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Δευτέρα 19 Νοεμβρίου 2018

Arsenic enhances cell death and DNA damage induced by ultraviolet B exposure in mouse epidermal cells through the production of reactive oxygen species

Summary

Background

Ultraviolet (UV)B radiation has long been considered a carcinogen in both epidemiological surveys and experimental studies. However, recent work has suggested that different dosages of UVB exert different influences on cells. There are also co‐carcinogenesis factors such as arsenic that affect the role of UVB.

Aim

To explore the co‐carcinogenesis effect of UVB and arsenic on the mouse epidermal cell line JB6 and the mechanism underlying it.

Methods

Growth of JB6 cells was measured by MTT assay. We carried out a comet assay to determine the DNA damage caused by UVB and arsenic, and tested the expression of DNA repair protein by western blotting. Reactive oxygen species (ROS) were measured using DCF and DHE staining, and changes in antioxidant enzymes were assessed using western blotting.

Results

Viability assays showed that arsenic increased the UVB‐induced death rate. Arsenic enhanced DNA damage caused by UVB both directly by injury to double‐stranded DNA and indirectly by reducing the capability of DNA repair in JB6 cells. All of these effects are the results of increased ROS generation and reduced expression of the antioxidant enzyme superoxide dismutase (SOD)1.

Conclusion

Arsenic was found to enhance UVB‐induced production of ROS and to downregulate SOD1 expression, leading to DNA damage and apoptosis in mouse skin cells. The combination of arsenic and UVB exposure was found to differentially regulate the expression of SOD1 and SOD2.



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Comparison of the Effects of Prophylactic and Therapeutic Administrations on Peripheral Neuropathy in Streptozotocin-Diabetic Rats with Gliclazide or Methylcobalamin

01-2018-0043-dia_10-1055-a-0635-0672-1.j

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0635-0672

Objective To observe the differences in curative effects between prophylactic and therapeutic administrations of Gliclazide (GLZ) or Methylcobalamin (MCA) on diabetic peripheral neuropathy in rats. Methods GLZ (25 mg/kg/day) or MCA (175 μg/kg/day) was orally administrated prophylactically to streptozotocin-induced diabetic rats for 8 weeks before diabetic peripheral neuropathy developed or administrated therapeutically after diabetic peripheral neuropathy developed, respectively. The motor nerve conduction velocities (MNCV), aldose reductase (AR) activities, the polyol contents and antioxidative enzyme activities in the sciatic never tissues were determined. The morphology of sciatic never tissues was observed. Results In comparison to vehicle, most of the changes in the sciatic nerves of the diabetic rats (e. g., delayed MNCV, altered/damaged nerve structure, enhanced AR activity, increased polyol contents, altered Cu, Zn-superoxide dismutase, glutathione-peroxidase activities, and elevated malondialdehyde level) were significantly ameliorated by prophylactic administration with either GLZ or MCA. In contrast, only few of above-mentioned parameters were alleviated in DPN rats by therapeutic administration with GLZ or MCA as compared to vehicle. The curative effects of GLZ or MCA prophylactic administration on MNCV, AR activity, polyol contents and antioxidative enzyme activities were markedly stronger than therapeutic administration. Conclusion prophylactic administration of GLZ or MCA was superior to the therapeutic administration in alleviation of diabetic neuropathy in STZ-rats, suggesting that pharmacotherapy should be initiated at a much earlier stage before diabetic neuropathy developed, but not at a later stage after never damage reached.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text



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Neuroendocrine Liver Metastasis—a Specific Set of Markers to Detect Primary Tumor Sites

Abstract

The diagnosis of neuroendocrine neoplasia (NEN) is often made at an advanced stage of disease, including hepatic metastasis. At this point, the primary may still be unknown and sometimes cannot even be detected by functional imaging, especially in very small tumors of the pancreas (pan) and small intestinal (si) entities. The site of the primary may be based on biopsy specimens of the liver applying a specific set of markers. Specimens of liver metastases from 87 patients with NENs were studied. In retrospect, 50 patients had si and 37 pan NENs. Tissue samples were evaluated by immunohistochemistry. The markers applied were insulin gene enhancer protein Islet-1 (ISL-1), homeobox protein CDX-2 (CDX2), thyroid transcription factor 1 (TTF-1), and serotonin. Positive stains for CDX2 were documented in 43 (86%) and for serotonin in 45 (90%) of 50 siNENs. Three panNENs were positive for CDX2 and one for serotonin, respectively. ISL-1 was negative throughout in siNENs and also negative in 8 of 50 panNENs (21.6%). TTF-1 was negative in more than 90% of the specimens of either entity. Immunohistochemical markers in liver metastasis can lead the way to the site of the primary NEN. They should always be used in combined clusters.



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Necrostatin-1 protects against ischemia/reperfusion injury by inhibiting receptor-interacting protein 1 in a rat flap model

: The failure of reconstructive surgeries remains a challenge for plastic surgeons. Ischemia reperfusion (I/R) injury is considered to be one of the major problems in flap surgery. Necroptosis is a recently discovered and caspase-3 independent programmed necrosis. Necrostatin-1 (Nec-1) is a specific inhibitor of necroptosis. Reports indicate that Nec-1 provides protection in ischemic models, such as brain, kidney and heart. The aim of this study is to investigate the influence of Nec-1 on the I/R process in rat abdominal skin flaps.

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Compartimental harvesting of dual lymph node flap from the right supraclavicular area for the treatment of lower extremity lymphedema: a case series

We report our clinical experience of supraclavicular lymph node flap (LNF) using a novel method of harvesting based on the compartimental lymphatic and vascular anatomy of the right posterior neck triangle, that allows to harvest two indipendent LNFs from the same donor-site.

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Physical activity in women with subclinical hypothyroidism

Abstract

Purpose

Physical activity is associated with many health-related benefits. However, there is a shift towards inactive lifestyles around the world. Subclinical hypothyroidism (SCH) may have adverse effects similar to hypothyroidism. The presence of symptoms and reduced physical performance in SCH may contribute to an inactive lifestyle. Therefore, the present study aimed to compare physical activity levels (PALs) between women with subclinical hypothyroidism and healthy controls.

Methods

Thirty-two women with newly diagnosed SCH and 28 healthy women were enrolled in this cross-sectional study. Arterial stiffness was evaluated by pulse wave velocity (PWV). Neuromuscular symptoms were questioned. Participants wore a physical activity monitor (SenseWear® Armband) for 4 consecutive days. Handgrip and quadriceps muscle strength were assessed by dynamometer. Functional exercise capacity was assessed by 6-minute walk test (6MWT).

Results

There was no significant difference in sociodemographic variables between the groups. PWV was significantly higher in the SCH group (P = 0.006). Physical activity duration and number of steps were significantly lower in the SCH group (P < 0.05). There was significant difference in neuromuscular symptoms, handgrip and quadriceps muscle strength, and 6MWT distance between the groups (P < 0.05).

Conclusions

This study demonstrates that women with SCH had lower PALs compared to healthy controls. Women with SCH should participate in exercise programs to increase physical activity and muscle strength to achieve adequate PALs.



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The long-term outcomes of breast implants studied

A recent analysis on existing data unearths information about the rare but serious long-term risks associated with silicone breast implants.

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The osmoresponsiveness of oxytocin and vasopressin neurones: mechanisms, allostasis and evolution

Abstract

In the rat supraoptic nucleus, every oxytocin cell projects to the posterior pituitary, and is involved in both reflex milk ejection during lactation, and in regulating uterine contractions during parturition. All are also osmosensitive, regulating natriuresis. All are also regulated by signals that control appetite, including neural and hormonal signals that arise from the gut after food intake and from the sites of energy storage. All are also involved in sexual behaviour, anxiety‐related behaviours, and social behaviours. The challenge is to understand how a single population of neurones can coherently regulate such a diverse set of functions, and adapt to changing physiological states. Their multiple functions arise from complex intrinsic properties which confer sensitivity to a wide range of internal and environmental signals. Many of these properties have a distant evolutionary origin, in multi‐functional, multisensory neurones of Urbilateria, the hypothesised common ancestor of vertebrates, insects and worms. Their properties allow different patterns of oxytocin release into the circulation from their axon terminals in the posterior pituitary, into other brain areas from axonal projections, and independent release from their dendrites.

This article is protected by copyright. All rights reserved.



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Definitive radiotherapy for Merkel cell carcinoma in the setting of epidermolysis bullosa simplex



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Pelvic lymph node metastasis in extramammary Paget disease of the scrotum without inguinal lymph node metastasis



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Unusual dermoscopic feature of a melanocytic naevus on load bearing plantar skin never pressured because of cerebral palsy



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The functions of FoxO transcription factors in epithelial wound healing

Abstract

Re‐epithelialisation is a complex process that involves the migration and proliferation of keratinocytes, as well as the production of cytokines and growth factors that affect wound healing. The precise mechanisms that control the tissue repair process remain poorly understood. Recent evidence indicates that FoxO transcription factors play a crucial role in wound healing. In mammals, different isoforms of FoxO, namely, FoxO1, FoxO3, FoxO4 and FoxO6, are present; however, FoxO1 and FoxO3 primarily function in epithelial wound healing. The functions of FoxO proteins in normal wound healing are opposite of those in diabetic wound healing. On the one hand, FoxO transcription factors promote the migration of keratinocytes through up‐regulating the expression of transforming growth factor‐beta and protecting keratinocytes from oxidative stress. On the other hand, FoxO transcription factors negatively regulate some genes that are needed for re‐epithelialisation and keratinocyte migration. This review provides a summary of the functions of FoxO proteins in re‐epithelialisation.



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Clinical and dermoscopic features associated with lichen planus‐like keratoses that undergo skin biopsy: A single‐center, observational study

Abstract

Background/Objectives

Lichen planus‐like keratoses (LPLK) are benign skin lesions that can mimic malignancy; the clinical and dermoscopic features distinguishing lichen planus‐like keratoses from skin tumors have not been extensively studied. The objective of this study was to identify dermoscopic features that may prevent unnecessary biopsies of lichen planus‐like keratoses.

Methods

Retrospective, observational study of biopsied skin lesions. We compared 355 lichen planus‐like keratoses to 118 non‐lichen planus‐like keratoses lesions with lichen planus‐like keratose in the differential diagnosis biopsied from August 1, 2015, to December 31, 2016. The investigators were blinded to the diagnosis of the lesions. A single‐center, observational study in a tertiary center.

Results

Lichen planus‐like keratoses were most frequently non‐pigmented (61.7%), truncal (52.1%), and on sun‐damaged skin (69.6%); the majority occurred in Whites (95.5%) and females (62.8%). Dermoscopically, lichen planus‐like keratoses were more likely than non‐lichen planus‐like keratoses to have scale (42.5% vs 31.4%, P = 0.03) and orange colour (8.2% vs 0.9%, P = 0.01). Among lesions with peppering (n = 76; 63 lichen planus‐like keratose and 13 non‐lichen planus‐like keratose), coarse ± fine peppering (73% vs 38.5%, P = 0.02) and peppering as the only feature (34.9% vs 0%, P = 0.01) were associated with lichen planus‐like keratoses.

Conclusions

Lichen planus‐like keratoses can be challenging to distinguish from benign and malignant skin tumors. The presence of dermoscopic scale and orange colour may aid in the recognition of lichen planus‐like keratose. Coarse peppering and the presence of peppering as the only dermoscopic feature may further aid the identification of pigmented lichen planus‐like keratoses.



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Patients’ understandings about cellulitis and views about how best to prevent recurrent episodes: mixed methods study in primary and secondary care

Summary

Background

Cellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. The only proven strategy to reduce the risk of recurrence is long‐term, low‐dose antibiotics. Given current concerns about antibiotic resistance and the pressure to reduce antibiotic prescribing, other prevention strategies are needed.

Objectives

To explore patients' views about cellulitis and different ways of preventing recurrent episodes.

Methods

Adults aged 18 or over with a history of first episode or recurrent cellulitis were invited through primary care, hospitals and advertising to complete a survey, take part in an interview, or both.

Results

Thirty interviews were conducted between August 2016 and July 2017. Two hundred and forty surveys were completed (response rate 17%). Triangulation of quantitative and qualitative data showed that people who have had cellulitis have wide‐ranging beliefs about what can cause cellulitis and are often unaware of risk of recurrence or potential strategies to prevent recurrence. Enhanced foot hygiene, applying emollients daily, exercise and losing weight were more popular potential strategies than use of compression stockings or long‐term antibiotics. Participants expressed caution about long‐term oral antibiotics, particularly those who had experienced only one episode of cellulitis.

Conclusions

People who have had cellulitis are keen to know about possible ways to prevent further episodes. Enhanced foot hygiene, applying emollients daily, exercise and losing weight were generally viewed to be more acceptable, feasible strategies than compression or antibiotics, but further research is needed to explore uptake and effectiveness in practice.

This article is protected by copyright. All rights reserved.



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POT1 germline mutations but not TERT promoter mutations are implicated in melanoma susceptibility in a large cohort of Spanish melanoma families

Summary

Background

Germline mutations in telomere‐related genes such as POT1 and the TERT promoter predispose to familial melanoma.

Objective

To evaluate the prevalence of germline mutations in the POT1 gene and in the TERT promoter in a large cohort of Spanish melanoma‐prone families (at least two affected individuals in first‐ or second‐degree relatives).

Methods

Overall, 228 CDKN2A wild‐type melanoma‐prone families were included in the study. Screening of POT1 was performed in one affected case of each family and TERT promoter was sequenced in one affected case from 202 families (26 families were excluded due to DNA exhaustion/degradation). Additionally, TERT promoter sequencing was extended to addition 30 CDKN2A mutated families and 70 sporadic multiple primary melanoma patients (MPM) with a family history of other cancers.

Results

We identified four families with potentially pathogenic POT1 germline mutations: a missense variant c.233T>C (p.Ile78Thr), a nonsense variant c.1030G>T (p.Glu344*), and two variants c.255G>A (r.125_255del) and c.1792G>A (r.1791_1792insAGTA, p.Asp598Serfs*22), which we confirmed disrupted POT1 mRNA splicing. A TERT promoter variant of unknown significance (c.‐125C>A) was detected in a MPM patient, but no germline mutations were detected in the TERT promoter in familial melanoma cases.

Conclusions

Overall, 1·75% of our CDKN2A/CDK4‐wild type Spanish melanoma‐prone families carry probably damaging mutations in POT1. The frequency of TERT promoter germline mutations in melanoma families in our population is extremely rare.

This article is protected by copyright. All rights reserved.



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Painful punctate palmoplantar keratoderma due to heterozygous mutations in AAGAB

Abstract

Punctate palmoplantar keratoderma (PPPK) is a rare, autosomal dominant disorder of keratinization with three main variants. PPPK type 1 (MIM 148600), also known as Buschke‐Fischer‐Brauer disease, is characterized by the progressive development of multiple small hyperkeratotic papules with central indentations that are irregularly distributed on the palms and soles, often deteriorating to more extensive diffuse hyperkeratosis on the weight‐bearing areas of plantar skin. The PPPK1 gene was recently identified as the α and γ‐adaptin binding protein p34 gene AAGAB, and in a single case, the COL14A1 gene.

This article is protected by copyright. All rights reserved.



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Autologous platelet‐rich gel for facial rejuvenation and wrinkle amelioration: A pilot study

Summary

Background

The demand for safe and minimally invasive soft tissue augmentation procedures has increased. Recently, a novel injectable gel based on the autologous platelet rich in growth factor (PRGF) technology has been developed to provide long‐term shape and volume stability. It can be customized into low (LVG) or high viscosity (HVG) gel forms to meet different dermatological requirements.

Objectives

The mechanical and biological properties of both gel forms have been evaluated. The clinical efficacy and safety of this autologous procedure were also evaluated.

Methods

Growth factor content and biomechanical properties of both gel forms were determined. The in vitro biological capacity on human dermal fibroblasts proliferation was assessed. Clinical performance analysis over ten patients was evaluated by standardized macrophotographs, 3D topographic images, and ultrasound analysis over periocular and nasolabial areas.

Results

Both gel types showed similar growth factor concentration. HVG showed a higher stiffness profile indicating its suitability for deeper tissue defect viscosupplementation while LVG showed optimal rheologic characteristics for superficial volumization. Both gels showed a noticeable biostability after catalytic enzyme degradation. Both forms significantly increased the mitogenic activity of dermal fibroblasts. All patients referred to be highly satisfied and presented optimal clinical results after one month. Overall clinical improvement was maintained for 16 weeks. At the end of the study, the ultrasound examination revealed a cutaneous regenerative effect. No adverse events occurred.

Conclusions

This preliminary study suggests that autologous platelet gels have desirable mechanical and bioactive properties and allows moderate wrinkle reduction and efficient facial volume reposition with natural results.



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Confined Thalamic Deep Brain Stimulation in Refractory Essential Tremor

Background: Thalamic ventral intermediate nucleus (VIM) deep brain stimulation (DBS) is an effective therapy for medication-refractory essential tremor (ET). However, 13–40% of patients with an initially robust tremor efficacy lose this benefit over time despite reprogramming attempts. At our institution, a cohort of ET patients with VIM DBS underwent implantation of a second anterior (ventralis oralis anterior; VOA) DBS lead to permit "confined stimulation." We sought to assess whether confined stimulation conferred additional tremor capture compared to VIM or VOA stimulation alone. Methods: Seven patients participated in a protocol-based programming session during which a video-recorded Fahn-Tolosa-Marin Part A (FTM-A) tremor rating scale was used in the following 4 DBS states: off stimulation, VIM stimulation alone, VOA stimulation alone, and dual lead (confined) stimulation. Results: The average (SD) baseline FTM-A off score was 17.6 (4.0). VIM stimulation alone lowered the average FTM-A total score to 6.9 (4.0). Confined stimulation further attenuated the tremor, reducing the total score to 5.7 (2.8). Conclusions: Confined thalamic DBS can provide additional symptomatic benefits in patients with unsatisfactory tremor control from VIM or VOA stimulation alone.
Stereotact Funct Neurosurg

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MRI based texture analysis to classify low grade gliomas into astrocytoma and 1p/19q codeleted oligodendroglioma

Publication date: Available online 19 November 2018

Source: Magnetic Resonance Imaging

Author(s): Shun Zhang, Gloria Chia-Yi Chiang, Rajiv S. Magge, Howard Alan Fine, Rohan Ramakrishna, Eileen Wang Chang, Tejas Pulisetty, Yi Wang, Wenzhen Zhu, Ilhami Kovanlikaya

Abstract

Purpose: Texture analysis performed on MR images can detect quantitative features that are imperceptible to human visual assessment. The purpose of this study was to evaluate the feasibility of texture analysis on preoperative conventional MRI to discriminate between histological subtypes in low-grade gliomas (LGGs), and to determine the utility of texture analysis compared to histogram analysis alone.

Methods: A total of 41 patients with LGG, 21 astrocytoma and 20 1p/19q codeleted oligodendroglioma were included in this study. Patients were randomly divided into training (60%) and testing (40%) sets. Texture analysis was performed on conventional MRI sequences to obtain the most discriminant factor (MDF) values for both the training and testing data. Receiver operating characteristic (ROC) curve analyses were then performed using the MDF values and 9 histogram parameters in the training data to obtain cut-off values for determining the correct rate of discriminating between astrocytoma and oligodendroglioma in the testing data.

Results: The ROC analyses using MDF values resulted in an area under the curve (AUC) of 0.91 (sensitivity 86%, specificity 87%) for T2w FLAIR, 0.94 (87%, 89%) for ADC, 0.98 (93%, 95%) for T1w, and 0.88 (78%, 86%) for T1w + Gd sequences. Using the best cut-off values, MDF correctly discriminated between the two groups in 94%, 82%, 100%, and 88% of cases in the testing data, respectively. The MDF outperformed all 9 of the histogram parameters.

Conclusion: Texture analysis performed on conventional preoperative MRI images can accurately predict histological subtype of LGGs, which would have an impact on clinical management.



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Reproducibility of inhomogeneous magnetization transfer (ihMT): A test-retest, multi-site study

Publication date: Available online 19 November 2018

Source: Magnetic Resonance Imaging

Author(s): Lei Zhang, Tao Chen, Hongzhe Tian, Hongqiang Xue, Huipeng Ren, Li Li, Qing Fan, Baohong Wen, Zhuanqin Ren

Abstract
Background

Inhomogeneous magnetization transfer (ihMT) has been reported to feature superior sensitivity and specificity for myelin imaging. However, the reproducibility on ihMT has yet been rarely investigated up to date. The purpose of the present study is to assess the multi-center reproducibility and test-retest variability of ihMT in central nervous system.

Methods

5 volunteers were recruited and scanned twice on three 3.0 T magnetic resonance imaging (MRI) scanners using ihMT with identical scan parameters. The maps of quantitative ihMT (qihMT) and ihMT ratio (ihMTR) for each scan were calculated. Voxel based analysis then was performed to generate qihMT and ihMTR values for major white matter fibers. The intra- and inter-scanner reliability and reproducibility was assessed with intraclass correlation coefficients (ICCs). Bland-Altman method was used to show the level of agreement between two measurement types. Paired t-test and one-way ANOVA test were also used to compare the difference between inter- and intra-scanner, respectively.

Results

In the 10 major white matter tracts areas, the ICCs indicated high intra- and inter-scanner measurement reliability and reproducibility. The Bland-Altman plots together with 95% confidence interval (CI) across all ROIs in the five volunteers also demonstrated good repeatability. No significant inter- and intra-scanner differences were found in Paired t-test and one-way ANOVA tests.

Conclusion

Good inter- and intra-scanner reliability and reproducibility of ihMT measurements were observed in this study. These findings support the use of ihMT measurements as biomarkers in multicenter and/or longitudinal studies.



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Simultaneous acquisition of magnetic resonance elastography of the supraspinatus and the trapezius muscles

Publication date: Available online 19 November 2018

Source: Magnetic Resonance Imaging

Author(s): Daiki Ito, Tomokazu Numano, Koichi Takamoto, Takamichi Ueki, Tetsushi Habe, Keisuke Igarashi, Kazuyuki Mizuhara, Hisao Nishijo

Abstract

We developed a Magnetic Resonance elastography (MRE) technique using a conventional magnetic resonance imaging (MRI), which allows a simultaneous elastography of the supraspinatus and trapezius muscles, by designing a new wave transducer (vibration pad) and optimizing the mechanical vibration frequency. Five healthy volunteers underwent an MRE. In order to transmit the mechanical vibration (pneumatic vibration) to the supraspinatus and trapezius muscles, a new vibration pad was designed using a three-dimensional (3D) printer. The vibration pad was placed on the skin 2 cm medial and 2 cm cephalad the deltoid tubercle. MRE acquisition was performed with a multi-slice gradient-echo type multi-echo MR sequence, which allows MREs even in a conventional MRI; two oblique axial images of the supraspinatus and trapezius muscles were obtained simultaneously. Vibration frequencies were set at 50–150 Hz, with a 25 Hz step. Wave image quality in each frequency was analyzed using a phase-to-noise ratio (PNR) and clarity of propagating wave that was assessed by two readers qualitatively. In the supraspinatus muscle, the wave images were of good quality especially at frequencies >75 Hz. In the trapezius muscle, the wave images were of better quality at low frequencies (50 and 75 Hz) compared with high frequencies (100–150 Hz). The PNR of both muscles were higher at low frequencies. The mean stiffness in the trapezius muscle (7.26 ± 2.13 kPa at 75 Hz) was larger than those in the supraspinatus muscle (4.16 ± 0.50 kPa at 75 Hz). The results demonstrated that our MRE technique allows simultaneous assessment of the stiffness in the supraspinatus and trapezius muscles using a conventional MRI, and that optimal vibration frequency for simultaneous MRE of these muscles is 75 Hz. This technique provides a new means for early detection of abnormality in the shoulder.



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Scholar : Aging, Neuropsychology, and Cognition, Volume 26, Issue 1, January 2019 is now available online on Taylor & Francis Online

Taylor & Francis Online - The new journals and reference work platform for Taylor & Francis
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Aging, Neuropsychology, and Cognition, Volume 26, Issue 1, January 2019 is now available online on Taylor & Francis Online.



This new issue contains the following articles:

Articles

The impact of physical activity and sex differences on intraindividual variability in inhibitory performance in older adults
Delphine Fagot, Christian Chicherio, Cédric T. Albinet, Nathalie André & Michel Audiffren
Pages: 1-23 | DOI: 10.1080/13825585.2017.1372357


Improving visual spatial working memory in younger and older adults: effects of cross-modal cues
Ashley F. Curtis, Gary R. Turner, Norman W. Park & Susan J. E. Murtha
Pages: 24-43 | DOI: 10.1080/13825585.2017.1397096


Same face, same place, different memory: manner of presentation modulates the associative deficit in older adults
Amy A. Overman, Nancy A. Dennis, John M. McCormick-Huhn, Abigail B. Steinsiek & Luisa B. Cesar
Pages: 44-57 | DOI: 10.1080/13825585.2017.1397097


Self-initiated object-location memory in young and older adults
Anat Berger-Mandelbaum & Hagit Magen
Pages: 58-85 | DOI: 10.1080/13825585.2017.1399981


Age-related changes in implicit emotion processing
Rosa Manenti, Michela Brambilla & Maria Cotelli
Pages: 86-104 | DOI: 10.1080/13825585.2017.1408769


Self-reference enhances relational memory in young and older adults
Mingzhu Hou, Matthew D. Grilli & Elizabeth L. Glisky
Pages: 105-120 | DOI: 10.1080/13825585.2017.1409333


Interactions between stereotype threat, subjective aging, and memory in older adults
Manon Marquet, Pierre Missotten, Benoit Dardenne & Stéphane Adam
Pages: 121-143 | DOI: 10.1080/13825585.2017.1413166


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Consensus statement on the use of HRT in postmenopausal women in the management of osteoporosis by SIE, SIOMMMS and SIGO



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A Practical Guide to Curing Onychomycosis: How to Maximize Cure at the Patient, Organism, Treatment, and Environmental Level

Abstract

Onychomycosis is a fungal nail infection caused by dermatophytes, non-dermatophyte molds, and yeasts. Treatment of this infection can be difficult, with relapse likely to occur within 2.5 years of cure. The objective of this article is to review factors that can impact cure and to suggest practical techniques that physicians can use to maximize cure rates. Co-morbidities, as well as disease severity and duration, are among the many patient factors that could influence the efficacy of antifungal therapies. Furthermore, organism, treatment, and environmental factors that may hinder cure include point mutations, biofilms, affinity for non-target enzymes, and exposure to fungal reservoirs. To address patient-related factors, physicians are encouraged to conduct confirmatory testing and treat co-morbidities such as tinea pedis early and completely. To combat organism-focused factors, it is recommended that disruption of biofilms is considered, and drugs with multiple routes of delivery and unique mechanisms of action are prescribed when traditional agents are not effective. Extending follow-up periods, using combination treatments, and considering pulse regimens may also be of benefit. Through these practical techniques, physicians can maximize cure and limit the risk of relapse and re-infection.



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