly ossified epiphyses of lower end of radius & ulna, valgus deformity of right knee, conical shape of tibial epiphyses, nonossified fibular epiphyses & a small bony exostoses from medial end of right tibia, abnormal teeth and nail of hand. Also there was evidence of left to right shunt in the heart. Oral frenulae, pseudocleft of upper lip were also noticed.
Subtrochanteric periosteal chondroma: A case report and tumor overview
Authors: Dhammi IK , Maheshwari AV , Jain AK , Gulati D
Published: October 2009

We report a rare case of subtrochanteric periosteal chondroma in a 16 years boy. The purpose of this presentation is to stress the importance of a proper clinico-radiological and histopathological diagnosis of this lesion. Awareness of the features of this lesion helps to prevent overtreatment of this benign condition, since its differentiation with malignant lesions may be extremely difficult, even at histology; and since conservative surgery with complete excision of the lesion leads to permanent cure.
Prenatal sonologic features of simple meconium peritonitis
Authors: Kharat A T , Prathima R , Singh A , Jacob D
Published: October 2009

A 25 yrs old female patient came to our department for routine antenatal ultrasound. Sonography revealed presence of a 24 week live intrauterine pregnancy. During routine screening for congenital anomalies, multiple highly echogenic foci were seen on the visceral peritoneal surface of liver and the parietal peritoneum. However no evidence of dilated bowel/ fetal ascites was detected. No other anomaly was detected.
Usefulness of dynamic maneuvers in MR evaluation of oral malignancies
Authors: Oberoi R , Jena A
Published: October 2009

Objectives: The purpose of this study was to evaluate the usefulness of dynamic maneuvers like "distended cheek" and "tongue deviation" in MR evaluation of oral malignancies. Methods: Ninety nine patients of oral malignancies who reported to this institute for treatment were enrolled in this study. All the patients evaluated with conventional MR imaging and supplemented by additional MR imaging with dynamic maneuvers using T1Weighted and STIR sequences with reduced scan time. Distended cheek imaging was performed in 73 cases of carcinoma cheek, gingiva & RMA (retromolar area) and tongue deviation in 24 cases of carcinoma tongue & floor of mouth. Two cases of carcinoma of lower gingiva performed both maneuvers. In selected cases MR imaging with dynamic maneuvers was also performed following contrast administration. Results: Lesions appearing inseparable from two mucosal surfaces (buccal mucosa and gingiva) on routine MR images were well separated in the distended cheek images in all cases except for two cases who could not perform the maneuvers. Distended cheek images demonstrated involvement of buccogingival sulci in 30 patients of carcinoma of cheek, involvement of cheek in 8 cases of carcinoma gingiva & involvement of gingiva in 6 cases of carcinoma cheek which were not appreciated on routine MR images. Similarly MR imaging with tongue deviation helped in better delineation of tongue lesions in 12 cases and showed involvement of glossogingival sulcus in 5 cases that were not appreciable on routine MR imaging. Conclusion: MR imaging with dynamic maneuvers provide additional information of clinical significance regarding origin and extent of disease in oral malignancies & should supplement the conventional MR imaging in selected cases.
Arrhyyhmogenic right ventricular dysplasia; radiologic findings of the left ventricle: A case report and review of the literature
Authors: Arda K , Ciledag N , Kacmaz F , Tufekcioglu O , Sereflisan Y
Published: October 2009

Arrhythmogenic right ventricular dysplasia (ARVD) is characterized by progressive fibro fatty replacement of the right ventricular myocardium which constitutes a substrate for electrical instability and a focus of ventricular arrhythmias. Most of the patients have some degree of left ventricular involvement which also affects the right ventricle by the same disease process. From thirty percent to 50% of patients with ARVD have a family history of the disease. The most common pattern of inheritance is autosomal dominant. Clinically, ARVD usually presents with ventricular arrhythmias, and there is approving evidence that this is the underlying disease in a substantial number of sudden deaths among young, especially healthy individuals. The diagnosis of ARVD relies on the presence of structural and functional abnormalities of the right ventricle, electrophysiological abnormalities, and family history. The imaging modalities are conventional angiography, echocardiography (ECO), radionuclide angiography, ultra fast computed tomography, and magnetic resonance imaging. (MRI). We are presenting a case of ARVD with ECO, computed tomography (CT), and MRI findings.
Achieving reduced radiation doses for CT examination of the brain using optimal exposure parameters
Authors: Livingstone R S , Eapen A , Dip N B , Hubert N
Published: October 2009

Objectives : Examinations performed using CT scanners impart high radiation dose to patients and use of this modality is on the increase in the present day scenario. This study was intended to evaluate and optimize radiation dose imparted to patients during CT examination of brain performed using spiral CT scanner.
Materials and Methods : One hundred and one patients who underwent CT examination of brain were included in the study. The effective dose to patients was calculated using volume computed tomography dose index (CTDIvol) and dose length product (DLP) values. Patients were categorized according to the type of examination involved. Patients who underwent a complete examination of brain (non-contrast as well as contrast) were categorized in Group A and patients who underwent either a non-contrast or contrast examination were categorized as Group B.
Results : The effective dose to patients ranged from 0.65 mSv to 0.93 mSv for Group A patients and 0.28 mSv to 0.53 mSv for Group B patients.
Conclusion : There was a reduction of doses imparted to patients undergoing CT examination of the brain using optimized exposure parameters without any loss of diagnostic information.
Dural venous thrombosis - A neglected finding on routine MRI sequences
Authors: Kumar Anil , Mukund A , Sharma G
Published: October 2009

Objectives - To establish the role of routine MR sequences in diagnosis of dural venous sinus thrombosis.
Materials and Methods - As dural venous sinus thrombosis has a non specific presentation, all the patients coming to our department for MRI head between March 2003 and May 2005 were looked for abnormal signal intensity within the dural sinuses. Twenty seven cases having loss of normal flow void within the major dural venous sinuses on routine sequences (FSE T2, SE T1 & FLAIR) were thought of having dural sinus thrombosis and so were further evaluated by MR venography. This study was carried out using 0.2 Tesla open magnet MR scanner (GE signa profile 4).
Results - On routine MR sequences absence of dural sinus flow void was noted in twenty seven patients and suspicion of cerebral venous thrombosis was raised. The diagnosis of thrombosis was confirmed in twenty three patients by 2-D TOF MR venography and no thrombosis could be demonstrated in remaining four patients. Thirteen patients had multiple sinus involved whereas in ten patients only single sinus was involved. Out of these twenty three patients, apart from thrombosis, six had infarcts, three had mastoiditis and one of them had cerebellar abscess too. Hemorrhage was noted in five patients and the most interesting fact was that nine patients had normal brain parenchyma.
Conclusion - Dural venous sinus thrombosis appears as loss of normal flow void on routine sequences especially on FSE T2W and FLAIR images. This fact may help us suspect DVT, and the finding can be confirmed by MR venography so that further management can be planned promptly.