bluuebunny/crossref_metadata_2025 huggingface dataset:
084 Treating yourself: a glucocorticoid secreting tumour suppressing myasthenia gravis
Authors: Swayne Andrew , Lane Michael , Brown Helen , Prain Kerri , Wong Richard , Gillis David , Blum Stefan
Published: May 2018

Introduction

We aimed to report a single patient seen at a tertiary neurology centre with a rarely described phenomenon of interaction between myasthenia gravis and a glucocorticoid secreting tumour.

Case

A 70 year old, otherwise healthy male underwent a CT imaging of his chest after being trampled by a cow. Apart from several rib fractures, this revealed a slightly lobulated but well-defined right adrenal mass. Further studies revealed elevated morning cortisol levels of 847 nmol/L (reference range 140–640 nmol/L). The mass was excised and was found to be a 60 mm by 30 mm by 25 mm lesion, which was well circumscribed. It comprised of clear cells with foamy cytoplasm and a lesser component of eosinophilic cells, consistent with a functional adrenal adenoma producing glucocorticoid. Within days of the resection the patient described becoming weaker with fatigable proximal weakness of both upper and lower limbs. Acetylcholine receptor antibodies were positive and a diagnosis of myasthenia gravis was made. Upon commencement of pyridostigmine at 60 mg TDS and prednisolone 10 mg OD the symptoms improved and the patient was able to resume his previous active lifestyle.

Conclusion

The phenomenon of myasthenia gravis being suppressed by a functional adrenal adenoma has only previously been reported twice.1 2 This case report adds to the literature and can be distinguished from the other two cases by the rapidity of onset of symptoms of myasthenia over days after tumour resection. It tells a cautionary tale of medical therapy disrupting the brittle balance of nature.

References

. Petramala L, Marinelli C, Giallonardo AT, Concistre A, Lucia P, Venuta F, … Letizia C. A case report of subclinical hypercortisolism due to adrenal incidentaloma complicated by myasthenia gravis after adrenalectomy. Tumori2016;102(Suppl.2).

. Topham L, Chapman A, Gibbs C, Saha M. A patient with pemphigus foliaceus and myasthenia gravis treated by a cortisol-secreting adrenal adenoma. Br J Dermatol2015;172(1):280–282.
095 Increased incidence of moyamoya angiopathy in northern queensland
Authors: Harrison Emma L , Devlin Michael J , Stoodley Marcus A , White Richard P
Published: May 2018

Introduction

Initially described in Japan in 1957, moyamoya angiopathy is recognised in other populations, particularly within Europe and North America. Moyamoya disease (MMD) is a rare chronic progressive cerebrovascular disorder of unknown aetiology characterised by concentric stenosis of large intracranial vessels with collateralisation from moyamoya vessels and the leptomeningeal vessels. Affected individuals may present with transient ischaemic attacks or ischaemic stroke, however presentations with intracerebral haemorrhage, epilepsy or cognitive impairment in both children and adults also occur. Those with moyamoya syndrome (MMS), MMD in the setting of an associated disease such as neurofibromatosis, type one diabetes mellitus and trisomy 21, appear to follow a similar clinical course.

Methods

We conducted a retrospective review of patients with Moyamoya angiopathy who presented to the Townsville or Mackay Hospital Health Service between January 2012 and January 2018.

Results

We identified eleven cases of moyamoya angiopathy between 2012 and 2018. The cumulative incidence in our study population was 0.436 per 1 00 000 persons per year. The most common presentation was ischaemic stroke. We will present additional morphologic data, functional cerebral blood flow studies and outcomes following revascularisation (including ECIC bypass).

Conclusion

The findings from our small case series suggests the incidence of moyamoya angiopathy within Northern Queensland is higher than anticipated in European and Northern American populations. Additional research is required to ascertain whether this is primarily due to an increased awareness of the condition and extended diagnostic workup within our centre, specific patient characteristics which predispose to the disease or due to increasing prevalence of moyamoya angiopathy in the general population.
John Douglas Parkinson
Authors: Harper Rob
Published: May 2018

A likeable practitioner – ferociously intelligent, fair minded and with strong principles – he was one of the last veterinary surgeons who saw action in the Second World War.
Genetic identity in genebanks: application of the SolCAP 12K SNP array in fingerprinting and diversity analysis in the global in trust potato collection
Authors: Ellis David , Chavez Oswaldo , Coombs Joseph , Soto Julian , Gomez Rene , Douches David , Panta Ana , Silvestre Rocio , Anglin Noelle L.
Published: May 2018

Breeders rely on genetic integrity of material from genebanks; however, admixture, mislabeling, and errors in original data can occur and be detrimental. Two hundred and fifty accessions, representing paired samples consisting of original mother plants and their in vitro counterparts from the cultivated potato collection at the International Potato Center (CIP) were fingerprinted using the Infinium 12K V2 Potato Array to confirm genetic identity of the accessions and evaluate genetic diversity of the potato collection. Diploid, triploid, and tetraploid accessions were included, representing seven cultivated potato taxa (based on Hawkes, 1990). Fingerprints between voucher mother plants maintained in the field and in vitro clones of the same accession were used to evaluate identity, relatedness, and ancestry using hierarchal clustering and model-based Bayesian admixture analyses. Generally, in vitro and field clones of the same accession grouped together; however, 11 (4.4%) accessions were mismatches genetically, and in some cases the SNP data revealed the identity of the mixed accession. SNP genotypes were used to assess genetic diversity and to evaluate inter- and intraspecific relationships along with determining population structure and hybrid origins. Phylogenetic analyses suggest that the triploids included in this study are genetically similar. Further, some genetic redundancies among individual accessions were also identified along with some putative misclassified accessions. Accessions generally clustered together based on taxonomic classification and ploidy level with some deviations. STRUCTURE analysis identified six populations with significant gene flow among the populations, as well as revealed hybrid taxa and accessions. Overall, the Infinium 12K V2 Potato Array proved useful in confirming identity and highlighting the diversity in this subset of the CIP collection, providing new insights into the accessions evaluated. This study provides a model for genetic identity of plant genetic resources collections as mistakes in conservation of these collections and in genebanks is a reality. For breeders and other users of these collections, confirmed identity is critical, as well as for quality management programs and to provide insights into the accessions evaluated.
Rhythmic patterns in the neuronal motifs induced by nonequal time-delays and correlated noises
Authors: Zhang X. , Yang J. , Wu W. Y. , Wu F. P. , Wu W. J. , Miao R. D. , Wang H. J. , Qi G. X. , Huang H. B.
Published: May 2018

Rhythmic patterns in the neuronal motifs are studied. For nonequal time-delays without noises, two situations are considered, where the conditions for synchronization, winnerless competition (WLC) and “two plus one” (TPO) are studied. In the first situation, if the coupling strengths are the same, then the time-delays are set the same. WLC and synchronization are easy to occur in this situation, while TPO is hard to occur. In the second situation, if the distances between two neurons are the same, then the time-delays are set the same. The complementary phenomenon is found and discussed in detail for TPO to occur in this situation. Next, when common noise with equal time-delay [Formula: see text] is added to the motifs, noise induced synchronization is compared for [Formula: see text] and [Formula: see text], where the motifs both exhibit WLC. When correlated noises with equal time-delay [Formula: see text] are added to the motifs, it is found that WLC is easier to be destroyed for [Formula: see text] than for [Formula: see text].
Study of open systems with molecules in isotropic liquids
Authors: Kondo Yasushi , Matsuzaki Masayuki
Published: May 2018

We are interested in dynamics of a system in an environment, or an open system. Such phenomena as crossover from Markovian to non-Markovian relaxation and thermal equilibration are of our interest. Open systems have experimentally been studied with ultra cold atoms, ions in traps, optics, and cold electric circuits because well-isolated systems can be prepared here and thus the effects of environments can be controlled. We point out that some molecules solved in isotropic liquid are well isolated and thus they can also be employed for studying open systems in Nuclear Magnetic Resonance (NMR) experiments. First, we provide a short review on related phenomena of open systems that helps readers to understand our motivation. We, then, present two experiments as examples of our approach with molecules in isotropic liquids. Crossover from Markovian to non-Markovian relaxation was realized in one NMR experiment, while relaxation-like phenomena were observed in approximately isolated systems in the other.
Morphological characterization of submarine slope failures in a semi-enclosed fjord, Frobisher Bay, eastern Canadian Arctic
Authors: Deering Robert , Bell Trevor , Forbes Donald L. , Campbell Calvin , Edinger Evan
Published: May 2018

Submarine slope failures in the nearshore waters of SE Baffin Island, eastern Canadian Arctic, present a challenge to coastal and seabed development. Submarine slope failures are a known geohazard in fjords in Norway, Chile, Alaska, British Columbia and elsewhere, but have received little attention in the coastal waters of Arctic Canada. Over the past 6 years, there has been a rapid expansion of multibeam echosounder (MBES) mapping in Canadian Arctic fjords, leading to the discovery of many submarine slope failures. One area that has been mapped in detail is inner Frobisher Bay. This macrotidal, seasonally ice-covered, semi-enclosed embayment has a glacially scoured bed, ice-contact deposits, including recessional moraines, and stratified glaciomarine and post-glacial silts and clays with abundant dropstones. The prevalence of submarine slope failures in the inner bay (one per 20 km
2
) appears to be anomalous. To date, MBES mapping has imaged at least 246 failures, ranging in size from 0.007 to 2.1 km
2
and all within the glaciomarine and post-glacial succession. Morphometric analysis of these features based on high-resolution MBES bathymetry provides an insight into their spatial distribution, relative chronology, triggers and flow characteristics; factors essential to understanding the mechanisms underlying their abundance in this Canadian Arctic fjord.
The Physics of the Metaphase Spindle
Authors: Oriola David , Needleman Daniel J. , Brugués Jan
Published: May 2018

The assembly of the mitotic spindle and the subsequent segregation of sister chromatids are based on the self-organized action of microtubule filaments, motor proteins, and other microtubule-associated proteins, which constitute the fundamental force-generating elements in the system. Many of the components in the spindle have been identified, but until recently it remained unclear how their collective behaviors resulted in such a robust bipolar structure. Here, we review the current understanding of the physics of the metaphase spindle that is only now starting to emerge.
Mechanotransduction by the Actin Cytoskeleton: Converting Mechanical Stimuli into Biochemical Signals
Authors: Harris Andrew R. , Jreij Pamela , Fletcher Daniel A.
Published: May 2018

Force transmission through the actin cytoskeleton plays a central role in cell movements, shape change, and internal organization. Dynamic reorganization of actin filaments by an array of specialized binding proteins creates biochemically and architecturally distinct structures, many of which are finely tuned to exert or resist mechanical loads. The molecular complexity of the actin cytoskeleton continues to be revealed by detailed biochemical assays, and the architectural diversity and dynamics of actin structures are being uncovered by advances in super-resolution fluorescence microscopy and electron microscopy. However, our understanding of how mechanical forces feed back on cytoskeletal architecture and actin-binding protein organization is comparatively limited. In this review, we discuss recent work investigating how mechanical forces applied to cytoskeletal proteins are transduced into biochemical signals. We explore multiple mechanisms for mechanical signal transduction, including the mechanosensitive behavior of actin-binding proteins, the effect of mechanical force on actin filament dynamics, and the influence of mechanical forces on the structure of single actin filaments. The emerging picture is one in which the actin cytoskeleton is defined not only by the set of proteins that constitute a network but also by the constant interplay of mechanical forces and biochemistry.
Study on Tripping Risks in Fast Walking through Cadence-Controlled Gait Analysis
Authors: Wang Wen-Fong , Lien Wei-Chih , Liu Che-Yu , Yang Ching-Yu
Published: May 2018

Fast walking is a common exercise for most people to promote health. However, a higher cadence due to fast walking on ordinary or uneven ground raises the risk of tripping. To investigate the tripping issue, research to observe the gait in fast walking is needed. To explore the relationship between fast gait and the risk of tripping, a gait recording system with a specific synchronization mechanism was developed in this work. The system can acquire gait signals from wearable sensors and action cameras at different cadences. Meanwhile, algorithms for gait cycle segmentation and characteristic extraction were proposed for analyzing a fast gait. In the gait analysis, the correlations of low, moderate, and high cadence in cueing and no cueing gaits were computed, and two results were obtained. First, the higher the cadence is, the larger the motion strength in the terminal foot swing will be and the smaller the motion strength at the starting foot swing. Second, the decreased distance of foot clearance becomes more conspicuous as the cadence increased, especially if one is walking more than 120 beats. The results indicate that fast walking with bigger strides and lower cadence is the best way to maintain safety in moving over ordinary ground.
Theoretical Study of the Effect of Instrument Parameters on the Flow Field of Air-Flow Impacting Based Mechanochemical Synthesis
Authors: Tao Yang , Lin Jun , Zhang Zhao , Guo Qiuting , Zuo Jin , Lu Bo
Published: May 2018

The air-flow impacting based mechanochemical synthesis is an alternative strategy to traditional mechanochemical preparations, which has many advantages in terms of reaction temperature, preparation speed, and cleanness. Herein, we theoretically study the effect of instrument parameters, including the axial position of physical target, the diameter difference between nozzle throat and suction pipe, and divergence angles of uniform speed region, on the flow field of the air-flow impacting based mechanochemical synthesis. The optimized parameters have been obtained. Under the optimal conditions, a stable and high-speed air flow is obtained, in which the speed can achieve a Mach number of approximately 2.6. The high-speed air flow is able to easily carry the reacting substances to arrive at the physical target, triggering a chemical reaction. These findings undoubtedly provide a key guideline for further development and application of the air-flow impacting based mechanochemical synthesis.
The Ethyl Acetate Extract of Gynura formosana Kitam. Leaves Inhibited Cervical Cancer Cell Proliferation via Induction of Autophagy
Authors: Ma Jing Fan , Wei Peng Fei , Guo Chang , Shi Yuan Peng , Lv Yang , Qiu Long Xin , Wen Long Ping
Published: May 2018

Gynura formosana Kitam. belongs to the Compositae family and has been traditionally used for the prevention of cancer, diabetes, and inflammation in China. Previous studies had indicated that the ethyl acetate extract of Gynura formosana Kitam. leaves (EAEG) exhibited antioxidant and anti-inflammatory activity. In this report, we demonstrated that EAEG possessed potent anticancer activity through autophagy-mediated inhibition of cell proliferation. EAEG induced a strong cytostatic effect towards HeLa cells and, to a lesser extent, HepG2 and MCF-7 cells. This cytostatic effect of EAEG was not a consequence of increased apoptosis, as neither DNA fragmentation nor change in protein expression level for a number of apoptosis-related genes including Bid, Bax, Bcl-2, and caspase-3 was observed after EAEG treatment, and the apoptosis inhibitor Z-VAD-FMK did not inhibit the EAEG-elicited cytostatic effect. On the other hand, EAEG induced autophagy in a dose-dependent fashion, as shown by increased GFP puncta formation, enhanced conversion of the microtubule-associated protein light chain LC3-I to LC3-II, and downregulation of the p62 protein. Treating the HeLa cells with EAEG together with Chloroquine (CQ) further accelerated LC3 conversion and p62 clearance, indicating that EAEG induced complete autophagy flux. Importantly, the autophagy inhibitor 3-methyladenine (3MA) significantly abrogated the cytostatic effect of EAEG, strongly suggesting that EAEG inhibited HeLa cell proliferation through the induction of autophagy rather than apoptosis. Our results provided a novel and interesting mechanistic insight into the anticancer action of EAEG, supporting the traditional use of this plant for the treatment of the cancer.
Stomatitis and VEGFR-Tyrosine Kinase Inhibitors (VR-TKIs): A Review of Current Literature in 4369 Patients
Authors: Arena Claudia , Troiano Giuseppe , De Lillo Alfredo , Testa Nunzio F. , Lo Muzio Lorenzo
Published: May 2018

Background. Multitargeted tyrosine kinase inhibitors (TKIs) represent a new class of target-specific antineoplastic agents. These agents show some specific adverse events such as fatigue/asthenia, anorexia/loss of appetite, dysgeusia, diarrhea/abdominal pain, hypothyroidism, hypertension, myelosuppression, and stomatitis. Materials and Methods. A systematic search was performed on PubMed online database using a combination of MESH terms and free text words, “sunitinib” OR “sorafenib” OR “axitinib” OR “cabozantinib” OR “pazopanib” OR “regorafenib” OR “nintedanib” OR “vatalanib” combined through the use of Boolean operator AND with the key words “stomatitis” OR “mucositis,” (i) on human subjects, (ii) written in the English language, and (iii) reporting about the incidence of stomatitis or oral mucositis. Results. The incidence of stomatitis of any grade was 35.2% for sunitinib, 20.52% for sorafenib, 20.63% for axitinib, and 34.21% for cabozantinib. All the agents showed high rates of low-grade stomatitis (G1-G2), while the onset of severe stomatitis (G3-G4) was very low. Conclusions. Analysis of the reports with patients treated with sunitinib, sorafenib, axitinib, and cabozantinib showed a clear prevalence of stomatitis grade 1 or grade 2. These data differ from those of patients treated with conventional chemotherapy in which mucositis is predominantly of grade 3 or grade 4.
Clinical Outcomes after Liver Transplantation for Hepatorenal Syndrome: A Systematic Review and Meta-Analysis
Authors: Utako Piyapon , Emyoo Thapanakul , Anothaisintawee Thunyarat , Yamashiki Noriyo , Thakkinstian Ammarin , Sobhonslidsuk Abhasnee
Published: May 2018

Aims. Hepatorenal syndrome (HRS) decreases survival of cirrhotic patients. The outcomes of HRS after liver transplantation (LT) were inconsistently reported. We conducted a systematic review and meta-analysis study to estimate the post-LT rates of death and HRS reversal. Methods. A thorough search of literatures was performed on PubMed, Scopus, and conference abstracts for reports on post-LT survival and HRS reversal. Data for the posttransplant rates of HRS reversal, death, and acute rejection were extracted. The rates were pooled using inverse variance method if there was no heterogeneity between studies. Otherwise, the random effect model was applied. Results. Twenty studies were included. Pooling HRS reversal rates indicated high heterogeneity with a pooled rate of 0.834 (95% CI: 0.709–0.933). The pooled overall death rates for HRS and non-HRS after LT were 0.25 (95% confidence interval (CI): 0.18–0.33) and 0.19 (95% CI: 0.14–0.26). The risk ratio of death between HRS and non-HRS patients was 1.29 (95% CI: 1.14–1.47, P<0.001). The probability of death at 1, 3, and 5 years tended to be higher among HRS. Conclusions. HRS is reversible in about 83% of patients after LT. However, the posttransplant mortality rate of HRS patients is still increased.
Genome-Wide Identification, Classification, and Expression Divergence of Glutathione-Transferase Family in Brassica rapa under Multiple Hormone Treatments
Authors: Khan Nadeem , Hu Chun-mei , Amjad Khan Waleed , Hou Xilin
Published: May 2018

The GSTs is one of the most important multifunctional protein families which has been playing a crucial role in the different aspects of plant growth. This extensive study about GSTs may establish a solid foundation for the brief functional analysis of BraGSTs in future. In this study, a total of 75 genes were identified in B. rapa. Phylogenetic analysis characterized them into eight different subclasses, while Tau and Phi subclasses were the most numerous. The exon-intron structure and the motif composition of BraGSTs were exhibited accordingly to their subclasses. Notably, we also investigated 15 tandem paralogous pairs of genes, which highlighted that all the pairs were purifying in nature as their synonymous values were lower than 1.00. Duplication analysis indicated that about 45.33% of genes mainly occurred through tandem duplication in B. rapa. Predominately, the tandem cluster of genes in subclass Tau was greater than the other subclasses. Furthermore, among eight multiple hormonal treatments (ABA, GA, BR, ETH, IAA, IBA, NPA, and JA), most number of BraGSTs was activated by NPA, BR, and ABA treatments. This analysis has provided comprehensive information about GSTs family which may assist in elucidating their exact functions in B. rapa.
The Use of Phage Display and Yeast Based Expression System for the Development of a Von Willebrand Factor Propeptide Assay: Development of a Von Willebrand Factor Propeptide Assay
Authors: Meiring S. M. , Setlai B. D. P. , Theron C. , Bragg R.
Published: May 2018

Background. The diagnosis of von Willebrand disease is complex due to the heterogeneity of the disease. About eighty percent of von Willebrand disease patients are diagnosed with a quantitative defect of von Willebrand factor (VWF) where fifty percent is due to an increased clearance of von Willebrand factor. These patients do not respond well to the treatment of choice, Desmopressin (DDAVP) due to decreased efficacy. The ratio between the VWF propeptide and the mature VWF antigen is used to diagnose these patients. Commercial VWF propeptide assays are too expensive for use in developing countries. In this study, we developed a cost-effective ELISA assay. Methods. We first displayed VWF propeptide on yeast. Antibody fragments were selected against the displayed VWF propeptide by using phage display technology. The antibodies were used to develop a cost-effective VWF propeptide assay and compared to a commercial VWF propeptide assay. Results. Two of these antibody fragments bound specific to the VWF propeptide and not to the yeast used for the expression of the propeptides. These purified antibody fragments were able to detect VWF propeptide in normal plasma. Conclusion. Our assay performed well when compared to a commercial kit. It also showed a higher binding affinity for VWF propeptide in plasma at especially lower plasma concentrations.
Biological Aspect of Pathophysiology for Frozen Shoulder
Authors: Cho Chul-Hyun , Song Kwang-Soon , Kim Beom-Soo , Kim Du Hwan , Lho Yun-Mee
Published: May 2018

It is fairly well understood that frozen shoulder involves several stages, which reflect the series of process from capsular inflammation and fibrosis to spontaneous resolution of this fibrosis. However, the underlying pathophysiologic process remains poorly determined. For this reason, management of frozen shoulder remains controversial. Determining the pathophysiological processes of frozen shoulder is a pivotal milestone in the development of novel treatment for patients with frozen shoulder. This article reviews what is known to date about the biological pathophysiology of frozen shoulder. Although articles for the pathophysiology of frozen shoulder provide inconsistent and inconclusive results, they have suggested both inflammation and fibrosis mediated by cytokines, growth factors, matrix metalloproteinases, and immune cells. Proinflammatory cytokines and growth factors released from immune cells control the action of fibroblast and matrix remodeling is regulated by the matrix metalloproteinases and their inhibitors. To improve our understanding of the disease continuum, better characterizing the biology of these processes at clearly defined stages will be needed. Further basic studies that use standardized protocols are required to more narrowly identify the role of cytokines, growth factors, matrix metalloproteinases, and immune cells. The results of these studies will provide needed clarity into the control mechanism of the pathogenesis of frozen shoulder and help identify new therapeutic targets for its treatment.
Artificial Liver and Renal Support System for Cynomolgus Monkeys with Surgery-Induced Acute Renal Failure: A Preclinical Study
Authors: Feng Lei , He Guolin , Cai Lei , Fu Chaoyi , Li Yang , Weng Jun , Huo Xiaolin , Peng Qing , Gao Yi
Published: May 2018

Renal dysfunction is one of the most common complications of liver cirrhosis and is associated with increased morbidity and mortality. However, no available technology can simultaneously support liver and renal function in these patients. The aim of this study was to evaluate the safety and efficacy of an artificial liver and renal support system in cynomolgus monkeys with surgery-induced ARF. The ARF model was established by ligature of bilateral renal arteries in eight cynomolgus monkeys, which were randomly divided into a treatment group (n=4) and control group (n=4). Biochemical indexes were determined before and after surgery. Blood endotoxin levels, biochemical indexes, and bacterial cultures were assessed at 0, 3, and 6 h during treatment. System pressures and vital signs were recorded at 1 h intervals. Pathological examination was performed after death. ARF was successfully established, based on significant elevation of biochemical indexes and pathological examination. The treatment group had significantly reduced biochemical indexes relative to the control group. Measurement of blood endotoxins and aerobic and anaerobic bacteria cultures indicated no bacterial growth. The system pressures and vital signs were stable during treatment. The results indicate that our support system for the treatment of cynomolgus monkeys with surgery-induced acute renal failure is safe and effective.
Intralymphatic Glutamic Acid Decarboxylase-Alum Administration Induced Th2-Like-Specific Immunomodulation in Responder Patients: A Pilot Clinical Trial in Type 1 Diabetes
Authors: Tavira Beatriz , Barcenilla Hugo , Wahlberg Jeannette , Achenbach Peter , Ludvigsson Johnny , Casas Rosaura
Published: May 2018

GAD-alum given into lymph nodes to type 1 diabetes patients participating in an open-label pilot trial resulted in preservation of C-peptide similar to promising results from other trials. Here, we compared the immunomodulatory effect of giving GAD-alum directly into lymph nodes versus that induced by subcutaneous administration. Samples from T1D patients (n=6) who received 4 μg GAD-alum into lymph nodes (LNs), followed by two booster injections one month apart, and from patients (n=6) who received two subcutaneous injections (SC) (20 μg) given one month apart were compared. GADA, IA-2A, GADA subclasses, IgE, GAD65-induced cytokines, PBMC proliferation, and T cell markers were analyzed. Lower doses of GAD-alum into LN induced higher GADA levels than SC injections and reduced proliferation and IgG1 GADA subclass, while enhancing IgG2, IgG3, and IgG4. The cytokine profile was dominated by the Th2-associated cytokine IL-13, and GAD65stimulation induced activated CD4 T cells. Patients responding clinically best account for most of the immunological changes. In contrast, SC treatment resulted in predominant IgG1, predominant IFN-γ, higher proliferation, and activated CD4 and CD8 cells. Patients from the LN group with best metabolic outcome seemed to have common immune correlates related to the treatment. This trial is registered with DIAGNODE (NCT02352974, clinicaltrials.gov) and DIABGAD (NCT01785108, clinicaltrials.gov).
Tema IX. Shock
Authors: Badía C. Waldemar
Published: May 2018

Sin resumen
Laboratorio de Micología.
Authors: Lobos Miranda Teresa
Published: May 2018

Sin resumen
Recent Developments in Radiation Oncology: An Overview of Individualised Treatment Strategies in Breast Cancer
Authors: Pazos Montserrat , Schönecker Stephan , Reitz Daniel , Rogowski Paul , Niyazi Maximilian , Alongi Filippo , Matuschek Christiane , Braun Michael , Harbeck Nadia , Belka Claus , Corradini Stefanie
Published: May 2018

Radiation therapy (RT) for breast cancer has dramatically changed over the past years, leading to individualized risk-adapted treatment strategies. Historically, the choice of RT regimen was limited to conventional fractionation protocols using standard tangential fields. Nowadays, technological and technical improvements in modern RT have added a variety of other RT modalities, different fractionation schedules, and individualised treatment volumes to the portfolio of breast RT. This review aims to give a short overview on the main topics which have recently found their way into clinical practice: hypofractionated treatment protocols, accelerated partial breast irradiation (APBI) for low-risk patients, deep inspiration breath hold (DIBH) for maximal heart protection, extent of regional nodal irradiation for high-risk patients, and the implementation of new radiation techniques such as intensity modulated RT (IMRT) and volumetric modulated RT (VMAT).
Cataract Surgery following Sequential Myopic and Hyperopic LASIK
Authors: Chia Tao Ming Thomas , Jung Hoon C.
Published: May 2018

We report a case of patient dissatisfaction after sequential myopic and hyperopic LASIK in the same eye. We discuss the course of management for this patient involving eventual cataract extraction and intraocular lens (IOL) implantation with attention to the IOL power calculation method used.
Nevus Lipomatosis Cutaneous Superficialis: A Single-Center Case Series of 5 Patients
Authors: Alotaibi Homaid , Alsaif Fahad , Alali Azhar , Almashali Mohammed , Al-Dabeeb Dana , Altaweel Abdul-Aziz
Published: May 2018

Background: Nevus lipomatosis cutaneous superficialis (NLCS) is a rare hamartoma of mature adipose tissue characterized by solitary or multiple, soft, skin-colored or yellowish lobules that may coalesce to give rise to plaques with a cerebriform surface. There are two clinical types: (1) multiple lesions that are usually presented in a segmental distribution and (2) a solitary papule or nodule. Aim and Objective: To study the clinical and histopathological features of 5 Saudi patients with NLCS. Method: A retrospective analysis of clinical data and histopathological findings of 5 cases of NLCS in King Khalid University Hospital between January 2011 and November 2016. Demographic and clinical data were obtained from the clinical case files. Slides and tissue blocks were retrieved. H&E- and EVG-stained slides were studied in all cases. Results: We identified 5 patients with NLCS, of whom 4 were female. The average age at diagnosis was 36 years. The mean duration of the lesion was 4.4 years. The most common location was the lower part of the body. Most of the cases were diagnosed as skin papilloma before skin biopsy. Surgical excision was effective and no recurrence was observed. Conclusion: This is the first study about this rare type of skin tumor in Saudi Arabia and highlights the need for awareness of this clinical condition among dermatologists.
Clinicopathologic Correlation of a Subretinal Proliferative Vitreoretinopathy Band in a Patient with Chronic Recurrent Retinal Detachment
Authors: Brown Karen R. , Dubovy Sander R. , Relhan Nidhi , Flynn Jr. Harry W.
Published: May 2018

Purpose: Proliferative vitreoretinopathy is a well-known cause of failure of retinal detachment surgery. The purpose of this case report is to illustrate the clinical occurrence and histopathology of a horizontal subretinal band (“clothesline” configuration) creating recurrent and persistent retinal detachment. Observations: A 67-year-old Hispanic female with diabetes type 2 and a history of retinal detachment surgery in the left eye (OS) presented with decreased vision OS. Best corrected visual acuity at this recent presentation was 20/80 OS. Clinical examination disclosed a recurrent inferior retinal detachment and a subretinal “clothesline” fibrotic band. Surgical removal of the subretinal band was performed. Histopathological evaluation of longitudinal and transverse sections of the band revealed a cable-like configuration composed predominantly of glial differentiation, RPE differentiation, and collagen, based on morphology and immunohistochemical staining. There was focal smooth muscle and neuroendocrine cell differentiation, as detected with smooth muscle actin (SMA) and S100 staining, respectively. Cross-sections demonstrated pigmented fibrocellular tissue with foci of cells staining positive for S100 and keratin peripherally around the tissue, suggestive of RPE differentiation. Scattered foci of SMA-positive cells suggested mild myoblastic differentiation. Conclusions and Importance: This case report presents further information on the structure and orientation of the cellular components of subretinal band proliferative vitreoretinopathy. Cells suggestive of Müller cell differentiation compose the central aspect of the band, alongside collagen fibers. RPE differentiation is variably present peripherally in the band, likely reflective of proliferating RPE encircling the subretinal fibrous tissue. A mild amount of myofibroblastic differentiation was present within the band of tissue, correlating with the clinical findings of subretinal tissue contraction and localized retinal detachment.
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC): An ASC-IAC-Sponsored System for Reporting Salivary Gland Fine-Needle Aspiration
Authors: Rossi Esther Diana , Baloch Zubair W. , Pusztaszeri Marc , Faquin William C.
Published: May 2018

The diagnostic role of salivary gland fine-needle aspiration (SG-FNA) is well established in the preoperative evaluation of patients with salivary gland lesions. At present, most salivary SG-FNA specimens are diagnosed based on conventional diagnostic criteria. However, there exists a lack of uniform reporting for these specimens to guide the clinical management of patients. This void motivated a group of experienced cytopathologists to spearhead the development of a uniform reporting system. This international panel, under the sponsorship of the American Society of Cytopathology (ASC) and the International Academy of Cytology (IAC), gathered in September 2015 at the European Congress of Cytology, held in Milan, Italy, to propose the “Milan System for Reporting Salivary Gland Cytopathology” (MSRSGC). This effort sparked the interest of many and brought forth an agreement to develop an evidence-based tiered classification consisting of 6 diagnostic categories. It is hoped that this standard reporting system will enhance the overall effectiveness of SG-FNA reporting across institutions, with the ultimate result being better communication and improved patient care.
Periocular Necrotizing Fasciitis with Toxic Shock Syndrome
Authors: Herdiana Tri Rejeki , Takahashi Yasuhiro , Valencia Ma. Regina Paula , Ana-Magadia Marian Grace , Kakizaki Hirohiko
Published: May 2018

Purpose: To report a case of periocular necrotizing fasciitis with toxic shock syndrome. Methods: This is a case report of a previously healthy 69-year-old woman with left preseptal eyelid infection that spread rapidly and deteriorated into necrosis of the eyelid with toxic shock syndrome. She was admitted to intensive care unit for hemodynamic stabilization. Results: Intravenous antibiotic and high-dose immunoglobulin were administered followed by surgical debridement. Rehabilitative eyelid reconstruction was performed after acute episode, resulting in patient satisfaction in relation to periocular function and appearance. Conclusion: We reported a case of periocular necrotizing fasciitis with toxic shock syndrome that necessitated early aggressive medical treatment and adequate surgical intervention to decrease morbidity and mortality. A high level of suspicion of periocular necrotizing fasciitis is necessary to make a prompt diagnosis.
Bullous Pemphigoid Associated with Adalimumab Therapy in a Patient with Ulcerative Colitis
Authors: Hoffmann Sebastian , Berneburg Mark , Schreml Stephan
Published: May 2018

Bullous pemphigoid (BP) is a blistering autoimmune disease mainly observed in elderly patients. Several triggers are known for this autoimmune disease and some drugs are known to be a cause of BP. However, there are only few case reports on the induction of BP under adalimumab therapy. Other autoimmune diseases, such as lupus erythematosus, are also known to occur under TNF inhibition. Here, we report on an 81-year-old patient who received adalimumab for ulcerative colitis and subsequently developed BP. Other causes of BP (tumors, other drugs, viral or toxoplasma infections) were excluded. We initiated a topical and systemic therapy (prednisolone 1 mg/kg/day) and stopped the adalimumab injections. The patient’s symptoms resolved quickly and we were able to taper corticosteroid therapy. This rare case highlights the importance to monitor for autoimmune events during TNF inhibition.
Association of Five Snps in Cytotoxic T-Lymphocyte Antigen 4 and Cancer Susceptibility: Evidence from 67 Studies
Authors: Fang Min , Huang Wencheng , Mo Dan , Zhao Wei , Huang Rongyong
Published: May 2018

Background/Aims: CTLA-4 polymorphisms are associated with susceptibility to various cancers, but the results are often conflicting. Hence, we performed a comprehensive meta-analysis to quantitatively investigate the association between CTLA-4 polymorphisms (rs231775, rs4553808，rs5742909, rs3087243 or rs733618) and cancer risk. Methods: Data were collected from PubMed and Web of Science. A total of 67 case-control studies were selected for quantitative analysis. Stata (Version 12) software was used to calculate the odds ratio (OR) and 95% confidence interval (CI) to evaluate the strength of the associations. Subgroup meta-analysis was conducted based on ethnicity and cancer type. Heterogeneity tests, sensitivity analysis, and publication bias assessments were also performed. Results: rs231775, rs4553808 and rs5742909 but not rs3087243 and rs733618 were significantly related to cancer risk. In analyses stratified by ethnicity, both rs231775 and rs4553808 were significant susceptibility polymorphisms in an Asian population but not in a Caucasian population. Moreover, there were stronger associations between the rs231775 polymorphism and increased risk of bone, breast, liver, head and neck and pancreatic cancers. Additionally, rs4553808 was associated with significantly increased susceptibility to breast cancer and head and neck cancer. Conclusion: rs231775, rs4553808 and rs5742909 may be used as predictive genetic biomarkers for cancer predisposition. Combined detection of CTLA-4 SNPs could be a useful tool for prediction of cancer susceptibility in clinical practice.
Acute Cholecystitis Reduces Interstitial Cells of Cajal in Porcine Gallbladder Through Decreased mRNA Synthesis
Authors: Huang Zhen-peng , Qiu Hu , Yu Bao-ping
Published: May 2018

Background/Aims: Acute cholecystitis is a common gastrointestinal disorder, often characterized by acute cholecystitis with gallbladder motility disorder. Interstitial cells of Cajal (ICCs) are the pacemaker cells of gut motility in the gastrointestinal tract. Disruption of ICC function is related to motility disorders. The aim of this study was to explore the cellular and molecular mechanisms of ICCs in acute cholecystitis and after the resolution of acute inflammation. Materials and Methods: Fifty adult guinea pigs were randomly divided into five groups: a sham-administered group (control group); two groups that were intraperitoneally administered an anti-polyclonal neutrophil (PMN) antibody 24 h before common bile duct ligation (CBDL); and two groups of guinea pigs that were subjected to CBDL without receiving the PMN antibody. Guinea pigs that underwent CBDL were held for 24 h or 48 h after surgery before being subjected to laparotomy and cholecystectomy. Immunohistochemistry, TUNEL assays, western blotting, and real-time PCR were performed to determine ICC morphology and density, to detect ICC apoptosis, and to examine stem cell factor (SCF) and c-kit protein expression and SCF and c-kit mRNA levels, respectively. Results: Both hematoxylin-eosin staining and histological inflammation scores in the PMN groups were lower than those in the control groups (P < 0.01). No differences were observed in ICC morphology between groups. During acute cholecystitis, ICCs numbers were reduced. Conversely, the density of ICCs increased after inflammation was relieved (P < 0.01). In addition, SCF and c-kit protein and mRNA expression levels decreased during acute cholecystitis (P < 0.05) and increased after inflammation was relieved (P < 0.05). Furthermore, ICC apoptosis increased during acute cholecystitis and decreased after resolution of acute cholecystitis (P < 0.01). Conclusions: In acute cholecystitis, ICC injury may be related to gallbladder motility disorder.
Intravenous Anesthetics Enhance the Ability of Human Bone Marrow-Derived Mesenchymal Stem Cells to Alleviate Hepatic Ischemia-Reperfusion Injury in a Receptor-Dependent Manner
Authors: Feng Jiayu , Yao Weifeng , Zhang Yihan , Xiang Andy Peng , Yuan Dongdong , Hei Ziqing
Published: May 2018

Background/Aims: The degree of hepatic ischemia-reperfusion injury (HIRI) is highly relevant to the incidence of postoperative liver failure and mortality. Bone marrow-derived mesenchymal stem cells (BM-MSCs) have been shown to migrate to the liver and restore the damaged liver. Intravenous anesthetics are commonly used in the perioperative period; however, it is not yet known whether they have an influence on the functions of BM-MSCs and eventually affect the recovery of HIRI. Methods: A rat model of HIRI and a hypoxia-reoxygenation (H/R) model using L02 cells were generated, and human BM-MSCs (hBM-MSCs) were injected through the portal vein or co-cultured with L02 cells in a Transwell system, respectively. Three intravenous anesthetics, namely, dexmedetomidine, midazolam, and propofol, were given as pretreatments to hBM-MSCs. Quantitative real-time PCR for growth factors (HGF, FGF, VEGF, and IGF) and a migration assay were used to detect the paracrine and migration abilities of hBM-MSCs. NF-κB expression was detected using an immunofluorescence method. Furthermore, three receptor inhibitors, namely, yohimbine, PK11195, and bicuculline, were given to explore whether the three anesthetics worked in a receptor-dependent manner. Results: Preconditioning with dexmedetomidine and midazolam, but not propofol, enhanced the efficacy of hBM-MSCs in HIRI. Dexmedetomidine and midazolam, but not propofol, changed the paracrine spectrum and NF-κB p65 nuclear translocation of hBM-MSCs co-cultured with L02 cells after H/R injury. All three anesthetics enhanced the migration ability of hBM-MSCs when cultured in L02 H/R conditioned medium. However, the addition of receptor antagonists resulted in an opposite tendency. Conclusions: The intravenous anesthetics dexmedetomidine and midazolam enhanced the liver protective effects of hBM-MSCs during HIRI more effectively than propofol, by binding with their receptors and regulating the paracrine effect, migration ability, and NF-κB p65 nuclear translocation of hBM-MSCs.
Exendin-4 Plays a Protective Role in a Rat Model of Spinal Cord Injury Through SERCA2
Authors: Sun Zhonglei , Liu Yingfu , Kong Xianbin , Wang Renjie , Xu Yunqiang , Shang Chongzhi , Huo Jingrui , Huang Mengqiang , Zhao Fei , Bian Kefeng , Zhang Sai , Tu Yue , Chen Xuyi
Published: May 2018

Background/Aims: Current therapies for spinal cord injury (SCI) have limited efficacy, and identifying a therapeutic target is a pressing need. Sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2 (SERCA2) plays an important role in regulating calcium homeostasis, which has been shown to inhibit apoptosis. Exendin-4 has been shown to inhibit the apoptosis of nerve cells in SCI, which can also improve SERCA2 expression. In this study, we sought to determine whether exendin-4 plays a protective role in a rat model of SCI via SERCA2. Methods: To investigate the effects of exendin-4 on SCI, a rat model of SCI was induced by a modified version of Allen’s method. Spinal cord tissue sections from rats and western blot analysis were used to examine SERCA2 expression after treatment with the long-acting glucagon-like peptide 1 receptor exendin-4 or the SERCA2 antagonist 5(6)-carboxyfluorescein diacetate N-succinimidyl ester (CE). Locomotor function was evaluated using the Basso Beattie Bresnahan locomotor rating scale and slanting board test. Results: Cell apoptosis was increased with CE treatment and decreased with exendin-4 treatment. Upregulation of SERCA2 in female rats with SCI resulted in an improvement of motor function scores and histological changes. Conclusion: These findings suggest that exendin-4 plays a protective role in a rat model of SCI through SERCA2 via inhibition of apoptosis. Existing drugs targeting SERCA2 may be an effective therapeutic strategy for the treatment of SCI.