Microvascular decompression and MRI findings in trigeminal neuralgia and hemifacial spasm

. A single center experience

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Patrick W. Hitchon, Mario Zanaty, Toshio Moritani, Ergun Uc, Connie L. Pieper, Wenzhuan He, Jennifer Noeller
ObjectiveFor patients with medically unresponsive trigeminal neuralgia (TIC) and hemifacial spasm (HS), surgical microvascular decompression (MVD) is the procedure of choice. The authors of this report sought to review their outcomes with MVD in patients with TIC and HS, and the success of preoperative magnetic resonance imaging (MRI) in identifying the offending vascular compression.MethodsSince 2004, there were a total of 51 patients with TIC and 12 with HS with available MRI scans. All patients underwent preoperative MRI to rule out non-surgical etiologies for facial pain and facial spasm, and confirm vascular compression. Follow-up after surgery was 13±22 months for the patients with TIC and 33±27 months for the patients with HS.ResultsThere were 45 responders to MVD in the TIC cohort (88%), with a Visual Analog Score (VAS) of 1±3. All patients with HS responded to MVD between 25 and 100%, with a mean of 75±22%. Wound complications occurred in 10% of patients with MVD for TIC, and 1 patient reported hearing loss after MVD for HS, documented by audiogram. The congruence rate between the preoperative MRI and operative findings of vascular compression was 84% in TIC and 75% in HS.ConclusionMVD is an effective and safe modality of treatment for TIC and HS. In addition to ruling out structural lesions, MRI can offer additional information by highlighting vascular loops associated with compressions. On conventional scans as obtained here, the resolution of MRI was congruent with operative findings in 84% in TIC and 75% in HS. This review emphasizes that the decision to undertake MVD in TIC or HS should be based on clinical diagnosis and not visualization of a compressing vessel by MRI. Conversely, the presence of a compressing vessel by MRI demands perseverance by the surgeon until the nerve is decompressed.

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Autonomic symptoms in hypertensive patients with post-acute minor ischemic stroke

Autonomic symptoms in hypertensive patients with post-acute minor ischemic stroke

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Juan Idiaquez, Hector Farias, Francisco Torres, Jorge Vega, David A. Low
BackgroundMost studies regarding autonomic dysfunction in ischemic stroke are limited to heart rate and blood pressure changes during the acute phase. However, there are few data on quantitative assessment of autonomic symptoms. We sought to assess autonomic symptoms in hypertensive ischemic stroke patients.MethodsIn 100 hypertensive patients (45 with symptomatic ischemic stroke (6 months after stroke onset) and 55 without stroke), we assessed autonomic symptoms using the Scale for Outcomes in Parkinson disease-Autonomic (SCOPA-AUT).ResultsThe age (mean±standard deviation) for the stroke group was 66±12 and 63±15 for the without stroke group (P=0.8). Orthostatic hypotension occurred in 3.6% of the stroke group and 4.4% in the group without stroke. The total SCOPA-AUT score was higher in the stroke group compared with the group without stroke (P=0.001). Domain scores for gastrointestinal (P=0.001), urinary (P=0.005) and cardiovascular (P=0.001) were higher in the stroke group. No differences were found when comparing the total SCOPA-AUT scores for stroke subtypes (P=0.168) and for lateralization (P=0.6). SCOPA AUT scores were correlated with depression scores (P=0.001) but not with stroke severity (P=0.2).ConclusionAutonomic symptoms, especially, gastrointestinal, urinary and cardiovascular function, were significantly increased in hypertensive patients with minor ischemic stroke. Symptoms were associated with depression but not with the characteristic of the stroke.

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Festination in patients with Parkinson's disease

Festination in Chinese patients with Parkinson's disease

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Ruwei Ou, Xiaoyan Guo, Qianqian Wei, Bei Cao, Jing Yang, Wei Song, Na Shao, Bi Zhao, Xueping Chen, Huifang Shang
ObjectiveTo investigate the occurrence and clinical associations of festination in Chinese patients with Parkinson's disease (PD).MethodsA total of 480 PD patients were recruited in this cross-sectional study. Assessments scales included the Unified PD Rating Scale (UPDRS) part III, PD Questionnaire-39 (PDQ-39), Non-Motor Symptoms Scale (NMSS), Mini-Mental State Examination (MMSE), frontal assessment battery (FAB), Montreal Cognitive Assessment (MoCA), Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA).ResultsOne hundred and forty PD patients (29.2%) reported festination. Festination occurred more frequently in patients with lower limbs as the site of onset and patients with longer disease duration or higher Hoehn and Yahr (H&Y) stage (P<0.05). The mean age, levodopa and entacapone use, incidences of motor complications, falls and freezing of gait, and the scores for the UPDRS part III, NMSS, HAMD and HAMA were higher in patients with festination than those without festination (P<0.05). There were no differences in the scores for the PDQ-39, MMSE, FAB and MoCA between the patients with and without festination. The binary logistic regression model indicated that UPDRS part III, lower limbs as the site of onset, freezing of gait and falls were associated with festination.ConclusionsFestination is a relatively common disabling symptom in Chinese PD patients. Patients with lower limbs as the site of onset and more severe disability were more likely to experience festination. Festination in PD is not related to non-motor symptoms and cognitive dysfunction.

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BacterioFiles 240 - Water Worms Make (carbon) Monoxide Meals

This episode: Marine worms and their microbial symbionts can live on the toxic gas carbon monoxide!

Reminder: this is the last episode for at least a few weeks while I am wrapping up my PhD. See you again when I'm done!

(11.1 MB, 12.1 minutes)

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Pre-operative image-based segmentation of the cranial nerves and blood vessels in microvascular decompression

: Can we prevent unnecessary explorations?

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Parviz Dolati, Alexandra Golby, Daniel Eichberg, Mohamad Abolfotoh, Ian F. Dunn, Srinivasan Mukundan, Mohamed M. Hulou, Ossama Al-Mefty
ObjectivesThis study was conducted to validate the accuracy of image-based pre-operative segmentation using the gold standard endoscopic and microscopic findings for localization and pre-operative diagnosis of the offensive vessel.Patients and methodsFourteen TN and 6 HS cases were randomly selected. All patients had 3T MRI, which included thin-sectioned 3D space T2, 3D Time of Flight and MPRAGE Sequences. Imaging sequences were loaded in BrainLab iPlanNet and fused. Individual segmentation of the affected cranial nerves and the compressing vascular structure was performed by a neurosurgeon, and the results were compared with the microscopic and endoscopic findings by two blinded neurosurgeons. For each case, at least three neurovascular landmarks were targeted. Each segmented neurovascular element was validated by manual placement of the navigation probe over each target, and errors of localization were measured in mm.ResultsAll patients underwent retro-sigmoid craniotomy and MVD using both microscope and endoscope. Based on image segmentation, the compressing vessel was identified in all cases except one, which was also negative intraoperatively. Perfect correspondence was found between image-based segmentation and endoscopic and microscopic images and videos (Dice coefficient of 1). Measurement accuracy was 0.45±0.21mm (mean±SD).ConclusionImage-based segmentation is a promising method for pre-operative identification and localization of offending blood vessels causing HFS and TN. Using this method may prevent some unnecessary explorations on especially atypical cases with no vascular contacts. However, negative pre-operative image segmentation may not preclude one from exploration in classic cases of TN or HFS. A multicenter study with larger number of cases is recommended.

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High coincidence of pituitary adenoma in patients with ruptured Rathke's cleft cyst

Demonstration of high coincidence of pituitary adenoma in patients with ruptured Rathke's cleft cyst: Results of a prospective study

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Hidetoshi Ikeda, Genichiro Ohhashi
ObjectiveRepeated chronic inflammation, such as under circumstances of ruptured Rathke's cleft cyst (RCC), is known as the fundamental basis of various pathological changes including neoplastic change, therefore to examine accurate incidence of pituitary adenomas is important for the preventive medicine.Materials and methodsAs a prospective study, patients were initially screened by the symptoms such as periodic headache and dizziness together with the abnormal findings such as seller floor bone defect on 3D-CT. Those screened patients who showed abnormal basal pituitary hormone values were additionally examined by several loading test and 3T magnetic resonance imaging (MRI) by three-dimensional reconstructions of Flair cube images. The presence of pituitary adenomas was evaluated by composite 3T MRI and ¹¹C methionine MET positron-emission tomography imaging. Immunohistochemical studies were employed for surgical biopsy specimens to demonstrate hormone production.Results308 cases of RCC were diagnosed by both radiologic and intraoperative findings. Pathological examination confirmed 111 pituitary adenomas in 106 patients with ruptured RCC, therefore the rate of coincidence was revealed 34%. In 78 patients with abnormalities of pituitary hormone secretion, MET uptake was observed in the pituitary gland and verified pituitary adenoma pathologically. In addition, 28 adenomas were verified without MET-PET study on pathological examination only, for a total of 106 cases.ConclusionsHigh coincidence (34%) of ruptured RCC and pituitary adenomas was demonstrated, which is a proof that ruptured RCC is contributed to a risk factor of pituitary adenoma.

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Spinal Ependymomas

Genetic and molecular distinctions in spinal ependymomas: A review

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Ian D. Connolly, Rohaid Ali, Yingmei Li, Melanie Hayden Gephart
While gross total resection of spinal ependymomas prevents recurrence, this surgical result is not always possible. Increasing evidence suggests that ependymomas occurring in the spine are genetically distinct from those originating in the brain. Herein we review the most recent developments detailing the molecular and genetic characteristics of spinal ependymomas, which may inform more effective and personalized adjuvant therapies for spinal ependymomas that are ineligible for gross total resection. We performed a key-word search for articles published on the molecular, genetic, chromosomal, and epigenetic transformations inherent in spinal ependymomas. We reviewed appropriate articles and their relevant citations. While resection can often achieve favorable outcomes in the treatment of spinal ependymoma, more research on the unique molecular, genetic, chromosomal and epigenetic traits must be conducted in order to tailor treatment and intervention for those patients for whom total resection is not possible.

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Spinal fractures in patients with ankylosing spondylitis

Management of 

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Najib E. El Tecle, Kingsley O. Abode-Iyamah, Patrick W. Hitchon, Nader S. Dahdaleh
Ankylosing spondlylitis is a seronegative spondyloarthropathy that primarily affects the spinal column and sacroiliac joints. With disease progression autofusion of the spinal column takes place. This combined with the brittle bone quality make patients prone to fractures and spinal cord injury. The typical fracture pattern is extension type and involves all three columns. These fractures and injuries may involve the craniovertebral junction, the subaxial cervical spine, and the thoracolumbar spine. While at times these fractures are challenging to manage especially when they affect the elderly, there is evidence that supports long segment fixation and fusion. This article presents a narrative review on managing spinal fractures in patients with ankylosing spondylitis.

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Prognostic markers for craniopharyngioma recurrence : Increased expression of HIF-1α and VEGF correlates with recurrence

Important 

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Aatman Shah, Henry Jung

Highlights

•

Craniopharyngioma markers that predict recurrence have not been identified.

•

Larger size and adherence to the hypothalamus correlated with recurrence.

•

Increased expression of HIF-1α and VEGF correlates with recurrence.

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Invasion-related molecules in the peritumoral brain

Expression pattern of 

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Álmos Klekner, Gábor Hutóczki, József Virga, Judit Reményi-Puskár, Judit Tóth, Beáta Scholtz, Éva Csősz, Gergő Kalló, László Steiner, Tibor Hortobágyi, László Bognár
ObjectiveThe effectiveness of therapy of intracerebral neoplasms is mainly influenced by the invasive behaviour of the tumour. The peritumoral invasion depends on the interaction between the tumour cells and the extracellular matrix (ECM) of the surrounding brain. The invading tumour cells induce change in the activity of proteases, synthases and expression of ECM-components. These alterations in the peritumoral ECM are in connection to the highly different invasiveness of gliomas and metastatic brain tumours. To understand the fairly modified invasive potential of anaplastic intracerebral tumours of different origin, the effect of tumour on the peritumoral ECM and alterations of invasion related ECM components in the peritumoral brain were evaluated.MethodsFor this reason the mRNA expression of 19 invasion-related molecules by quantitative reverse transcriptase polymerase chain reaction was determined in normal brain tissue (Norm), in the peritumoral brain tissue of glioblastoma (peri-GBM) and of intracerebral adenocarcinoma metastasis (peri-Met). To evaluate the translational expression of the investigated molecules protein levels were determined by targeted proteomic methods.ResultsEstablishing the invasion pattern of the investigated tissue samples 8 molecules showed concordant difference at mRNA and protein levels in the peri-GBM and peri-Met, 11 molecules in the peri-Met and normal brain and 12 in the peri-GBM and normal brain comparison.ConclusionOur results bring some ECM molecules into focus that probably play key role in arresting tumour cell invasion around the metastatic tumour, and also in the lack of impeding tumour cell migration in case of glioblastoma.

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Intracerebral hemorrhages in Deep brain stimulation surgeries

A detailed analysis of 

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Mehmet Tonge, Linda Ackermans, Ersoy Kocabicak, Vivianne van Kranen-Mastenbroek, Mark Kuijf, Mayke Oosterloo, Pieter Kubben, Yasin Temel
ObjectivesDeep brain stimulation is nowadays a frequently performed surgery in patients with movement disorders, intractable epilepsy, and severe psychiatric disorders. The most feared complication of this surgery is an intracerebral hemorrhage due to the electrode placement, either for intraoperative electrophysiology (microelectrode recording) and/or implantation of the final electrode (macroelectrode). Here, we have investigated the risk of developing an intracerebral hemorrhage in our cohort of deep brain stimulation patients over a period of 15 years.Patients and methodsWe have collected demographic data and analyzed the effect of performing surgery with single-electrode versus multiple electrode guided DBS. The effect of using single-dose versus double-dose contrast enhanced MRI to visualize vessels for the electrode trajectory planning has been investigated as well.ResultsWe have found that the overall calculated risk of an intracerebral hemorrhage in our series was 1.81% per patient, 0.3% per recording electrode and 0.23% per brain insertion. While three out of four patients recovered without neurological deficits, there was one mortality in a patient with cardiovascular comorbidities. Statistical comparisons between the groups of single-electrode versus multiple electrode guided surgery and single-dose gadolinium versus double-dose contrast enhanced MRI revealed no significant differences. In addition, there was no meaningful correlation between the age at surgery and the risk of bleeding.ConclusionWe have found that the risk of developing an intracerebral hemorrhage due to deep brain stimulation surgery is low. The clinical course of the patients with an intracerebral hemorrhage was generally favorable.

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Surgical management of ventrally based lower cervical (subaxial) meningiomas through the lateral approach

: Report on 16 cases

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Hisham Adel Aboul-Enein, Wael Mahmoud Khidr, Khaled Mohamed Abdeen, Aly Abo Madawi
ObjectivesSpinal meningiomas are benign and relatively rare tumors. These tumors present about only 25% of primary spinal tumors. Although spinal meningiomas are considered as slowly growing benign tumors, yet they may cause devastating neurological deficits rendering patients crippled. This study describes performing a posterolateral approach to surgically treat anterior based cervical meningioma. We hereby report on 16 cases operated upon using this approach, and we present our results and display some of our cases with special emphasis on achieving total resection, rate of recurrence and the neurological outcome.Patients and methodsThe study reports on 16 patients who underwent surgery for anterior based cervical meningioma. Data regarding age, sex, duration and type of symptoms, levels, topographical locations, surgical results, and histological features are presented.ResultsThe age ranged between 19 and 78 years old with a mean age of 48.3 years. The initial symptom among most patients (13 patients) was neck pain, numbness and radicular pain were found in 9, and clumsiness of the upper extremity in 7 patients. Total excision with dural coagulation was done in 11 cases, and spilt dura technique was feasible in 4 cases where the tumor together with the inner dura layer was resected. We encountered one case of atypical meningioma with Pia and arachnoid invasion which rendered total excision too risky and only subtotal resection was achieved. There were no major surgical or permanent neurological complications. Lateral mass fixation was used in 2 patients with a strictly midline anterior tumor in which a total facetectomy was done. All patients were followed up for an average of 3.6 years. Tumor recurrence was seen in 3 patients.ConclusionsThe lateral approach allows for safe and total removal of ventral cervical meningioma. This approach gives a direct avenue to the tumor without risk of destabilizing the vertebral column. The rate of recurrence is the same when using the anterior approach but is less invasive with less blood loss.

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The risk of meningitis in patients undergoing endoscopic endonasal transsphenoidal surgery

Efficacy of ultra-short single agent regimen antibiotic chemo-prophylaxis in reducing the risk of meningitis in patients undergoing endoscopic endonasal transsphenoidal surgery

via Clinical Neurology and Neurosurgery

Publication date: December 2015
Source:Clinical Neurology and Neurosurgery, Volume 139
Author(s): Teresa Somma, Alberto Enrico Maraolo, Felice Esposito, Luigi Maria Cavallo, Grazia Tosone, Raffaele Orlando, Paolo Cappabianca
ObjectivesThe study aims to evaluate the incidence of infectious complications (namely meningitis) within 30 days after endoscopic endonasal transspheinodal neurosurgery (EETS) in patients receiving an ultra-short peri-operative chemo-prophylaxis regimen with 2 doses of 1st generation cephalosporin or macrolide.Patients and methodsWe retrospectively analyzed the clinical records of 145 patients who received an ultra-short chemoprophylaxis with two doses of an antibiotic, given 30min before and 8h after EETS, over a 30-month time-frame. Ninety-seven patients (66.89%) received endovenous cefazolin, a 1st generation cephalosporin, administered at a dosage of 1000mg, and 48 patients (33.10%) with an history of allergy to various agents, received endovenous clarithromycin at a dosage of 500mg.ResultsNo case of peri- and post-operative meningitis occurred in patients receiving the 2 doses of antibiotic. Only one patient (0.68%) developed cerebral fluid leakage on the 7th postoperative day, which required the switching to a broad-spectrum antibiotic prophylaxis for one week; this patient received the ultrashort prophylaxis with a macrolide. In addition, 7 patients (4.82%) developed minor infectious complications such as low-grade fever (3 cases, all of them receiving cefazolin), enlarged submandibular and cervical lymphnodes (3 cases, all of them receiving cefazolin), and upper and lower respiratory tract infection (1 case receiving clarithromycin). The cost of this prophylaxis regimen ranged from 7.76 Euro (cefazolin) to 39.54 Euro (clarithromycin).ConclusionsThis study suggested that an ultra-short single-antibiotic prophylaxis is a safe, cheap and effective regimen to prevent post-operative meningitis in patients undergoing EETS and who do not require lumbar drainage after surgery. In these patients also the rate of minor infective complications was acceptable when compared with the previous more expensive regimen based on 3rd generation cephalosporin plus aminoglycoside or alone, that could be suitable only for at-risk patients (e.g. smokers, cerebrospinal leak or Cushing's diseases).

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Effects of mandibular advancement surgery on the temporomandibular joint and muscular and articular adaptive changes

—a systematic review

via Oral and Maxillofacial Surgery

Publication date: Available online 28 November 2015
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): A. Bermell-Baviera, C. Bellot-Arcís, J.M. Montiel-Company, J.M. Almerich-Silla
The objective of this study was to assess the anatomical changes to the condyle and articular disc following mandibular advancement surgery, the adaptation of the masticatory muscles, and the improvement or worsening of temporomandibular disorders (TMD) in patients with pre-existing disorders and those who developed them following surgery. Four databases were searched systematically: PubMed, Scopus, Embase, and Cochrane Library. Of the 544 articles initially selected, 219 were duplicates and a further 165 were excluded on the basis of their titles and abstracts. On reading the full text, 89 were excluded because they were of no interest and 43 because they did not meet the inclusion criteria. Of the remaining 28 articles, six were excluded because they were considered of low quality and 22 articles were reviewed. Mandibular advancement surgery with condyle repositioning is associated with less TMD. Condylar resorption is a physiological process with a multifactorial aetiology. It is accelerated following mandibular advancement surgery but is not a contraindication to this procedure. Despite the large number of studies on the effects of mandibular advancement surgery on the temporomandibular joint (TMJ), this surgery can neither be said to improve nor to worsen TMJ health.

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Orienting versus inhibition in the Concealed Information Test: Different cognitive processes drive different physiological measures

Abstract

The Concealed Information Test (CIT) provides a valid tool for psychophysiological detection of concealed knowledge. However, its precise theoretical underpinnings remain a matter of debate. The differential physiological responses elicited by concealed, relevant items, relative to control items, were traditionally explained as reflecting an orienting response (OR). According to an alternative account, these responses reflect attempts to inhibit arousal. The present study examined whether and to what extent CIT detection efficiency is affected by instructions aimed at manipulating arousal inhibition (AI). One hundred and forty-eight undergraduate students completed a CIT, while electrodermal, cardiac, and respiratory measures were recorded. Half of the participants were requested to imagine that they are suspected of committing a crime and were motivated to avoid detection (presumably eliciting both OR and AI), while the other half were requested to imagine that they are witnesses of a crime and were motivated to be detected (presumably eliciting OR only). All participants were further requested to remain silent throughout the test. In both conditions, concealed items led to a similar increase in skin conductance as compared to the control items. However, the typically observed heart rate deceleration and respiratory suppression were found in suspects, but not in witnesses. These data imply that different mechanisms drive the responding of different psychophysiological measures used in the CIT, with skin conductance reflecting OR, and heart rate and respiration primarily reflecting AI.

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Factors associated with the severity of childhood rhinoconjunctivitis

Factors associated with the severity of childhood rhinoconjunctivitis

via Allergology International

Publication date: Available online 29 November 2015
Source:Allergology International
Author(s): Koichi Yoshida, Mari Sasaki, Yuichi Adachi, Toshiko Itazawa, Hiroshi Odajima, Hirohisa Saito, Akira Akasawa
BackgroundAllergic rhinitis is one of the most common chronic diseases in children. Although it has a large impact on the patient's quality of life, little is known about the factors associated with its severity. The aim of this study was to assess the factors associated with the severity of rhinoconjunctivitis among children in the general population.MethodsA survey was conducted using an online research panel in 2012. Parents were asked to answer an International Study of Asthma and Allergies in Childhood-based questionnaire to identify children with current rhinoconjunctivitis and evaluate factors associated with the severity of its symptoms. Severity was rated according to the degree of impairment caused by the symptoms in the patient's daily life.ResultsAmong 26,725 children aged 6–12 years old, rhinoconjunctivitis was defined in 5175 (19.4%), and of these, 688 children (13.3% of children with current rhinoconjunctivitis) presented severe symptoms. Living in areas with a high cedar and cypress pollen count and having concurrent eczema were associated with severe rhinoconjunctivitis [adjusted OR (95% CI): 1.21 (1.00–1.46) and 1.45 (1.20–1.75), respectively]. Further, a maternal history of asthma and allergic rhinitis was a significant risk factor for severe rhinoconjunctivitis [1.34 (1.04–1.74) and 1.30 (1.10–1.53), respectively]. However, living with fur-bearing animals (pets) before 1 year of age proved to be a protective factor against severe rhinoconjunctivitis [0.70 (0.52–0.94)].ConclusionsEnvironmental factors such as pets and pollen, together with comorbidities and a maternal history of allergic diseases, play an important role in determining the severity of rhinoconjunctivitis.

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Hen's egg (HE) allergy develops during infancy

Natural history of immediate-type hen's egg allergy in Japanese children

via Allergology International

Publication date: Available online 28 November 2015
Source:Allergology International
Author(s): Kiyotaka Ohtani, Sakura Sato, Akinori Syukuya, Tomoyuki Asaumi, Kiyotake Ogura, Yumi Koike, Katsuhito Iikura, Noriyuki Yanagida, Takanori Imai, Motohiro Ebisawa
BackgroundHen's egg (HE) allergy develops during infancy. We investigated tolerance acquisition in Japanese children allergic to HE aging <6 years.MethodsIn this retrospective study, 226 children born in 2005 with a history of immediate-type HE allergy underwent an oral food challenge (OFC). Tolerance was defined as no reaction to an OFC with half of whole heated HE or accidental HE consumption at home. Participants were divided into three groups based on age at tolerance acquisition: group I (<3 years) (n = 66), group II (3–6 years) (n = 98), and group III (prolonged allergic groups) (n = 62).ResultsTolerance acquisition occurred in 30% (66/226) by 3 years of age, 59% (133/226) by 5 years of age, and 73% (164/226) at 6 years of age. At 3 years, incidences of allergy-related complications (bronchial asthma, p = 0.02; atopic dermatitis, p = 0.04) were higher in the group III than in the group I. Anaphylaxis to any food occurred more frequently in the group III than in the group I (p = 0.03); anaphylaxis to HE was more common in the group III (p = 0.04). Egg white (EW)- and ovomucoid (OM)-specific immunoglobulin E (IgE) levels were higher in the group III than in the group I (p < 0.05).ConclusionsThe group III experienced HE-related anaphylaxis and complications more frequently and exhibited sustained, high EW- and OM-specific IgE levels.

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Orienting versus inhibition in the Concealed Information Test: Different cognitive processes drive different physiological measures

Abstract

The Concealed Information Test (CIT) provides a valid tool for psychophysiological detection of concealed knowledge. However, its precise theoretical underpinnings remain a matter of debate. The differential physiological responses elicited by concealed, relevant items, relative to control items, were traditionally explained as reflecting an orienting response (OR). According to an alternative account, these responses reflect attempts to inhibit arousal. The present study examined whether and to what extent CIT detection efficiency is affected by instructions aimed at manipulating arousal inhibition (AI). One hundred and forty-eight undergraduate students completed a CIT, while electrodermal, cardiac, and respiratory measures were recorded. Half of the participants were requested to imagine that they are suspected of committing a crime and were motivated to avoid detection (presumably eliciting both OR and AI), while the other half were requested to imagine that they are witnesses of a crime and were motivated to be detected (presumably eliciting OR only). All participants were further requested to remain silent throughout the test. In both conditions, concealed items led to a similar increase in skin conductance as compared to the control items. However, the typically observed heart rate deceleration and respiratory suppression were found in suspects, but not in witnesses. These data imply that different mechanisms drive the responding of different psychophysiological measures used in the CIT, with skin conductance reflecting OR, and heart rate and respiration primarily reflecting AI.

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Volatile Organic Compounds in Plasma for the Diagnosis of Esophageal Adenocarcinoma

Volatile Organic Compounds in Plasma for the Diagnosis of Esophageal Adenocarcinoma: A Pilot Study: A non-invasive screening test that can detect esophageal adenocarcinoma (EAC) at an earlier stage could improve the prognosis associated with EAC. The role of plasma volatile organic compounds (VOCs) for diagnosis of EAC has not been previously studied.

Abstract

Background & Aims

A non-invasive screening test that can detect esophageal adenocarcinoma (EAC) at an earlier stage could improve the prognosis associated with EAC. The role of plasma volatile organic compounds (VOCs) for diagnosis of EAC has not been previously studied.

Methods

Plasma samples were collected from subjects with EAC and gastroesophageal reflux (GERD) before endoscopy. 22 pre-selected VOCs were analyzed with a selected ion flow tube mass spectrometry.

Results

The headspaces from 39 plasma samples (20 EAC, 19 GERD) were analyzed. Levels of 9 VOCs (acetonitrile, acrylonitrile, carbon disulfide, isoprene, 1-heptene, 3-methylhexane, (E)-2-nonene, hydrogen sulfide and triethylamine) were significantly altered in EAC patients compared with GERD patients. A multivariable logistic regression analysis was performed to build a model for prediction of EAC. The model identified patients with EAC with an area under the curve (AUC) of 0.83 (95% CI, 0.67, 0.98).

Conclusion

Plasma VOCs maybe useful in diagnosing EAC. Larger studies are needed to confirm our pilot study observations.

Keywords:

biomarker, esophageal cancer, gastroesophageal reflux disease

Abbreviations:

Analysis of variance (ANOVA), analysis of covariance (ANCOVA), area under the ROC curve (AUROC),esophageal adenocarcinoma (EAC), Barrett's esophagus (BE), computed tomography (CT), endoscopic ultrasound (EUS), gastroesophageal reflux disease (GERD), volatile organic compounds (VOCs)

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Task oriented program and balance training on postural stability in stroke patients

Comparison between the effects of task oriented program and balance training on postural stability in stroke patients: 2015-11-29T17-03-15Z

Source: International Journal of Therapies and Rehabilitation Research

Hosam Magdy Metwally, Waleed Talat Mansour, Amal Sayed Ashour, Islam Hasan Fayed.


Background: Sensorimotor cortex is responsive to peripheral and central stimulation by mechanisms that are important for learning motor tasks. The purpose of this study was to investigate difference between the effect of task oriented program and balance exercises on postural stability in stroke patients.Subjects and procedures: Thirty stroke hemiparetic subjects were assigned into two equal groups (group I and II): group ( I ) received task oriented training program in addition to selected physical therapy program ( PNF technique, weight bearing exercises and gait training ) while group ( II ) received balance exercise in addition to selected physical therapy program ( PNF technique, weight bearing exercises and gait training ). Subjects were assessed using biodex stability system including postural stability test. Results: This study revealed that balance is significantly improved in both groups with the best results for group I. Conclusion: Task oriented training could be considered a valuable method for treating balance in stroke patients.

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The anterior horn cells control all voluntary movement: motor activity, respiratory, speech, and swallowing functions are dependent upon signals from the anterior horn cells

Anterior Horn Cell Diseases: 2015-11-29T18-03-41Z

Source: Archives Medical Review Journal

Merve Fırıncıoğulları, Burak Yavuz, Filiz Koç.


The anterior horn cells control all voluntary movement: motor activity, respiratory, speech, and swallowing functions are dependent upon signals from the anterior horn cells. Diseases that damage the anterior horn cells, therefore, have a profound impact. Symptoms of anterior horn cell loss (weakness, falling, choking) lead patients to seek medical attention. In this article, anterior horn disease were reviewed, diagnostic criteria and management were discussed in detail.

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Anesthesia Management in Diabetic Patients witht Cardiovascular Autonomic Neuropathy

Anesthesia Management in Diabetic Patients witht Cardiovascular Autonomic Neuropathy: 2015-11-29T18-03-41Z

Source: Archives Medical Review Journal

Feride Karacaer.


Cardiovascular autonomic neuropathy is frequently observed in patients with diabetes mellitus and encompasses damage to the autonomic nerve fibers, resulting in abnormalities in heart rate control and vascular dynamics. There is an increased mortality and morbidity rate among these patients. A series of cardiovascular reflex tests known as Ewings battery tests are used for diagnosis cardiac autonomic neuropathy and provide valuable information to the clinical assessment of these patients. As anesthesia has a major influence on perioperative autonomic function, the interplay between cardiovascular autonomic neuropathy and anesthesia may result in unexpected haemodynamic instability during surgery and postoperative recovery. A comprehensive preoperative assessment and perioperative cautious monitoring are necessary for successful anesthesia management.

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Superoxide anions produced by Streptococcus pyogenes group A-stimulated keratinocytes are responsible for cellular necrosis and bacterial growth inhibition

Superoxide anions produced by Streptococcus pyogenes group A-stimulated keratinocytes are responsible for cellular necrosis and bacterial growth inhibition:

Gram-positive Streptococcus pyogenes (group A Streptococcus or GAS) is a major skin pathogen and interacts with keratinocytes in cutaneous tissues. GAS can cause diverse suppurative and inflammatory infections, such as cellulitis, a common acute bacterial dermo-hypodermitis with a high morbidity. Bacterial isolation yields from the lesions are low despite the strong local inflammation observed, raising numerous questions about the pathogenesis of the infection. Using an in vitro model of GAS-infected keratinocytes, we show that the major ROS produced is the superoxide anion (O2-), and that its production is time- and dose-dependent. Using specific modulators of ROS production, we show that O2- is mainly synthesized by the cytoplasmic NADPH oxidase. Superoxide anion production leads to keratinocyte necrosis but incomplete inhibition of GAS growth, suggesting that GAS may be partially resistant to the oxidative burst. In conclusion, GAS-stimulated keratinocytes are able to develop an innate immune response based on the production of ROS. This local immune response limits GAS development and induces keratinocyte cell death, resulting in the skin lesions observed in patients with cellulitis.

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Making a Good (Ear) Impression: Setting Up a Successful Impression-Taking Protocol

Making a Good (Ear) Impression: Setting Up a Successful Impression-Taking Protocol: There is a need to be skilled at taking impressions for a number of reasons. One of those is the opportunity that lies in being able to be proficient at making ear impressions. The opportunity to provide custom solutions for your patient in a non-custom world is one of the key benefits of being skilled and proficient at making ear impressions. The opportunity to demonstrate your professionalism through the care and effort that it takes to provide the best impression of anatomy, ear texture, and desired product are essential. Although we may be fitting primarily non-custom technology, there are a lot of other options where we might need an impression. We need to be able to maintain those skills.

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Soil moisture and chemistry influence diversity of ectomycorrhizal fungal communities associating with willow along an hydrologic gradient

Influences of soil environment and willow host species on ectomycorrhizal fungi communities was studied across an hydrologic gradient in temperate North America. Soil moisture, organic matter and pH strongly predicted changes in fungal community composition. In contrast, increased fungal richness strongly correlated with higher plant-available phosphorus. The 93 willow trees sampled for ectomycorrhizal fungi included seven willow species. Host identity did not influence fungal richness or community composition, nor was there strong evidence of willow host preference for fungal species. Network analysis suggests that these mutualist interaction networks are not significantly nested or modular. Across a strong environmental gradient, fungal abiotic niche determined the fungal species available to associate with host plants within a habitat.

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ECsafeSEAFOOD Seminar on the Island of Frøya in May 2016

The seminar has been arranged by the Norwegian Veterinary Institute, Blue Competence Center, and Frøya VGS in the framework of the ECsafeSEAFOOD project. The island of Frøya is situated in the Trondheim fjord and is famous for its seafood production.

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Superoxide anions produced by Streptococcus pyogenes group A-stimulated keratinocytes are responsible for cellular necrosis and bacterial growth inhibition

Gram-positive Streptococcus pyogenes (group A Streptococcus or GAS) is a major skin pathogen and interacts with keratinocytes in cutaneous tissues. GAS can cause diverse suppurative and inflammatory infections, such as cellulitis, a common acute bacterial dermo-hypodermitis with a high morbidity. Bacterial isolation yields from the lesions are low despite the strong local inflammation observed, raising numerous questions about the pathogenesis of the infection. Using an in vitro model of GAS-infected keratinocytes, we show that the major ROS produced is the superoxide anion (O2-), and that its production is time- and dose-dependent. Using specific modulators of ROS production, we show that O2- is mainly synthesized by the cytoplasmic NADPH oxidase. Superoxide anion production leads to keratinocyte necrosis but incomplete inhibition of GAS growth, suggesting that GAS may be partially resistant to the oxidative burst. In conclusion, GAS-stimulated keratinocytes are able to develop an innate immune response based on the production of ROS. This local immune response limits GAS development and induces keratinocyte cell death, resulting in the skin lesions observed in patients with cellulitis.

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ECsafeSEAFOOD Seminar on the Island of Frøya in May 2016

The seminar has been arranged by the Norwegian Veterinary Institute, Blue Competence Center, and Frøya VGS in the framework of the ECsafeSEAFOOD project. The island of Frøya is situated in the Trondheim fjord and is famous for its seafood production.

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Comparison of the effect of W shaped skin incisions on scar visibility

Yazici B

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Comparison of the effect of W shaped skin incisions on scar visibility

Yazici B

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Corrigendum to “Enamel thickness trends in Plio-Pleistocene hominin mandibular molars” [J Hum Evol 85 (2015) 35–45]

Publication date: Available online 29 November 2015
Source:Journal of Human Evolution
Author(s): Matthew M. Skinner, Zeresenay Alemseged, Charleen Gaunitz, Jean-Jacques Hublin




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Corrigendum to “Enamel thickness trends in Plio-Pleistocene hominin mandibular molars” [J Hum Evol 85 (2015) 35–45]

Publication date: Available online 29 November 2015
Source:Journal of Human Evolution
Author(s): Matthew M. Skinner, Zeresenay Alemseged, Charleen Gaunitz, Jean-Jacques Hublin




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Adverse events and the relation with quality of life in adults with intellectual disability and challenging behaviour using psychotropic drugs

Publication date: February–March 2016
Source:Research in Developmental Disabilities, Volumes 49–50
Author(s): Arlette Scheifes, Sanne Walraven, Joost Jan Stolker, Henk L.I. Nijman, Toine C.G. Egberts, Eibert R. Heerdink
BackgroundPsychotropic drugs are prescribed to approximately 30–40% of adults with intellectual disability (ID) and challenging behaviour, despite the limited evidence of effectiveness and the potential of adverse events.AimsTo assess the prevalence of adverse events in association with psychotropic drug use in adults with ID and challenging behaviour and to examine the relation of these adverse events with the person's quality of life.MethodThe presence of adverse events was measured with a questionnaire that had to be filled in by the physicians of the participants. Movement disorders were measured separately with a standardised protocol. The strength of the association between adverse events and Intellectual Disability Quality of Life-16 (IDQOL-16), and daily functioning was investigated using linear regression analyses, taking into account the severity of disease (CGI-S) as potential confounder.ResultsVirtually all of 103 adults with ID and challenging behaviour had at least one adverse event (84.4%) and almost half had ≥3 adverse events (45.6%) across different subclasses. Using psychotropic drugs increased the prevalence of adverse events significantly. Respectively 13% of the patients without psychotropic drugs and 61% of the patients with ≥2 psychotropic drugs had ≥3 adverse events. Having adverse events had a significantly negative influence on the quality of life.ConclusionsA large majority of all patients had at least one adverse event associated with psychotropic drug use. More attention is needed for these adverse events and their negative influence on the quality of life of these patients, taking into account the lack of evidence of effectiveness of psychotropic drugs for challenging behaviour.



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Event-based prospective memory in mildly and severely autistic children

Publication date: February–March 2016
Source:Research in Developmental Disabilities, Volumes 49–50
Author(s): Daniel P. Sheppard, Lia Kvavilashvili, Nuala Ryder
BackgroundThere is a growing body of research into the development of prospective memory (PM) in typically developing children but research is limited in autistic children (Aut) and rarely includes children with more severe symptoms.AimsThis study is the first to specifically compare event-based PM in severely autistic children to mildly autistic and typically developing children.Methods and proceduresFourteen mildly autistic children and 14 severely autistic children, aged 5–13 years, were matched for educational attainment with 26 typically developing children aged 5–6 years. Three PM tasks and a retrospective memory task were administered.Outcomes and resultsResults showed that severely autistic children performed less well than typically developing children on two PM tasks but mildly autistic children did not differ from either group. No group differences were found on the most motivating (a toy reward) task.Conclusions and implicationsThe findings suggest naturalistic tasks and motivation are important factors in PM success in severely autistic children and highlights the need to consider the heterogeneity of autism and symptom severity in relation to performance on event-based PM tasks.



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Early speech perception in Mandarin-speaking children at one-year post cochlear implantation

Publication date: February–March 2016
Source:Research in Developmental Disabilities, Volumes 49–50
Author(s): Yuan Chen, Lena L.N. Wong, Shufeng Zhu, Xin Xi
PurposeThe aim in this study was to examine early speech perception outcomes in Mandarin-speaking children during the first year of cochlear implant (CI) use.MethodA hierarchical early speech perception battery was administered to 80 children before and 3, 6, and 12 months after implantation. Demographic information was obtained to evaluate its relationship with these outcomes.ResultsRegardless of dialect exposure and whether a hearing aid was trialed before implantation, implant recipients were able to attain similar pre-lingual auditory skills after 12 months of CI use. Children speaking Mandarin developed early Mandarin speech perception faster than those with greater exposure to other Chinese dialects. In addition, children with better pre-implant hearing levels and younger age at implantation attained significantly better speech perception scores after 12 months of CI use. Better pre-implant hearing levels and higher maternal education level were also associated with a significantly steeper growth in early speech perception ability.ConclusionsMandarin-speaking children with CIs are able to attain early speech perception results comparable to those of their English-speaking counterparts. In addition, consistent single language input via CI probably enhances early speech perception development at least during the first-year of CI use.



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Retinal thickness and optic disc-to-fovea angle

Yamashita T, Sakamoto T, Terasaki H, Tanaka M, Kii Y, Uchino E, Hisatomi T, Nakao K

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Volatile Organic Compounds in Plasma for the Diagnosis of Esophageal Adenocarcinoma: A Pilot Study

A non-invasive screening test that can detect esophageal adenocarcinoma (EAC) at an earlier stage could improve the prognosis associated with EAC. The role of plasma volatile organic compounds (VOCs) for diagnosis of EAC has not been previously studied.

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2016 Sleep & Wellness Conference

At the 2016 Sleep & Wellness conference you will learn from the most successful practitioners in the field of Sleep Medicine in an intimate environment where you can have your questions answered directly.

Our theme "Innovation, Cooperation and Team" will give you the tools to exceed your financial and therapeutic goals. Increase your knowledge and help you develop one on one relationships with the most wired in leaders in the field of dental sleep medicine.

Presenter Spotlight

Michael Breus PHD

Michael J. Breus, Ph.D., is a Clinical Psychologist and both a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine. He was one of the youngest people to have passed the Board at age 31 and, with a specialty in Sleep Disorders, is one of only 163 psychologists in the world with his credentials and distinction.

Dr. Breus is the author of The Sleep Doctor's Diet Plan: Lose Weight Through Better Sleep (Rodale Books; May 2011), a groundbreaking book discussing the science and relationship between quality sleep and metabolism. His first book, GOOD NIGHT: The Sleep Doctor's 4-Week Program to Better Sleep and Better Health (Dutton/Penguin), an Amazon Top 100 Best Seller, has been met with rave reviews and continues to change the lives of readers.

It is now available in paperback as BEAUTY SLEEP: Look Younger, Lose Weight, and Feel Great Through Better Sleep..

Dennis Hwang MD

Dr Hwang is the medical director of Kaiser Pemanente Sleep Lab in Fontana CA.

"I have a passion to help people get the best sleep they can get and a passion to find ways to improve the kind of care we can provide for our members. We have a wonderful team of doctors, nurses, case managers, technologists and receptionists that really care and try to be as accessible as possible. We have programs that are dedicated towards helping people with a comprehensive spectrum of sleep disorders including sleep apnea, insomnia, narcolepsy, and other conditions that cause excessive sleepiness, and people with lung disease such as emphysema that may require assistance with breathing while asleep. We also take care of children, including newborns. Our sleep center is nationally recognized as being at the cutting edge of sleep medicine, and our staff is regularly invited to lecture nationally. But our passion will always be focused on each individual that comes into our center whom we have the privilege to serve and whose life in turn touches us. "

 

Mack Newton 

Mack Newton has collected three World Series rings for his work as a trainer for the Oakland A's during their 1988-90 heyday and a Super Bowl ring for the expertise he brought to the Dallas Cowboys in their 1993 Super Bowl. Newton is a Champion's Champion for his work with Athletes such as Bo Jackson, Sammy Sosa, Tory Aikman, Emmitt Smith, and Charles Barley. Most importantly he inspires others to make THE CHANGE NOW! and make that quantam leap that it takes professionals to succeed.

In 1981, Mr. Newton was named Head Coach of the USA Taekwon-Do Team and held that position until 1984. He is credited with creating the competition format currently being used in International Taekwon-Do competition.

 

 

Make the Quantum Leap! Aim higher and achieve more as a result of our time together. Click here to register: http://bit.ly/1MYrP1C

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Functional characterization of the tumor suppressor CMTM8 and its association with prognosis in bladder cancer

Abstract

Previous research revealed that CMTM8 acts as a tumor suppressor gene in variety cancers. However, the role of CMTM8 in bladder cancer has never been reported. In this study, the expression profile of CMTM8 was examined in bladder cancer tissues and bladder cancer cell lines. The effects of CMTM8 on bladder cancer cell proliferation, apoptosis, migration, and invasion were examined. Bladder tumor tissues from 84 cases were examined for CMTM8 expression by immunohistochemistry. Disease-specific survival was investigated using a Kaplan-Meier analysis, and Cox proportional hazards analysis was assessed. Our results showed that upregulation of CMTM8 in the T24 cell line could suppress T24 cells proliferation, migration and invasion and enhance the sensitivity to Epirubicin. Kaplan-Meier analysis revealed that the expression of CMTM8 was correlated with the survival time of bladder cancer patients. Altogether, our data suggested that CMTM8 is an important tumor suppressor gene in human bladder cancer and qualified as a useful prognostic indicator for patients with bladder cancer.

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Why the avian immune response impacts influenza effects (not just on human health)

In the happy afterglow of Thanksgiving, many Americans will have leftovers for reheating and turning into sandwiches. Unfortunately, there might not be as much leftover turkey as in previous years because of the price increase this year. The cause of the recent jump in turkey price talk? Good, o...

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An Evolutionary Perspective of Nutrition and Inflammation as Mechanisms of Cardiovascular Disease

When cardiovascular diseases are viewed from an evolutionary biology perspective, a heightened thrifty and an inflammatory design could be their mechanisms. Human ancestors confronted a greater infectious load and were subjected to the selection for proinflammatory genes and a strong inflammatory function. Ancestors also faced starvation periods that pressed for a thrifty genotype which caused fat accumulation. The pressure of sustaining gluconeogenesis during periods of poor nourishment selected individuals with insulin resistance. Obesity induces a proinflammatory state due to the secretion of adipokines which underlie cardiometabolic diseases. Our actual lifestyle needs no more of such proinflammatory and thrifty genotypes and these ancestral genes might increase predisposition to diseases. Risk factors for atherosclerosis and diabetes are based on inflammatory and genetic foundations that can be accounted for by excess fat. Longevity has also increased in recent times and is related to a proinflammatory response with cardiovascular consequences. If human ancestral lifestyle could be recovered by increasing exercise and adapting a calorie restriction diet, obesity would decrease and the effects on chronic low-grade inflammation would be limited. Thereby, the rates of both atherosclerosis and diabetes could be reduced.

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Flavonolignan 2,3-dehydroderivatives: Preparation, antiradical and cytoprotective activity

Publication date: January 2016
Source:Free Radical Biology and Medicine, Volume 90
Author(s): Michaela Pyszková, Michal Biler, David Biedermann, Kateřina Valentová, Marek Kuzma, Jiří Vrba, Jitka Ulrichová, Romana Sokolová, Miloš Mojović, Ana Popović-Bijelić, Martin Kubala, Patrick Trouillas, Vladimír Křen, Jan Vacek
The protective constituents of silymarin, an extract from Silybum marianum fruits, have been extensively studied in terms of their antioxidant and hepatoprotective activities. Here, we explore the electron-donor properties of the major silymarin flavonolignans. Silybin (SB), silychristin (SCH), silydianin (SD) and their respective 2,3-dehydroderivatives (DHSB, DHSCH and DHSD) were oxidized electrochemically and their antiradical/antioxidant properties were investigated. Namely, Folin–Ciocalteau reduction, DPPH and ABTS⁺ radical scavenging, inhibition of microsomal lipid peroxidation and cytoprotective effects against tert-butyl hydroperoxide-induced damage to a human hepatocellular carcinoma HepG2 cell line were evaluated. Due to the presence of the highly reactive C3-OH group and the C-2,3 double bond (ring C) allowing electron delocalization across the whole structure in the 2,3-dehydroderivatives, these compounds are much more easily oxidized than the corresponding flavonolignans SB, SCH and SD. This finding was unequivocally confirmed not only by experimental approaches, but also by density functional theory (DFT) calculations. The hierarchy in terms of ability to undergo electrochemical oxidation (DHSCH~DHSD>DHSB>>SCH/SD>SB) was consistent with their antiradical activities, mainly DPPH scavenging, as well as in vitro cytoprotection of HepG2 cells. The results are discussed in the context of the antioxidant vs. prooxidant activities of flavonolignans and molecular interactions in complex biological systems.

Graphical abstract

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Pre-treatment of rats with ad-hepcidin prevents iron-induced oxidative stress in the brain

Publication date: January 2016
Source:Free Radical Biology and Medicine, Volume 90
Author(s): Jing Gong, Fang Du, Zhong Ming Qian, Qian Qian Luo, Yuan Sheng, Wing-ho Yung, Yan Xin Xu, Ya Ke
Our recent investigation showed that hepcidin can reduce iron in the brain of iron-overloaded rat by down-regulating iron-transport proteins. It has also been demonstrated that iron is a major generator of reactive oxygen species. We therefore hypothesized that hepcidin could prevent iron accumulation and thus reduce iron-mediated oxidative stress in iron-overloaded rats. To test this hypothesis, we investigated the effects of pre-treatment of rats with recombinant-hepcidin-adenovirus (ad-hepcidin) on the contents of iron, dichlorofluorescein and 8-isoprostane in the brain. Hepcidin expression was detected by real-time PCR and immunofluorescence analysis. Iron contents were measured using Perl's staining as well as graphite furnace atomic absorption spectrophotometry. Dichlorofluorescein and 8-isoprostane were determined using a fluorescence spectrophotometer and an ELISA kit, respectively. We found that hepcidin contents in the cortex, hippocampus, striatum and substantia nigra of rats treated with ad-hepcidin are 3.50, 2.98, 2.93 and 4.07 fold of those of the control rats respectively. Also, we demonstrated that the increased iron as well as dichlorofluorescein and 8-isoprostane levels in all four brain regions, induced by injection of iron dextran, could be effectively prevented by pre-treatment of the rats with ad-hepcidin. We concluded that pre-treatment with ad-hepcidin could increase hepcidin expression and prevent the increase in iron and reduce reactive oxygen species in the brain of iron-overloaded rats.



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Citron Rho-interacting kinase mediates arsenite-induced decrease in endothelial nitric oxide synthase activity by increasing phosphorylation at threonine 497: Mechanism underlying arsenite-induced vascular dysfunction

Publication date: January 2016
Source:Free Radical Biology and Medicine, Volume 90
Author(s): Jungwon Seo, Du-Hyong Cho, Hyeon-Ju Lee, Min-Sun Sung, Jee Young Lee, Kyung-Jong Won, Jung-Hyun Park, Inho Jo
We reported that arsenite causes an acute decrease in nitric oxide (NO) production by increasing phosphorylation of endothelial NO synthase at threonine 497 (eNOS-Thr⁴⁹⁷); however, the detailed mechanism has not yet been clarified. Here, we investigated the kinase involving in arsenite-stimulated eNOS-Thr⁴⁹⁷ phosphorylation. Although treatment with H-89, a known protein kinase A (PKA) inhibitor, inhibited arsenite-stimulated eNOS-Thr⁴⁹⁷ phosphorylation, no inhibition was found in cells treated with other PKA inhibitors, including Rp-8-Br-cAMPS or PKI. Based on previous reports, we also tested whether RhoA mediates arsenite-stimulated eNOS-Thr⁴⁹⁷ phosphorylation and found that arsenite causes an acute increase in RhoA activity. Ectopic expression of dominant negative (DN)-RhoA significantly reversed arsenite-stimulated eNOS-Thr⁴⁹⁷ phosphorylation. An in vitro phosphorylation assay also revealed that the well-known Rho effectors, Rho-associated protein kinase 1/2 (ROCK1/2), directly phosphorylate eNOS-Thr⁴⁹⁷. Y27632, a selective ROCK inhibitor, reversed arsenite-stimulated eNOS-Thr⁴⁹⁷ phosphorylation. However, overexpression of a small interfering RNA (siRNA) against ROCK1/2 or DN-ROCK did not reverse arsenite-stimulated eNOS-Thr⁴⁹⁷ phosphorylation, thereby providing no conclusive evidence of a role for ROCK1/2. Knockdown of PKC-related protein kinase 1/2, another Rho effector, also did not reverse arsenite-stimulated eNOS-Thr⁴⁹⁷ phosphorylation. In contrast, we found that transfection with an siRNA against citron Rho-interacting kinase (CRIK), the other downstream effector of Rho, significantly reversed the arsenite-induced eNOS-Thr⁴⁹⁷ phosphorylation that was accompanied by restoration of eNOS enzymatic activity repressed by arsenite. Moreover, CRIK directly phosphorylated eNOS-Thr⁴⁹⁷in vitro. Finally, we also found that arsenite increased eNOS-Thr⁴⁹⁷ phosphorylation and decreased acetylcholine-induced vessel relaxation in rat aortas. In conclusion, we demonstrate that arsenite acutely inhibits eNOS enzymatic activity and vessel relaxation in part by increasing the RhoA/CRIK/eNOS-Thr⁴⁹⁷ phosphorylation signaling axis, which provides a molecular mechanism underlying arsenite-induced impaired vascular diseases.



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Rat Model of Photochemically-Induced Posterior Ischemic Optic Neuropathy

The goal of this protocol is to photochemically induce ischemic injury to the posterior optic nerve in rat. This model is critical to studies of the pathophysiology of posterior ischemic optic neuropathy, and therapeutic approaches for this and other optic neuropathies, as well as of other CNS ischemic diseases.

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Commentary on ‘Operative Factors Associated with the Development of New Brain Lesions During Awake Carotid Endarterectomy’

Publication date: Available online 28 November 2015
Source:European Journal of Vascular and Endovascular Surgery
Author(s): G.J. de Borst




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An Evolutionary Perspective of Nutrition and Inflammation as Mechanisms of Cardiovascular Disease

When cardiovascular diseases are viewed from an evolutionary biology perspective, a heightened thrifty and an inflammatory design could be their mechanisms. Human ancestors confronted a greater infectious load and were subjected to the selection for proinflammatory genes and a strong inflammatory function. Ancestors also faced starvation periods that pressed for a thrifty genotype which caused fat accumulation. The pressure of sustaining gluconeogenesis during periods of poor nourishment selected individuals with insulin resistance. Obesity induces a proinflammatory state due to the secretion of adipokines which underlie cardiometabolic diseases. Our actual lifestyle needs no more of such proinflammatory and thrifty genotypes and these ancestral genes might increase predisposition to diseases. Risk factors for atherosclerosis and diabetes are based on inflammatory and genetic foundations that can be accounted for by excess fat. Longevity has also increased in recent times and is related to a proinflammatory response with cardiovascular consequences. If human ancestral lifestyle could be recovered by increasing exercise and adapting a calorie restriction diet, obesity would decrease and the effects on chronic low-grade inflammation would be limited. Thereby, the rates of both atherosclerosis and diabetes could be reduced.

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Upregulation of centrosomal protein 55 is associated with unfavorable prognosis and tumor invasion in epithelial ovarian carcinoma

Abstract

Centrosomal protein 55 (CEP55) is a cell cycle regulator implicated in development of certain cancers. However, characteristics of CEP55 expression and its clinical/prognostic significance are unclear in human epithelial ovarian carcinoma (EOC). Therefore, we investigated the expression and clinicopathological significance of CEP55 in patients with EOC and its role in regulating invasion and metastasis of ovarian cell lines. CEP55 mRNA and protein expression levels were detected by quantitative real-time PCR (qRT-PCR), Western blotting, and immunohistochemistry (IHC). Potential associations of CEP55 expression scores with clinical parameters and patient survival were evaluated. CEP55 function was investigated further using RNA interference, wound healing assay, transwell assay, immunofluorescence analysis, qRT-PCR, and Western blotting. CEP55 was significantly upregulated in ovarian cancer cell lines and lesions compared with normal cells and adjacent noncancerous ovarian tissues. In the 213 EOC samples, CEP55 protein levels were positively correlated with clinical stage (P < 0.001), lymph node metastasis (P < 0.001), intraperitoneal metastasis (P < 0.001), tumor recurrence (P < 0.001), differentiation grade (P < 0.001), residual tumor size (P < 0.001), ascites see tumor cells (P = 0.020), and serum CA153 level (P < 0.001). Moreover, patients with aberrant CEP55 protein expression showed tendencies to receive neoadjuvant chemotherapy (P < 0.001) and cytoreductive surgery (P = 0.020). By contrast, no significant correlation was detected between the protein levels and patient age, histological type, or serum CA125, CA199, CA724, NSE, CEA, and β-HCG levels. Patients with high CEP55 protein expression had shorter overall survival and disease-free survival compared with those with low CEP55 expression. Multivariate analysis implicated CEP55 as an independent prognostic indicator for EOC patients. Additionally, downregulation of CEP55 in ovarian cancer cells remarkably inhibited cellular motility and invasion. Aberrant CEP55 expression may predict unfavorable clinical outcomes in EOC patients and play an important role in regulating invasion in ovarian cancer cells. Thus, CEP55 may serve as a prognostic marker and therapeutic target for EOC.

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