bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Poststroke Seizures on Neurological Deficits: Magnetic Resonance Diffusion-Weighted Imaging Study
Authors: Kumral Emre , Uncu Gülgün , Dönmez İlknur , Cerrahoglu Şirin Tuba , Alpaydın Sezin , Çallı Cem , Kitiş Ömer
Published: January 2013

Background: The impact of poststroke seizures on the neurological deficits related to ischemic stroke is not well known. It has been reported that following poststroke epilepsy, transient or long-lasting worsening of the poststroke sequelae may develop, but the underlying mechanism of deficit worsening has not been systematically studied by magnetic resonance diffusion-weighted imaging (MRI-DWI). Methods: From 2008 to 2009, 1,010 ischemic stroke patients were admitted to our stroke unit at the Ege University Hospital with first-time strokes. Of these, 76 (7.5%) patients developed delayed seizures in a follow-up period of 18 months. We extracted the clinical and imaging data of the patients from our Stroke Registry databases and other medical records, and evaluated brain MRI, including spin-echo DWI with apparent diffusion coefficient (ADC) maps, FLAIR and T2-weighted images. Results: There were 15 (20%) patients who had long-lasting worsening of the previous neurological sequelae, which we called long-lasting neurological worsening (LLW); 38 (50%) had transient neurological worsening (TNW) and 23 (30%) were without neurological worsening (WNW) after poststroke seizures. DWI findings were present in 3/23 (13%) patients with simple partial-type seizure, in 4/17 (29%) patients with complex partial-type seizure, and in 7/13 (54%) patients with generalized toni-clonic type seizure (p = 0.002). Patients with LLW showed more frequent changes on DWI than those with TNW (53 vs. 16%; p = 0.009). Forty percent of patients with LLW and 5% of those with TNW had ADC decrease (p = 0.004). Patients with LLW had DWI changes in the occipital region more frequently than those with TNW (57 vs. 18%; p = 0.05). Correlation analysis found a significant association between LLW and DWI changes, multiple DWI lesions, ADC decrease, and recurrent seizures. In the control MRI-DWI 1 month after the poststroke seizure, no signal abnormalities were detected in neuroimaging studies of all patients. Despite no functional outcome differences between the groups before the seizure, the functional scales 1 week after the seizure (National Institutes of Health Stroke Scale, Modified Rankin Scale and Barthel Index) showed significantly worse neurological functional statements in the patients with LLW than those with TNW and WNW (p = 0.001). Conclusions: Poststroke seizures may affect poststroke sequelae transiently, which we see more often, but some seizure types may prolong the duration of deficits. Multiple DWI changes and LLW following recurrent and longer poststroke seizures were strongly associated, and this may be due to the effect of seizures causing additional metabolical changes.
Association of Nesfatin-1 and Fat Mass in Cystic Fibrosis
Authors: Cohen Rubin I. , Ginsberg Nicole , Tsang Donna , Wann Li Chen , Ye Xiaobing , Liu Shu Fang
Published: January 2013

Background: The mechanisms of fat mass (FM) loss in cystic fibrosis (CF) are poorly understood but could represent complex pathways involving dysregulation of appetite-modulating peptides and an amplified inflammatory response. Nesfatin-1 is a newly described peptide that decreases food intake and FM but has not been studied in CF. Objectives: We hypothesized that changes in the appetite-suppressing hormone nesfatin-1 would be physiological, and levels would be lower in advanced CF patients with lower FM compared to those with milder disease and healthy controls. We determined the levels of the cytokines TNF-α, IL-1β, and IL-6 as they have been associated with weight loss in disease states. Methods: Fifty-four adult CF subjects, i.e. 17 with severe, 22 with moderate, and 15 with mild disease, as well as 18 controls were recruited. PFT and body composition analysis (via bioelectrical impedance) were performed. Nesfatin-1 and cytokine levels were determined by ELISA. Results: Contrary to our proposed hypothesis, nesfatin-1 levels were highest in CF patients with severe disease and the lowest FM. A significant negative correlation between nesfatin-1 levels and FM was found only in the severe CF group (r = -0.7, p = 0.003). In forward stepwise regression analysis, only FM was significantly associated with nesfatin-1 levels. Levels of TNF-α and IL-6 were elevated in the severe CF group, but there was no association with either FM or nesfatin-1. Conclusion: In advanced CF and low FM, nesfatin-1 plasma levels are significantly increased and inversely correlated with the FM. Our results further suggest that nesfatin-1 exerts its effects independently of TNF-α or IL-6.
Env Gene Expression of Human Endogenous Retrovirus-K and Human Endogenous Retrovirus-W in Childhood Acute Leukemia Cells
Authors: Januszkiewicz-Lewandowska Danuta , Nowicka Karina , Rembowska Jolanta , Fichna Marta , Żurawek Magda , Derwich Katarzyna , Nowak Jerzy
Published: January 2013

Introduction: The etiopathogenesis of childhood leukemia is not fully understood. It is suggested that endogenous viral sequences may play a role in leukemogenesis. Human endogenous retroviruses (HERVs) constitute about 8% of the human genome. Most HERVs are dysfunctional because of numerous mutations and deletions. Some HERVs, however, contain sequences capable of transcription. In patients with leukemia, the presence of antibodies against HERV-K has been identified, which could suggest increased expression of HERV-K in leukemic cells. To elucidate the role of endogenous retroviruses in leukemogenesis, studies were undertaken to assess env gene expression of HERV-K and HERV-W in childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Results: This study was performed in 170 children with ALL, 38 subjects with AML, and 30 healthy subjects. Expression of the env gene of HERV-K and HERV-W and the control gene ACTB was studied by real-time PCR using specific oligonucleotide primers and SYBR Green marker. Env gene expression was assessed on the basis of the absolute threshold-Ct, as well as normalized against ACTB expression and double normalized expression relative to ACTB and reference cells – normal peripheral blood lymphocytes (PBL). Env gene expression of HERV-K normalized against ACTB, as well as double normalized expression relative to ACTB and normal PBL, was significantly higher only in AML. There were no statistically significant differences in env gene expression of HERV-W normalized to ACTB in ALL and AML as compared to normal PBL. Conclusion: High normalized expression of the env gene of HERV-K in AML strongly suggests a possible contribution of this gene in the pathogenesis of AML.
Simultaneous Visualization of Myosin Heavy Chain Isoforms in Single Muscle Sections
Authors: Ribarič Samo , ČebaŠek Vita
Published: January 2013

We developed a staining protocol that enables simultaneous visualization of myosin heavy chain (MHC) pure and hybrid muscle fiber types in rat skeletal muscle. Up to eight different muscle fiber types can be visualized in a single section of the rat extensor digitorum longus muscle, which contains all four adult MHC isoforms and shows plasticity during the denervation-reinnervation process. Triple immunofluorescent staining of MHC-1, MHC-2a and MHC-2b with primary antibodies BA-D5 (isotype IgG2b), SC-71 (isotype IgG1) and BF-F3 (isotype IgM) and with three fluorophore-labeled isotype-specific secondary antibodies displays different muscle fiber types in a merged image of red, green and blue channels, each in its own color. Immunoperoxidase staining with primary antibody 6H1 directed against MHC-2x can be additionally applied on the same tissue section to facilitate the identification of muscle fibers containing MHC-2x. Triple staining can also be used in combination with other staining procedures to derive more information about the number of capillaries or the oxidative potential of muscle fiber types. Simultaneous visualization of multiple fiber types in a single merged image enables economical use of muscle samples and provides simple and rapid identification of all fiber types that are present in rat limb muscles.
Comparison of Sutures and Cyanoacrylate Tissue Adhesives for Wound Repair in a Rat Model of Corneal Laceration
Authors: Nuhoglu Fadime , Altiparmak Ugur E. , Hazirolan Dicle O. , Kasim Remzi , Duman Sunay
Published: January 2013

Aims: The aim of the present study was to evaluate the cicatricial repair of a corneal artificial perforation in rats with 10-0 nylon suture, N-butyl-2-cyanoacrylate (NBCA) adhesive, or NBCA + methacryloxysulfolane (NBCA-MS) adhesive through microscopic and histological assays. Methods: Twenty Wistar rats were randomly divided into 4 groups each containing 5 rats: (1) control group (corneal trauma without suturing and tissue adhesives), (2) suture group, (3) NBCA group and (4) NBCA-MS group. A central full-thickness 2-mm laceration was performed in the left eyes of the studied rats in all 4 groups. The presence of corneal edema, corneal neovascularization and tissue adhesive/suture were evaluated. On the 21st day, the rats were sacrificed and histological examination was performed to determine irregularity of corneal layers, superficial epithelization, polymorphonuclear leucocytes and neovascularization. Results: Tissue adhesives were as effective as suturing in closing full-thickness corneal wounds and no difference in postoperative healing was observed clinically. As for the histological results, suture-treated eyes had persistent corneal irregularity that can limit visual acuity and may also lead to astigmatism. Conclusions: The use of tissue adhesives constitutes a viable alternative clinical procedure to conventional sutures. Possible influences on astigmatism are hypothetical, as no objective measure of astigmatism was performed in the test animals.
Antiviral Therapy for HCV-Associated Cryoglobulinemic Glomerulonephritis: Case Report and Review of the Literature
Authors: Fabrizi Fabrizio , Fogazzi Giovanni Battista , Cresseri Donata , Passerini Patrizia , Martin Paul , Donato Maria Francesca , Rumi Maria Grazia , Messa Piergiorgio
Published: January 2013

We describe the case of a 51-year-old woman with HCV-associated cryoglobulinemic glomerulonephritis (GN). She presented mild deterioration of kidney function, non-nephrotic proteinuria, and active urinary sediment. Kidney biopsy showed features of membranoproliferative changes with some sclerosis. Sustained viral response (SVR) was obtained by 6 months of antiviral therapy (peg-IFN-α2a plus ribavirin). SVR was linked with improvement of kidney function and remission of proteinuria. Clinical and virological remission persists over a 25-month follow-up. This case report emphasizes efficacy and safety of antiviral treatment of HCV-associated glomerulonephritis – preliminary but encouraging results exist. We identified by systematic review of the literature 9 studies (156 unique patients); the pooled estimate of frequency of sustained virological response after IFN-based therapy was 0.49 (95% confidence interval, CI: 0.21, 0.77; p < 0.0005; random effects model). Heterogeneity was found (I2 = 98.9%, p < 0.0001). Two possible regimens should be considered for the treatment of HCV-associated cryoglobulinemic GN according to the clinical presentation. Immunosuppressive therapy is recommended for HCV-related kidney disease having aggressive course, and recent evidence supports rituximab (RTX) use with a reduced exposure to corticosteroids. We identified six studies (66 unique patients) on RTX therapy for HCV-associated kidney disease; at the end of RTX therapy, the pooled estimate of the mean decrease in proteinuria was 1.4 g/24 h (95% CI: 0.75, 2.05, p < 0.001); The p test for heterogeneity gave a value of 0.94 (I2 = 0). Several questions related to RTX use remain. HCV-induced GN is uncommon among CKD patients of developed countries, and this clearly hampers prospective controlled clinical trials aimed to evaluate efficacy and safety of antiviral or immunosuppressive therapy in this population.
Is the Standardized Uptake Value of FDG-PET/CT Predictive of Pathological Complete Response in Locally Advanced Rectal Cancer Treated with Capecitabine-Based Neoadjuvant Chemoradiation?
Authors: Bampo Chiara , Alessi Alessandra , Fantini Simona , Bertarelli Gaia , de Braud Filippo , Bombardieri Emilio , Valvo Francesca , Crippa Flavio , Di Bartolomeo Maria , Mariani Luigi , Milione Massimo , Biondani Pamela , Avuzzi Barbara , Chiruzzi Chiara , Pietrantonio Filippo
Published: January 2013

Objectives: Our aim was to assess FDG-PET/CT as a surrogate biomarker of the pathological complete response in locally advanced rectal cancer treated with neoadjuvant chemoradiation. Methods: T3–4 and/or N+ rectal cancer patients were treated prospectively with capecitabine-based chemoradiation and total mesorectal excision 7–8 weeks later. FDG-PET/CT uptake was obtained at baseline, after 2 weeks, and 6 weeks following treatment completion, calculating the maximum standardized uptake value (SUV) and percentage difference to identify the early and late metabolic ‘response index’. Results: Thirty-one patients were treated from January 2009 to January 2012 at the Istituto Nazionale dei Tumori of Milan. One patient was excluded due to surgery refusal. The pathological complete response rate was 30%. Early FDG-PET/CT was performed in 24 consenting patients and failed to show predictive utility. On the contrary, significant differences in late SUV value and response index were observed between complete and noncomplete pathological responders (p = 0.0006 and 0.03). In multivariate analysis including most relevant SUV parameters, none of them was independently associated with a pathological complete response. With receiver operating characteristic curve analysis, a late SUV threshold <5.4 had 81% sensitivity and 100% specificity, with 90% overall accuracy. Conclusions: We evidenced a possible predictive role of late FDG-PET/CT for the assessment of pathological response in locally advanced rectal cancer following neoadjuvant chemoradiation.
Comparison of Two Approaches in Microsurgical Varicocelectomy in Chinese Infertile Males
Authors: Pan Feng , Pan Lianjun , Zhang Aixia , Liu Yong , Zhang Fenglei , Dai Yutian
Published: January 2013

Objective: To compare the outcomes of two approaches (inguinal and subinguinal) of microsurgical varicocelectomy (MV) in Chinese infertile men. Patients and Methods: 120 infertile men who met the inclusion criteria were randomly assigned to two groups and operated with MV using different approaches. The outcomes and complications were then compared. Results: The two groups were similar in all aspects except the percentage of patients using analgesic at 27 h postoperatively (57.6% in the inguinal group, 37.5% in the subinguinal group; p < 0.05). Spontaneous pregnancy was achieved at a ratio of 33.9% in the inguinal group and 30.4% in subinguinal group. The median values of semen parameters were significantly improved postoperatively in both groups. Conclusions: Both approaches are effective methods in the repair of varicocele in infertile men, but more analgesic medication at the first day after operation may be required in inguinal group.
Location and Characterization of GAPDS in Male Reproduction
Authors: Liu J. , Sun C.M. , Zhang C.L. , Wang X. , Li J.Y.
Published: January 2013

Sperm-specific glyceraldehyde 3-phosphate dehydrogenase (GAPDS) originates from spermatogenic cells of the human testis. A strong staining of GAPDS was detected in epididymal epithelium, especially in principal cells and basal cells of the epithelium. GAPDS also bound to the fibrous sheet of the sperm tail and inhibited the motility and penetration ability of sperms. The rat model showed that at postnatal day 28 the spermatogenic cells began to express GAPDS protein. By day 60 its expression decreased in spermatogenic cells while it increased in Sertoli cells. After sexual maturation (120 days) GAPDS protein was expressed in both Sertoli cells and elongated sperms. The expression of GAPDS gradually increased with age in the epididymis.
Spatiotemporal Dynamics of Complement C5a Production within Bacterial Extracellular Polymeric Substance
Authors: Conrad Erin C. , Hsu Yueh-Ya , Bortz David M. , Younger John G.
Published: January 2013

Opsonization and anaphylatoxin production are early events in the innate response to bacterial pathogens. Opsonization alone is frequently not lethal and production of anaphy-latoxins, especially C5a, allows for recruitment of cellular defenses. Complement biochemistry is extensively studied and computational models have been reported previously. However, a critical feature of complement-mediated attack is its spatial dependence: diffusion of mediators into and away from a bacterium is central to understanding C5a generation. Spatial dependence is especially important in biofilms, where diffusion limitation is crucial to bacterial counterdefense. Here we develop a model of opsonization and C5a production in the presence of a common blood-borne pathogen, Staphylococcus epidermidis. Our results indicate that when complement attacks a single cell, diffusion into the extracellular polymeric substance (EPS) is complete within 10 ms and that production of C5a peaks over the next 15 min. When longer diffusion lengths (as in an EPS-rich biofilm) are incorporated, diffusion limitation appears such that the intensity and duration of C5a production is increased. However, the amount of C5a produced under several likely clinical scenarios where single cells or sparse biofilms are present is below the kD of the C5a receptor suggesting that complement activation by a single bacterium may be difficult to detect when diffusion is taken into account.
A Retrospective Study of the Safety and Efficacy of a First-Line Treatment with Modified FOLFOX-4 in Unresectable Advanced or Recurrent Gastric Cancer Patients
Authors: Yeh Yung-Sung , Tsai Hsiang-Lin , Ma Cheng-Jen , Wu Deng-Chyang , Lu Chien-Yu , Wu I-Chen , Hou Ming-Feng , Wang Jaw-Yuan
Published: January 2013

Aim: Dismal clinical results in patients with unresectable advanced or recurrent gastric cancer highlight the need for effective systemic chemotherapy. An increase in adverse events associated with systemic chemotherapy is shown in elderly patients, but it remains controversial whether they should receive the same chemotherapy used for younger patients. We retrospectively studied 73 patients with unresectable advanced or recurrent gastric cancer, including 48 nonelderly patients (<65 years old) and 25 elderly patients (≥65 years old) who received a combination of oxaliplatin, 5-fluorouracil and leucovorin (modified FOLFOX-4, mFOLFOX-4 regimen). Patients and Methods: From January 2006 to June 2011, 73 patients with histologically confirmed unresectable advanced or recurrent gastric cancer were enrolled in this study. All patients were treated with an mFOLFOX-4 regimen of 85 mg/m2 of oxaliplatin and 200 mg/m2 of leucovorin on the first day, followed by a 24-hour continuous infusion of 1,000 mg/m2 of 5-fluorouracil in 2 days with a 2-week interval. Treatment continued until disease progression or intolerable adverse events occurred. Results: Overall response rates show clinical efficacy (41.1%, 30/73 patients), stable cancer (26.0%, 19/73 patients) and progressive cancer (32.9%, 24/73 patients). The response rate was 36.0% in the elderly group and 43.8% in the nonelderly group (p = 0.891). In elderly patients, the overall time to progression was 8.1 months and the median overall survival was 11.9 months. On the other hand, in nonelderly patients, the overall time to progression was 7.9 months (p = 0.483) and the median overall survival was 11.2 months (p = 0.953). The results show no statistical differences in efficacy and adverse events between elderly and nonelderly groups (all p > 0.05). Conclusion: The mFOLFOX-4 therapy is an effective and safe first-line treatment for unresectable advanced or recurrent gastric cancer patients. Moreover, mFOLFOX-4 was well tolerated and effective in both nonelderly and elderly patients.
Meta-Analysis of MMP9 –1562C/T and the Risk of Coronary Heart Disease
Authors: Li Junyan , Lu Hao , Tao Feng , Zhou Hua , Feng GuoyYing , He Lin , Zhou Ligang
Published: January 2013

Introduction: Previous case-control studies have suggested that the –1562C/T and R279Q polymorphisms of the matrix metalloproteinase 9 gene (MMP9) are associated with coronary heart disease (CHD). However, other studies do not confirm these relationships. The objective is to assess these relationships using meta-analysis. Methods: Databases, including PubMed and ScienceDirect, were searched to access the genetic association studies. Then data were extracted. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated. Moreover, subgroup and sensitive analysis were performed. Results: The meta-analysis of the –1562C/T polymorphism included 12 studies with 8,336 cases and 3,984 controls. The –1562T allele was significantly associated with CHD (OR 1.25, 95% CI 1.08–1.45, p = 0.004). There was heterogeneity among the 12 studies (I2 = 61%, p = 0.003). The overall results were consistent and were not changed substantially by the removal of any data set. The meta-analysis of the R279Q polymorphism, including 6 studies with 6,983 cases and 3,282 controls, showed that the R279Q polymorphism was not associated with CHD (p = 0.16). Conclusions: The synthesis of available evidence supports the fact that the MMP9 –1562C/T polymorphism is a risk factor for CHD.
Frontotemporal Dementia in Southeast Asia: A Comparative Study
Authors: Tan Yee-Leng , Ng Amanda , Kandiah Nagaendran
Published: January 2013

Background: The clinical profile of frontotemporal dementia (FTD) in Southeast Asia is not known. We characterized and compared the demographic and clinical characteristics of FTD patients in Southeast Asia with North Asian and Western patients. Methods: The study included Southeast Asian FTD patients presenting to a tertiary neurology institute. Behavioral variant (bv-FTD) and language variant (lv-FTD) subtypes of FTD were diagnosed based on the Lund-Manchester criteria. The patients were characterized according to demographics, clinical, neuroimaging and longitudinal profiles. Results: Twenty-five bv-FTD and 19 lv-FTD patients were identified, with a female predominance ratio of 2:1 and a mean age of 56 years. The mean MMSE score was 16.2, and 88.4% of patients had memory symptoms. Over 5.1 ± 2.4 years of follow-up, 60% of bv-FTD and 36.8% of lv-FTD patients developed a second FTD syndrome. bv-FTD was the predominant type of FTD among Southeast Asians. Conclusion: FTD represents an important cause of young-onset dementia in Southeast Asia. Greater awareness of FTD is required to ensure early diagnosis and management.
P21 Gene Variation and Late-Onset Alzheimer’s Disease in the Italian Population
Authors: Scacchi R. , Gambina G. , Moretto G. , Corbo R.M.
Published: January 2013

Background: Variation at the cyclin-dependent kinase inhibitor gene P21 in a patient sample of the Italian population was investigated in search of genetic factors potentially involved in sporadic late-onset Alzheimer’s disease (AD). Methods: Two single nucleotide polymorphisms (SNPs) were studied in this gene: a C>A transversion at codon 31 (ser>arg) in exon 2 (RS1801270) and a C>T transition occurring 20 bp downstream from the stop codon of exon 3 (RS1059234). Results: The odd ratios were: RS1801270 A allele = 0.62 (95% CI = 0.33–1.18; p = 0.14); RS1059234 T allele = 0.57 (95% CI = 0.33–0.98; p = 0.04). In addition, a longer duration of disease was found with genotypes carrying the RS1059234 T allele (4.3 ± 2.5 years) than with those not carrying it (3.3 ± 2.1 years) (p = 0.001). Conclusion: In the present sample, one of the two SNPs seems in some way related to AD, since carriers of one allele were slightly protected against AD onset.
Supplementary X-Ray for Ultrasound-Guided Percutaneous Nephrolithotomy in Supine Position versus Standard Technique: A Randomized Controlled Trial
Authors: Basiri A. , Mirjalili M.A. , Kardoust Parizi M. , Moosa Nejad N.A.
Published: January 2013

Objectives: To compare the success and complication rates of sonography-guided supine percutaneous nephrolithotomy (PCNL) versus prone standard technique (fluoroscopic guidance) in a randomized controlled trial. Subjects and Methods: Between April 2009 and August 2011, 92 candidates for PCNL were randomly divided into two groups: 46 B-mode sonography-guided supine PCNL (group A) and 46 standard fluoroscopic-guided prone PCNL (group B). Demographic, clinical and perioperative patient characteristics were analyzed, and complications and success rates were compared between the two approaches. Results: Preoperative parameters were comparable in the two groups. The primary success rate was 79.0 and 65.2% in groups A and B, respectively, after one session of PCNL (p = 0.485). Sonography-guided access failed in 3 cases (failure rate 6.5% in group A vs. 0% in group B). Mean hospital stay (2.48 days for group A vs. 2.95 days for group B; p = 0.039) and mean nephrostomy tube stay time (1.79 days for group A vs. 2.56 days for group B; p = 0.007) were significantly prolonged in the standard technique. Postoperative fever was more prevalent in the standard PCNL group (p = 0.024), but no significant difference was observed in other complications between the two groups. Conclusion: In this study, sonography-guided supine PCNL was presented as a safe and effective technique, similar to standard PCNL, with comparable success and complication rates. In addition, using this technique eliminates the possible harmful impacts of radiation on the surgical team and decreases postoperative fever.
Quantitative MRI Analysis of the Brain after Twenty-Two Years of Neuromyelitis Optica Indicates Focal Tissue Damage
Authors: Aradi Mihaly , Koszegi Edit , Orsi Gergely , Perlaki Gabor , Trauninger Anita , Toth Arnold , Schwarcz Attila , Illes Zsolt
Published: January 2013

Background: The long-term effect of neuromyelitis optica (NMO) on the brain is not well established. Methods: After 22 years of NMO, a patient’s brain was examined by quantitative T1- and T2-weighted mono- and biexponential diffusion and proton spectroscopy. It was compared to 3 cases with short-term NMO and 20 healthy subjects. Results: Although routine T1- and T2-weighted images appeared to be normal, quantitative T1-, T2- and diffusion-weighted magnetic resonance imaging identified areas with high diffusivity and altered relaxation time in ‘normal appearing white matter’ (NAWM). In such abnormal NAWM regions, biexponential diffusion analysis and quantitative spectroscopy indicated extracellular edema and axonal loss, respectively. Repeated analysis 6 months later identified the same alterations. Such patchy alterations were not detectable in the NAWM of the 3 cases with short-term NMO, and they were also not quantitatively different from the controls. Conclusion: After NMO of 22-year duration, metabolic changes, altered diffusivity and magnetic resonance relaxation features of patchy brain areas may suggest tissue damage in NAWM that persist for at least 6 months.
Hyperventilation-Induced Nystagmus in Vestibular Neuritis: Pattern and Clinical Implication
Authors: Hong Jeong-Ho , Yang Jun-Gyu , Kim Hyun-Ah , Yi Hyon-Ah , Le Hyung
Published: January 2013

Background: It was the aim of this study to investigate the pattern of evolution of hyperventilation-induced nystagmus (HIN) in vestibular neuritis (VN) and to determine whether HIN influences the dizziness outcome at the last follow-up visit. Methods: Fifty-three consecutive patients with VN underwent a quantitative vestibular function test including hyperventilation and the Korean version of the Dizziness Handicap Inventory during the acute period and the follow-up visit. Results: The incidence of HIN was higher in the acute (62%, 33/53) than in the chronic (17%, 9/53) stages of VN. Approximately 70% (6/9) of patients who continued to have persistent HIN at the last follow-up reported dizziness compared to only 27% (12/44) of patients who had no HIN. Patients who complained of persistent dizziness were significantly more likely to have persistent HIN and high Korean Dizziness Handicap Inventory scores at the last follow-up compared with patients who did not suffer from dizziness. In terms of the degree of recovery of dizziness, patients with HIN initially beating toward the contralesional side exhibited significantly more improvement than patients with HIN initially beating toward the ipsilesional side. Conclusions: The presence of either HIN beating toward the ipsilesional side at the acute stage of VN or persistent HIN at the follow-up visit is associated with persistent dizziness.
Endoskopische Möglichkeiten der Behandlung von Nahtinsuffizienzen im Rektum
Authors: Steinkamp Martin , Gress Thomas M.
Published: January 2013

Hintergrund: Anastomoseninsuffizienzen stellen eine gefürchtete Komplikation der kolorektalen Chirurgie dar. Endoskopische Techniken haben sich in der Therapie der Leckagen zunehmend etabliert. In dieser Übersicht möchten wir einen Überblick der wichtigsten endoskopischen Verfahren geben. Methode: Systematische Recherche der vorhandenen Literatur. Ergebnisse: Die bedeutendsten endoskopischen Verfahren zur Behandlung der kolorektalen Anastomoseninsuffizienzen stellen die Fibrininjektion, die Vakuumschwammtherapie (Endo-Sponge), spezielle Clip-Systeme (OTSC) sowie die Stentimplantation dar. Der breiten klinischen Anwendung dieser Verfahren steht jedoch eine unzureichende Studienlage gegenüber. Schlussfolgerung: Die Einschätzung der Wertigkeit der einzelnen endoskopischen Verfahren untereinander und in speziellen therapeutischen Situationen hängt im Wesentlichen von der Erfahrung der Untersucher ab. Es bedarf der Durchführung randomisierter, prospektiver Studien, um diese Erfahrungen zu objektivieren.
The Prognostic Use of Inflammation and Tissue Necrosis in Benign Prostatic Hyperplasia
Authors: Willder Jennifer M. , Walker Victoria C. , Halbert Gwen L. , Dick Craig P.C. , Orange Clare , Qayyum Tahir , Horgan Paul G. , Underwood Mark A. , Edwards Joanne
Published: January 2013

Introduction: Evidence for the role of inflammation in benign prostatic hyperplasia (BPH) is conflicting. Establishing the prognostic significance of local and systemic inflammation and tissue necrosis scoring systems in BPH may elucidate the potential of inflammatory pathways as a target of therapeutic intervention in these patients. Patients and Methods: Consecutive patients with histological BPH diagnosed between 1996 and 2005 were identified. Systemic inflammation was assessed by the modified Glasgow prognostic score (mGPS), local inflammation by the Klintrup-Makinen criteria and tissue necrosis was evaluated by an extent-based classification. Results: In 392 BPH patients, there was a trend for increased local inflammation and tissue necrosis to be associated with shorter time to failure of pre-operative medical treatment of BPH (p = 0.096 and 0.088, respectively). High modified Glasgow prognostic score was associated with older age (p = 0.002) and higher levels of deprivation (measured by the Scottish Index of Multiple Deprivation) (p = 0.021). Conclusions: The prognostic use of established scoring systems of systemic and local inflammation and tissue necrosis in BPH requires further investigation. It remains unclear as to whether targeting inflammation in BPH has therapeutic potential.
Postmortem Biopsy to Obtain Lung Tissue in Congenital Diaphragmatic Hernia
Authors: Van Loenhout R.B. , De Krijger R.R. , Van de Ven C.P. , Van der Horst I.W.J.M. , Beurskens L.W.J.E. , Tibboel D. , Keijzer R.
Published: January 2013

Background: The accrual of human tissues from autopsies for diagnostic and translational research has decreased significantly over the last decades. Objectives: The objective of this study was to evaluate our experience with lung biopsy through a minithoracotomy as an alternative for obtaining postmortem tissue when full autopsy is refused in congenital diaphragmatic hernia (CDH) patients. Methods: Within 2 h of death we routinely asked parents for permission to perform an autopsy. Starting in 2001, parents who refused autopsy were asked permission for a postmortem lung biopsy. Pathology autopsy and biopsy reports were compared to clinical records. Results: Between 2001 and 2009, 46 patients died from CDH. Permission for autopsy was granted in 5 patients (11%). Of the remaining 41 patients, the parents of 15 (33%) agreed to postmortem lung biopsy. In all cases, additional findings were reported from the autopsy or biopsy, without changing the originally reported cause of death. In 1 case, we isolated fibroblasts from the lung biopsy using standardized cell culture techniques. Parents were able to take their child home with a minimal delay following biopsy. Conclusions: Parents refusing a full autopsy frequently agree to postmortem organ biopsy. This approach should therefore be considered as a valuable alternative, when permission for full autopsy is declined, for obtaining human tissues for both diagnostic and research purposes and is potentially applicable to other anomalies.
Endoskopische Drainage von Pankreaspseudozysten
Authors: Denzer Ulrike W. , Rösch Thomas
Published: January 2013

Hintergrund: Die Pankreaspseudozyste ist eine häufige Komplikation der akuten oder chronischen Pankreatitis. Bei symptomatischer Zyste mit Vorliegen von abdominellen Schmerzen, einer Magenausgangsstenose, Gewichtsverlust, Ikterus, Infektion oder Größenzunahme stellt die endoskopische Drainage (transpapillär und/ oder transmural) eine effektive Erstlinientherapie dar. Methode: Die Übersicht basiert auf einer strukturierten Analyse der aktuellen, in Pubmed gelisteten Studien. Ergebnisse: Die Langzeitregressionsraten liegen bei 71–90%; die Komplikationsrate beträgt 3–35% mit einer geringen Mortalität von 0–1%. Die wesentlichen Komplikationen der endoskopischen Pseudozystendrainage sind Blutungen in bis zu 9%, Infektionen in bis zu 8%, retroperitoneale Perforation in bis zu 5% und Zystenrekurrenz in bis zu 14% der Fälle. Differenziert zu betrachten sind die infizierte Nekrose und der Pankreasabszess (walled-off necrosis) nach akuter Pankreatitis. In diesen Fällen ist die endoskopische Therapie technisch komplexer und im Vergleich zur unkomplizierten Pankreaspseudozyste mit höherer Morbidität und geringerem Langzeitansprechen verbunden. Dennoch stellt die endoskopische Drainage bei technischer Machbarkeit für beide Entitäten die Methode der ersten Wahl dar. Dies basiert insbesondere auf der nach aktuellen Daten geringeren Morbidität der Methode im Vergleich zu chirurgischen Drainageverfahren. Schlussfolgerung: Der vorliegende Review gibt einen Überblick über Therapieindikation und Differenzialdiagnose von Pankreaspseudozysten, erläutert die Drainagetechniken und stellt die Daten zu Effektivität und Komplikationen der endoskopischen Zystendrainage umfassend dar.
Morphological and Morphometric Analysis of the Hippocampus in Wistar Rats with Experimental Hydrocephalus
Authors: Meira Taveira Karinna Veríssimo , Carraro Kleber Tadeu , Rocha Catalão Carlos Henrique , da Silva Lopes Luiza
Published: January 2013

Background: The present study aims at better establishing the alterations caused by the usual enlargement of brain ventricles in this structure. Methods: Hydrocephalus was induced in 7-day-old Wistar rats by the injection of kaolin into the cisterna magna. Morphological studies were performed on the hippocampus 7, 14 and 21 days after injection. The total number of neurons in each hippocampus subarea as well as that of pyknotic neurons were counted. Then we calculated the pyknotic index (PI) by hippocampal subarea, taking into account the level of ventricular dilatation and time of induction of hydrocephalus. Results: PI was statistically larger in the CA1 subarea of the experimental group after 1 week of hydrocephalus induction as compared to the corresponding control as well as in animals that had developed mild hydrocephalus in groups G1, G2 and G3. Conclusion: Hydrocephalus caused morphological alterations in the hippocampus, leading to important changes in its shape.
Photoprotective Properties of the Fluorescent Europium Complex in UV-Irradiated Skin
Authors: Vogt O. , Lademann J. , Rancan F. , Meinke M.C. , Schanzer S. , Stockfleth E. , Sterry W. , Lange-Asschenfeldt B.
Published: January 2013

In this study, we compared the UV-protective abilities of the europium complex compared to titanium dioxide, which represents the most common physical filter for ultraviolet light in the broad-band spectral range. The UV absorption and light transformative capacities of the europium complex were evaluated using a spectrometer with a double-integrating sphere showing that the europium complex does not only absorb and reflect UV light, but transforms it into red and infrared light. It was found that the europium complex binds to the surface of Jurkat cells in vitro. Cells incubated with the europium complex showed a significantly higher viability after UVA and UVB irradiation as compared to untreated cells and cells incubated with titanium dioxide pointing out its photoprotective properties. The europium complex and titanium dioxide show similar penetration capacities into the stratum corneum as tested in human and porcine skin using tape stripping analysis. The europium complex has proved to be an efficient UV filter with a low cyto- and phototoxic profile and therefore represents a potential candidate for use in sunscreen formulations.
Transdermal Is Better than Oral: Observational Research of the Satisfaction of Caregivers of Patients with Alzheimer’s Disease Treated with Rivastigmine
Authors: Boada Mercè , Arranz Francisco Javier
Published: January 2013

Background and Aims: Poor adherence to anti-dementia drugs is common among patients with Alzheimer’s disease. This study evaluated whether caregivers were more satisfied with, and patients more adherent to, transdermal rivastigmine than oral rivastigmine. Methods: Neurologists, psychiatrists and geriatricians collected sociodemographic and clinical data from 1,078 patients and administered the Treatment Satisfaction with Medicines (SATMED-Q) and the Morisky-Green questionnaires to their caregivers at outpatient consultations. Results: Satisfaction reported was greater with transdermal than oral rivastigmine: mean ± SD of the total SATMED-Q score, 72.5 ± 14.1 vs. 65.2 ± 12.5, p < 0.001. The proportion of adherent patients was greater with transdermal than with oral rivastigmine (65.0 vs. 41.4%, p < 0.001). Satisfaction, in turn, was significantly greater in adherent cases than in nonadherent cases. Conclusions: Facilitating the administration of anti-dementia drugs would improve adherence.
Spinal Cord Brain-Derived Neurotrophic Factor Levels Increase after Dexamethasone Treatment in Male Rats with Chronic Inflammation
Authors: Laste Gabriela , Ripoll Rozisky Joanna , de Macedo Isabel Cristina , Souza dos Santos Vinicius , Custódio de Souza Izabel Cristina , Caumo Wolnei , Torres Iraci L.S.
Published: January 2013

Dexamethasone is widely used in the therapy of chronic inflammatory diseases for its pain-modulating effects. The objective of this study was to evaluate the effect of dexamethasone on nociception and local inflammation, and the levels of brain-derived neurotrophic factor (BDNF) in the spinal cord in male rats with chronic inflammation induced by complete Freund’s adjuvant (CFA). Rats were randomly divided into a control group (not manipulated) and 2 CFA-induced chronic inflammation groups (in the 15th post-CFA injection): 1 injected with vehicle (saline solution) and 1 received dexamethasone (0.25 mg/kg) for 8 days. The hot-plate and electronic von Frey tests were performed 24 h after the end of treatment. BDNF spinal cord levels were determined by enzyme-linked immunosorbent assay (ELISA). The level of inflammation in the tibiotarsal joint (the ankle region) was evaluated histologically at the end of treatment. Dexamethasone produced significantly increased latency in the hot-plate test (one-way ANOVA, p < 0.05) and withdrawal threshold in the electronic von Frey test (p < 0.005). The dexamethasone group showed increased spinal cord BDNF levels compared to the other groups (one-way ANOVA p, < 0.05). Histological analysis showed a local inflammatory response only in animals treated with vehicle, which demonstrated that the dexamethasone treatment decreased the inflammatory process. Our findings corroborate the antinociceptive and anti-inflammatory properties of dexamethasone. In addition, we showed that the dexamethasone treatment increased BDNF levels in the spinal cord; its pain- modulating effects can be attributed to this effect.
‘Augustine’
Authors: Walusinski Olivier , Poirier Jacques , Déchy Hubert
Published: January 2013

No abstract available
Concordance of ATM (Ataxia Telangiectasia Mutated) Immunohistochemistry between Biopsy or Metastatic Tumor Samples and Primary Tumors in Gastric Cancer Patients
Authors: Kim Hee Sung , Kim Min A , Hodgson Darren , Harbron Christopher , Wellings Robert , O’Connor Mark J. , Womack Christopher , Yin Xiaolu , Bang Yung-Jue , Im Seok-Ah , Lee Byung Lan , Kim Woo Ho
Published: January 2013

ATM (ataxia telangiectasia mutated) is one of several DNA repair proteins that are suggested to sensitize tumor cells to the poly(ADP-ribose) polymerase inhibitor olaparib when deficient. The aim of this study was to assess the spatiotemporal concordance of ATM immunohistochemistry (IHC) in gastric cancer in order to determine if measurements made at the level of various sample types and times could be inferred as having the potential to be relevant to treatment decisions made at the patient level. Two independent cohorts composed of 591 gastric cancer patients divided into a gastrectomy cohort (n = 450) and a metastasis cohort (n = 141) were used in this study. A total of 2,705 ATM IHC samples were examined, including 450 whole tissue, 3 sets of 450 tissue microarray (TMA), 301 biopsy, 222 metastatic tumor and 2 additional whole tissue samples of 50 cases from the gastrectomy cohort, and 141 pairs of primary and metastatic tumors from the metastasis cohort. The prevalence of ATM negativity was 13.1% in biopsies, 13.9, 15.1, and 16.0% in TMAs and 15.9% in whole tissue samples of the gastrectomy cohort, and 21.4% in primary tumor and 21.5% in metastatic tumor samples of the metastasis cohort.  coefficients were 0.341 for biopsy, 0.572 as the average of 3 TMAs and 0.415 for the largely synchronous metastatic tumors of the gastrectomy cohort, and 0.153 for the largely asynchronous metastatic tumors of the metastasis cohort. Using whole tissue sections from tumor resections or primary tumor, respectively, as the reference standards, specificity and sensitivity were 91.6 and 41.0% for biopsy, 93.9 and 61.9% as the average of 3 TMAs, and 86.6 and 58.8% for metastatic tumors of the gastrectomy cohort and 81.7 and 33.3% for metastatic tumors of the metastasis cohort, respectively. Although we have demonstrated that the IHC assay for ATM was robust and reproducible in gastric tumor samples, we have also found that measurements were subject to significant discordance across multiple sample types from the same patient. Further work will be necessary to determine if classification may be made more consistent by multiple sampling. However, the lack of agreement between primary and asynchronous metastatic samples suggests that such sampling would need to be performed at the time of any treatment decision.
BCQ–: A Body Constitution Questionnaire to Assess Yin-Xu
Authors: Lin Jui-Shan , Chen Li-Li , Lin Jun-Dai , Chang Chih-Hung , Huang Chien-Hsun , Mayer Peter Karl , Su Yi-Chang
Published: January 2013

Background: Based on the Traditional Chinese Medicine (TCM) theory and guided by the principles of modern medicine (MM), we aimed to develop an effective and reliable diagnostic tool using self-reported data in order to assess the Yin-Xu body constitution. In this study, we further evaluated a provisional 22-item version of the Yin-Xu Body Constitution Questionnaire (BCQ–) previously derived from the Delphi process. Methods: A total of 1,272 eligible participants aged between 20 and 60 years was recruited. The participants had received health examination in teaching hospitals and had not shown any disease onset in the prior month. The factor structure of the BCQ– was explored, and the reliability and validity of each derived factor (scale) were evaluated. Results: Exploratory factor analysis revealed 5 factors corresponding to the manifestations of the diminishing Yin-Xu level in 5 different body areas: head, 4 limbs, gastrointestinal tract, body surface, and abdominal cavity. 3 items with low factor loading (<0.4) were dropped, resulting in a 19-item BCQ–. Cronbach’s α ranged from 0.57 to 0.85, and the intra-class correlation coefficients were greater than 0.7 for most items. The diagnoses of Yin-Xu by both the BCQ– and experienced TCM doctors were consistent. The concurrent validity showed that higher Yin-Xu scores were associated with lower hemoglobin. Conclusions: The final BCQ– measures the Yin-Xu constitution of 5 different body areas. The questionnaire is a reliable, valid, and potentially useful instrument for evaluating the Yin-Xu constitution in clinical research and practice.
The Role of Neck Dissection after Radical Chemoradiation for Locally Advanced Head and Neck Cancer: Should We Move Back?
Authors: Denaro N. , Russi E.G. , Numico G. , Pazzaia T. , Vitiello R. , Merlano M.C.
Published: January 2013

Until a few decades ago neck dissection (ND) was the standard surgical approach for node-positive tumours. Nowadays patients with locally advanced head and neck cancer can be treated with definitive chemoradiation (CRT), which includes the treatment of the neck; however, results on residual viable tumour after conservative treatment are heterogeneous and depend on initial node stage and primary treatment. Many authors accept adjuvant surgery in patients with N2–3 disease. Regardless of the results of upfront CRT, even if there is no evidence of lymph node metastases, when the risk for persistent positive neck nodes exceeds 15–20%, elective ND might be indicated. However, despite the diffusion of innovative technologies and therapies, there are controversies about both response evaluation and surgical management of initially involved neck nodes after definitive CRT and organ preservation treatment. In this paper we will analyse state of art of neck evaluation after CRT and discuss the role of ND.