bluuebunny/crossref_metadata_2025 huggingface dataset:
Abnormal antioxidant system in erythrocytes of mercury-exposed workers
Authors: de Souza Queiroz Mary Luci , Pena Socrates Calvoso , Salles Tereza Sueko Ide , de Capitani Eduardo Melo , Saad Sara Teresinha Olalla
Published: January 2017

To investigate the effects of chronic exposure to mercury we studied the red cell antioxidant system in mercury-exposed workers through the evaluation of reduced glutathione, catalase and superoxide dismutase systems. Oftheseworkers, somewerebeingexposedatthetimeand had presented urinary mercury levels considered safe for occupational exposure for at least 3 months prior to the initiation of this study, and others had been on leave for at least 6 months because of intoxication symptoms. Reduced glutathione levels were lower and catalase activity was higher in the workers which were still being exposed, compared to those on leave and controls. No differences were observed between the workers on leave and controls.
Only the glutathione dependent antioxidant enzymes are inhibited by haematotoxic hydroxylamines
Authors: Spooren Anita AMG , Evelo Chris TA
Published: January 2017

Hydroxylamine and some of its derivatives are known to cause oxidative effects both in vitro and in vivo.Inthe current study we investigated the effects of hydroxyla-mines on the enzymatic antioxidant defense system in human erythrocytes. The activity of catalase and super-oxide dismutase was not significantly influenced by any of the hydroxylamines tested. However, the activity of glutathione peroxidase (GPX) and glutathione S-transferase (GST) was strongly inhibited by hydroxylamine and its O-derivatives (O-methyl and O-ethyl hydroxylamine). GPX was also inhibited by two N-derivatives of hydro-xylamine (i.e. N-dimethyl and N, O-dimethyl hydroxyla-mine). This indicates that exposure to hydroxylamines not only changes the cellular oxidation-reduction status but also leads to inhibition of the glutathione dependent antioxidant enzymes. GST as well as GPX have cysteine residues at the active site of the enzymes. Such an accessible thiol group is generally susceptible to formation of protein-mixed disulphides or intramolecular disulphides. If these thiol groups are essential for activity this would be accompanied by an increase or decrease in the enzyme activity. In principle this is also true for glutathione reductase (GR), which in this study was only inhibited by N, O-dimethyl and N-methyl hydroxylamines. However, GR is capable to reduce these disulphides by taking up two electrons, either from its substrate NAPDH or from another reductant. Oxidation of these thiol groups in GR would thus not lead to impairment of GR activity. The fact that NODMH and NMH do decrease the GR activity can therefore only be explained by other modifications. The activity loss of GST and GPX on the other hand, is likely to involve oxidation of critical cysteine residues. The practical consequence of these findings is that the cellular prooxidant state that may arise in erythrocytes exposed to hydroxylamines can be further increased by activity loss of protective enzymes, which may decrease the average life span of the red blood cell.
Effect of retinoid (vitamin A or retinoic acid) treatment (hormonal imprinting) through breastmilk on the glucocorticoid receptor and estrogen receptor binding capacity of the adult rat offspring
Authors: Gaál Annamária , Csaba G
Published: January 2017

Hormonal imprinting occurs perinatally when the developing receptor and the appropriate hormone meet each other. The presence of related molecules in this critical period causes misimprinting. Ligands bound to a member of the steroid-thyroid receptor superfamily can disturb the normal maturation of other members of the family, which is manifested in altered binding capacity of the receptor and decreased or increased response of the receptor-bearing cell for life. Excess or absence of the hormone also can cause misimprinting. Treatments once a week for 3 weeks of nursing rat mothers with 6 mg/animal all-trans retinol/dose caused faulty imprinting manifested in significantly reduced density (Bmax) of thymic glucocorticoid receptor in male and female adult progenies alike. 0.03 mg all-trans retinoic acid treatment of nursing mothers was ineffective. Receptor affinity (Kd)wasun-changed in both cases as well, as the binding values of uterine estrogen receptors. The results of the experiment call attention to the transmission of imprinter molecules by breastmilk to the progenies, which can cause lifelong alterations at receptorial level and points to the human health aspect. Possible reasons for the differences between retinol and retinoic acid effects and in the sensitivity of receptors are discussed.
Q-T interval prolongation and pleomorphic ventricular tachyarrhythmia (`Torsade de pointes') in organophosphate poisoning: report of a case
Authors: Wang Ming-Hsi , Tseng Chuen-Den , Bair Shyi-Yann
Published: January 2017

1 A 63-year-old woman presented with drowsy consciousness and dyspnea, followed by respiratory failure, after taking a bottle of parathion for suicide.

2 Sinus tachycardia was noted initially by ECG and Q-T interval prolongation with pleomorphic ventricular tachyarrhythmia (`Torsade de pointes') occurred on the third day of admission.

3 Torsade de pointes was relieved by magnesium sulfate and atropine sulfate intravenously. Q-T interval returned to normal on the fifth day of admission.

4 Practicing physicians should be aware of this uncommon type of cardiac toxicity caused by organophosphate poisoning, Q-T interval prolongation and pleomorphic ventricular tachyarrhythmia.
Poisoning with tilidine and naloxone: toxicokinetic and clinical observations
Authors: Regenthal R , Krüger M , Richter M , Preiss R
Published: January 2017

The opioid analgesic tilidine and its metabolites were detected by high performance liquid chromatography (HPLC) with UV-detection in serum from a 28 year-old woman who ingested 100 ml Valoron8N containing 6.94 g of tilidine and about 0.56 g of naloxone with suicidal intention.

Data on the toxicokinetics of tilidine in severe poisonings are missing. Therefore we followed serum concentrations of tilidine and metabolites for 48 or 96 h and for the first time calculated basic kinetic parameters in a massive life threatening poisoning.

Serum concentration of tilidine 3 h after ingestion was 38.1 mg/l which is about 70 times of the upper therapeutic level in man and about ninefold above toxic concentrations known so far. The concentration of nortilidine, the primary active metabolite at this time was 18.8 mg/l. The terminal elimination half life's of tilidine and nortilidine were explicit, prolonged with 23.9 and 13.9 h respectively.

The competitive opiate antagonist naloxone, which is added as a part of the industrially produced preparation Valoron8N solution to minimise oral abuse is not able to prevent ventilatory depression in massive overdoses.
Random effects models for HIV marker data: practical approaches with currently available software
Authors: Raab Gillian M , Parpia Tamiza
Published: January 2017

The analysis of marker data from HIV positive patients has been the motivation for many new developments in applied statistics. As well as reviewing these methods, this paper considers the extent to which programs to implement them are available in current software. Particular areas of development have been the joint modelling of markers and survival outcomes, non-linear random effects models that are of particular relevance for studying the efficacy of treatments and the use of Bayesian computational methods for inference from marker data. The package Win BUGS is recommended as being particularly well suited to the analysis of marker data.
Mathematical biology and medical statistics: contributions to the understanding of AIDS epidemiology
Authors: Donnelly C A , Cox D R
Published: January 2017

Some of the many ways in which mathematical biology and statistics have been used in investigating the acquired immunodeficiency syndrome (AIDS) epidemic are reviewed. Aspects of the spread of the disease via social and sexual networks are discussed. The different kinds of data involved are critically compared. Some studies of the incubation period are briefly reviewed and some comments made on the role of adherence to therapy.
An introduction to the use of physiologically based pharmacokinetic models in risk assessment
Authors: Bailer A J , Dankovic D A
Published: January 2017

Many extrapolation issues surface in quantitative risk assessments. The extrapolation from high-dose animal studies to low-dose human exposures is of particular concern. Physiologically based pharmacokinetic (PBPK) models are often proposed as tools to mitigate the problems of extrapolation. These models provide a representation of the disposition, metabolism, and excretion of xenobiotics that are believed to possess the potential of inducing adverse human health responses. Given a model of xenobiotic disposition that is applicable for multiple species and appropriate for nonlinearity of the xenobiotic biotransformation process, better extrapolation may be possible. Unfortunately, the true structure of these models (e.g. number of compartments, type of metabolism, etc.) is seldom known, and attributes of these models (tissue volumes, partition coefficients, etc.) are often experimentally determined and often only central measures of these quantities are reported. We describe the use of PBPK models in risk assessment, the structural and parameter uncertainty in these models, and provide a simple illustration of how these characteristics can be incorporated in a statistical analysis of PBPK models. Additional complexity in the analysis of variability in the models is also outlined. This discussion is illustrated using data from methylene chloride.
Evaluation of diagnostic tests without gold standards
Authors: Hui Siu L , Zhou Xiao H
Published: January 2017

This paper reviews statistical methods developed to estimate the sensitivity and specificity of screening or diagnostic tests when the fallible tests are not evaluated against a gold standard. It gives a brief summary of the earlier historical developments and focuses on the more recent methods. It covers Bayesian approaches and longitudinal studies with repeated testing. In particular, it reviews the procedures that do not require the assumption of independence between tests conditional on the true disease status.
Berkeley Moynihan
Authors: Bevan P Gilroy
Published: January 2017

The surgical career of Berkeley George Andrew Moynihan (Figure 1) spanned the last decade of the nineteenth and the first third of the twentieth century. He gained an international reputation, establishing an especial bond of friendship with the leading American surgeons of his day, and became known as a champion of provincial surgery in Britain. There were many facets to his character, and in view of his multiple interests he could fairly be described as the Renaissance man of British surgery of his time.
Sir Gordon Gordon-Taylor: A Biography and an Appreciation
Authors: Hobsley Michael
Published: January 2017

This biography of Gordon Gordon-Taylor is divided into three parts: the facts as they are generally known; an analysis of the facts; and finally, an appreciation of his role in British and international surgery.
Laennec and the Invention of the Stethoscope
Authors: Sakula Alex
Published: January 2017

The story of the great French physician R T H Laennec has been told many times1–4. This paper will therefore present only a brief biographical sketch but will focus on the circumstances surrounding the actual moment when Laennec invented the monaural stethoscope as a tool to aid diagnosis of affections of the heart and lungs.
Noise Transmission Through Profiled Metal Cladding Part I: Single Skin Measurements
Authors: Lam Y.W. , Windle R.M.
Published: January 2017

The sound reduction of single-skin trapezoidal profiled metal cladding systems often displays pronounced “dips” in mid frequency range. Because of their magnitude and frequency range, these “dips” can be a critical limiting factor in a cladding system's performance towards insulating noise from industrial premises. This paper investigates in detail the sound reduction of these cladding systems. A series of sound reduction measurements employing a systematic and comprehensive change of profile geometry involving 15 cladding systems was conducted to examine the effect of the profile geometry on the sound reduction “dips”. It is suggested that the “dips” are caused by resonant vibration modes that are local to the geometry of a profile corrugation. Vibration measurements on cladding sheets excited by a diffuse field in a transmission suite and on free hanging cladding sheets excited by a normal incidence plane wave in an anechoic chamber were conducted to test and confirm the explanation.
Experimental Approach to the Effect of Diffusers on the Sound Attenuation in Long Enclosures
Authors: Kang Jian
Published: January 2017

The objective of this paper is to experimentally demonstrate the effect of diffusers on the sound attenuation in long enclosures. For this purpose, a ribbed diffuser and a Schroeder diffuser were tested in a 1:16 scale model of an underground station. It is shown that for both train noise and loudspeaker sources, and under conditions of both high and low absorption, the diffusers are effective for increasing the sound attenuation along the length. With carefully designed diffuser distribution the extra sound attenuation caused by the ribbed diffuser could be more than 6 dB and the effectiveness of the Schroeder diffuser is even greater. It is also demonstrated that the diffusers could be useful for improving the intelligibility of a multiple loudspeaker public address system in long enclosures by increasing the sound energy of the nearest loudspeaker and avoiding the disturbance from the neighbouring loudspeakers. In principle, the measurements are in correspondence with the theoretical analysis.
Observations on the Systematic Deviations between Two Methods of Measuring Sound Transmission Loss
Authors: Jacobsen F. , Ding H.
Published: January 2017

The paper examines and discusses possible explanations of the systematic deviations between conventional and intensity-based sound transmission loss measurements frequently reported in the literature. Both the conventional diffuse-field method and the method based on the sound intensity technique are subject to several systematic errors of comparable size. The sources of error include non-linear decay functions, the absorption of the partition itself, and intensity measurement errors, which are aggravated by the fact that the sound field conditions are usually fairly difficult. It is concluded that with very careful measurement procedures there are no systematic deviations.
Elastic Wave Transmission between Walls in Framed Buildings
Authors: Steel John A
Published: January 2017

The majority of framed buildings have joints between walls with a column running along the joint. Recent work has identified the importance of the column which generally reduces sound transmission between walls at high frequencies. In this work the effects of incident longitudinal or transverse waves as well as flexural waves at a joint with a column is studied together with the effects of an eccentricity. For incident flexural waves the importance of deformation of a column cross section due to shear forces on connected plates has been identified. In this work all of these properties are considered and effects on predicted sound transmission through framed buildings are demonstrated for each of the three wave types.

Solutions for transmission coefficients for bending, longitudinal and transverse shear waves at inline, corner cross and tee joints are obtained. The results satisfy reciprocity conditions. It is important to know what properties of the column have greatest effect on transmission so that the overall performance of buildings can be improved. The effects of varying the column cross section, materials properties and eccentricity are studied. Of these, variations in column dimensions produce the largest changes in transmission while typical variations in material properties and eccentricity are not important.
Determination of Acoustical Impedance of Absorbing Surfaces by Two-Microphone Transfer Function Techniques: Measurement In-Situ
Authors: Waddington D.C. , Orlowski R.J.
Published: January 2017

In the fourth and final of a series of papers on the measurement of acoustical impedance of absorbing surfaces using the two-microphone transfer function technique, the application of the technique to the measurement of a suspended ceiling and to soft grassland is described. Real materials often exhibit extended reaction, and detailed experimental data is currently difficult to obtain for such samples. But for precise sound field predictions, accurate acoustical data is required. The suspended ceiling tiles investigated are extended reaction panels and measurements are performed in-situ. Consequently, no restrictions on the sample area, edge conditions, or homogeneity are applied. Comparisons with theoretical models are presented. These investigations indicate that the panel absorber can be described by its surface impedance, and that the two-microphone transfer function technique can be used to successfully measure this characteristic in-situ. The surface impedance of soft grassland is also successfully measured using both normal and oblique incident sound. These measurements are compared with theoretical models, which are then used to obtain information concerning the structure of the ground, without invasive sampling.
Introductory remarks: immunosuppressive and immunomodulating drugs, where and how do they act?
Authors: Gonsette RE
Published: January 2017

Immunotherapies used in multiple sclerosis are reviewed. The mechanisms of action supporting their clinical application are described according to our current understanding. Immune treatments can be divided into three groups: (1) cytostatic and cytotoxic immunosuppressants which block the cell cycle of immunocompetent cells and/or provoke their deletion; (2) immunomodulatory which specifically interfere in cellular or humoral immune mechanisms; (3) immunoregulators which restore immunodeficient states but have also immunosuppressive properties at the same time. Numerous attempts have been made to correct almost all abnormal immune mechanisms underlying disease progression. The results of those clinical trials are reviewed. Recent studies have demonstrated that a severe, unspecific and sustained immunosuppression markedly downregulates the clinical and pathological activity of the disease. Unfortunately, serious delayed adverse effects prevent a long-term administration. Recent specific immunomodulators with an acceptable toxicity have provided modest but unquestionable benefit on the attack rate and MRI lesion burden. No dear effect on progression has been demonstrated to date. There is still much work to be done to improve the efficacy of our current therapies on the attack rate and particularly on the progression. Several promising new compounds are already under evaluation. Another approach is combination therapies which will certainly become critical in MS like in other autoimmune diseases.
Interferon β-1b: latest published results, 1995
Authors: Noseworthy John H
Published: January 2017

Interferon β-1b (Betaseron) has been shown in a randomized, double-blind, placebo-controlled study to reduce relapse rate, relapse severity and MRI progression in patients with relapsing-remitting MS. The recently published Betaseron extension trial and studies from the National Institutes of Health provide additional evidence suggesting an important treatment effect The major new findings from these studies are reviewed in this paper. Other findings from these recent studies merit attention, however. Specifically, neutralizing antibody formation was seen in 38% of patients receiving high-dose Betaseron at 3 years. With the development of these antibodies, there was no longer clinical evidence that the drug remained effective. This observation must be considered carefully when initiating Betaseron therapy. The Betaseron trial suggests that MRI is an imperfect predictor of clinical disease activity. Of particular interest was the finding that patients receiving low-dose Betaseron developed ‘confirmed treatment failure’ sooner than placebo-treated patients, despite a clear treatment benefit on MRI-detected evidence of subclinical disease activity.
Interferon beta treatment for multiple sclerosis: persisting questions
Authors: Goodkin Donald E
Published: January 2017

Doctors Noteworthy and Summerfield have reviewed the results of placebo-controlled, double-masked, clinical trials of interferon beta-1b (IFNB-1b, Betaseron) and interferons beta-1a (IFNB-1a, Avonex,) in patients with relapsing multiple sclerosis (MS). IFNB-1b, administered subcutaneously every other day to ambulatory patients with relapsing-remitting MS, significantly reduces annual exacerbation rate and percentage change from baseline MRI T2-weighted total lesion area.1-4 There is also evidence that IFNB-1b reduces the number of new gadolinium-enhancing lesions in patients with relapsing-remitting MS.5 IFNB-1a (Avonex), administered intramuscularly every week to patients with relapsing MS, significantly reduces annual exacerbation rate, the number and volume of new focal gadolinium-enhanced T1-weighted lesions, and slows the accumulation of physical disability over time.6 However, questions remain regarding the efficacy of these treatments, the significance of neutralizing antibody formation, indications for therapy, adverse events, optimal dose, and route of administration. Design limitations of the Phase III trial of IFNB-1b have been reviewed elsewhere, 7 and a critical review of the results of the Phase III trial of IFNB-1a should be undertaken after the publication of the clinical and imaging results of that study.
Development of cladribine treatment in multiple sclerosis
Authors: Sipe JC , Romine JS , Koziol JA , McMillan R , Zyroff J , Beutler E
Published: January 2017

Cladribine is a new type of drug with properties of selective lymphocyte suppression that appear to favorably alter the clinical course of progressive multiple sclerosis (MS). The history of the development of cladribine treatment in chronic progressive MS is discussed, and the application of cladribine treatment to progressive multiple sclerosis in a double-blind, placebo crossover study is reviewed. Cladribine selectively targets both resting and dividing lymphocytes and may be able to destroy the activated lymphocytes that induce CNS demyelination, thus producing stabilization or improvement in chronic MS. Although the role of cladribine has not yet been fully defined, additional studies are underway to evaluate the efficacy and safety of cladribine in both progressive MS and relapsing-remitting MS.
CAMPATH-1H in multiple sclerosis
Authors: Moreau Th , Coles A , Wing M , Thorpe J , Miller D , Moseley I , Issacs J , Hale G , Clayton D , Scolding N , Waldmann H , Compston A
Published: January 2017

In a pilot study, seven patients with multiple sclerosis were treated with CAMPATH-1H which targets the CD52 antigen present on lymphocytes and monocytes. There was a substantial reduction in disease activity as measured by gadoliunium-enhancing lesions on MRI. Encouraged by this result a further seven patients have been treated with CAMPATH-1H; four also received anti-CD4 antibody. Lymphopaenia developed rapidly and was sustained for at least one year. In 12 patients, the first infusion of antibody was characterised by significant exacerbation or re-awakening of pre-existing symptoms lasting several hours. These clinical effects of antibody treatment correlated with increased levels of circulating cytokines. Peak levels of tumour necrosis factor alpha (TNFα) and interferon gamma (IFNγ) occurred at 2 h whereas the rise in interleukin-6 (IL-6) was significantly delayed and peaked at 4 h after starting antibody treatment The neurological symptoms could not be attributed directly to pyrexia and were not provoked (in one patient) by an artificial rise in temperature. In the remaining two patients, a single pre-treatment with intravenous methylprednisolone (500 mg) prevented both the transient increase in neurological symptoms and the cytokine release. Our results suggest that soluble immune mediators contribute to symptom production in multiple sclerosis by directly or indirectly blocking conduction through partially demyelinated pathways.
Long term recombinant interferon alpha treatment in MS with special emphasis to side effects
Authors: Durelli Luca , Bongioanni MR , Ferrero B , Imperiale D , Verdun E , Oggero A , Gentile E , Bradac GB , Bergui M , Bergamini L , Bergamasco B
Published: January 2017

Twenty relapsing-remitting (RR) clinically definite MS patients were treated with 9 MIU intramuscular recombinant interferon alpha-2a (rIFNA) (Rof eron-A, Roche) (n=12) or placebo (n=8) every other day for 6 months and followed up for a further 6 months after stopping treatment Numbers of active lesions at MRI and of patients with clinical-MRI signs of disease activity and lymphocyte interferon gamma production, which were decreased during treatment, returned to values similar to baseline and placebos after stopping treatment rIFNA chronic therapy seems therefore needed in order to maintain drug efficacy. Side effect prof ile was monitored, too, for over 1 year in the same 20 patients plus 25 additional RR MS patients. Besides the typical side effects of type 1 interferon therapy (fever, fatigue, depression, lymphopenia, hepatic enzyme elevation), occurrence of serum autoAbs was noted in 30% patients (in 60% antinuclear and in 80% antithyroid autoAbs). In two patients rIFNA treatment was stopped, in one case for antithyroid autoAbs and hypothyroidism, in the other for antinuclear autoAbs and a five-fold increase of ALT. A careful monitoring of serum autoAbs and of signs of thyroid or liver damage must always precede and accompany longterm type 1 IFN therapy.
Treatment of relapsing-remittent multiple sclerosis with recombinant human interferon-alfa-2a: design of a randomised, placebo-controlled, double blind trial in Norway
Authors: Nyland H , Myhr K-M , Lillås F , Smievoll AI , Riise T , Nortvedt M , Nilsen R
Published: January 2017

A multicentre, randomised, double-blind, placebo controlled study to evaluate the efficacy and safety of 4.5 and 9.0 MIU recombinant human interferon alfa-2a (Rof eron-A™) given thrice weekly in patients with relapsing-remittent multiple sclerosis is described. The patients are treated for 6 months followed by a 6 months drug-free period. The primary objective is to determine new disease activity analysed by monthly MRI with gadodiamide (GdDTPA-BMA, Omniscan™). The study is conducted at eight centers in Norway and is completed in January 1996.
Inhibitors of tumor necrosis factor-α: Promising agents for the treatment of multiple sclerosis?
Authors: Hohlfeld Reinhard
Published: January 2017

Tumor necrosis factor (TNF)-α is a critical inflammatory mediator of experimental autoimmune encephalomyelitis and multiple sclerosis, and may therefore be a useful target for immunotherapy. Therapeutic strategies aimed at TNF include pharmacological inhibitors of TNF synthesis and/or processing and biological inhibitors of TNF effects. Several anti-TNF agents are currently being tested in multiple sclerosis in pilot clinical trials.
Impairment of central and peripheral myelin in mitochondrial diseases
Authors: Kalman Bernadette , Lublin Fred D , Alder Hansjuerg
Published: January 2017

Clinical or sub-clinical impairment of central and peripheral myelin is of ten part of the overlapping multisystem disorders associated with a variety of mitochondrial (mt)DNA abnormalities. Suboptimal energy metabolism of the oligodendrocytes and Schwann cells carrying mitochondrial defects may cause insufficient production of myelin. Further, edema, vascular and toxic factors may directly damage myelin. The recognition that certain mtDNA point mutations are associated with inflammatory demyelination of the central nervous system suggests that additional mechanisms besides degeneration need to be considered in the development of some forms of myelin damage.
Screening for Leber's hereditary optic neuropathy associated mitochondrial DNA mutations in patients with prominent optic neuritis
Authors: Kalman Bernadette , Rodriguez-Valdez Jose Luis , Bosch Ursula , Lublin Fred D
Published: January 2017

Previous case reports demonstrated the presence of Leber's hereditary optic neuropathy (LHON) associated mitochondrial (mt) DNA mutations in patients presenting with prominent optic neuritis (PON). By screening the mtDNA, we have excluded vie presence of these mutations in 22 patients with PON, indicating that the frequency of these mutations is less than 4.5% in our selected patient population. Reviewing the clinical data of these patients revealed that severe optic nerve atrophy developed in association with both the benign and the severely disabling form of Multiple Sclerosis (MS). This observation suggests that the prominent feature of ON in MS may be related to local factors or to a selective vulnerability of the optic nerve in some patients. However, it also may be a consequence of a deleterious process associated with inflammatory demyelination in the central nervous system (CNS) of another, genetically probably distinct subgroup of severely disabled patients.
Serial magnetic resonance imaging (MRI) study of a patient with Balo's concentric sclerosis treated with immunoadsorption plasmapheresis
Authors: Sekijima Y , Tokuda T , Hashimoto T , Koh C-S , Shoji S , Yanagisawa N
Published: January 2017

A 28-year-old Japanese woman with Balo's concentric sclerosis developed a rapidly progressive form of encephalopathy. Magnetic resonance imaging (MRI) showed multiple concentric lesions in the central white matter and the cerebellum. The administration of corticosteroid regimen resulted in little benefit Immunoadsorption plasmapheresis led to a remission within 1 month of onset Serial MRI study was described here for the first time, which allowed us to observe the development of concentric stuctures. The observation indicated that initially, a central core, a round demyelinated area, and surrounding edema appeared around a vessel. Subsequently, concentric demyelineated bands formed simultaneously, not centrifugally, with diminution of the edema. Analysis of cerebrospinal fluid showed elevated levels of interleukin-6 and tumor necrosis factor-α. The success of immunoadsorption plasmapheresis therapy in this patient suggests that both humoral demyelinating factors and cell-mediated immunity may be involved in the pathogenesis of this disorder.
Telemedicine in Australia. 1: The Health-Care System and the Development of Telemedicine
Authors: Alexander M
Published: January 2017

Telemedicine developments are intimately linked to the society in which they occur. Some of the salient factors are: the structure of the health-care system, especially its funding arrangements and the relationship between hospital and community care; the telecommunications network environment and business developments in communications technology; geographic factors of distance and isolation; and government policy dealing with interacting sectors. These factors are all considered in this review of the background to telemedicine developments in Australia.
Design of a Clinical Data-Collection Form for Remote Health Care
Authors: Thomas A D , Maclean J R
Published: January 2017

A clinical data-collection form was designed for use in the consultation process between an astronaut and Earth. It can also be applied in most remote health-care settings. The form was tested by non-medically trained individuals in 101 simulated and 19 real cases. A completion rate of 88% was achieved, with a diagnostic accuracy of 85%. This compares favourably with studies by other workers in the field of medical decision support. Space telemedicine research will contribute to developments that will benefit not only space activities but also terrestrial applications.
The Scrapping of End of Life Vehicles: Is New European Legislation Necessary?
Authors: Lea Anne
Published: January 2017

The proposed Directive aims to ensure that end of life vehicles are discarded without endangering the environment. It builds upon the concept of producer responsibility and will apply to all vehicles discarded after 1 January 2006 regardless of the date of manufacture. Collection systems will be established, dismantling information will be provided, certificates of destruction issued, and targets will be set for re-use and recycling. Car dismantlers will be obliged to separate components and markets will be developed for all recycled components. The proposal aims to reduce landfill but has a difficult relationship with other environmental commitments associated with climate change. As currently drafted the Directive will have significant resource implications for manufacturers and car breakers.
Proceduralisation and the Aarhus Convention
Authors: Getliffe Kate
Published: January 2017

In the context of legal evolution, it is apparent that initiatives in environmental law are having an impact upon other legal fields and additionally upon the workings of the legal system itself. The legal system is failing adequately to protect the environment; once we accept this it is necessary to turn to solutions. Aspects of reflexive legal theory, such as increased access to the decision-making arena, are being eagerly adopted at EU level as an attempt to overcome the shortcomings inherent in the legalisation of environmental matters. One principal problem relating to the process of legalising environmental concerns is that of problem definition. It is argued that the advancement of enhanced participation in this field will result in more readily applicable solutions being raised. The issue assessed in this article is whether procedures which lead to greater participation in the decision-making process result in more effective legal output which ensures better protection of the environment. Enhanced participation is touted as a means to clarify the public interest and inculcate responsibility for the environment. It is thus assumed that the policy output is more representative of the consensus of public opinion. The Aarhus Convention is assessed in terms of its standing as a potential normative model of proceduralisation. Its compatibility with the sections of the Convention relating to participation and EU environmental law are analysed.
Agriculture, the EC and the WTO: A Legal Critical Analysis of the Concepts of Sustainability and Multifunctionality
Authors: Cardwell Michael
Published: January 2017

The agricultural policies of the Member States of the EC have for many years now been controlled from Brussels under the Common Agricultural Policy (CAP). In recent years the CAP has, together with other policies of the EC, been refocused from crop production support to a European rural policy, with the term ‘sustainability’ being written into many policy documents. This term has achieved international recognition and the definition used by the Brundtland Commission has been widely accepted, as evidenced by its use in OECD documentation. While the term ‘sustainability’ has been written into World Trade Organisation (WTO) texts, the robustness of the term is questionable. The question then arises as to the legal interaction of WTO texts and multilateral environmental agreements, which do have ‘sustainability’ as their core philosophy. A new term has entered the regional and global debate in the policy area of agriculture, that of ‘multifunctionality’. The EC is increasingly defining agriculture as being multifunctional. This term has yet to be clearly defined at EC level, although the OECD has done some work in this area. How the millennium round of WTO negotiations reacts to the term ‘multifunctionality’ will have an important impact on the EC's CAP. This paper examines the issues of sustainability and multifunctionality, with particular reference to the agricultural policies of the EU and WTO, and their interaction.
The Release of Genetically Modified Organisms into the Environment: Public Concerns and Regulatory Responses
Authors: Cardwell Michael
Published: January 2017

Public concern about the health and environmental implications of genetically modified organisms has not been allayed. This concern has been reflected in, for example, consumer choice and the reluctance of juries to convict those protesting against field trials. Two aspects of the response by the Community legislature may be examined: first, increasing recourse to the precautionary principle; and, secondly, the proposed regime to address environmental liability. The adequacy of such measures is, however, to be judged against the background of calls at the highest level for an entrepreneurial Community to participate more fully in the biotechnology revolution.
Environmental Assessment Australia's New Outlook under the Environment Protection and Biodiversity Conservation Act 1999 (Cth)
Authors: Bates Gerry
Published: January 2017

Environmental law in Australia owes much of its origins to British ancestry, but as a political federation of states and territories, Australia has also looked to other federal jurisdictions in the USA and Canada to help determine appropriate legal responsibilities for protection of the environment and management of natural resources. Environmental assessment of activities at Commonwealth level indeed was initially influenced by the American and Canadian models; but in recent years Australian governments have sought a more refined approach that reflects the realities of a new era of ‘co-operative federalism’ ushered in by the Inter-governmental Agreement on the Environment 1992. The promulgation of the Environment Protection and Biodiversity Conservation Act 1999 (Cth) (EPBCA) represents the conclusion of this search for the most appropriate statement of Commonwealth/state responsibilities for the environment; and represents the most fundamental reform of Commonwealth responsibility for the environment in the past 30 years.

The Act, which came into force on 16 July 2000, replaces five existing statutes; the Endangered Species Protection Act 1992 (Cth); the Environment Protection (Impact of Proposals) Act 1974 (Cth) (EPIP Act); the National Parks and Wildlife Conservation Act 1975 (Cth); the Whale Protection Act 1980 (Cth), and the World Heritage Properties Conservation Act 1983 (Cth).1 The passage of the Act has been controversial because it appears to limit the legal responsibilities of the federal government to a narrow list of defined circumstances, omitting in the process some environmental issues in Australia that might appear to demand a national approach. The purpose of this paper is to describe the background and philosophy behind the new legislation, and outline the provisions for Commonwealth environmental assessment and approval of actions that might significantly affect the environment.
Effects of M2000 (D-Mannuronic Acid) on Learning, Memory Retrieval, and Associated Determinants in a Rat Model of Alzheimer’s Disease
Authors: Athari Nik Azm Somayeh , Vafa Mohammadreza , Sharifzadeh Mohammad , Safa Majid , Barati Anis , Mirshafiey Abbas
Published: January 2017

The d-mannuronic acid (M2000) is a novel nonsteroidal anti-inflammatory drug that has immunosuppressive effects together with antioxidant property. M2000 has shown a notable efficacy in experimental models of multiple sclerosis, rheumatoid arthritis, and nephrotic syndrome. In this work, the effect of M2000 on the treatment of Alzheimer’s disease (AD) was performed by Morris water maze experiment, and the immunological assessments were carried out by Western blot, apoptosis (procaspase-3, Bax/Bcl2, P53), enzymatic (superoxide dismutase [SOD]), and nonenzymatic oxidative stress (malondialdehyde [MDA]) tests. We found that pretreatment of AD in the rat model by M2000 had a potent efficacy on rat behavior and also it led to a significant inhibition of amyloid plaque production. Moreover, our data showed that M2000 can reduce the amount of Bax/Bcl2, P53, MDA, and SOD, as well as it normalized the level of procaspase-3. Our results suggest M2000 is a potential therapeutic agent for the treatment of AD.
Endovascular Thermal Coagulation Using the Double-Helix GDC
Authors: Guglielmi G. , Ji C.
Published: January 2017

An experimental study was undertaken to explore the possibility of treating this subset of aneurysms with thermal coagulation.

Endovascular endosaccular thermal coagulation of experimental aneurysms was successfully performed using a radiofrequency electrical current applied to a novel device, the double-helix GDC. Theoretically this technique could be utilized in selected patients to occlude large and giant intracranial aneurysms.
Transvenous Treatment of Cranial Dural Arteriovenous Fistulas with Hydrogel Coated Coils
Authors: Klurfan P. , Gunnarsson T. , Shelef I. , Terbrugge K.G. , Willinsky R.A.
Published: January 2017

Intracranial dural arteriovenous fistulas (DAVF) with cortical venous reflux may become symptomatic due to venous congestion or intracranial hemorrhage. Venous congestion in the orbit can also occur resulting in proptosis, chemosis, double vision and progressive visual loss. The transvenous approach has been used for selective disconnection of the venous drainage to eliminate the venous congestion and future risk of intracranial bleeding and/or neurological deficit. Hydrogel coated coils (HydroCoil®) expand after contact with blood causing the coils to swell up to five to 11 times a standard 10-system bare platinum coil. Due to this property, HydroCoils could have an advantage over platinum coils in the transvenous approach to embolization of DAVFs.

Ten patients with symptomatic cranial DAVF underwent a transvenous embolization using HydroCoils as the only embolic agent or in a combination with bare platinum coils. The patients' characteristics, symptoms, angioarchitecture of the DAVF, treatment, complications and results were analyzed.

All the treated DAVFs were disconnected at the end of the procedure. All the patients with orbital symptoms had complete or significant improvement. There were no periprocedural complications. Nine patients had radiological follow-up showing cure.

HydroCoils can be used effectively and safely to treat intracranial DAVFs transvenously. The volume expansion of Hydrocoils may have significant advantage over bare platinum coils given the large venous spaces that need to be filled. The use of HydroCoils may decrease the procedure time and consequently reduce the radiation dose to the patient.
Pseudoaneurysm of Internal Carotid Artery following Mandibular Reconstruction Treated by Covered Stent
Authors: Mejdoubi M. , Dekeister C. , Irsutti M. , Cognard C. , Paoli J-R.
Published: January 2017

We describe the case of a 68-year-old woman who had a mandibular titanium plate reconstruction following surgery for a parotid carcinoma. Fifteen months later she presented bleeding episodes related to a pseudoaneurysm of the internal carotid artery located just above the bulb. This was probably related to the weakening of the arterial wall following friction with the mandibular plate and radiotherapy. We successfully obliterated this pseudoaneurysm using a covered stent.

This rare diagnosis should be evoked in case of bleeding following a mandibular reconstruction. Stenting is an effective treatment strategy obviating the need for open surgery.
Three-Stent Placement for Treatment of Carotid Artery Pseudoaneurysm
Authors: Amistà P. , Barbisan D. , Beghetto M. , Cavasin N. , Zucchetta P. , Frego M.
Published: January 2017

Pseudoaneurysm treatment with overlapping stents may be a useful technique to reduce flow and enhance thrombosis in the aneurysmal sac. We treated a pseudoaneurysm of the left carotid artery in a patient with a history of bilateral carotid thromboendarterectomy by placing three stents and overlapping them at the level of the aneurysmal neck.

Nine month follow-up revealed almost complete pseudoaneurysm exclusion and patency of the carotid artery.
A Potential Pitfall in the Use of the Monorail System for Carotid Stenting
Authors: Pereira E. , Birnbaum L.
Published: January 2017

The use of EPDs seems to be necessary for safe CAS. Though the monorail system may offer advantages for a single operator, we caution its use with certain aortic arch anatomies.

In such anatomies, using an OTW system or at least a 300 cm filter wire or devices that support wire extension will remedy some complications, such as the loss of the guiding sheath. As in our case, the added advantage of a 300 cm filter wire enabled us to avoid a poor outcome or an emergency vascular surgery.
MIF Expression in Induced Peripheral Blood Mononuclear Cells by Vitamin D3 and its Potential Correlation with Resting Metabolic Rate in Obesity
Authors: Hossein-Nezhad A. , Mirzaei K. , Aslani S. , Tootee A. , Karimi F.
Published: January 2017

Macrophage migration inhibitory factor (MIF) plays a pivotal role in systemic and local inflammatory and immune responses. The aim of this study is to assess MIF gene expression in PBMCs harvested from obese individuals and to compare it with that of lean subjects to analyze any potential relationship between resting metabolic rate as well as several different parameters and MIF expression in PBMC. We also aim to assess anti-inflammatory characteristics of vitamin D3 on MIF expression in vitro. Participants were 30 obese and 18 non-obese subjects who were assessed following an overnight fasting for RMR by means of indirect calorimetry. Body composition was measured using a Bodystat device. The PBMCs were separated from whole blood by the Ficoll-hypaque technique. The mRNA was extracted and the cDNA was synthesized. This process was followed by real-time PCR using primer pairs specific for MIF mRNA and beta actin as internal control. Our findings clearly demonstrate that there were significant differences in terms of BMI, BMR predict, fat proportion, fat mass, free fat mass, TBW, visceral fat, fasting serum glucose, TG, HDL, Hs-CRP and RMR between the two groups. Moreover, the level of MIF expression in the obese group was approximately 2.5 times higher compared to the lean group. An increased level of MIF expression in the obese group and a decreased expression of that non-obese was observed after inducing PBMCs with vitamin D3. One of the intriguing results of this study was the observed reverse correlation between MIF expression and fat mass as well as fat proportion after PBMCs were cultured in the presence of vitamin D3. Therefore, it could be concluded that MIF expression, which is in turn influenced by vitamin D3, has a role in the hyperactive immune profile and the pro-inflammatory state observed in obese individuals which is suggested to have a causal relationship with obesity.