bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophils Amplify Autoimmune Central Nervous System Infiltrates by Maturing Local APCs
Authors: Steinbach Karin , Piedavent Melanie , Bauer Simone , Neumann Johannes T. , Friese Manuel A. 
Published: September 2013

Abstract
Multiple sclerosis is considered to be initiated by a deregulated, myelin-specific T cell response. However, the formation of inflammatory CNS lesions and the contribution of different leukocyte subsets in setting up these lesions are still incompletely understood. In this study, we show that, in the mouse model of multiple sclerosis, experimental autoimmune encephalomyelitis, neutrophil granulocytes are important contributors in preparing CNS inflammation. Preclinical single-dose Ab-mediated depletion of neutrophils delayed the onset and continuous depletion attenuated the development of experimental autoimmune encephalomyelitis, whereas the generation of a myelin-specific T cell response remained unaffected. Neutrophil-related enzymes such as myeloperoxidase and neutrophil elastase did not contribute in mounting CNS inflammation, as analyzed by using respective knockout mice and inhibitors. CNS-infiltrating neutrophils secreted proinflammatory molecules and matured bone marrow–derived dendritic cells in vitro, which in turn enhanced their ability to restimulate myelin-specific T cells. This was mirrored in vivo, in which depletion of neutrophils specifically impaired maturation of microglia and macrophages into professional APCs, resulting in a diminished amplification of early CNS inflammation. Therefore, inside the CNS neutrophils provide local cofactors that are required for the maturation of myeloid cells into professional APCs representing an essential step for the local restimulation of myelin-specific T cells and the development of autoimmune disease.
Suprachiasmatic Astrocytes Modulate the Circadian Clock in Response to TNF-α
Authors: Duhart José M. , Leone María Juliana , Paladino Natalia , Evans Jennifer A. , Castanon-Cervantes Oscar , Davidson Alec J. , Golombek Diego A. 
Published: September 2013

Abstract
The immune and the circadian systems interact in a bidirectional fashion. The master circadian oscillator, located in the suprachiasmatic nuclei (SCN) of the hypothalamus, responds to peripheral and local immune stimuli, such as proinflammatory cytokines and bacterial endotoxin. Astrocytes exert several immune functions in the CNS, and there is growing evidence that points toward a role of these cells in the regulation of circadian rhythms. The aim of this work was to assess the response of SCN astrocytes to immune stimuli, particularly to the proinflammatory cytokine TNF-α. TNF-α applied to cultures of SCN astrocytes from Per2luc knockin mice altered both the phase and amplitude of PER2 expression rhythms, in a phase-dependent manner. Furthermore, conditioned media from SCN astrocyte cultures transiently challenged with TNF-α induced an increase in Per1 expression in NIH 3T3 cells, which was blocked by TNF-α antagonism. In addition, these conditioned media could induce phase shifts in SCN PER2 rhythms and, when administered intracerebroventricularly, induced phase delays in behavioral circadian rhythms and SCN activation in control mice, but not in TNFR-1 mutants. In summary, our results show that TNF-α modulates the molecular clock of SCN astrocytes in vitro, and also that, in response to this molecule, SCN astrocytes can modulate clock gene expression in other cells and tissues, and induce phase shifts in a circadian behavioral output in vivo. These findings suggest a role for astroglial cells in the alteration of circadian timing by immune activation.
Preclinical In Vivo Modeling of Cytokine Release Syndrome Induced by ErbB-Retargeted Human T Cells: Identifying a Window of Therapeutic Opportunity?
Authors: van der Stegen Sjoukje J. C. , Davies David M. , Wilkie Scott , Foster Julie , Sosabowski Jane K. , Burnet Jerome , Whilding Lynsey M. , Petrovic Roseanna M. , Ghaem-Maghami Sadaf , Mather Stephen , Jeannon Jean-Pierre , Parente-Pereira Ana C. , Maher John 
Published: September 2013

Abstract
The ErbB network is dysregulated in many solid tumors. To exploit this, we have developed a chimeric Ag receptor (CAR) named T1E28z that targets several pathogenetically relevant ErbB dimers. T1E28z is coexpressed with a chimeric cytokine receptor named 4αβ (combination termed T4), enabling the selective expansion of engineered T cells using IL-4. Human T4+ T cells exhibit antitumor activity against several ErbB+ cancer types. However, ErbB receptors are also expressed in several healthy tissues, raising concerns about toxic potential. In this study, we have evaluated safety of T4 immunotherapy in vivo using a SCID beige mouse model. We show that the human T1E28z CAR efficiently recognizes mouse ErbB+ cells, rendering this species suitable to evaluate preclinical toxicity. Administration of T4+ T cells using the i.v. or intratumoral routes achieves partial tumor regression without clinical or histopathologic toxicity. In contrast, when delivered i.p., tumor reduction is accompanied by dose-dependent side effects. Toxicity mediated by T4+ T cells results from target recognition in both tumor and healthy tissues, leading to release of both human (IL-2/IFN-γ) and murine (IL-6) cytokines. In extreme cases, outcome is lethal. Both toxicity and IL-6 release can be ameliorated by prior macrophage depletion, consistent with clinical data that implicate IL-6 in this pathogenic event. These data demonstrate that CAR-induced cytokine release syndrome can be modeled in mice that express target Ag in an appropriate distribution. Furthermore, our findings argue that ErbB-retargeted T cells can achieve therapeutic benefit in the absence of unacceptable toxicity, providing that route of administration and dose are carefully optimized.
Estrogen Signaling through the G Protein–Coupled Estrogen Receptor Regulates Granulocyte Activation in Fish
Authors: Cabas Isabel , Rodenas M. Carmen , Abellán Emilia , Meseguer José , Mulero Victoriano , García-Ayala Alfonsa 
Published: September 2013

Abstract
Neutrophils are major participants in innate host responses. It is well known that estrogens have an immune-modulatory role, and some evidence exists that neutrophil physiology can be altered by these molecules. Traditionally, estrogens act via classical nuclear estrogen receptors, but the identification of a G protein–coupled estrogen receptor (GPER), a membrane estrogen receptor that binds estradiol and other estrogens, has opened up the possibility of exploring additional estrogen-mediated effects. However, information on the importance of GPER for immunity, especially, in neutrophils is scant. In this study, we report that gilthead seabream (Sparus aurata L.) acidophilic granulocytes, which are the functional equivalent of mammalian neutrophils, express GPER at both mRNA and protein levels. By using a GPER selective agonist, G1, it was found that GPER activation in vitro slightly reduced the respiratory burst of acidophilic granulocytes and drastically altered the expression profile of several genes encoding major pro- and anti-inflammatory mediators. In addition, GPER signaling in vivo modulated adaptive immunity. Finally, a cAMP analog mimicked the effects of G1 in the induction of the gene coding for PG-endoperoxide synthase 2 and in the induction of CREB phosphorylation, whereas pharmacological inhibition of protein kinase A superinduced PG-endoperoxide synthase 2. Taken together, our results demonstrate for the first time, to our knowledge, that estrogens are able to modulate vertebrate granulocyte functions through a GPER/cAMP/protein kinase A/CREB signaling pathway and could establish therapeutic targets for several immune disorders in which estrogens play a prominent role.
Neurological and functional outcomes of subdural hematoma evacuation in patients over 70 years of age
Authors: Mulligan Patrick , Raore Bethwel , Liu Shuling , Olson Jeffrey J 
Published: September 2013

ABSTRACT
Background: Subdural hematoma (SDH) is a common disease entity treated by neurosurgical intervention. Although the incidence increases in the elderly population, there is a paucity of studies examining their surgical outcomes. Objectives: To determine the neurological and functional outcomes of patients over 70 years of age undergoing surgical decompression for subdural hematoma. Materials and Methods: We retrospectively reviewed data on 45 patients above 70 years who underwent craniotomy or burr holes for acute, chronic or mixed subdural hematomas. We analyzed both neurological and functional status before and after surgery. Results: Forty-five patients 70 years of age or older were treated in our department during the study period. There was a significant improvement in the neurological status of patients from admission to follow up as assessed using the Markwalder grading scale (1.98 vs. 1.39; P =0.005), yet no improvement in functional outcome was observed as assessed by Glasgow Outcome Score. Forty-one patients were admitted from home, however only 20 patients (44%) were discharged home, 16 (36%) discharged to nursing home or rehab, 6 (13%) to hospice and 3 (7%) died in the postoperative period. Neurological function improved in patients who were older, had a worse pre-operative neurological status, were on anticoagulation and had chronic or mixed acute and chronic hematoma. However, no improvement in functional status was observed. Conclusion: Surgical management of SDH in patients over 70 years of age provides significant improvement in neurological status, but does not change functional status.
Spontaneous intra.cerebral hemorrhage: A retrospective study of risk factors and outcome in a Turkish population
Authors: Celikbilek Asuman , Goksel Basak Karakurum , Zararsiz Gokmen , Benli Sibel 
Published: September 2013

ABSTRACT
Background and Purpose: Stroke, which remains the third leading cause of death after heart disease and cancer in developed countries, is a disorder causing permanent neurologic disability. Even though, hemorrhagic strokes are seen less than the ischemic type, they are more fatal. We studied the risk factors for spontaneous intra-cerebral hemorrhage (ICH) to direct the proper preventive treatment modalities and the effects of these factors on mortality as well as applied therapeutic strategies on survival. Materials and Methods: The archive records of 106 patients (60 male, 46 female) who were diagnosed with spontaneous ICH in Baskent University Hospital, Ankara, between January 2003 and September 2008, were assessed retrospectively. Results: The mean age was found as 62.5. The most frequent risk factor was hypertension (73.5%); 69.2% of these hypertensive patients had uncontrolled blood pressure levels. The mortality rate was detected as 34.9% and patients were found to die approximately within 9 days after ICH. Older age, increased hemorrhage volume, ventricular extension of hemorrhage, and the presence of midline shift were found to significantly correlate with increased mortality (P < 0.05). Patients who underwent surgical therapy showed a longer survival rate (P = 0.016); however, no association was found between medical and surgical therapy in terms of mortality (P = 0.555). Conclusion: The results of this study suggest that effective control of blood pressure is important in the prevention of spontaneous ICH; clinical and radiological findings with treatment modalities influencing mortality should be carefully managed.
Prevalence of fatigue in patients with multiple sclerosis and its effect on the quality of life
Authors: Nagaraj Karthik , Taly Arun B , Gupta Anupam , Prasad Chandrajit , Christopher Rita 
Published: September 2013

ABSTRACTObjective: This prospective study was carried out to observe the prevalence of fatigue in patients with multiple sclerosis (MS) and its effect on quality-of-life (QoL). Study Design and Setting: Prospective observational study in a University Tertiary Research Hospital in India. Patients and Methods: A total of 31 patients (25 females) with definite MS according to McDonald ′s criteria presented in out-patient/admitted in the Department of Neurology (between February 2010 and December 2011) were included in the study. Disease severity was evaluated using the Kurtzke′s expanded disability status scale (EDSS). Fatigue was assessed using Krupp′s fatigue severity scale (FSS). QoL was assessed by the World Health Organization QoL-BREF questionnaire. Results: The mean age of patients was 30.1 ± 9.1 years. The mean age at first symptom was 25.23 ± 6.4 years. The mean number of relapses was 4.7 ± 3.6 in the patients. The mean duration of illness was 4.9 ± 4.4 years. The mean EDSS score was 3.5 ± 2.2. Mean fatigue score was 38.7 ± 18.5 (cut-off value 36 in FSS). The prevalence of fatigue in patients with MS was 58.1% (18/31). MS patients with fatigue were significantly more impaired (P < 0.05) on all QoL domains (i.e., physical, psychosocial, social, and environment) than MS patients without fatigue. Conclusion: Prevalence of fatigue was found to be high in the MS patients in the study. All four domains of QoL were significantly more impaired in the group with fatigue than in those without fatigue.
Removal of cervical spinal tumor with large inferio.lateral extension through anterolateral (interscalene and transforaminal) approach
Authors: Chowdhury Forhad , Haque Mohammod , Kawsar Khandkar , Alam Sarwar 
Published: September 2013

ABSTRACTCervical spinal tumor with large lateral extension is usually removed through posterolateral approach and rarely through anterolateral approach. A young man presented with neck pain and brachialgia. Cervical spinal MRI showed a intraspinal tumor with huge extraforaminal paraspinal extension. We removed the tumor through anterolateral (interscalene and transforaminal) approach. Post operatively patient recovered from his sufferings and returned to normal life. Here we report the case along with operative technical aspects.
Was it a case of acute disseminated encephalomyelitis? A rare association following dengue fever
Authors: Karoli Ritu , Siddiqi Zeba , Fatima Jalees , Maini Sumit 
Published: September 2013

ABSTRACTDengue infection, caused by a flavivirus is endemic in more than hundred countries, mostly in the developing world. Recent observations indicate that the clinical profile of dengue is changing, and that atypical manifestations are being reported more frequently. The exact incidence of various neurological complications is variable. Acute disseminated encephalomyelitis (ADEM) is a neurological manifestation rarely described in association with dengue. We present a patient, 32-year-old female who was diagnosed as a case of dengue fever initially after an acute febrile illness and two weeks later admitted in emergency with seizures and altered sensorium. Although MRI did not show typical lesions suggestive of ADEM, the lag period between initial dengue infection and neurological manifestations and complete recovery with methyl prednisolone point towards immune mediated demyelinating illness.
Effects of α‑tocopherol and ascorbic acid in the severity and management of traumatic brain injury in albino rats
Authors: Ishaq Gaafar M , Saidu Yusuf , Bilbis Lawal S , Muhammad Suleiman A , Jinjir Nasir , Shehu Bello B 
Published: September 2013

ABSTRACT
Background: Traumatic brain injury (TBI) is accompanied by substantial accumulation of biomarkers of oxidative stress and depletion of antioxidants reserve which initiate chain reactions that damage brain cells. The present study investigated the role of ascorbic acid and α-tocopherol on the severity and management of TBI in rats.
Materials and Methods: Wistar rats were subjected to closed head injury using an accelerated impact device. Rats were administered 45 mg/kg and 60 mg/kg body weight of ascorbic acid, α-tocopherol or a combination of the two vitamins for 2 weeks pre- and post injury. Blood and brain tissue homogenates were analyzed for vitamin C, vitamin E, malondialdehyde, superoxide dismutase, and creatine kinase activities.
Results: The results indicated that TBI caused significant (P < 0.05) decreased in vitamins C and E levels in the blood and brain tissue of TBI-untreated rats. The activities of superoxide dismutase in TBI rats were markedly reduced when compared with non traumatized control and showed a tendency to increased following supplementation with vitamins C and E. Supplementation of the vitamins significantly (P < 0.05) reduced malondialdehyde in the treatment groups compared with the TBI-untreated group.
Conclusion: The study indicated that pre and post treatment with ascorbic acid and α-tocopherol reduced oxidative stress induced by brain injury and effectively reduced mortality rate in rats.
The enigma of transient splenial hyperintensity: In cryptococcal meningitis
Authors: Sen Kaushik , Khandelwal Kapil , Lalhmachhuana Joseph , Guha Gautam 
Published: September 2013

ABSTRACTTransient hyperintensity in splenium of corpus callosum is a relatively infrequent finding in MRI. Although it has been most consistently linked with frequent seizure episodes, many other possible causes have been proposed by different workers. Cryptococcal meningitis as a cause of transient splenial hyperintensity has never been reported till date. Here, we report a young girl who is congenitally immunodeficient and had suffered from cryptococcal meningitis with typical transient splenial hyperintense lesions in MRI.
Uncommon dyselectrolytemia complicating Guillain–Barré syndrome
Authors: Saroja Aralikatte Onkarappa , Naik Karkal Ravishankar , Khanpet S Mallikarjun 
Published: September 2013

ABSTRACTGuillain-Barré syndrome (GBS) and hypokalemic paralysis are common causes of acute flaccid quadriparesis and specific therapeutic interventions differ. Simultaneous occurrence of severe hypokalemia in patients with GBS at the time of presentation can cause diagnostic and therapeutic dilemma. Presence of hypomagnesemia with hypokalemia in patients with GBS can be perplexing and pose further challenges. Evaluation for preexisting inherited or other associated metabolic disturbances is needed in the presence of such complex dyselectrolytemia. We report the rare association of GBS with severe hypokalemia and hypomagnesemia in a 41-year-old male presenting with acute flaccid quadriparesis and the therapeutic challenges faced.
A diagnostic and therapeutic challenge involving a case of dysphagia in association with cervical osteophytosis and a dental pain
Authors: Dable Rajani A , Wasnik Pradnya B , Nagmode Sunilkumar L , Ali Mukkaram Faridi 
Published: September 2013

ABSTRACTHerein, presenting a case of a 42-year-old female with the chief complaint of dysphagia. The problem was assumed to be of dental origin, due to the onset of dental pain followed by dysphagia. A cervical radiograph revealed the presence of osteophytic lipping which proved to be the cause of dysphagia. Confusing and overlapping disease entities showing similar symptoms need thorough investigation. Dysphagia related to cervical spondylosis may have a direct connection with the person′s occupation. Dentistry is considered a potentially hazardous occupation with regard to musculoskeletal disorders. However, additional studies are required to understand the occupational hazards faced by dentists.
Suprasellar dermoid cyst associated with colloid cyst of the third ventricle: Disordered embryogenesis or a mere coincidence?
Authors: Kurwale Nilesh , Kumar Rajinder , Mehar Sharma C , Sharma Bhavani Shankar 
Published: September 2013

ABSTRACTIntracranial dermoid cyst and colloid cysts of the third ventricle are rare benign congenital lesions of early adulthood. Both lesions are thought to be congenital in origin however association is rare. Only one case of this association has been reported. We report a 22-year-old male with suprasellar dermoid cyst and colloid cyst of the third ventricle presenting simultaneously. Embryogenesis of this association has been discussed.
Trauma Craneoencefálico en el Departamento del Cesar, Colombia: Análisis de Frecuencia, Severidad y Complicaciones
Authors: Alvis-Miranda Hernando Raphael , Adie-Villafañe Richard José , Velasquez-Loperena Duffays , Velasquez-Loperena Robert Andres , Meza Zenen Carmona , Alcalá-Cerra Gabriel , Moscote-Salazar Luis Rafael 
Published: September 2013

RESUMEN

Objetivo
Analizar la epidemiología del traumatismo craneoencefálico durante los días de semana y los fines de semana en el departamento del Cesar, Colombia.

Materiales y métodos
Estudio retrospectivo, de base poblacional; se realizó análisis estadístico determinándose distribución de frecuencia a cada una de las variables de los datos obtenidos.

Resultados
Se analizaron las características epidemiológicas de los pacientes en el departamento del Cesar, la edad promedio de 38 ±18,8, siendo 98 (70,5%) del sexo masculino y 41 (29,5%) del sexo femenino. De acuerdo al sexo en relación a las zona, la zona Norte 84 (68,9%) hombres y 39 (31,1%) mujeres, la zona centro 5 hombres (100%) y la zona sur 9 hombres (75%) y 3 mujeres (25%), por otro lado se analizó la distribución de acuerdo al sexo y a la ocurrencia de traumas craneoencefálicos los fines de semana y días hábiles, el sexo masculino presentó 40 casos (81,6%) y los días hábiles 72 casos (69,2%), en relación al sexo femenino presento 9 casos (18,4%) y los días hábiles 34 (32,7%).

Conclusiones
El trauma craneoencefálico es un problema de salud pública. En el departamento del Cesar se requiere la implantación de estrategias de prevención de este tipo de lesiones. Los accidentes de tráfico continúan como primera causa, afectando, principalmente a la población joven masculina.
Traumatic Thoracic Duct Transection managed with Left Thoracoscopy: A Case Report and Review of Literature
Authors: Smith-Singares Eduardo , Saied Abdul 
Published: September 2013

ABSTRACT

Context
Chylothorax is an uncommon complication after penetrating trauma to the chest and the neck. Only 25% of all chylothorax cases are related to penetrating trauma. We report such a case on a transmediastinal stab wound, managed by video-assisted thoracic surgery.

Case report
A 48-year-old male presented to our level I trauma center after sustaining a stab wound to the right chest. Initial workup revealed a left side pneumothorax. After chest tube placement 700 ml of blood and milky fluid were recovered. The patient was managed initially with TPN, without success. On day 3, he was taken to the OR for a left VATS. The thoracic duct was dissected and the injury identified and controlled with hemoclips. The intervention was successful and the patient was discharged on POD #4.

Discussion
Chylothorax are classified and managed according to the daily output of the fistula. While low output chylothorax are more frequent, more likely related to malignancy of the mediastinum and lymph nodes, and more likely to close with nonsurgical management; traumatic chylothorax are generally high output and more likely to require surgical intervention. The different approaches to this difficult pathology are reviewed.

How to cite this article
Smith-Singares E, Saied A. Traumatic Thoracic Duct Transection managed with Left Thoracoscopy: A Case Report and Review of Literature. Panam J Trauma Critical Care Emerg Surg 2013;2(2):97-99.
Utility of Transesophageal Echocardiography in Confirmation of Spread of Local Anesthetic in the Epidural Space
Authors: Puri GD , Kumar Bhupesh , Goswami Vikas , Rana SS 
Published: September 2013

ABSTRACTA 30-years-old female with diagnosis of carcinoid tumor of right bronchus was planned to undergo right pneumonectomy under combined epidural and general anesthesia. A pediatric transesophageal echocardiography (TEE) probe was inserted for intraoperative monitoring of the right ventricular function. It also showed spinal canal structures (dura matter, epidural and subarachnoid space and spinal cord) and helped in visualization of local anesthetic spread in the epidural space.How to cite this articleKumar B, Goswami V, Rana SS, Puri GD. Utility of Transesophageal Echocardiography in Confirmation of Spread of Local Anesthetic in the Epidural Space. J Perioper Echocardiogr 2013;1(2):72-74.