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Τετάρτη 14 Νοεμβρίου 2018
Function and Strength after Free Abdominally Based Breast Reconstruction: A 10-year follow-up
BACKGROUND: The long-term impact of abdominally-based free flap breast reconstruction is incompletely understood. The aim of this study is to provide long-term, subjective and objective health data on abdominally based free flap breast reconstruction patients with specific attention to the effects of laterality, flap type and obesity. METHODS: Patients enrolled in this prospective study between 2005 and 2010 and completed preoperative, early (
https://ift.tt/2Pr5Vke
https://ift.tt/2Pr5Vke
Pakistan Comprehensive Fistula Classification: A novel Scheme and Algorithm for management of palatal fistula/dehiscence
Background: It is not easy to find a management based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae which do not describe the fistula details comprehensively and guide towards its management. We have come across wide variety of fistulae which could not be classified according to any of the prevailing classification systems. The presented classification gives a clear and exact understanding of location and size of fistula/dehiscence. Palatal function has been included as one of the important determinants for devising a management plan. Based on this classification, we have proposed an algorithm which encompasses clear guidelines for surgical treatment of these fistulae. Materials and Methods: Over the last 15 years, our team operated upon 2537 palatal fistula patients. The medical records of these patients were reviewed to determine the location, size and velopharyngeal competence. A new classification and algorithm were developed.Results: Out of 2537 patients, 2258 patients had midline fistulae, 208 patients had lateral fistulae and 53 patients had subtotal fistulae. There were 18 patients with dehiscence. Recurrence developed in 181 patients. Conclusion: We believe that this classification and algorithm can help follow a practical approach to manage palatal fistulae and dehiscence. Financial Disclosure: None. ACKNOWLEDGMENT: We are grateful to Prof. Herman Sailer, Founder/Chairman of Cleft Children International, Zurich, Switzerland, for supervision and guidance of our Cleft Program in Pakistan & Afghanistan. ©2018American Society of Plastic Surgeons
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https://ift.tt/2PsPpjV
Identification of paddy crop phenological parameters using dual polarized SCATSAT-1 (ISRO, India) scatterometer data
Abstract
Paddy crop is one of the foremost food crops in the world. Human consumption accounts for 85% of total production of paddy. Paddy delivers 21% of human per capita energy and 15% of per capita protein. The present study focused on estimating the crop phenological parameters. The phenological parameters were estimated using soil moisture active passive (SMAP), MODIS NDVI, and SCATSAT-1 scatterometer data. The statistical models adopted in the study are two-parameter Gaussian distribution and two-parameter logistic distributions. The puddling stage is the first phenological stage, and it is estimated by the application of soil wetness index (SWI) and anomaly method. The transplanting stage is estimated using the anomaly method. The heading stages are estimated using statistical models, and it is found that Gaussian distribution is the best-fitted model. The harvesting stage is identified using SCATSAT-1 scatterometer and MODIS NDVI data. A chi-square test and degrees of freedom are used to identify the performance and comparison of statistical models. Chi-square test measure is equal to 80.561 and corresponding tabulated chi-square value with N-K-1 degrees of freedom that is equal to 117 is 151.929. The null hypothesis is not rejected.
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Enantioselective degradation of the chiral alpha-cypermethrin and detection of its metabolites in five plants
Abstract
Alpha-cypermethrin (α-cypermethrin), an important chiral pyrethroid insecticide, is frequently detected in human samples. Because of the possible human health risks caused by α-cypermethrin, we studied dynamics, residues, and metabolism of α-cypermethrin in five common vegetables (tomato, cucumber, rape, cabbage, and pepper) on enantiomeric levels after foliar spray. α-Cypermethrin was qualified by a HP-5 column and its enantiomers could be separated by gas chromatograph (GC) using a BGB-172 chiral column. The results of degradation showed that α-cypermethrin dissipated rapidly in vegetables with half-lives being only 2.85–8.88 days. Stereoselective degradation was observed on pepper and cucumber while the two metabolites (cis-DCCA and 3-PBA) of α-cypermethrin were not detected during its dissipation in all plants. This is the first evidence of enantioselective degradation of α-cypermethrin in the five common vegetables and the results should be considered in future environmental risk and food safety evaluations.
https://ift.tt/2PqK1h3
Antibody-Based Therapies for Cutaneous T-Cell Lymphoma
Abstract
Cutaneous T-cell lymphomas (CTCLs) are a group of non-Hodgkin's lymphomas that present in the skin. In early-stage disease, the course is generally chronic and indolent; however, in advanced stages of disease, therapies rarely provide long-lasting responses, and the only potential curative therapy is allogeneic hematopoietic stem-cell transplantation. This has led to the search for novel targeted therapies to better treat more advanced stages of CTCLs that cannot be controlled by typical treatment regimens. One area of advancement has been the development of antibodies specifically targeted to cell types that are known to be involved in CTCL. At present, brentuximab vedotin, an antibody–drug conjugate composed of an anti-cluster of differentiation (CD)-30 antibody covalently linked to monomethyl auristatin E, is approved for the treatment of CD30+ lymphoproliferative disorders [lymphomatoid papulosis (LyP) and primary cutaneous-anaplastic large-cell lymphoma (pc-ALCL)] as well as transformed CD30+ mycosis fungoides (MF). Additionally, mogamulizumab, an anti-chemokine receptor 4 (CCR4) monoclonal antibody, is approved for patients with MF or Sézary syndrome (SS) for whom one prior systemic therapy has failed. Trials are underway looking into the use of immune checkpoint inhibitors in the treatment of CTCLs. As we continue to research CTCL, and as antibody-based therapies continue to advance, more antibody-specific targeted therapy could provide alternative treatment regimens for patients with advanced CTCL.
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Distinctive impact of polystyrene nano-spherules as an emergent pollutant toward the environment
Abstract
The increasing load of nanoplastic pollution in the environment has become a major concern toward human and environmental safety. The current investigation mainly focused on assessing the toxic behavior of nanoplastics (polystyrene nano-spheres (PNS)) toward blood cells and marine crustacean. The study also investigated the temporal stability of PNS under different water matrices and its size-dependent sedimentation behavior in the sea water dispersion. The nano-dispersion showed mean particle size of 561.4 ± 0.80 and 613.7 ± 0.11 nm for PNS 1 and 781.4 ± 0.80 and 913.7 ± 0.11 nm for PNS 2 in lake and seawater, respectively after 48-h incubation, which is ~ 8-fold increase from its original size. The LC50 value against Artemia salina and lymphocytes were found to be 4.82 and 8.79 μg/mL, and 75 μg/mL, respectively for PNS 1 and PNS 2. The genotoxic study reveals that around 50% of lymphocytes were affected by both PNS at 50 μg/mL concentration, whereas the cytotoxic studies on RBC and lymphocytes showed 50% toxicity only at 100 μg/mL concentration. The genotoxic study displayed numerous tri- and multi-nucleated cells. The biochemical profile of A. salina exposed to lethal concentration demonstrated a significant decrease in the total protein, reduced glutathione, and catalase activity and increase in lipid peroxidation activity as a result of PNS permeation to tissues. In conclusion, the present study demonstrated that the polystyrene nano-spheres are emerging pollutant in the environment and are hazardous to humans.
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Interference mechanism of Sophora alopecuroides L. alkaloids extract on host finding and selection of the Asian citrus psyllid Diaphorina citri Kuwayama (Hemiptera: Psyllidae)
Abstract
Manipulating insect behavior through the deployment of semiochemicals offers a promising opportunity for protecting crops in a sustainable manner. Therefore, there is still a significant opportunity for the development of natural crop protectants as eco-friendly tools in pest management. In this context, the aim of the current investigation is to find a novel prophylactic against the Asian citrus psyllid (ACP) and to gain a better understanding of the host-finding and selection ability of the ACP towards Murraya paniculata seedlings treated with Sophora alopecuroides alkaloids extract (SAAE). Our results indicate that foliar application of SAAE influences the psyllid host-finding and selection process. The behavioral assay with M. paniculata seedlings treated with 15 and 30 mg/mL of SAAE, with masked visual cues, revealed that only 6.6 and 10.4% psyllids were able to locate the host in the vials. The results also indicate that citrus psyllids mainly rely on both visual and olfaction in host-finding and selection. In choice settling experiments, psyllids settled almost completely on control seedlings rather than on seedlings treated with SAAE at a concentration of 30 mg/mL. Chemical analyses of the alkaloids extract revealed the presence of sophocarpine (33.90%), sophoridine (6.23%), anagyrine (2.77%), matrine (2.38%), lupanine (1.68%) aphylline (0.89%), and sophoramine (0.75%). In further behavioral bioassays with the dominant alkaloids sophocarpine and sophoridine, the alkaloids repelled ACP at higher concentrations of 50 and 70 mg/mL as compared to SAAE. Furthermore, the 50 mg/mL (1:1, v/v) combination of sophocarpine and sophoridine displayed a synergistic effect and showed the maximum behavioral effect as compared to the individual alkaloid. Based on our results, SAAE makes M. paniculata seedlings unattractive to the psyllids, and therefore, alkaloids could be used in reducing the colonization of citrus plants, subsequently curtailing HLB infection.
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Carney Complex
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0753-4943
Carney complex is a rare, autosomal dominant, multiple endocrine neoplasia and lentiginosis syndrome, caused in most patients by defects in the PRKAR1A gene, which encodes the regulatory subunit type 1α of protein kinase A. Inactivating defects of PRKAR1A lead to aberrant cyclic-AMP-protein kinase A signaling. Patients may develop multiple skin abnormalities and a variety of endocrine and non-endocrine tumors. Endocrine manifestations include primary pigmented nodular adrenocortical disease, that may cause Cushing syndrome, growth-hormone secreting pituitary adenoma or pituitary somatotropic hyperplasia which can result in acromegaly, as well as gonadal and thyroid tumors. Non-endocrine tumors associated with Carney complex include myxomas of the heart, breast, and other sites, psamommatous melanotic schwannomas, breast ductal adenomas, osteochondromyxomas, and a predisposition to a number of malignancies from adrenal to pancreatic and liver cancer.
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© Georg Thieme Verlag KG Stuttgart · New York
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Treatment of Refractory Adrenocortical Carcinoma with Thalidomide: Analysis of 27 Patients from the European Network for the Study of Adrenal Tumours Registry
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0747-5571
Objective Adrenocortical carcinoma (ACC) is a rare malignancy with a dismal prognosis. In advanced stages, tumour control by mitotane and cytotoxic chemotherapy is often temporary and salvage treatments are warranted. Methods Retrospective cohort study of participants in the prospective European Networks for the Study of Adrenal Tumours (ENSAT) registry. Main outcome measures were best response during treatment, progression-free survival (PFS), both measured according to RECIST 1.1 by two blinded radiologists, and overall survival (OS). Results Twenty-seven patients (13 males; median age 44.1 years) progressing after mitotane and a median of 4 further systemic treatments were included. Thalidomide was administered as tolerated with a starting dose of 50 mg and target dose of 200 mg /d. The median interval between treatment initiation and first imaging was 10.5 (4.4-17.5) weeks. The best response to treatment was stable disease (SD, n=2) and progressive disease (n=25), with a median PFS of 11.2 weeks and a median OS of 36.4 weeks. The first patient with SD discontinued treatment due to mild epistaxis and diarrhea after 22.3 weeks. The second patient had SD at the second treatment evaluation after 25.2 weeks and continued thalidomide but then had clinical progression and deceased after 54.3 weeks. In general, thalidomide induced only mild or moderate adverse effects (mainly fatigue and gastrointestinal complaints). Conclusion Thalidomide was overall well tolerated but resulted in disease control in only 2/27 (7.4%) patients. In the absence of predictive response markers, thalidomide should only be considered in exceptional cases as a salvage therapy in ACC.
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© Georg Thieme Verlag KG Stuttgart · New York
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Association of HLA Class II alleles and Haplotypes with Type 1 Diabetes in Tunisian Arabs
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0754-5586
The molecular association of HLA class II with type 1 diabetes (T1DM) was investigated in Tunisian Arabs using 3 kinds of analyses. The first was a case-control association study, using Relative Predispositional Effects method, involved 137 T1DM cases and 258 control subjects. The second was family-based association-linkage study, using Transmission Disequilibrium Test, and covering 50 Tunisian families comprising 73 T1DM patients and 100 parents. The third was a wide correlation study between 4 DRB1 alleles (DRB1*03, *04, *11, *15) and T1DM in 52 countries, using Spearman's Rho. Results from Case-control and family-based association studies showed that DRB1*03 and DRB1*04 alleles predispose to T1DM in Tunisian Arabs. Conversely, only DRB1*11 was protective for T1DM. DRB1*04-DQB1*03 haplotype was consistently associated positively with T1DM; DRB1*03/DRB1*04 genotype had the highest risk of T1DM development. Compared to DRB1*03, HLA-DRB1*04 was associated with higher T1DM incidence. Thus, the contribution of HLA class II to T1DM genetic susceptibility must be evaluated with regards to specific HLA alleles, genotypes, and haplotypes, and also ethnic and racial background.
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© Georg Thieme Verlag KG Stuttgart · New York
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Hypoglycemia and Glucagon Utilization in Insulin-Treated Diabetic Patients *
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0741-6763
Background First choice of therapy for severe hypoglycemia outside hospital environment is glucagon injection, an undertaught and underused remedy. Aim of this study was to investigate knowledge about glucagon therapy, possession rate and usage rate in insulin-treated diabetic patients, with special emphasis on history of hypoglycemia and severe hypoglycemia episodes. Methods In this cross-sectional study, 300 insulin-treated diabetic patients (146 males and 154 females, mean age 61.1±16.4 years) were recruited from comprehensive Diabetes Center in Croatia. Specialized self-administered, 13-item questionnaire regarding glucagon therapy and history of hypoglycemia was obtained from each patient, as well as data collected from medical history documentation. Results Experience of hypoglycemic episode was reported by 233 (77.7%), and severe hypoglycemia by 73 (24.3%) patients. Participants with experience of hypoglycemia have significantly longer diabetes duration (17.2±11.2 vs. 11.9±8.5 years, P<0.001) and lower BMI values (26.38±3.97 vs. 31.11±7.17 kg/m2, P<0.001). Knowledge about glucagon therapy had 55.3% patients, 44.7% obtained it from the pharmacy, while glucagon was used in 35.6% cases of severe hypoglycemia. Glucagon knowledge was better in patients that attended at least one diabetes lecture (P=0.038), while educational level showed no statistical significance (P=0.286). Main significant positive predictor of glucagon knowledge was history of severe hypoglycemia (OR 4.71, 95% CI 1.38 – 16.02, P=0.013). Conclusions Glucagon therapy was underused in treating severe hypoglycemia. It is highly important to emphasize value of quality education as one of the fundamentals of good diabetes management.
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© Georg Thieme Verlag KG Stuttgart · New York
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AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 2018; S 01 Article in Thieme...
AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 2018; S 01
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Traumatische Verletzungen des zentralen Nervensystems
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 668-681
DOI: 10.1055/s-0043-118969
Traumatische Verletzungen des zentralen Nervensystems stellen die Folge einer äußeren Gewalteinwirkung auf Gehirn oder Rückenmark dar. Sowohl das Schädel-Hirn-Trauma als auch das spinale Trauma sind dynamische Krankheitsbilder, die besondere Anforderungen an Diagnostik und Therapie stellen und somit in spezialisierten Zentren versorgt werden sollten.
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Georg Thieme Verlag KG Stuttgart · New York
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Gefährliche Verzögerung: Warten erhöht Mortalität bei Sepsis
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 644-645
DOI: 10.1055/a-0727-4782
Georg Thieme Verlag KG Stuttgart · New York
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Neurointensivmedizin: aneurysmatische Subarachnoidalblutung – State of the Art
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 654-667
DOI: 10.1055/s-0043-118963
Die spontane, nicht traumatische Subarachnoidalblutung ist eine lebensbedrohliche Erkrankung, die mit vielfältigen Komplikationen und einer hohen Morbidität und Mortalität vergesellschaftet ist. In den ersten 24 Stunden hat die Ausschaltung der Blutungsursache Vorrang. Die Patienten sollen intensivmedizinisch überwacht und behandelt werden. Stringente Diagnostik und konsequente Behandlung verbessern das Outcome der Patienten nachweislich.
[...]
Georg Thieme Verlag KG Stuttgart · New York
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ICU: längeres Überleben durch Delirprophylaxe mit Haloperidol?
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 645-645
DOI: 10.1055/a-0727-5752
Georg Thieme Verlag KG Stuttgart · New York
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Geburtshilfliche Anästhesie und postoperative Überwachung
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 696-702
DOI: 10.1055/s-0043-111309
Die von ASA (American Society of Anesthesiologists) und SOAP (Society for Obstetric Anesthesia and Perinatology) für das Jahr 2016 aktualisierten Leitlinien sind eine Handlungsempfehlung in erster Linie für Anästhesisten, die auf das anästhesiologische Management Gebärender, nicht operative und operative Entbindung sowie auf die postpartale Versorgung und Analgesie fokussiert.
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Georg Thieme Verlag KG Stuttgart · New York
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Mukopolysaccharidose: hohes Anästhesierisiko bei Kindern
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 645-646
DOI: 10.1055/a-0727-6682
Georg Thieme Verlag KG Stuttgart · New York
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Neurointensivmedizin
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 652-653
DOI: 10.1055/a-0668-4925
Georg Thieme Verlag KG Stuttgart · New York
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(Über-)Leben nach Lungenversagen: die DACAPO-Studie
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 646-647
DOI: 10.1055/a-0727-6029
Georg Thieme Verlag KG Stuttgart · New York
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Schmerztherapeutische Aspekte bei Tumoroperationen
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 704-717
DOI: 10.1055/s-0043-104600
Trotz einer Vielzahl von Therapieoptionen wird die Akutschmerztherapie nach onkologischen Operationen häufig als unzureichend beschrieben. Neben einer unzureichenden Akutschmerztherapie können weitere Faktoren eine Hypersensitivierung und Chronifizierung sowie den Verlauf der Tumorerkrankung beeinflussen. Dieser Beitrag erklärt pathophysiologische Hintergründe und erläutert geeignete Therapiemodalitäten.
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Georg Thieme Verlag KG Stuttgart · New York
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Herzstillstand nach Infarkt: bessere Ergebnisse mit mechanischer Kreislaufunterstützung
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 647-648
DOI: 10.1055/a-0727-6465
Georg Thieme Verlag KG Stuttgart · New York
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Neuromonitoring und Therapieentscheidungen auf der Intensivstation
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 682-695
DOI: 10.1055/s-0043-118971
Bei Patienten mit einer akuten Hirnschädigung besteht das Risiko einer weiteren neurologischen Verschlechterung aufgrund der Entwicklung eines sekundären Hirnschadens. Ziel des Neuromonitorings ist es frühzeitig pathophysiologische Veränderung des Gehirns zu erkennen um adäquate diagnostische und therapeutische Maßnahmen einzuleiten, um die Entstehung eines sekundären Hirnschadens zu vermeiden. Neben der klassischen Methode des klinischen Neuromonitorings bei wachen Patienten werden invasive Methoden mit Implantation von Messsonden zur Bestimmung des Hirndruckes, des zerebralen Sauerstoffpartialdruckes sowie des Hirnmetabolismus bei komatösen Patienten angewendet. Ein elektrophysiologisches Monitoring mittels Elektrokortikografie oder evozierter Potenziale sowie die Messung des zerebralen Blutflusses liefert ergänzende Informationen. Die Indikationen und die klinische Relevanz der verschiedenen Monitoring-Techniken werden im Hinblick auf eine Optimierung der Behandlung von Patienten mit akuten zerebralen Schädigungen besprochen.
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Georg Thieme Verlag KG Stuttgart · New York
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„Ich muss genau hier sein!“
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 650-651
DOI: 10.1055/a-0663-1715
Georg Thieme Verlag KG Stuttgart · New York
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Metabolische Azidose unter Paracetamol – eine ungewöhnliche Nebenwirkung
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 718-722
DOI: 10.1055/a-0636-2595
Die metabolische Azidose ist bei hospitalisierten Patienten keine Rarität. Doch nur selten ist eine metabolische Azidose mit erweiterter Anionenlücke unter chronischer Paracetamol-Therapie und konsekutiver transienter 5-Oxoprolin-Akkumulation (Pyroglutaminsäure) bei Erwachsenen beschrieben 1, 2, 3, 4. Dieser Beitrag stellt einen solchen Fall dar und erläutert die wenig bekannte Pathogenese.
[...]
Georg Thieme Verlag KG Stuttgart · New York
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The correlation between the concentration of hepcidin in serum and the occurrence of insulin resistance and hyperandrogenemia in women with polycystic ovary syndrome
OBJECTIVE: Scarce clinical and experimental studies suggest that hepcidin can be a protein participating in the development of metabolic disorders, while its synthesis and concentration in the circulation outside of the iron metabolism parameters can be influenced by hormones. The aim of the present study was to determine the correlation between the concentration of hepcidin in serum and the occurrence of insulin resistance and hyperandrogenemia in women with PCOS.
PATIENTS AND METHODS: Five groups of women with PCOS were divided based on: correct body mass (17 without hyperandrogenemia and insulin resistance – G1; 17 with hyperandrogenemia and without insulin resistance – G2; 11 without hyperandrogenemia and with insulin resistance – G3; 10 with hyperandrogenemia and insulin resistance – G4), metabolic and hormonal parameters and selected markers of iron metabolism.
RESULTS: Serum glucose levels were significantly higher in the group G3 than G1 and in the group G4 than G1 and G2. Serum insulin levels and HOMA–IR values were significantly higher in the groups G3 and G4 than G1 and G2. Serum androstenedione levels were significantly higher in the group G2 than G1 and G3 than G2. Serum transferrin levels were significantly lower in the group G1 than in the reaming study groups.
CONCLUSIONS: It has been demonstrated that insulin resistance and hyperandrogenemia appear to be the factors decreasing the concentration of transferrin circulation, but not the remaining parameters of the iron metabolism in the studied women. No relationship between the concentration of hepcidin circulation and other studied parameters of the iron metabolism and the parameters of the carbohydrate metabolism was discovered. Androstenedione can stimulate hepcidin synthesis in women with PCOS with correct body mass.
L'articolo The correlation between the concentration of hepcidin in serum and the occurrence of insulin resistance and hyperandrogenemia in women with polycystic ovary syndrome sembra essere il primo su European Review.
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Silicone-based simulation models for peripheral nerve microsurgery
There is a need for a peripheral nerve model on which surgeons-in-training can simulate the repair of nerve injuries at their own pace. Although practicing on animal models/cadavers is considered the "gold standard" of microsurgical training, the proposed model aims to provide a platform for improving the technical skills of surgical trainees prior to their practice on cadaver/animal models. In addition, this model has the potential to serve as a standardized test medium for assessing the skill sets of surgeons.
https://ift.tt/2qMF2bV
Skin shop: A new model for high volume skin cancer care
Non-melanoma skin cancer incidence is increasing in New Zealand. Increased cost of care has led to service pressure and a review of models of care. A high volume skin surgery service at Waikato Hospital has been developed to reduce service costs. This study examines the oncological safety of the new model.
https://ift.tt/2Fk66cj
Larger ascending aorta in primary aldosteronism: a 3-year prospective evaluation of adrenalectomy vs. medical treatment
Abstract
Objective
Primary aldosteronism is associated with higher cardiovascular morbidity as compared with essential hypertension. Vascular complications encompass myocardial infarction and cerebrovascular events. Aortic damage in primary aldosteronism has never been explored, although a few cases of ascending aorta aneurisms have been reported.
Design and methods
We consecutively enrolled patients affected by primary aldosteronism (n = 45) and compared them with patients affected by essential hypertension (n = 47), on an outpatient setting. Echocardiographic data of patients with primary aldosteronism were collected during a mean follow-up of 3 years, in subjects who underwent adrenal surgery (n = 12) and those on mineralocorticoid receptor antagonists (n = 33).
Results and conclusion
We found that patients with primary aldosteronism had larger ascending aorta diameters than those with essential hypertension before starting any specific treatment. Patients with primary aldosteronism did not show significant changes in the size of ascending aorta during a mean of 3 years of follow-up, irrespective of the type of treatment (medical vs. surgical treatment). A longer follow-up will better clarify if worsening of the aortic damage may be better prevented by surgery rather than by mineralocorticoid receptor antagonists.
https://ift.tt/2DmaOnl
Larger ascending aorta in primary aldosteronism: a 3-year prospective evaluation of adrenalectomy vs. medical treatment
Abstract
Objective
Primary aldosteronism is associated with higher cardiovascular morbidity as compared with essential hypertension. Vascular complications encompass myocardial infarction and cerebrovascular events. Aortic damage in primary aldosteronism has never been explored, although a few cases of ascending aorta aneurisms have been reported.
Design and methods
We consecutively enrolled patients affected by primary aldosteronism (n = 45) and compared them with patients affected by essential hypertension (n = 47), on an outpatient setting. Echocardiographic data of patients with primary aldosteronism were collected during a mean follow-up of 3 years, in subjects who underwent adrenal surgery (n = 12) and those on mineralocorticoid receptor antagonists (n = 33).
Results and conclusion
We found that patients with primary aldosteronism had larger ascending aorta diameters than those with essential hypertension before starting any specific treatment. Patients with primary aldosteronism did not show significant changes in the size of ascending aorta during a mean of 3 years of follow-up, irrespective of the type of treatment (medical vs. surgical treatment). A longer follow-up will better clarify if worsening of the aortic damage may be better prevented by surgery rather than by mineralocorticoid receptor antagonists.
https://ift.tt/2DmaOnl
MM-398 and Ramucirumab in Treating Patients With Gastric Cancer or Gastroesophageal Junction Adenocarcinoma
Conditions: Clinical Stage III Gastric Cancer AJCC v8; Clinical Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8; Clinical Stage IV Gastric Cancer AJCC v8; Clinical Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Clinical Stage IVA Gastric Cancer AJCC v8; Clinical Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8; Clinical Stage IVB Gastric Cancer AJCC v8; Clinical Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8; Locally Advanced Unresectable Gastric Adenocarcinoma; Metastatic Gastroesophageal Junction Adenocarcinoma; Metastatic Unresectable Gastric Adenocarcinoma; Pathologic Stage III Gastric Cancer AJCC v8; Pathologic Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IIIA Gastric Cancer AJCC v8; Pathologic Stage IIIA Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IIIB Gastric Cancer AJCC v8; Pathologic Stage IIIB Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IIIC Gastric Cancer AJCC v8; Pathologic Stage IV Gastric Cancer AJCC v8; Pathologic Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage III Gastric Cancer AJCC v8; Postneoadjuvant Therapy Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IIIA Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IIIB Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IV Gastric Cancer AJCC v8; Postneoadjuvant Therapy Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8; Unresectable Gastroesophageal Junction Adenocarcinoma
Interventions: Drug: Liposomal Irinotecan; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Biological: Ramucirumab
Sponsors: University of Southern California; National Cancer Institute (NCI); Ipsen
Not yet recruiting
https://ift.tt/2B656EF
Interventions: Drug: Liposomal Irinotecan; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Biological: Ramucirumab
Sponsors: University of Southern California; National Cancer Institute (NCI); Ipsen
Not yet recruiting
https://ift.tt/2B656EF
Study Evaluating Safety and Efficacy of Bimiralisib in Patients With Head and Neck Squameous Cell Carcinoma
Condition: HNSCC
Intervention: Drug: Bimiralisib
Sponsor: PIQUR Therapeutics AG
Not yet recruiting
https://ift.tt/2K2G78h
Intervention: Drug: Bimiralisib
Sponsor: PIQUR Therapeutics AG
Not yet recruiting
https://ift.tt/2K2G78h
Binary Oncolytic Adenovirus in Combination With HER2-Specific CAR VST, Advanced HER2 Positive Solid Tumors (VISTA)
Conditions: Bladder Cancer; Head and Neck Squamous Cell Carcinoma; Cancer of the Salivary Gland; Lung Cancer; Breast Cancer; Gastric Cancer; Esophageal Cancer; Colorectal Cancer; Pancreatic Adenocarcinoma
Intervention: Biological: CAdVEC
Sponsors: Baylor College of Medicine; The Methodist Hospital System; Texas Children's Hospital
Not yet recruiting
https://ift.tt/2B5fCMA
Intervention: Biological: CAdVEC
Sponsors: Baylor College of Medicine; The Methodist Hospital System; Texas Children's Hospital
Not yet recruiting
https://ift.tt/2B5fCMA
Hormonal control of vas deferens fluid volume and aquaporin expression in rats
Abstract
Precise regulation of vas deferens fluid volume which is important for sperm survival might be influenced by testosterone. In order to investigate changes in vas deferens fluid volume and aquoporins (AQP) isoforms expression under testosterone influence, orchidectomized Sprague–Dawley rats were given 125 and 250 µg/kg/day testosterone with or without flutamide, an androgen receptor blocker or finasteride, a 5alpha-reductase inhibitor for seven consecutive days. Following treatment completion, vas deferens was perfused and changes in the fluid secretion rate and osmolality were determined in the presence of acetazolamide. Rats were then sacrificed and vas deferens was harvested for histology, tissue expression and distribution analyses of AQP-1, AQP-2, AQP-5, AQP-7 and AQP-9 proteins by Western blotting and immunohistochemistry, respectively. Our findings indicate that testosterone causes vas deferens fluid secretion rate to increase, which was antagonized by acetazolamide. Fluid osmolality increased following testosterone treatment and further increased when acetazolamide was given. Co-administration of flutamide or finasteride with testosterone causing both fluid secretion rate and osmolality to decrease. Histology revealed increased size of vas deferens lumen with increased thickness of vas deferens stroma. Expression of AQP-1, AQP-2 and AQP-9 were detected in vas deferens but not AQP-5 and AQP-7, and the levels of these proteins were increased by testosterone treatment mainly at the apical membrane of vas deferens epithelium. In conclusion, increased in vas deferens fluid secretion rate under testosterone influence mediated via the up-regulation of AQP-1, 2 and 9 might be important for vas deferens fluid homeostasis in order to ensure normal male fertility.
https://ift.tt/2B5TiSR
Assessment of heavy metal release into the soil after mine clearing in Halgurd-Sakran National Park, Kurdistan, Iraq
Abstract
The aim of this study was to assess the heavy metal pollution in soils after mine clearance and disposal through controlled explosions in dugout pits during demining operations at two hotspot areas, in the Halgurd-Sakran National Park (HSNP). This investigation was undertaken in order to reveal the concentration level, migration and enrichment in various heavy metals present in polluted soils. Eighteen samples, nine sampling positions at each site, were collected. The current study used inductively coupled plasma-emission spectroscopy (ICP-ES) methodology to determine the concentration levels of Cu, Pb, Zn, Ni, Co, Mn, As and Cr in the soil samples as important toxic contaminants resulting from the demining process. The results show concentration levels of 63.33, 16.22, 116.44, 328, 32.66, 1594.33, 7 and 291.55 ppm in site 1 for Cu, Pb, Zn, Ni, Co, Mn, As and Cr, respectively, while site 2 gave 72.55, 17, 102.55, 296.55, 32, 1851.88, 9.11 and 308.77 ppm. Soil enrichment factor (EF) in sites 1 and 2 of the heavy metals Ni, Cr, Mn, Co and Cu ranged from extremely high enrichment to moderate-high enrichment, respectively. The geo-accumulation (I-geo) index indicated contamination levels that ranged from very strongly to moderately contaminated soil for Ni, Cr, Mn, Co and Cu, respectively. On the other hand, the pollution load index (PLI) showed all values from all samples in both sites were above 1 indicating totally contaminated areas. However, the most polluting heavy metals in the soil at both sites are Ni and Cr with high contamination levels attributed to the controlled mines' detonations. In conclusion, these mines' detonations are producing residual heavy metals in the soil that are potentially harmful to the vegetation cover, animals and ultimately humans.
https://ift.tt/2B6nXzi
Destabilization of polyethylene and polyvinylchloride structure by marine bacterial strain
Abstract
Plastics are recalcitrant and inert to degrade, and destabilization leads to accumulate in the terrestrial and marine ecosystems; need for the development of strategies for reducing these plastic wastes in a sustainable manner would be revolutionary. We studied the bacterial adherence, degradation and destabilization of polyvinylchloride (PVC), low-density polyethylene (LDPE), and high-density polyethylene (HDPE) by marine bacterial strain AIIW2 by a series of analytical and microscopic observations over 3 months. Based on 16S rRNA gene sequence and the phylogenetic analysis of the strain AIIW2, it showed 97.39% similarity with Bacillus species. Degradation of plastics was determined by the weight loss after 90 days with bacterial strain which detected up to 0.26 ± 0.02, 0.96 ± 0.02, and 1.0 ± 0.01% for PVC, LDPE, and HDPE films, respectively over initial weights. The mineralization of plastic film was found to be maximum in LDPE followed by HDPE and PVC. Bacterial interaction had increased roughness and deteriorated the surface of plastics which is revealed by the scanning electron microscope and atomic force microscope. Bending vibrations of the alkane rock chain (–CH2 and –CH3) and carbonyl (–CO) regions in LDPE and HDPE films, while there was slight stretching in the hydroxyl (–OH) regions of carboxylic acid in PVC which is evidenced through Fourier transform infrared spectral studies, suggested the oxidative activities of the bacteria. Though, the bacterial activity was higher on the LDPE and HDPE than PVC film which may be due to the presence of chlorine atom in PVC structure making it more versatile. The results of the present study revealed the ability of marine bacterial strain for instigating their colonization over plastic films and deteriorating the polymeric structure.
https://ift.tt/2K3JxYk
Editorial Board and Contents
Publication date: December 2018
Source: Trends in Endocrinology & Metabolism, Volume 29, Issue 12
Author(s):
https://ift.tt/2QINunU
Scholar : Human–Computer Interaction, Volume 34, Issue 1, 2019 is now available online on Taylor & Francis Online
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Acetylcholinesterase activity and bone biochemical markers in premature and full-term neonates
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
https://ift.tt/2B5NpVS
Papillary Thyroid Carcinoma as a Lateral Neck Cyst: A Cystic Metastatic Node versus an Ectopic Thyroid Tissue.
| Related Articles |
Papillary Thyroid Carcinoma as a Lateral Neck Cyst: A Cystic Metastatic Node versus an Ectopic Thyroid Tissue.
Case Rep Endocrinol. 2018;2018:5198297
Authors: Rahmat F, Kumar Marutha Muthu A, S Raja Gopal N, Jo Han S, Yahaya AS
Abstract
Papillary thyroid carcinoma is the most common thyroid malignancy and frequently metastasizes to regional lymph nodes. Occasionally, metastatic lymph nodes are palpable without the evidence of primary tumour. Papillary thyroid carcinoma of lateral neck cyst is a rare condition. It may arise from thyroid primary which underwent cystic degeneration or true malignant transformation of ectopic thyroid tissue. Herein, we reported two cases with preoperative diagnosis of benign lateral neck cyst but postoperative histopathological results showed primary papillary thyroid carcinoma. Ultrasonography and computed tomography of the neck in both cases showed no significant thyroid lesion. However, the patient in Case 2 was subjected for total thyroidectomy and histopathological results showed the origin of primary tumour. In conclusion, thorough investigations including total thyroidectomy are indicated in cases of papillary thyroid carcinoma of lateral neck cyst. This practice is to ensure that this type of thyroid cancer can be detected earlier because it has a very good prognosis if treated earlier.
PMID: 30420925 [PubMed]
https://ift.tt/2zRBgSz
Microbial Etiology and Prognostic Factors of Ventilator-associated Pneumonia: A Multicenter Retrospective Study in Shanghai.
Microbial Etiology and Prognostic Factors of Ventilator-associated Pneumonia: A Multicenter Retrospective Study in Shanghai.
Clin Infect Dis. 2018 Nov 13;67(suppl_2):S146-S152
Authors: Huang Y, Jiao Y, Zhang J, Xu J, Cheng Q, Li Y, Liang S, Li H, Gong J, Zhu Y, Song L, Rong Z, Liu B, Jie Z, Sun S, Li P, Wang G, Qu J, Infection Assembly of Shanghai Respiratory Society
Abstract
Background: The microbial etiology and mortality risk factors of ventilator-associated pneumonia (VAP) have not been investigated extensively in Shanghai.
Methods: VAP cases were identified from the patients hospitalized during the period from 1 January 2013 to 30 December 2017 in Shanghai. The relevant data were reviewed and analyzed retrospectively.
Results: One hundred ninety-four VAP cases were included in this analysis. The overall mortality rate was 32.47%. The respiratory pathogens isolated from these patients included 212 bacterial strains and 54 fungal strains. The leading pathogens were Acinetobacter baumannii (33.96%), Klebsiella pneumoniae (23.58%), Pseudomonas aeruginosa (19.81%), and Staphylococcus aureus (7.08%). Candida colonization was associated with higher mortality of VAP patients compared to those without Candida colonization (45.45% vs 28.67%, P < .05). The VAP patients with Candida colonization also showed higher prevalence of P. aeruginosa, carbapenem-resistant P. aeruginosa (CRPA), K. pneumoniae, carbapenem-resistant K. pneumoniae (CRKP), A. baumannii, and carbapenem-resistant A. baumannii (CRAB) (P < .05). VAP nonsurvivors had higher prevalence of CRPA, K. pneumoniae, CRAB, and Candida than VAP survivors (P < .05). Multivariate analysis showed that prior antibiotic use was a significant risk factor for Candida colonization, while hypertension and length of hospital stay were significant risk factors of VAP mortality (P < .05).
Conclusions: The top pathogens of VAP patients in Shanghai tertiary teaching hospitals are A. baumannii, K. pneumoniae, and P. aeruginosa, with high prevalence of carbapenem resistance. Carbapenem-resistant bacterial pathogens and Candida may predict poor outcome.
PMID: 30423049 [PubMed - in process]
https://ift.tt/2TcMKbZ
Changes in the composition of the upper respiratory tract microbial community in granulomatosis with polyangiitis.
| Related Articles |
Changes in the composition of the upper respiratory tract microbial community in granulomatosis with polyangiitis.
J Autoimmun. 2018 Nov 09;:
Authors: Lamprecht P, Fischer N, Huang J, Burkhardt L, Lütgehetmann M, Arndt F, Rolfs I, Kerstein A, Iking-Konert C, Laudien M
Abstract
Dysbiosis¸ i.e. changes in microbial composition at a mucosal interface, is implicated in the pathogenesis of many chronic inflammatory and autoimmune diseases. To assess the composition of the microbial upper respiratory tract (URT) community in patients with granulomatosis with polyangiitis (GPA), we used culture-independent high-throughput methods. In this prospective clinical study, nasal swabs were collected from patients with GPA, patients with rheumatoid arthritis (RA, disease control), and healthy controls. Nasal bacterial taxa were assessed using V3-V4 region 16S rRNA amplicon sequencing. Staphylococcus aureus, Haemophilus influenza, and entero- and rhinoviruses were detected using qPCR. Unbiased metagenomic RNA sequencing (UMERS) was performed in a subset of samples to determine the relative abundance of bacterial, fungal, and viral species. A trend toward reduced microbiome diversity was detected in GPA samples compared with healthy controls. The abundance of bacterial taxa and microbial richness were significantly decreased in GPA samples compared with RA samples. The relative abundance of bacterial families shifted, with increased Planococcaceae and decreased Moraxellaceae, Tissierellaceae, Staphylococcaceae, and Propionibacteriaceae in GPA and RA. Further, decreased abundance of Corynebacteriaceae, and Aerococcaceae was observed in GPA samples. Significantly more colonization of S. aureus was seen in the nasal microbiome of GPA compared with RA and healthy control samples. H. influenzae colonization was also observed in GPA samples. UMERS detected the presence of rhinoviral sequences in some GPA samples. Thus, our study uncovered changes in the URT microbial composition in patients with GPA and RA, suggesting that both immunosuppression and disease background affect the URT microbiome. Complex alterations of host-microbiome interactions in the URT could influence chronic endonasal inflammation in GPA.
PMID: 30420263 [PubMed - as supplied by publisher]
https://ift.tt/2Fk8NuH
Association of bovine major histocompatibility complex (BoLA) gene polymorphism with colostrum and milk microbiota of dairy cows during the first week of lactation.
| Related Articles |
Association of bovine major histocompatibility complex (BoLA) gene polymorphism with colostrum and milk microbiota of dairy cows during the first week of lactation.
Microbiome. 2018 Nov 12;6(1):203
Authors: Derakhshani H, Plaizier JC, De Buck J, Barkema HW, Khafipour E
Abstract
BACKGROUND: The interplay between host genotype and commensal microbiota at different body sites can have important implications for health and disease. In dairy cows, polymorphism of bovine major histocompatibility complex (BoLA) gene has been associated with susceptibility to several infectious diseases, most importantly mastitis. However, mechanisms underlying this association are yet poorly understood. In the present study, we sought to explore the association of BoLA gene polymorphism with the dynamics of mammary microbiota during the first week of lactation.
RESULTS: Colostrum and milk samples were collected from multiparous Holstein dairy cows at the day of calving and days 1 and 6 after calving. Microbiota profiling was performed using high-throughput sequencing of the V1-V2 regions of the bacterial 16S rRNA genes and ITS2 region of the fungal ribosomal DNA. Polymorphism of BoLA genes was determined using PCR-RFLP of exon 2 of the BoLA-DRB3. In general, transition from colostrum to milk resulted in increased species richness and diversity of both bacterial and fungal communities. The most dominant members of intramammary microbiota included Staphylococcus, Ruminococcaceae, and Clostridiales within the bacterial community and Alternaria, Aspergillus, Candida, and Cryptococcus within the fungal community. Comparing the composition of intramammary microbiota between identified BoLA-DRB3.2 variants (n = 2) revealed distinct clustering pattern on day 0, whereas this effect was not significant on the microbiota of milk samples collected on subsequent days. On day 0, proportions of several non-aureus Staphylococcus (NAS) OTUs, including those aligned to Staphylococcus equorum, Staphylococcus gallinarum, Staphylococcus sciuri, and Staphylococcus haemolyticus, were enriched within the microbiota of one of the BoLA-DRB3.2 variants, whereas lactic acid bacteria (LAB) including Lactobacillus and Enterococcus were enriched within the colostrum microbiota of the other variant.
CONCLUSION: Our results suggest a potential role for BoLA-gene polymorphism in modulating the composition of colostrum microbiota in dairy cows. Determining whether BoLA-mediated shifts in the composition of colostrum microbiota are regulated directly by immune system or indirectly by microbiota-derived colonization resistant can have important implications for future development of preventive/therapeutic strategies for controlling mastitis.
PMID: 30419937 [PubMed - in process]
https://ift.tt/2qNduDa
Overexpression of CAV3 facilitates bone formation via the Wnt signaling pathway in osteoporotic rats
Abstract
Purpose
Osteoporosis is a condition characterized by decreased bone density and bone strength, commonly observed among older individuals. Caveolin-3 (CAV3) is a principal structural protein of the caveolae membrane domains, which has been reported to participate in cell signaling as well as the maintenance of cell structure. The aim of the current study was to investigate the effects involved with the silencing of CAV3 on bone formation among osteoporotic rat models via the Wnt signaling pathway.
Methods
Osteoporosis was initially induced by means of ovariotomy among rat models in order to determine the expression of CAV3. Then, to confirm the specific function and mechanism of CAV3 from an osteoporosis perspective, the CAV3 expression vector was constructed and transfected into the osteoblasts of the osteoporotic rats. Afterward, the mRNA and protein expressions of CAV3, β-catenin, low-density lipoprotein receptor-related protein 5 (LRP5), T-cell factor (TCF), and Wnt3a in addition to cell proliferation and apoptosis were detected accordingly.
Results
Positive expression of CAV3 exhibited diminished levels in the bone tissues of osteoporotic rats. The osteoblasts of the osteoporotic rats treated with overexpressed CAV3 displayed elevated mRNA and protein expression levels of β-catenin, LRP5, TCF, and Wnt3a. Increased cell proliferation and decreased cell apoptosis were also observed, while the osteoblasts of the osteoporotic rats treated with si-CAV3 exhibited an opposite result.
Conclusion
Overexpressed CAV3 promotes bone formation and suppresses the osteoporosis progression via the activation of the Wnt signaling in rat models, suggesting CAV3 as a potential target biomarker in the treatment of osteoporosis.
https://ift.tt/2RNL47i
Visualizing and quantifying flow stasis in abdominal aortic aneurysms in men using 4D flow MRI
Publication date: Available online 13 November 2018
Source: Magnetic Resonance Imaging
Author(s): Magnus Ziegler, Martin Welander, Jonas Lantz, Marcus Lindenberger, Niclas Bjarnegård, Matts Karlsson, Tino Ebbers, Toste Länne, Petter Dyverfeldt
Abstract
Purpose
To examine methods for visualizing and quantifying flow stasis in abdominal aortic aneurysms (AAA) using 4D Flow MRI.
Methods
Three methods were investigated: conventional volumetric residence time (VRT), mean velocity analysis (MVA), and particle travel distance analysis (TDA). First, ideal 4D Flow MRI data was generated using numerical simulations and used as a platform to explore the effects of noise and background phase-offset errors, both of which are common 4D Flow MRI artifacts. Error-free results were compared to noise or offset affected results using linear regression. Subsequently, 4D Flow MRI data for thirteen (13) subjects with AAA was acquired and used to compare the stasis quantification methods against conventional flow visualization.
Results
VRT (R2 = 0.69) was more sensitive to noise than MVA (R2 = 0.98) and TDA (R2 = 0.99) at typical non-contrast signal-to-noise ratio levels (SNR = 20). VRT (R2 = 0.14) was more sensitive to background phase-offsets than MVA (R2 = 0.99) and TDA (R2 = 0.96) when considering a 95% effective background phase-offset correction. Qualitatively, TDA outperformed MVA (Wilcoxon p < 0.005, mean score improvement 1.6/5), and had good agreement (median score 4/5) with flow visualizations.
Conclusion
Flow stasis can be quantitatively assessed using 4D Flow MRI. While conventional residence time calculations fail due to error accumulation as a result of imperfect measured velocity fields, methods that do not require lengthy particle tracking perform better. MVA and TDA are less sensitive to measurement errors, and TDA generates results most similar to those obtained using conventional flow visualization.
https://ift.tt/2OGpjo7
Assessment of metallic patient support devices and other items at 7-Tesla: Findings applied to 46 additional devices
Publication date: Available online 12 November 2018
Source: Magnetic Resonance Imaging
Author(s): Bozena Culo, Samuel Valencerina, Meng Law, Frank G. Shellock
Abstract
Objective
Recently, the first 7-Tesla MR system was approved for clinical use in Europe and the United States. Unfortunately, few metallic objects have undergone testing in association with this high-field-strength scanner, including essential equipment such as patient support devices and other items. Therefore, the objective of this investigation was to assess metallic patient support devices and other items for translational attraction at 7-Tesla.
Methods
Thirteen different metallic items (e.g., gurney, Mayo stand, step stool, utility table, wheelchair, etc.) underwent testing for translational attraction using a previously described methodology in association with a clinical 7-T MR system. The findings were categorized as pass (no translational attraction) or fail (the item was attracted by the scanner).
Results
Every metallic item tested exhibited a lack of magnetism while in a worst-case use position and, thus, passed the test for translational attraction in associated with the 7-Tesla MR system.
Conclusions
The different thirteen different metallic patient support devices and other items can be designated as MR Conditional at 7-T or less. Furthermore, because each item represented a worst-case with respect to its mass and the type of metallic material used for its fabrication, the results can be applied to 46 additional smaller items made from the same material or material with a lower magnetic susceptibility. This expanded list of essential patient support devices and other items will facilitate the clinical use of a comparable 7-Tesla scanner, or another UHF scanner with similar fringe field characteristics.
https://ift.tt/2z6NmaH
Linking spherical mean diffusion weighted signal with intra-axonal volume fraction
Publication date: Available online 12 November 2018
Source: Magnetic Resonance Imaging
Author(s): Hua Li, Ho Ming Chow, Diane C. Chugani, Harry T. Chugani
Abstract
Diffusion MRI has been widely used to assess brain tissue microstructure. However, the conventional diffusion tensor imaging (DTI) is inadequate for characterizing fiber direction or fiber density in voxels with crossing fibers in brain white matter. The constrained spherical deconvolution (CSD) technique has been proposed to measure the complex fiber orientation distribution (FOD) using a single high b-value (b ≥ 3000 s/mm2) to derive the intra-axonal volume fraction (Vin) from the calculated FOD. Recently, the spherical mean technique (SMT) was developed to fit Vin directly from a multi-compartment model with multi-shell b-values. Although different numbers of b-values are needed in the two techniques, both methods have been suggested to be related to the spherical mean diffusion weighted signal (S¯). The current study compared the two techniques on the same high-quality Human Connectome Project diffusion data and investigated the relation between S¯ and Vin systematically. At high b-values (b ≥ 3000 s/mm2), S¯ is linearly related to Vin, and S¯ provides similar contrast with Vin in white matter. At low b-values (b ~ 1000 s/mm2), the linear relation between S¯ and Vin is sensitive to the variations of intrinsic diffusivity. These results demonstrate that S¯ measured with the typical b-value of 1000 s/mm2 is not an indicator of Vin, and previous DTI studies acquired with b = 1000 s/mm2 cannot be re-analyzed to provide Vin-weighted contrast.
https://ift.tt/2ONB24w
Rigid motion correction for magnetic resonance fingerprinting with sliding-window reconstruction and image registration
Publication date: Available online 12 November 2018
Source: Magnetic Resonance Imaging
Author(s): Zhongbiao Xu, Huihui Ye, Mengye Lyu, Hongjian He, Jianhui Zhong, Yingjie Mei, Zhifeng Chen, Ed X. Wu, Wufan Chen, Qianjin Feng, Yanqiu Feng
Abstract
Magnetic resonance fingerprinting (MRF) can be used to simultaneously obtain multiple parameter maps from a single pulse sequence. However, patient motion during MRF acquisition may result in blurring and artifacts in estimated parameter maps. In this work, a novel motion correction method was proposed to correct for rigid motion in MRF. The proposed method involved sliding-window reconstruction to obtain intermediate images followed by image registration to estimate rigid motion information between these images. Finally, the motion-corrupted k-space data were corrected with the estimated motion parameters and then reconstructed to obtain the parameter maps via the conventional MRF processing pipeline. The proposed method was evaluated using both simulations and in vivo MRF experiments with intently different types of motion. For motion-corrupted data, the proposed method yielded brain T1, T2 and proton density maps with obviously reduced blurring and artifacts and lower normalized root-mean-square error, compared to MRF without motion correction. In conclusion, motion-corrected MRF using the proposed method has the potential to produce accurate parameter maps in the presence of in-plane rigid motion.
https://ift.tt/2z9usjH
Characterizing contrast origins and noise contribution in spin-echo EPI BOLD at 3 T
Publication date: Available online 12 November 2018
Source: Magnetic Resonance Imaging
Author(s): Don M. Ragot, J. Jean Chen
Abstract
In this work, we characterize contrast origins and noise contributions of spin echo (SE) EPI BOLD signal at 3 T. SE BOLD is a fMRI method of choice for imaging brain regions affected by susceptibility artifacts at lower fields, but its sensitivity remains a limiting factor for whole-brain imaging. To resolve this, the signal and noise contributions as well as TE dependence of SE EPI are characterized in this study. By integrating a two-compartment BOLD model with a physiological-thermal noise model, a new SE-BOLD signal model was introduced. The new SE-BOLD model was fit into SE-EPI fMRI data acquired during hypercapnic manipulations at various TEs, using typical fMRI voxel dimensions (3.4 × 3.4 × 5 mm3). Our model predicts intra- and extravascular signal and noise contributions consistent with our understanding of the SE-EPI contrast mechanism. The intravascular BOLD contribution is shown to dominate at TEs lower than tissue T2, but the physiological noise contributions in SE-EPI signal is also shown to be lower than that of gradient-echo (GE). Furthermore, SE-EPI contrast-to-noise ratio (CNR) is not maximized at tissue T2 as is typically assumed. To summarize, a new SE-BOLD model was proposed to characterize SE-BOLD contrast and physiological noise contribution at 3 T. Results suggests that SE-BOLD sensitivity can be improved by using shorter TEs, making it a more attractive choice for fMRI, especially in regions with susceptibility artifacts. Such optimizations could also help extend the application of SE BOLD to WM fMRI studies.
https://ift.tt/2OGp8cr
Gadoxetic acid-enhanced dynamic magnetic resonance imaging using optimized integrated combination of compressed sensing and parallel imaging technique
Publication date: Available online 12 November 2018
Source: Magnetic Resonance Imaging
Author(s): Nobuyuki Kawai, Satoshi Goshima, Yoshifumi Noda, Kimihiro Kajita, Hiroshi Kawada, Yukichi Tanahashi, Shoma Nagata, Masayuki Matsuo
Abstract
Purpose
To evaluate the feasibility of optimized integrated combination of compressed sensing and parallel imaging technique (prototype Compressed SENSE) in gadoxetic acid-enhanced dynamic magnetic resonance (MR) imaging.
Materials and methods
Sixty-one patients underwent gadoxetic acid-enhanced dynamic imaging using enhanced T1 high-resolution isotropic volume excitation (eTHRIVE) with the Compressed SENSE (CS-eTHRIVE; C SENSE factor, 3.4; acquisition time, 10 s). Results were compared with 61 propensity score-matched patients who underwent conventional eTHRIVE (eTHRIVE; acquisition time, 20 s). For quantitative image analyses, signal intensity ratio (SIR) and signal-to-noise ratio (SNR), coefficient of variation (CV) of liver parenchyma were calculated in each dynamic phase. For qualitative image analyses, two radiologists rated the homogeneity of liver parenchyma, sharpness of liver edge and left external lobe, motion artifacts, and overall image quality in each dynamic phase using a five-point scale.
Results
SIRs of liver parenchyma with CS-eTHRIVE were significantly higher than with eTHRIVE in the hepatic arterial phase (HAP) (1.70 vs. 1.52) and transitional phase (TP) (2.18 vs. 2.06) (P ≤ 0.030). SNR of liver parenchyma were comparable between the two sequences in all phases. CV of liver parenchyma in HAP with eTHRIVE (0.079) was significantly higher than with CS-eTHRIVE (0.065) (P < 0.001). Motion artifacts were significantly reduced with CS-eTHRIVE compared with eTHRIVE in all phases (P ≤ 0.005). The appearance ratio of extensive motion artifacts in HAP with CS-eTHRIVE (0/61; 0%) were significantly reduced compared with eTHRIVE (4/61; 6.6%) (P = 0.042). Overall image quality with CS-eTHRIVE was significantly better than with eTHRIVE in all phases (P ≤ 0.039).
Conclusion
CS-eTHRIVE compared with eTHRIVE effectively reduced the acquisition time and extensive motion artifacts without degradation of image quality.
https://ift.tt/2z6FZQM
Universal varicella vaccination reduced the incidence of herpes zoster in vaccine recipients 1 to 4 years of age
Publication date: Available online 13 November 2018
Source: Journal of Dermatological Science
Author(s): Nozomu Toyama, Kimiyasu Shiraki, for the Miyazaki Dermatologist Society
https://ift.tt/2OIkv1n
A long-lived IL-2 mutein that selectively activates and expands regulatory T cells as a therapy for autoimmune disease
Publication date: Available online 13 November 2018
Source: Journal of Autoimmunity
Author(s): Laurence B. Peterson, Charles J.M. Bell, Sarah K. Howlett, Marcin L. Pekalski, Kevin Brady, Heather Hinton, Denise Sauter, John A. Todd, Pablo Umana, Oliver Ast, Inja Waldhauer, Anne Freimoser-Grundschober, Ekkehard Moessner, Christian Klein, Ralf J. Hosse, Linda S. Wicker
Abstract
Susceptibility to multiple autoimmune diseases is associated with common gene polymorphisms influencing IL-2 signaling and Treg function, making Treg-specific expansion by IL-2 a compelling therapeutic approach to treatment. As an in vivo IL-2 half-life enhancer we used a non-targeted, effector-function-silent human IgG1 as a fusion protein. An IL-2 mutein (N88D) with reduced binding to the intermediate affinity IL-2Rβγ receptor was engineered with a stoichiometry of two IL-2N88D molecules per IgG, i.e. IgG-(IL-2N88D)2. The reduced affinity of IgG-(IL-2N88D)2 for the IL-2Rβγ receptor resulted in a Treg-selective molecule in human whole blood pSTAT5 assays. Treatment of cynomolgus monkeys with single low doses of IgG-(IL-2N88D)2 induced sustained preferential activation of Tregs accompanied by a corresponding 10–14-fold increase in CD4+ and CD8+ CD25+FOXP3+ Tregs; conditions that had no effect on CD4+ or CD8+ memory effector T cells. The expanded cynomolgus Tregs had demethylated FOXP3 and CTLA4 epigenetic signatures characteristic of functionally suppressive cells. Humanized mice had similar selective in vivo responses; IgG-(IL-2N88D)2 increased Tregs while wild-type IgG-IL-2 increased NK cells in addition to Tregs. The expanded human Tregs had demethylated FOXP3 and CTLA4 signatures and were immunosuppressive. These results describe a next-generation immunotherapy using a long-lived and Treg-selective IL-2 that activates and expands functional Tregsin vivo. Patients should benefit from restored immune homeostasis in a personalized fashion to the extent that their autoimmune disease condition dictates opening up the possibility for remissions and cures.
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Correction to: Prof. Dr. Luther W. Brady verstorben
Correction to:
Strahlenther Onkol 2018
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Leider ist uns im Nachruf auf Professor Dr. Luther W. Brady bei der Nennung der Ehrendoktorwürden ein Fehler unterlaufen.
Die korrekte Nennung der Ehrendoktorwürden lautet folgendermaßen:
Neben zwei amerikanischen …
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Overexpression of CAV3 facilitates bone formation via the Wnt signaling pathway in osteoporotic rats
Abstract
Purpose
Osteoporosis is a condition characterized by decreased bone density and bone strength, commonly observed among older individuals. Caveolin-3 (CAV3) is a principal structural protein of the caveolae membrane domains, which has been reported to participate in cell signaling as well as the maintenance of cell structure. The aim of the current study was to investigate the effects involved with the silencing of CAV3 on bone formation among osteoporotic rat models via the Wnt signaling pathway.
Methods
Osteoporosis was initially induced by means of ovariotomy among rat models in order to determine the expression of CAV3. Then, to confirm the specific function and mechanism of CAV3 from an osteoporosis perspective, the CAV3 expression vector was constructed and transfected into the osteoblasts of the osteoporotic rats. Afterward, the mRNA and protein expressions of CAV3, β-catenin, low-density lipoprotein receptor-related protein 5 (LRP5), T-cell factor (TCF), and Wnt3a in addition to cell proliferation and apoptosis were detected accordingly.
Results
Positive expression of CAV3 exhibited diminished levels in the bone tissues of osteoporotic rats. The osteoblasts of the osteoporotic rats treated with overexpressed CAV3 displayed elevated mRNA and protein expression levels of β-catenin, LRP5, TCF, and Wnt3a. Increased cell proliferation and decreased cell apoptosis were also observed, while the osteoblasts of the osteoporotic rats treated with si-CAV3 exhibited an opposite result.
Conclusion
Overexpressed CAV3 promotes bone formation and suppresses the osteoporosis progression via the activation of the Wnt signaling in rat models, suggesting CAV3 as a potential target biomarker in the treatment of osteoporosis.
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Role of the HDAC6/STAT3 pathway in regulating PD-L1 expression in osteosarcoma cell lines
Abstract
Histone deacetylases (HDACs), initially described as histone modifiers, have more recently been verified to target various other proteins unrelated to the chromatin environment. On this basis, findings of the current study demonstrates that the pharmacological or genetic abrogation of HDAC6 in osteosarcoma cell lines down-regulates the expression of program death receptor ligand-1 (PD-L1), an important co-stimulatory molecule expressed in cancer cells, which activates the inhibitory regulatory pathway PD-1 in T cells. As shown by our results, the mechanism by which HDAC6 regulated PD-L1 expression was mediated by the transcription factor STAT3. In addition, we observed that selective HDAC6 inhibitors could inhibit tumor progression in vivo. Crucially, these results provide an essential pre-clinical rationale and justification for the necessity of further research on HDAC6 inhibitors as potential immuno-modulatory agents in osteosarcoma.
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Pharmacokinetics of liposomal curcumin (Lipocurc™) infusion: effect of co-medication in cancer patients and comparison with healthy individuals
Abstract
Purpose
Investigation of the impact of co-medication on the plasma levels of curcumin and tetrahydrocurcumin (THC) in cancer patients and a comparison of the pharmacokinetics of curcumin and plasma levels of THC between cancer patients and healthy individuals following intravenous infusion of Lipocurc™ (liposomal curcumin).
Methods
Correlation analysis was used to determine the impact of co-medication on infusion rate normalized plasma levels of curcumin and THC in cancer patients and to compare the plasma levels of curcumin and THC at different infusion rates between cancer patients and healthy individuals. In vitro hepatocyte and red blood cell distribution experiments were conducted with Lipocurc™ to support clinical findings. Plasma concentration time data were analyzed by the non-compartmental method to determine and compare the pharmacokinetic parameters of curcumin in cancer patients and healthy individuals.
Results
Of 44 co-medications studied, three medications targeting the renin–angiotensin system, Lisinopril, Ramipril, and Valsartan elevated plasma levels of curcumin and THC in three cancer patients infused with Lipocurc™. Cell distribution experiments indicated that the disposition of curcumin in red blood cells may be a target for elevation of the plasma levels of curcumin. Plasma levels of curcumin in cancer patients increased to a greater extent with increased infusion rate compared to healthy individuals. Upon termination of infusion, the elimination phase for curcumin was shorter with a shorter terminal half-life and smaller volume of distribution for curcumin in cancer patients compared to healthy individuals.
Conclusion
Either co-medications or health status, or both, can impact the pharmacokinetics of curcumin infusion (as Lipocurc™) in cancer patients.
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Pathogenesis of Leprosy: An Insight Into B Lymphocytes and Plasma Cells
Abstract: The pathogenesis of leprosy is still not fully understood. Several studies have been performed on the involvement of T cells in leprosy and more recently have focused on genetic factors and innate immune response. There are still only few reports about the role of B cells in active leprosy lesions in different spectral forms of the disease. The literature on tuberculosis suggests that B cells play an important role in the regulation of the granulomas, in cytokine production, T-cell response, and antigen presentation. Only few studies investigated the role of B cell in leprosy. We investigated the distribution of B cells in 85 leprosy biopsies covering all forms of the disease and compared results with 13 biopsies of tuberculosis and atypical mycobacteriosis, expanding the previous experiences. A statistically significant difference in the number of CD20+ (P = 0.014) and CD138+ (P = 0.01) cells between the different forms of leprosy was observed. A remarkable amount of CD138+ cells could also be detected in borderline tuberculoid. The median of the CD20+ cells decreased from the bacilloscopy-negative samples to the bacilloscopy-positive samples by 50% (P = 0.004). Contrarily, the median of CD138+ cells showed an increase from bacilloscopy-negative to bacilloscopy-positive samples of 966.67% (P = 0.001). In our experience, tuberculoid leprosy showed more B cells and less plasma cells than lepromatous leprosy. Our results show that B cells might be implicated in leprosy pathogenesis, not only in the lepromatous pole as previously postulated, but also in tuberculoid granuloma formation and type 1 reactions. Correspondence: Cesare Massone, MD, Dermatology Unit, Ospedali Galliera, Via Volta 6, 16128 Genova, Italy (e-mail: cesare.massone@galliera.it). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Eosinophils Among the Histological Features of Psoriasis
Abstract: "Eosinophils are absent in psoriasis" has been dogma for generations; yet, there is little published to support this statement. Two recent studies examining the presence of eosinophils in psoriasis came to contrasting conclusions. We reviewed skin biopsies from 50 patients with clinically confirmed cases of psoriasis vulgaris to characterize the histologic features, with a focus on the number of eosinophils in the dermis. We noted the presence of eosinophils in nearly half of our study population (n = 23, 46.0%). There was no significant association between the presence of eosinophils and degree of spongiosis (P = 0.405). Eosinophil density ranged from 0 to 8 per tissue section. The mean average eosinophil density was 1.04 (range: 0–8) per tissue section. Among cases with eosinophils, there were 73.9% (n = 17/23) of cases with 1–2 eosinophils, and 26.1% (n = 6) with 3–8 eosinophils. Mild to moderate spongiosis was noted in the majority of cases (n = 48; 96.0%). Eosinophils were only present in psoriasis cases with evidence of spongiosis (n = 23; 47.9%). We conclude that eosinophils are not an uncommon finding in the dermis of psoriasis vulgaris, although the number is often few. The presence of eosinophils should not preclude a diagnosis of psoriasis, particularly if other histologic features are supportive. Correspondence: Nooshin K. Brinster, MD, Ronald O. Perelman Department of Dermatology, Dermatopathology Section, New York University Langone Health, 11th Floor, 240 East 38th Street, New York, NY 10016 (e-mail: nooshin.brinster@nyumc.org). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Sex‐ and sub region‐dependent modulation of arcuate kisspeptin neurons by vasopressin and vasoactive intestinal peptide
Abstract
A population of kisspeptin neurons located in the hypothalamic arcuate nucleus (ARN) very likely represent the gonadotrophin‐releasing hormone pulse generator responsible for driving pulsatile luteinizing hormone secretion in mammals. As such, it has become important to understand the neural inputs that modulate the activity of ARN kisspeptin (ARNKISS) neurons. Using a transgenic GCaMP6 mouse model allowing the intracellular calcium levels (i[Ca2+]) of individual ARNKISS neurons to be assessed simultaneously, we examined whether the circadian neuropeptides vasoactive intestinal peptide (VIP) and arginine vasopressin (AVP) modulated the activity of ARNKISS neurons directly. To validate this methodology, we initially evaluated the effects of neurokinin B (NKB) on i[Ca2+] in kisspeptin neurons residing within the rostral, middle and caudal ARN subregions of adult male and female mice. All experiments were undertaken in the presence of tetrodotoxin and ionotropic amino acid antagonists. NKB was found to evoke an abrupt increase in i[Ca2+] in 95‐100% of kisspeptin neurons throughout the ARN of both sexes. In marked contrast, both VIP and AVP were found to primarily activate kisspeptin neurons located in the caudal ARN of female mice. Whereas 58 and 59% of caudal ARN kisspeptin neurons responded to AVP and VIP, respectively, in female mice, only 0‐8% of kisspeptin neurons located in other ARN subregions responded in females and 0‐12% of cells in any subregion in males (p<0.05). These observations demonstrate unexpected sex differences and marked heterogeneity in functional neuropeptide receptor expression amongst ARNKISS neurons organized on a rostro‐caudal basis. The functional significance of this unexpected influence of VIP and AVP on ARNKISS neurons remains to be established.
This article is protected by copyright. All rights reserved.
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