bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardenolide Increase in Foxglove after 2,1,3-Benzothiadiazole Treatment Reveals a Potential Link between Cardenolide and Phytosterol Biosynthesis
Authors: Raghavan Indu , Ravi Gopal Baradwaj , Carroll Emily , Wang Zhen Q 
Published: October 2022

Abstract
Cardenolides are steroidal metabolites in Digitalis lanata with potent cardioactive effects on animals. In plants, cardenolides are likely involved in various stress responses. However, the molecular mechanism of cardenolide increase during stresses is mostly unknown. Additionally, cardenolides are proposed to arise from cholesterol, but indirect results show that phytosterols may also be substrates for cardenolide biosynthesis. Here, we show that cardenolides increased after methyl jasmonate (MJ), sorbitol, potassium chloride (KCl) and salicylic acid analog [2,1,3-benzothiadiazole (BTH)] treatments. However, the expression of three known genes for cardenolide biosynthesis did not correlate well with these increases. Specifically, the expression of progesterone-5β-reductases (P5βR and P5βR2) did not correlate with the cardenolide increase. The expression of 3β-hydroxysteroid dehydrogenase (3βHSD) correlated with changes in cardenolide levels only during the BTH treatment. Mining the D. lanata transcriptome identified genes involved in cholesterol and phytosterol biosynthesis: C24 sterol sidechain reductase 1 (SSR1), C4 sterol methyl oxidase 1, and 3 (SMO1 and SMO3). Surprisingly, the expression of all three genes correlated well with the cardenolide increase after the BTH treatment. Phylogenetic analysis showed that SSR1 is likely involved in both cholesterol and phytosterol biosynthesis. In addition, SMO1 is likely specific to phytosterol biosynthesis, and SMO3 is specific to cholesterol biosynthesis. These results suggest that stress-induced increase of cardenolides in foxglove may correlate with cholesterol and phytosterol biosynthesis. In summary, this work shows that cardenolides are important for stress responses in D. lanata and reveals a potential link between phytosterol and cardenolide biosynthesis.
Functional autoantibodies in systemic sclerosis: influence of autologous stem cell transplantation and correlation with clinical outcome
Authors: Bankamp Lukas , Preuß Beate , Pecher Ann-Christin , Vogel Wichard , Henes Jörg , Klein Reinhild 
Published: October 2022

Abstract

Objectives
To evaluate the effect of autologous stem cell transplantation (aSCT) on functional antibodies (abs) to the angiotensin II type-1-receptor (AT1R) and topoisomerase-I (topo-I) in SSc-patients and to analyse their prognostic relevance.

Material and methods
Forty-three SSc-patients in whom aSCT was performed were analysed. Thirty-one patients had a favourable outcome after aSCT (group 1), 12 patients showed no response or relapse (group 2). Patients’ sera were tested for anti-AT1R and anti-topo-I antibodies by ELISA and in a luminometric assay (LA) using AT1R-expressing Huh7-cells for inhibitory or stimulatory anti-AT1R antibodies before and after aSCT (4–217 months, median 28 months). Anti-topo-I antibodies were also analysed for their capacity to inhibit enzyme function.

Results
A total of 70% of the SSc patients had anti-topo-I- and 51% anti-AT1R antibodies in the ELISA before aSCT. In all instances, anti-topo-I antibodies inhibited topo-I-enzyme function. In the LA, 40% had stimulatory and 12% inhibitory anti-AT1R antibodies. Anti-topo-I- and anti-AT1R-reactivity (ELISA) significantly decreased after aSCT. Before aSCT, anti-topo-I-reactivity was significantly higher in group 2 patients than in group 1 patients (P &lt; 0.001), while there was no difference between both groups for anti-AT1R antibodies detected by ELISA. Stimulatory anti-AT1R antibodies detected by LA were confined to group 1-patients.

Conclusions
Reactivity of functionally active anti-AT1R antibodies was not influenced by aSCT, while anti-topo-I antibodies decreased after aSCT. The fact that anti-topo-I antibodies inhibited enzyme function in all instances supports the hypothesis of a pathogenetic role of the topo-I antigen/antibody-system in SSc. High anti-topo-I reactivity before aSCT was associated with an unfavourable, presence of stimulatory anti-AT1R antibodies with a favourable course after aSCT.
Exercise Leg Blood Flow Is Preserved in Long-term Breast Cancer Survivors Previously Treated With Anthracycline Chemotherapy
Authors: Beaudry Rhys I. , Akins John D. , Richey Rauchelle E. , Brothers R. Matthew , Nelson Michael D. , Sarma Satyam , Tucker Wesley J. , Haykowsky Mark J. 
Published: October 2022

Purpose:
The objective of this investigation was to compare the acute hemodynamic responses during single-leg knee extension (SLKE) exercise between female breast cancer (BC) survivors previously treated with anthracycline chemotherapy and age- and sex-matched control (CON) subjects.

Methods:
Fourteen BC survivors (age: 61 ± 7 yr; time post-anthracycline therapy: 12 ± 6 yr) and nine CON subjects (age: 59 ± 7 yr) performed SLKE exercise at 25%, 50%, and 75% of peak power output during which heart rate, blood pressure (BP), leg blood flow (Doppler ultrasonography), and vascular conductance (leg blood flow/mean BP) were measured. Quadriceps mass was estimated from thigh volume and skinfold measures.

Results:
Breast cancer survivors had lower quadriceps mass compared with CON subjects (1803 ± 607 vs 2601 ± 1102 g, P = .04). No difference was found between groups for maximal SLKE power output (28 ± 11 vs 34 ± 17 W, P = .35), heart rate (109 ± 14 vs 103 ± 13 bpm, P = .36), or mean arterial BP (122 ± 18 vs 119 ± 26 mm Hg, P = .33). Rest and submaximal exercise mean arterial BP, leg blood flow (indexed to quadriceps muscle mass), and leg vascular conductance were not significantly different between BC survivors and CON subjects.

Conclusion:
Leg blood flow during submaximal SLKE exercise is preserved in long-term BC survivors previously treated with anthracycline chemotherapy.
Chronic Obstructive Pulmonary Disease Patients With High Peripheral Blood Eosinophil Counts Have Better Predicted Improvement in 6MWD After Rehabilitation
Authors: Shui Li-Li , Cai Ji-Jun , Zhong Xiao-Qing , Li You-Lun , He Mao-Rui , Chen Ya-Juan 
Published: October 2022

Purpose:
The objective of this investigation was to determine whether chronic obstructive pulmonary disease (COPD) patients with high blood eosinophil (EOS) counts had better improvement in 6-min walk test (6MWT) after pulmonary rehabilitation (PR).

Methods:
Fifty COPD patients were randomly assigned to either the rehabilitation group (RG) or the control group (CG). Patients in the RG (8 wk PR + routine medication) and the CG (routine medication) were followed for 32 wk. According to the blood EOS level, the RG was divided into an EOS ≥ 200 cells/μL group and EOS < 200 cells/μL group. The 6MWT distance, Borg Scale, and COPD Assessment Test (CAT) were evaluated before intervention and 8 wk and 32 wk later.

Results:
After the 8-wk intervention, 37 patients (19 RG/18 CG) completed the study. At 8-wk and 32-wk follow-up from baseline, a statistically significant difference was found between these two groups in the 6MWT, Borg Scale, and CAT. Compared with baseline, the 6MWT in the RG increased 49.1 ± 40.2 m (95% CI, 29.7-68.5, P < .001) at 8 wk and 60.8 ± 42.1 m (95% CI, 40.5-81.6, P < .001) at 32 wk. In addition, the improvement of 6MWT in the EOS ≥ 200 cells/μL RG group was higher than that in the EOS < 200 cells/μL group (40.1 ± 17.6 m, 95% CI, 36.8-43.4; P = .036) at 32-wk follow-up from baseline.

Conclusion:
An 8-wk PR can improve the exercise capacity of COPD patients, and the benefits persistent for 24 wk. The improvement in the 6MWT was more significant in COPD patients with a high blood EOS count.
Effects of Low-dose Splenic Irradiation on T lymphocyte Immune Function
Authors: Li Yanzi , Lv Hongying , Liang Donghai , Jiang Tao , Zhao Wei , Zhou Fei , Jiao Chenchen , Zhou Yuyuan , Yu Hongsheng 
Published: October 2022

Abstract
Relevant studies have confirmed that the stimulation of spleen function caused by low-dose splenic irradiation can have positive effects on tumors and other diseases. This study aimed to determine radiation-induced changes in spleen index, lymphocyte subsets, spleen cell apoptosis, and pathological features of the spleen in mice. The mouse model was established by irradiating the spleen at different doses. The mice were divided into the following groups: blank control, low-dose, low-dose fractionated irradiation, and challenge dose irradiation. The mice were sacrificed under humanitarian conditions, and spleen tissue and peripheral blood were collected. The spleen index was calculated, and flow cytometry was used to analyze spleen T lymphocyte subsets and spleen apoptosis. The pathological changes in the spleen were determined by hematoxylin and eosin (H&E) staining. The spleen index of mice in the low-dose fractionated irradiation group was significantly increased compared with that in the blank control group. The spleen indexes of the low-dose irradiation and low-dose fractionated irradiation groups were much higher than that of the challenge dose irradiation group. Compared with the blank control group, the percentage of CD3+ and CD4+ T lymphocytes in the peripheral blood and spleen tissues in the low-dose irradiation and low-dose fractionated irradiation groups was significantly increased, whereas that from the challenge dose irradiation group was obviously decreased. CD8+ T lymphocytes in the peripheral blood and spleen tissues in the low-dose irradiation, low-dose fractionated irradiation, and challenge dose irradiation groups were significantly lower than those in the blank control group. The apoptosis rate of the spleen in the challenge dose irradiation group was significantly higher than that in the blank control, low-dose irradiation, and low-dose fractionated irradiation groups. H&E staining analysis of the spleen showed pathological changes in the different irradiation groups compared with the blank control group. Low-dose irradiation and low-dose fractionated irradiation can change the T lymphocyte subsets in the peripheral blood and spleen of mice, which can promote immune excitation and improve immune effects.
PROGRESSION OF MYOPIC MACULOPATHY IN PATIENTS WITH MYOPIC TRACTION MACULOPATHY AFTER VITRECTOMY
Authors: Park Hyo Song , Lee Christopher Seungkyu , Koh Hyoung Jun 
Published: October 2022

Purpose:
To compare the progression of myopic maculopathy with or without vitrectomy in patients with myopic traction maculopathy (MTM).

Methods:
Seventy-seven eyes with MTM were classified into either the observation group (n = 38) or the vitrectomy group (n = 39). Progression of myopic maculopathy was assessed with fundus photography using infrared images. Progression within stage was evaluated as an increase in the area of atrophic lesions on infrared images using ImageJ software. The rate of progression was compared using the paired t-test.

Results:
The mean follow-up period was 60.0 ± 47.5 months. The initial mean stage of myopic maculopathy for the observation group was 1.86 ± 0.86, and it progressed to 2.00 ± 0.83 (P = 0.023) at the last visit. For the vitrectomy group, the stage progressed from 1.82 ± 0.96 to 2.05 ± 1.09 (P = 0.011). Four eyes (10.5%) in the observation group showed progression at 87.3 months, and seven eyes (17.9%) in the vitrectomy group showed progression at 31.3 months.

Conclusion:
Surgery in patients with MTM may accelerate the progression of myopic maculopathy. Therefore, care should be taken when considering surgery for patients with MTM.
CHOROIDAL VASCULAR DENSITY IN DIABETIC RETINOPATHY ASSESSED WITH SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY
Authors: Nakano Hideyuki , Hasebe Hiruma , Murakami Kenji , Nakamura Yusuke , Fukuchi Takeo 
Published: October 2022

Purpose:
We aimed to assess choroidal vascularity by diabetic retinopathy (DR) stage using the choroidal vascular density (CVD) obtained from swept-source optical coherence tomography en-face images.

Methods:
This prospective, cross-sectional, multicenter study included patients from Niigata City General Hospital and Saiseikai Niigata Hospital between October 2016 and October 2017. Choroidal vascular density was obtained by binarizing swept-source optical coherence tomography en-face images of patients with diabetes and those with DR, patients without DR, and healthy age-matched volunteers.

Results:
Patients were allocated to the healthy control (n = 28), no DR (n = 23), nonproliferative DR (NPDR) without diabetic macular edema (DME) (n = 50), NPDR + DME (n = 38), and proliferative DR (PDR) or any previous treatment with panretinal photocoagulation (n = 26) groups. Investigation of the choriocapillaris slab level indicated that the no DR group had significantly high CVD values (P < 0.05), and the PDR groups had significantly low CVD values (P < 0.01). Investigation of the large choroidal vessel level indicated that the NPDR + DME and PDR groups had significantly lower CVD values than the control group (P < 0.05 and P < 0.01, respectively).

Conclusion:
We found that at the choriocapillaris slab level, the no DR group had a higher CVD and the NPDR with DME and PDR groups had a lower CVD than the control group. At the level of the large choroidal vessels, the NPDR with DME and PDR groups had a lower CVD than the control group. There were significant differences in choroidal vasculature found using CVD obtained from swept-source optical coherence tomography en-face images of patients with diabetes and DR.
Glaucoma Detection in Myopic Eyes: Structural and Vascular Assessment by Optic Coherence Tomography Methods
Authors: Cakir Ihsan , Altan Cigdem , Yalcinkaya Gulay , Yayla Gizem , Alagoz Nese , Basgil Pasaoglu Isil , Yasar Tekin 
Published: October 2022

Précis:
Retinal nerve fiber layer (RNFL) thickness is helpful in the diagnosis of glaucoma in myopic eyes but neuroretinal rim (NRR) thickness is the most valuable measure. However, changes in optical coherence tomography angiography (OCT-A) parameters are insufficient for the diagnosis of mild to moderate glaucoma in myopia.

Purpose:
To detect how a multimodal evaluation, which includes RNFL, NRR thickness, and optic nerve head (ONH) OCT-A, affects glaucoma diagnosis in myopic patients.

Materials and Methods:
Parameters of healthy myopic and myopic glaucoma eyes with an axial length of ≥24 mm were compared. The ONH structural features and peripapillary RNFL thickness were determined with Cirrus 5000 HD-OCT (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA). The Cirrus 5000 HD-OCT with AngioPlex was utilized to perform OCT-A imaging. The sensitivity and specificity levels were calculated by the best cut-off values with area under curve (AUC).

Results:
One hundred healthy myopic and 54 myopic glaucoma eyes were evaluated. In all areas, myopic glaucoma patients exhibited lower RNFL and NRR thickness than healthy myopic individuals (P<0.05), with the exception of nasal quadrant RNFL thickness (P=0.152). The mean entire and 4 quadrants of global radial peripapillary capillary (RPC)-perfusion and global RPC flux index (FI) were significantly lower in the group of myopic glaucoma patients except for the nasal quadrant mean RPC perfusion (P=0.224). The average RNFL and NRR thickness had a significant difference in AUC for the diagnosis of glaucoma in myopic individuals (P=0.001, for each). The average NRR showed excellent diagnostic performance, whereas the average RNFL showed good diagnostic performance. Average RPC perfusion and average RPC FI showed poor diagnostic ability. The average NRR AUC was more significant than average RPC perfusion and average RPC FI AUC (P<0.001).

Conclusions:
Although RNFL thickness was helpful to diagnose glaucoma in patients with myopia, the diagnostic power of NRR thickness performed best. OCT-A parameters showed poor diagnostic accuracy for glaucoma and the observed perfusion decrease in myopic glaucoma eyes was not sufficiently discriminative compared with NRR and RNFL thickness measurements.
Clinical Application of CLSM, Dermoscope, and Wood’s Lamp in Diagnosis and Differential Diagnosis of Five Hypopigmentation Disorders: A Cross-Sectional Study
Authors: Lu Yu , Wan Xiao , Lu Quan-Sheng , Sun Chao , Lyu Shan-Rong , Li Yi-Zhi , Jiang Guan 
Published: October 2022

Objective:
Noninvasive instruments including confocal laser scanning microscope (CLSM), dermoscope, and Wood’s lamp afford the advantage of obtaining skin microanatomical images quickly, in real-time, and dynamically. However, further understanding is needed regarding the differences between various techniques for diagnosis on hypopigmentation diseases. This study was aimed to observe the characteristics of hypopigmentation diseases by using CLSM, dermoscope, and Wood’s lamp, in order to provide evidence for clinician to choose appropriate instruments for assistant diagnosis.

Methods:
In total, data from 397 patients with vitiligo, nevus anemicus, achromic nevus, pityriasis alba, and senile leukoderma were collected from January 2019 to January 2021 in affiliated hospital of Xuzhou Medical University. CLSM, dermoscope, and Wood’s lamp were used to analyze the characteristics of lesions and the differences between the diseases. Enumeration data were presented as frequencies and percentages.

Results:
CLSM showed that the pigment ring of vitiligo was absent (126/126, 100.0%), senile leukoderma had hypopigmentation, skin atrophy and thinning, and flat epidermis mutation (79/79, 100.0%). In dermoscope, vitiligo showed a milky white hypopigmented area (113/126, 89.8%), nevus anemicus showed a clear but irregular (38/45, 84.4%) white hypopigmentation area (41/45, 91.1%), pityriasis alba showed a clear and light white hypopigmented area, with a grayish-white chaff-like scaly appearance (98/107, 91.6%), senile leukoderma showed a white radially hypopigmentation area with a small amount of pigmentation (79/79, 100.0%). Under Wood’s lamp, bright blue-white patches with clear boundaries can be observed in vitiligo, nevus anemicus, pityriasis alba (93/107, 86.9%) and senile leukoderma appeared clear bluish-white patches, achromic nevus appeared unclear bluish-white patches, respectively.

Conclusion:
Vitiligo, nevus anemicus, achromic nevus, pityriasis alba, and senile leukoderma all belong to hypopigmentation diseases, however, they have own imaging characteristics under CLSM, dermoscope, and Woods lamp techniques, which may be used to help the diagnosis and differential diagnosis of these diseases.
Anagen effluvium due to azathioprine in a patient with normal thiopurine S-methyltransferase levels: A videodermoscopic analysis
Authors: Shah Swapnil , Ankad Balachandra S , Rajagopal Tanuja 
Published: October 2022

Introduction:
Anagen effluvium (AE) is caused by impaired mitotic activity of matrix cells in the hair follicles. It presents with sudden loss of hair and myelosuppression. The diagnosis is based on the clinical history, trichoscopy, and trichogram.
We herein report a case in which videodermoscopy revealed new trichoscopic features of AE caused by azathioprine in a patient with normal thiopurine S-methyltransferase levels.

Case presentation:
A 20-year-old woman presented with sudden loss of hair following treatment with oral azathioprine. Evaluation of the thiopurine S-methyltransferase (TPMT) were within normal limits both in genotype and phenotype levels. Hair pull test was positive. Trichoscopy revealed yellow dots and multiple black dots, empty yellow dots, dark lines, upright regrowing hairs, and circle hairs. Azathioprine was stopped, and minoxidil 5% and oral multivitamin were started. Post-treatment trichoscopic analysis revealed terminal hairs and upright regrowing hairs

Discussion:
AE is characterized by abrupt loss of anagen hairs due to impaired metabolic activity. Trichoscopy in AE shows coudability hairs, black dots, exclamation mark hairs, multiple broken shafts, and regrowing hairs. Empty yellow dots, yellow dots with black dots, pigtail hairs, and dark lines were additional features in this study.

Conclusion:
Trichoscopy assists in the accurate diagnosis of AE. Adverse effects of azathioprine can be observed even with normal TPMT levels. Weekly monitoring is therefore of prime importance.
Secukinumab efficacy in the treatment of pediatricpsoriasis in China: a case series
Authors: Ma Yi-Ping , Jia Hong 
Published: October 2022

Introduction:
There is a lack of data on the use of biologic therapy inrefractory pediatric psoriasis in China. This study presents pediatric psoriasis cases treated with Secukinumab in our center.

Case presentation:
In this retrospective case series,we collected the data of moderate to severe psoriasis patients under 18 years old treated with secukinumab in our hospital from 2019 to 2020. The demographic data, previous treatments, efficacy and side effects were recorded and analyzed.

Discussion:
These five patients had a median age of 10 years (8-17) with a median history of plaque psoriasis of 2 years.At Week 4, 3 out of 5 cases have achieved PASI 75, and at Week 16, 100% of the patients have achieved PASI 100.No adverse events occurred.

Conclusion:
It is safe and effective to treat recalcitrant pediatric psoriasis with secukinumab. Larger series are needed to confirm our observation.
Treatment of Basal Cell Carcinoma Involving the Medial Canthus by Multiple Local Flaps: A Case Report
Authors: Fei Yang-Honghong , Jin Jian , Sun Hua-Feng , Fan Hao , Hong Xu-Dong , Chen Ai-Fen , Lu Hai-Shan , Wu Jin-Fang 
Published: October 2022

Introduction:
Basal cell carcinoma (BCC) is a skin malignancy that commonly appears on the face. Although surgical resection remains the therapeutic gold standard, it always produces a skin defect. Fine aesthetic reconstruction is a persisting challenge for all dermatologists. We herein present a case of BCC affecting the patient’s medial canthus.

Case presentation:
A 61-year-old woman presented with BCC of her right medial canthus. After lesion excision, a 2.5- × 3.5-cm skin defect remained in her canthal area. We used three local flaps to cover the defect according to aesthetic subunits. The defect over the nasal dorsum was covered by a glabellar flap, the upper eyelid defect was covered by a rotation advancement flap, and the lower eyelid defect was covered by a subcutaneous island pedicle flap. The result remained both functionally and aesthetically satisfactory throughout 2 months of follow-up.

Discussion:
Skin malignancies can occur in areas that require special treatment. The medial canthus is a fundamental element of the “facial triangle.” Restoration of color, texture, and thickness of the soft tissue is essential in this area. Full-thickness skin grafts and single flaps seem unsuitable for large defects in this region. Instead, a combination of local flaps according to aesthetic subunits can give desirable results.

Conclusion:
Defects in the medial canthus are difficult to reconstruct. This case provides a novel technique for the treatment of BCC in the medial canthus. Multiple local flaps were used to cover the defect with low tension, giving both a good cosmetic appearance and effective structural reconstruction.