The readily releasable pool of synaptic vesicles

Publication date: April 2017
Source:Current Opinion in Neurobiology, Volume 43
Author(s): Pascal S Kaeser, Wade G Regehr
Each presynaptic bouton is densely packed with many vesicles, only a small fraction of which are available for immediate release. These vesicles constitute the readily releasable pool (RRP). The RRP size, and the probability of release of each vesicle within the RRP, together determine synaptic strength. Here, we discuss complications and recent advances in determining the size of the physiologically relevant RRP. We consider molecular mechanisms to generate and regulate the RRP, and discuss the relationship between vesicle docking and the RRP. We conclude that many RRP vesicles are docked, that some docked vesicles may not be part of the RRP, and that undocked vesicles can contribute to the RRP by rapid recruitment to unoccupied, molecularly activated ready-to-release sites.



http://ift.tt/2jJ4s5o

The Role of the Antiangiogenetic Ramucirumab in the Treatment of Advanced Non Small Cell Lung Cancer

Angiogenesis is one of the most important phenomena sustaining tumor development and metastatization, including for non small cell lung cancer (NSCLC). A dominant role in angiogenesis is played by the vascular endothelial growth factor (VEGF) and its signaling pathway. Ramucirumab, is a fully human immunoglobulin G1 monoclonal antibody that binds to the extracellular domain of the VEGF receptor-2 (VEGFR-2) with high specificity and affinity blocking the interaction of VEGFR-2 and VEGF ligands, thus inhibiting their signaling pathways and the consequential endothelial proliferation and migration. A recent phase III randomized trial named REVEL, demonstrated the efficacy of ramucirumab in combination with docetaxel as second line treatment of advanced NSCLC, leading to its FDA and EMA approval in this clinical setting. In the REVEL trial advanced NSCLC patients whose disease had progressed after first line platinum-based chemotherapy, were administered ramucirumab plus docetaxel or placebo plus docetaxel. More than 1,250 patients were treated and patients randomized to the treatment with ramucirumab plus docetaxel showed a significant longer median overall survival compared to those randomized to chemotherapy only. Ramucirumab is the first antiangiogenetic agent approved in the treatment both of squamous and non squamous NSCLC. In fact, it is not associated with increased risk of respiratory bleeding in the squamous histology, and also has demonstrated efficacy in both histology types. The role of ramucirumab, already cleared in the second-line treatment of advanced NSCLC, needs to be clarified further and is currently being explored also in the first-line treatment of advanced NSCLC.

http://ift.tt/2izUMgN

Development of actinobacterial resources for functional cosmetics

Summary

Background

Actinobacteria usually produce different functional compounds for various applications.

Objective

The aim of this research was to develop actinobacterial resources through the isolation and identification of soil bacteria with antibacterial and enzyme inhibitory activities for cosmetics application.

Methods

Soil bacteria were isolated and tested for antibacterial activity against Propionibacterium acnes and Staphylococcus epidermidis using the spotting method. Isolates exhibiting antibacterial activities were assayed for tyrosinase inhibition, elastase inhibition, and free radical scavenging activity.

Results

Twelve actinobacterial strains were found to inhibit the growth of P. acnes and S. epidermidis. Among them, ten were from the genus Streptomyces and the other two were from the genera Actinokineospora and Calidifontibacter, and potentially represented novel species. For tyrosinase inhibition activities, when compared with arbutin (IC₅₀=47.84±0.36 μg mL⁻¹), strain T65 had similar activity with an IC₅₀ value of 49.05±3.29 μg mL⁻¹. For elastase inhibition, strains T65, T811, and R311 had similar activities with IC₅₀ values of 10.78±1.88 μg mL⁻¹, 10.19±0.82 μg mL⁻¹, and 10.19±2.1 μg mL⁻¹, respectively, which had similar inhibitory activity to the IC₅₀ value of the standard oleanolic acid (8.94±1.38 μg mL⁻¹). For DPPH radical scavenging activities, two strains, R311 and T327, with IC₅₀ values of 6.11±1.17 μg mL⁻¹ and 5.25±0.93 μg mL⁻¹, respectively, had slightly lower activities than ascorbic acid (IC₅₀=4.08±0.03 μg mL⁻¹).

Conclusion

Among twelve strains of actinobacteria, the most effective strains were selected for the inhibition of both P. acnes and S. epidermidis as well as for enzyme activities. Actinobacterial strains isolated in this study could be used to produce active metabolites for cosmetics applications.

http://ift.tt/2k3cXvA

Development of actinobacterial resources for functional cosmetics

Summary

Background

Actinobacteria usually produce different functional compounds for various applications.

Objective

The aim of this research was to develop actinobacterial resources through the isolation and identification of soil bacteria with antibacterial and enzyme inhibitory activities for cosmetics application.

Methods

Soil bacteria were isolated and tested for antibacterial activity against Propionibacterium acnes and Staphylococcus epidermidis using the spotting method. Isolates exhibiting antibacterial activities were assayed for tyrosinase inhibition, elastase inhibition, and free radical scavenging activity.

Results

Twelve actinobacterial strains were found to inhibit the growth of P. acnes and S. epidermidis. Among them, ten were from the genus Streptomyces and the other two were from the genera Actinokineospora and Calidifontibacter, and potentially represented novel species. For tyrosinase inhibition activities, when compared with arbutin (IC₅₀=47.84±0.36 μg mL⁻¹), strain T65 had similar activity with an IC₅₀ value of 49.05±3.29 μg mL⁻¹. For elastase inhibition, strains T65, T811, and R311 had similar activities with IC₅₀ values of 10.78±1.88 μg mL⁻¹, 10.19±0.82 μg mL⁻¹, and 10.19±2.1 μg mL⁻¹, respectively, which had similar inhibitory activity to the IC₅₀ value of the standard oleanolic acid (8.94±1.38 μg mL⁻¹). For DPPH radical scavenging activities, two strains, R311 and T327, with IC₅₀ values of 6.11±1.17 μg mL⁻¹ and 5.25±0.93 μg mL⁻¹, respectively, had slightly lower activities than ascorbic acid (IC₅₀=4.08±0.03 μg mL⁻¹).

Conclusion

Among twelve strains of actinobacteria, the most effective strains were selected for the inhibition of both P. acnes and S. epidermidis as well as for enzyme activities. Actinobacterial strains isolated in this study could be used to produce active metabolites for cosmetics applications.

http://ift.tt/2k3cXvA

A novel acylhydrazone-based derivative as dual-mode chemosensor for Al3+, Zn2+ and Fe3+ and its applications in cell imaging

Publication date: June 2017
Source:Sensors and Actuators B: Chemical, Volume 244
Author(s): Zhuang Liao, Yang Liu, Su-Fang Han, Dan Wang, Jian-Quan Zheng, Xiang-Jun Zheng, Lin-Pei Jin
An acylhydrazone-based derivative, 3-hydroxy-N'-(2-hydroxy-1-naphthalene methylene)-2-naphthalene hydrazide (H3L), was synthesized and characterized by elemental analyses, IR, ¹H NMR and mass spectrum. H3L is non-fluorescent in DMSO. But the fluorescence emission is enhanced obviously via the formation of aggregates in DMSO/H2O mixture. The formed aggregates were confirmed by DLS and SEM. H3L is an aggregation-induced emission (AIE)-active fluorophore. H3L can act as a fluorescence sensor for Al³⁺ and Zn²⁺ in DMSO/H2O (v/v, 9/1) and THF/H2O (v/v, 999/1), respectively. And H3L is also a naked-eye probe for Fe³⁺ in DMSO/H2O (v/v, 9/1). The binding stoichiometry of H3L to both Al³⁺ and Zn²⁺ is 1:1, but that to Fe³⁺ is 2:1. The metal complex species formed in the detection procedure are deduced by Job plot, spectroscopic titrations and ESI–MS to be [AlL(DMSO)2], [Zn(HL)(H2O)] and [Fe(HL)(H2L)]. The detection limit is as low as 3.66μM for Al³⁺, 1.01μM for Zn²⁺ and 0.34μM for Fe³⁺. H3L can also be used to detect intracellular Al³⁺ and Zn²⁺. The sensing event might be attributed to a combinational effect of excited state intramolecular proton transfer (ESIPT) and chelation-enhanced fluorescence (CHEF) mechanism for selective detection of Al³⁺ and Zn²⁺ ions, and ligand-metal charge transfer (LMCT) mechanism for Fe³⁺ ion.

Graphical abstract

http://ift.tt/2iNXGgn

Morbihan Disease Complicated by Dermatosis Neglecta: A Unique Presentation

Abstract

Morbihan disease (MD), also referred to as solid facial edema, or rosacea lymphedema, is a rare disorder that involves chronic erythema and solid edema of the cheeks, eyelids, forehead and glabella and may arise as a complication of acne vulgaris or rosacea. Of note, it may be the only initial presenting symptom of these associated diseases.1,2 Few cases have been described in the literature, since its first description by Robert Degos in 1957. The condition is characterized by its chronicity, a typical clinical appearance, and the lack of specific histopathologic or laboratory findings. The condition may wax and wane but typically does not resolve without treatment.3 Many cases of this condition tend to be recalcitrant to therapy, with topical and oral antibiotics regimens commonly used for rosacea generally being ineffective. The disease may easily go undiagnosed, as it mimics other more common skin conditions.

We present a case of originally undiagnosed Morbihan disease mistaken for an atypical allergic rash, resistant to treatment, and complicated by Dermatosis Neglecta.

http://ift.tt/2k36KQi

Aberrant tyrosinase expression in an atypical fibroxanthoma: a case report

Abstract

Atypical fibroxanthoma (AFX) is a histologic mimicker of a variety of spindle cell neoplasms and careful microscopic and immunohistochemical evaluation is critical in establishing the correct diagnosis. Here we report the histologic and immunohistochemical work-up of a 1 cm nodule involving the left dorsal hand of a 66-year-old patient. Light microscopy revealed fascicles of spindled and pleomorphic cells within the dermis demonstrating increased mitotic activity occurring in the background of sun-damaged skin. There were numerous multinucleated cells with hyperchromatic nuclei and ample finely vacuolated or foamy cytoplasms. There was strong and diffuse CD10 and focal CD68 expression amongst the spindled cells and multinucleated cells. The neoplastic cells did not demonstrate immunoreactivity against S100, p75-NGFR, HMB-45, or a panel of keratinocytic, vascular and smooth muscle markers. Tyrosinase and Melan-A were not expressed within the spindle cell component of this neoplasm, however there was tyrosinase expression amongst numerous multinucleated giant cells. Melan-A expression was also observed among rare multinucleated giant cells. Tyrosinase expression has not previously been reported in AFX.

http://ift.tt/2izHAbv

Metformin and Anti-Cancer Therapeutics: Hopes for a More Enhanced Armamentarium Against Human Neoplasias?

Metformin, a natural product from Galega officinalis, is an oral drug, now in the forefront of the therapeutic management of type-2 diabetes mellitus. A series of clinical observations of the last decades, support that metformin may contribute to lowering the risk of cancer development in diabetic patients, and also to improvement of response-to-therapy and survival in individuals with certain types of malignancies. Moreover, several preclinical in vitro and in vivo data indicate that metformin indeed exerts anti-proliferative capacities upon tumor cells mediated through a variety of mechanisms. Interestingly, metformin has been shown to act in synergy with certain anti-cancer agents and also to overcome chemo- and/or radio-resistance of various types of tumors, providing a hopeful rationale for novel therapeutic strategies against cancer development and progression. However, this remains an issue of controversy, since significant contradictions exist among the available data. Limitations of preclinical studies and caveats of epidemiological works, together with significant variances among the several types of cancer and the fact that the mode of metformin's action is largely unknown, make longitudinal surveys urgently needed. Now, a plethora of large clinical trials are active worldwide, aiming at determining the effect of metformin in the prevention or prognosis of a variety of human cancers. If encouraging results arise, metformin will be an attractive candidate adjuvant in the management of human neoplasias, due to its safety, tolerability and low-cost, expected to mitigate adverse effects and no-response parameters of current anti-cancer therapeutics, thus improving the quality of life and survival of cancer patients.

http://ift.tt/2jJ4BWj

Epigenetic Basis of Cancer Health Disparities: Looking Beyond Genetic Differences

Publication date: Available online 17 January 2017
Source:Biochimica et Biophysica Acta (BBA) - Reviews on Cancer
Author(s): Aamir Ahmad, Shafquat Azim, Haseeb Zubair, Mohammad Aslam Khan, Seema Singh, James E. Carter, Rodney Rocconi, Ajay P. Singh
Despite efforts at various levels, racial health disparities still exist in cancer patients. These inequalities in incidence and/or clinical outcome can only be explained by a multitude of factors, with genetic basis being one of them. Several investigations have provided convincing evidence to support epigenetic regulation of cancer-associated genes, which results in the differential transcriptome and proteome, and may be linked to a pre-disposition of individuals of certain race/ethnicity to early or more aggressive cancers. Recent technological advancements and the ability to quickly analyze whole genome have aided in these efforts, and owing to their relatively easy detection, methylation events are much well-characterized, than the acetylation events, across human populations. The early trend of investigating a pre-determined set of genes for differential epigenetic regulation is paving way for more unbiased screening. This review summarizes our current understanding of the epigenetic events that have been tied to the racial differences in cancer incidence and mortality. A better understanding of the epigenetics of racial diversity holds promise for the design and execution of novel strategies targeting the human epigenome for reducing the disparity gaps.



http://ift.tt/2jwXHWu

Measurement of immunofunctional leptin to detect and monitor patients with functional leptin deficiency

Context and aims

Functional leptin deficiency is characterized by high levels of circulating immunoreactive leptin (irLep), but a reduced bioactivity of the hormone due to defective receptor binding. As a result of the fact that affected patients can be successfully treated with metreleptin, it was aimed to develop and validate a diagnostic tool to detect functional leptin deficiency.

Methods

An immunoassay capable of recognizing the functionally relevant receptor-binding complex with leptin was developed (bioLep). The analytical quality of bioLep was validated and compared to a conventional assay for immune-reactive leptin (irLep). Its clinical relevance was evaluated in a cohort of lean and obese children and adults as well as in children diagnosed with functional leptin deficiency and their parents.

Results

In the clinical cohort, a bioLep/irLep ratio of 1.07 (range: 0.80–1.41) was observed. Serum of patients with non-functional leptin due to homozygous amino acid exchanges (D100Y or N103K) revealed high irLep but non-detectable bioLep levels. Upon treatment of these patients with metreleptin, irLep levels decreased, whereas levels of bioLep increased continuously. In patient relatives with heterozygous amino acid exchanges, a bioLep/irLep ratio of 0.52 (range: 0.48–0.55) being distinct from normal was observed.

Conclusions

The new bioLep assay is able to diagnose impaired leptin bioactivity in severely obese patients with a homozygous gene defect and in heterozygous carriers of such mutations. The assay serves as a diagnostic tool to monitor leptin bioactivity during treatment of these patients.

http://ift.tt/2jXgBTw

Isolated GNRH deficiency: genotypic and phenotypic characteristics of the genetically heterogeneous Greek population

http://ift.tt/2jv36xO

Efficient CRISPR/Cas9-assisted gene targeting enables rapid and precise genetic manipulation of mammalian neural stem cells [RESEARCH ARTICLE]

Raul Bardini Bressan, Pooran Singh Dewari, Maria Kalantzaki, Ester Gangoso, Mantas Matjusaitis, Claudia Garcia-Diaz, Carla Blin, Vivien Grant, Harry Bulstrode, Sabine Gogolok, William C. Skarnes, and Steven M. Pollard

Mammalian neural stem (NS) cell lines provide a tractable model for discovery across stem cell and developmental biology, regenerative medicine and neuroscience. They can be derived from foetal or adult germinal tissues and continuously propagated in vitro as adherent monolayers. NS cells are clonally expandable, genetically stable, and easily transfectable – experimental attributes compatible with targeted genetic manipulations. However, gene targeting – so critical for functional studies of embryonic stem cells – has not been exploited to date in NS cells. Here we deploy CRISPR/Cas technology to demonstrate a variety of sophisticated genetic modifications via gene targeting in both mouse and human NS cell lines, including: 1) efficient targeted transgene insertion at safe harbor loci (Rosa26 and AAVS1); 2) biallelic knockout of neurodevelopmental transcription factor genes; 3) simple knockin of epitope tags and fluorescent reporters (e.g. Sox2-V5 and Sox2-mCherry); and 4) engineering of glioma mutations (TP53 deletion; H3F3A point mutations). These resources and optimized methods enable facile and scalable genome editing in mammalian NS cells, providing significant new opportunities for functional genetic analysis.

http://ift.tt/2jINNPm

Teaching Communication Skills to Radiology Residents

Publication date: Available online 17 January 2017
Source:Current Problems in Diagnostic Radiology
Author(s): Jason N. Itri, Sammy Yacob, Ayman Mithqal
The transition of healthcare in the United States from volume to value requires a systems-based approach aligning clinical services across the continuum of care. The ability to communicate effectively and resolve conflict is a critical skill within the systems-based model. Recognizing the essential role of communication in medicine, the Accreditation Council of Graduate Medical Education has designated interpersonal and communication skills a core competency for all residents regardless of specialty. Yet communication skills are often developed through on the job training or not at all. Traditional educational curricula use a predominantly didactic approach without opportunities for trainees to observe, actively experiment, or reflect on what is learned as a part of the learning process. In this article, we describe 1-day experiential communication skills workshop customized for radiology residents that consists of Myers-Briggs Type Indicator (MBTI) and conflict management sessions designed to develop interpersonal, communication and conflict management skills through group discussion, role-play, and simulation. The purpose of this educational initiative was to determine the perceived value of an experiential communication skills workshop designed for radiology trainees.



http://ift.tt/2iNANcX

Expression Profiling-Based Clustering of Healthy Subjects Recapitulates Classifications Defined by Clinical Observation in Chinese Medicine

Publication date: Available online 17 January 2017
Source:Journal of Genetics and Genomics
Author(s): Ruoxi Yu, Dan Liu, Yin Yang, Yuanyuan Han, Lingru Li, Luyu Zheng, Donna May Winges, Ji Wang, Yan Zhang, Qian-Fei Wang, Qi Wang
Differences between healthy subjects and associated disease risks are of substantial interest in clinical medicine. Based on clinical presentations, Traditional Chinese Medicine (TCM) classifies healthy people into nine constitutions: Balanced, Qi, Yang or Yin deficiency, Phlegm-dampness, Damp-heat, Blood stasis, Qi stagnation, and Inherited special constitutions. In particular, Yang and Yin deficiency constitutions exhibit cold and heat aversion, respectively. However, the intrinsic molecular characteristics of unbalanced phenotypes remain unclear. To determine whether gene expression-based clustering can recapitulate TCM-based classification, peripheral blood mononuclear cells (PBMCs) were collected from Chinese Han individuals with Yang/Yin deficiency (n = 12 each) and Balanced (n = 8) constitutions, and global gene expression profiles were determined using the Affymetrix HG-U133A Plus 2.0 array. Notably, we found that gene expression-based classifications reflected distinct TCM-based subtypes. Consistent with the clinical observation that subjects with Yang deficiency tend toward obesity, series-clustering analysis detected several key lipid metabolic genes (diacylglycerol acyltransferase (DGAT2), acyl-CoA synthetase (ACSL1), and ATP-binding cassette subfamily A member 1 (ABCA1)) to be down- and up-regulated in Yin and Yang deficiency constitutions, respectively. Our findings suggest that Yin/Yang deficiency and Balanced constitutions are unique entities in their mRNA expression profiles. Moreover, the distinct physical and clinical characteristics of each unbalanced constitution can be explained, in part, by specific gene expression signatures.



http://ift.tt/2iNyiaB

Time of Flight Secondary Ion Mass Spectrometry (ToF-SIMS) enabled analysis of inter-polymer phases formation in poly (diaminonaphthalene) doped conducting poly (vinyl alcohol) films

Publication date: 10 February 2017
Source:Polymer, Volume 110
Author(s): Anil Kumar Bajpai, Rinkesh Bhatt
In the present work, polymerization of monomer diaminonaphthalene (DAN) was carried out inside the poly (vinyl alcohol) (PVA) film that resulted in the formation of multi inter-phases of the two polymers. The presence of functional groups of the PVA and PDAN in the blend film was confirmed by the FTIR spectra. The formation of multi-interphases was further confirmed by the ToF-SIMS technique. The positive ion beam spectra of the prepared polymer matrix provided insights about the morphology of the top most layer and the interphases layers developed within the polymer blend film. The formation of multi inter-phases offered potential in designing bulk hetero-junction semiconductor structures.

Graphical abstract

http://ift.tt/2izm075

Conductive poly(high internal phase emulsion) foams incorporated with polydopamine-coated carbon nanotubes

Publication date: 10 February 2017
Source:Polymer, Volume 110
Author(s): Haseung Kim, Kyung Hyun Ahn, Seong Jae Lee
Electrically conductive poly(high internal phase emulsion) (polyHIPE) nanocomposite foams based on poly(styrene-co-divinylbenzene) were prepared by incorporating polydopamine-coated carbon nanotubes (PDA-CNTs). Conductive yet amphiphobic CNTs were modified to PDA-CNTs by coating with PDA on the surface of CNTs to provide hydrophilicity. As a result, it was possible to prepare highly stable HIPEs having PDA-CNT content >10 wt% and resultant polyHIPE foams having enhanced conductivity due to the good dispersion of PDA-CNTs in aqueous phase. The foams made with a water-to-monomer ratio of 10:1 showed well-developed interconnected microcellular structure. With increasing PDA-CNT content, the yield stress and storage modulus of HIPE increased and the cell size of the polyHIPE foam decreased. The electrical percolation threshold was determined to be less than PDA-CNT 1 wt% and the conductivity at PDA-CNT content of 8 wt% was increased to as high as 10⁻² Sm⁻¹. Surface modification of CNTs by PDA was very effective in providing electrical conductivity due to their stable dispersion in aqueous phase while keeping the intrinsic properties of CNTs intact.

Graphical abstract

http://ift.tt/2izuQBy

Layer structure by shear-induced crystallization and thermal mechanical properties of injection-molded poly(l-lactide) with nucleating agents

Publication date: 10 February 2017
Source:Polymer, Volume 110
Author(s): Xu-Long Xie, Zi-Hong Sang, Jia-Zhuang Xu, Gan-Ji Zhong, Zhong-Ming Li, Xu Ji, Ruyin Wang, Ling Xu
A unique oscillation shear injection molding was utilized to investigate the crystallization of poly (l-lactide) (PLLA) under the coexistence of an intense shear flow and nucleating agents. The crystalline morphology and its distribution of injection-molded PLLA were probed by wide-angle X-ray diffraction, showing that an intense shear flow promotes the crystallization significantly, whereas the nucleation effect by nucleating agents is negligible. Additionally, applying an intense shear flow during injection molding processing at a low mold temperature makes PLLA form a crystalline layer structure, including skin, intermediate and core layers. Meanwhile, nucleating agents were found to play different roles in the crystallization of injection-molded PLLA under different processing conditions. The results of thermal mechanical property and Vicat softening temperature show the injection-molded PLLA sample with a thick crystalline layer structure has a greatly enhanced heat resistance property.

Graphical abstract

http://ift.tt/2izvVcS

Acute effect of exercise intensity and duration on acylated ghrelin and hunger in men

Acute exercise transiently suppresses the orexigenic gut hormone acylated ghrelin, but the extent to which exercise intensity and duration determine this response is not fully understood. The effects of manipulating exercise intensity and duration on acylated ghrelin concentrations and hunger were examined in two experiments. In experiment one, nine healthy males completed three, 4-h conditions (control, moderate-intensity running (MOD) and vigorous-intensity running (VIG)), with an energy expenditure of ~2.5 MJ induced in both MOD (55-min running at 52% peak oxygen uptake (V.O_2peak)) and VIG (36-min running at 75% V.O_2peak). In experiment two, nine healthy males completed three, 9-h conditions (control, 45-min running (EX45) and 90-min running (EX90)). Exercise was performed at 70% V.O_2peak. In both experiments, participants consumed standardised meals, and acylated ghrelin concentrations and hunger were quantified at predetermined intervals. In experiment one, delta acylated ghrelin concentrations were lower than control in MOD (ES = 0.44, P = 0.01) and VIG (ES = 0.98, P < 0.001); VIG was lower than MOD (ES = 0.54, P = 0.003). Hunger ratings were similar across the conditions (P = 0.35). In experiment two, delta acylated ghrelin concentrations were lower than control in EX45 (ES = 0.77, P < 0.001) and EX90 (ES = 0.68, P < 0.001); EX45 and EX90 were similar (ES = 0.09, P = 0.55). Hunger ratings were lower than control in EX45 (ES = 0.20, P = 0.01) and EX90 (ES = 0.27, P = 0.001); EX45 and EX90 were similar (ES = 0.07, P = 0.34). Hunger and delta acylated ghrelin concentrations remained suppressed at 1.5 h in EX90 but not EX45. In conclusion, exercise intensity, and to a lesser extent duration, are determinants of the acylated ghrelin response to acute exercise.

http://ift.tt/2jv1C6D

Keratosis Obturans: A Disease of the Tropics?

Abstract

Keratosis obturans appears to be an obscure and relatively uncommon entity, even in literature search of journals and reference texts, so much so that there is not even any prevalence or incidence statistics available. However, the condition did not appear to be as uncommon based on our clinical observations. We have managed to obtain 64 patients representing 67 ears with keratosis obturans in our study period of about 18 months with a pattern of occurrence during this period. Humid weather seemed to play a role in the frequency of its appearance during certain period in our observation. There also appears to be a correlation between the severity of symptoms (predominantly pain and hearing loss) and the presenting appearance of the condition, i.e., presence or absence of granulation tissue, as well as that the degree of difficulty in exenteration of the keratosis obturans (matrix and content) depending on the expansion of the bony canal. Our figures showed the majority of the patients are females and young individuals, the majority of them occur unilaterally. The condition also appear to stop short of involving the tympanic membrane with only the bony canal being expanded with the surrounding oedema creating an apparent "canal stenosis".

http://ift.tt/2iKfR6m

Outcomes of Newborn Hearing Screening Program: A Hospital Based Study

Abstract

Hearing loss is hidden disability and second most common congenital pathology. Prevention, early identification and early intervention of hearing loss can prevent further disability in development of speech, language, cognition and other developmental domains. The prevalence of congenital hearing loss has been estimated to be 1.2–5.7 per thousand in neonates. In these contexts, the aim of study was to determine outcomes of neonates hearing screening program in Hospital. It is a clinical cross-sectional study which was conducted in tertiary care centre from 8th July, 2015 to 31th May, 2016. Total no of 2254 cases were screened. Details case history including high risk register, Pediatric Audiometry, Otoacoustic Emission tests were performed followed brainstem evoked response audiometry. The Prevalence of hearing loss among high risk babies confirmation by BERA was 8.8% per 1000 babies and 16 cases were recommended for Cochlear Implant. The screening protocol with objective test i.e. Distortion Product Otoacoustic Emission and confirmation by Brainstem Evoked Response Audiometry is very useful tool in early identification of congenital hearing loss in neonates. Hence, the results of this study will be used to initiate universal newborn hearing screening in other hospitals. Moreover, this study highlights the relevance of neonatal hearing screening in other states of India and country where this screening is not performed routinely in all hospitals and creating awareness to identify neonatal risk factors associated with hearing loss and understand the importance of early identification and early intervention and among health care professionals.

http://ift.tt/2jGfTdS

Role of Topical Medication in Prevention of Post-extubation Subglottic Stenosis

Abstract

Iatrogenic laryngotracheal injury is the most serious complication of endotracheal intubation since this method of establishing airway was first described by Eugene Bouchut in 1858. Even today, subglottic stenosis is the most dreaded complication of intubation. This animal study is focused on the host tissue response to intubation induced injury resulting in subglottic stenosis and methods to prevent this complication. To assess the role of topically applied Mitomycin-C and Triamcinolone Acetonide in wound healing process following post-extubation subglottic injury. Prospective Randomized block, single-blinded, experimental study. Forty New-Zealand white rabbits where block randomized and allocated into 4 groups based on the type of topical medication that was applied post-extubation. Further these groups where subdivided into 3 subgroups based on the time of sacrifice (4, 6 and 12 weeks) to study the histopathological changes that occurred in a temporal sequence at the subglottis. It was observed that the rabbits in the control group and those that received Mitomycin-C only had more respiratory distress compared to those treated with Triamcinolone Acetonide. Statistically significant histopathological changes were observed in all the 4 groups. Mitomycin-C applied topically did not alter the wound healing process following post-extubation injury in the subglottis. Triamcinolone Acetonide significantly altered wound healing in the subglottis and prevented occurrence of respiratory distress.

http://ift.tt/2iMiPrg

Keratosis Obturans: A Disease of the Tropics?

Abstract

Keratosis obturans appears to be an obscure and relatively uncommon entity, even in literature search of journals and reference texts, so much so that there is not even any prevalence or incidence statistics available. However, the condition did not appear to be as uncommon based on our clinical observations. We have managed to obtain 64 patients representing 67 ears with keratosis obturans in our study period of about 18 months with a pattern of occurrence during this period. Humid weather seemed to play a role in the frequency of its appearance during certain period in our observation. There also appears to be a correlation between the severity of symptoms (predominantly pain and hearing loss) and the presenting appearance of the condition, i.e., presence or absence of granulation tissue, as well as that the degree of difficulty in exenteration of the keratosis obturans (matrix and content) depending on the expansion of the bony canal. Our figures showed the majority of the patients are females and young individuals, the majority of them occur unilaterally. The condition also appear to stop short of involving the tympanic membrane with only the bony canal being expanded with the surrounding oedema creating an apparent "canal stenosis".

http://ift.tt/2iKfR6m

Outcomes of Newborn Hearing Screening Program: A Hospital Based Study

Abstract

Hearing loss is hidden disability and second most common congenital pathology. Prevention, early identification and early intervention of hearing loss can prevent further disability in development of speech, language, cognition and other developmental domains. The prevalence of congenital hearing loss has been estimated to be 1.2–5.7 per thousand in neonates. In these contexts, the aim of study was to determine outcomes of neonates hearing screening program in Hospital. It is a clinical cross-sectional study which was conducted in tertiary care centre from 8th July, 2015 to 31th May, 2016. Total no of 2254 cases were screened. Details case history including high risk register, Pediatric Audiometry, Otoacoustic Emission tests were performed followed brainstem evoked response audiometry. The Prevalence of hearing loss among high risk babies confirmation by BERA was 8.8% per 1000 babies and 16 cases were recommended for Cochlear Implant. The screening protocol with objective test i.e. Distortion Product Otoacoustic Emission and confirmation by Brainstem Evoked Response Audiometry is very useful tool in early identification of congenital hearing loss in neonates. Hence, the results of this study will be used to initiate universal newborn hearing screening in other hospitals. Moreover, this study highlights the relevance of neonatal hearing screening in other states of India and country where this screening is not performed routinely in all hospitals and creating awareness to identify neonatal risk factors associated with hearing loss and understand the importance of early identification and early intervention and among health care professionals.

http://ift.tt/2jGfTdS

Role of Topical Medication in Prevention of Post-extubation Subglottic Stenosis

Abstract

Iatrogenic laryngotracheal injury is the most serious complication of endotracheal intubation since this method of establishing airway was first described by Eugene Bouchut in 1858. Even today, subglottic stenosis is the most dreaded complication of intubation. This animal study is focused on the host tissue response to intubation induced injury resulting in subglottic stenosis and methods to prevent this complication. To assess the role of topically applied Mitomycin-C and Triamcinolone Acetonide in wound healing process following post-extubation subglottic injury. Prospective Randomized block, single-blinded, experimental study. Forty New-Zealand white rabbits where block randomized and allocated into 4 groups based on the type of topical medication that was applied post-extubation. Further these groups where subdivided into 3 subgroups based on the time of sacrifice (4, 6 and 12 weeks) to study the histopathological changes that occurred in a temporal sequence at the subglottis. It was observed that the rabbits in the control group and those that received Mitomycin-C only had more respiratory distress compared to those treated with Triamcinolone Acetonide. Statistically significant histopathological changes were observed in all the 4 groups. Mitomycin-C applied topically did not alter the wound healing process following post-extubation injury in the subglottis. Triamcinolone Acetonide significantly altered wound healing in the subglottis and prevented occurrence of respiratory distress.

http://ift.tt/2iMiPrg

Modeling Responses in the Superior Paraolivary Nucleus: Implications for Forward Masking in the Inferior Colliculus

Abstract

A phenomenological model of the responses of neurons in the superior paraolivary nucleus (SPON) of the rodent is presented in this study. Pure tones at the characteristic frequency (CF) and broadband noise stimuli evoke offset-type responses in these neurons. SPON neurons also phase-lock to the envelope of sinusoidally amplitude-modulated (SAM) stimuli for a range of modulation frequencies. Model SPON neuron received inhibitory input that was relayed by the ipsilateral medial nucleus of the trapezoid body from the contralateral model ventral cochlear nucleus neuron. The SPON model response was simulated by detecting the slope of its inhibitory postsynaptic potential. Responses of the proposed model to pure tones at CF and broadband noise were offset-type independent of the duration of the input stimulus. SPON model responses were also synchronized to the envelope of SAM stimuli with precise timing for a range of modulation frequencies. Modulation transfer functions (MTFs) obtained from the model response to SAM stimuli resemble the physiological MTFs. The output of the proposed SPON model provides an input for models of physiological responses at higher levels of the ascending auditory pathway and can also be utilized to infer possible mechanisms underlying gap detection and duration encoding as well as forward masking at the level of the auditory midbrain.

http://ift.tt/2j7emNu

Tumid lupus: An unexpected diagnosis for the otolaryngologist

Tumid lupus is an uncommon variant of lupus erythematosus. Patients present with subcutaneous lesions. Ophthalmic literature reports disease manifestation as orbital inflammation. Autoimmune serology is often negative. Without a high index of suspicion, the diagnosis is easily overlooked delaying treatment. Tumid lupus is not significantly discussed in the Otolaryngologic literature. Here we present a Case Report of a male who initially presented to Ophthalmology with unilateral orbital complaint of eyelid puffiness.

http://ift.tt/2juqSdp

Tumid lupus: An unexpected diagnosis for the otolaryngologist

Tumid lupus is an uncommon variant of lupus erythematosus. Patients present with subcutaneous lesions. Ophthalmic literature reports disease manifestation as orbital inflammation. Autoimmune serology is often negative. Without a high index of suspicion, the diagnosis is easily overlooked delaying treatment. Tumid lupus is not significantly discussed in the Otolaryngologic literature. Here we present a Case Report of a male who initially presented to Ophthalmology with unilateral orbital complaint of eyelid puffiness.

http://ift.tt/2juqSdp

Modeling Responses in the Superior Paraolivary Nucleus: Implications for Forward Masking in the Inferior Colliculus

Abstract

A phenomenological model of the responses of neurons in the superior paraolivary nucleus (SPON) of the rodent is presented in this study. Pure tones at the characteristic frequency (CF) and broadband noise stimuli evoke offset-type responses in these neurons. SPON neurons also phase-lock to the envelope of sinusoidally amplitude-modulated (SAM) stimuli for a range of modulation frequencies. Model SPON neuron received inhibitory input that was relayed by the ipsilateral medial nucleus of the trapezoid body from the contralateral model ventral cochlear nucleus neuron. The SPON model response was simulated by detecting the slope of its inhibitory postsynaptic potential. Responses of the proposed model to pure tones at CF and broadband noise were offset-type independent of the duration of the input stimulus. SPON model responses were also synchronized to the envelope of SAM stimuli with precise timing for a range of modulation frequencies. Modulation transfer functions (MTFs) obtained from the model response to SAM stimuli resemble the physiological MTFs. The output of the proposed SPON model provides an input for models of physiological responses at higher levels of the ascending auditory pathway and can also be utilized to infer possible mechanisms underlying gap detection and duration encoding as well as forward masking at the level of the auditory midbrain.

http://ift.tt/2j7emNu

Modeling Responses in the Superior Paraolivary Nucleus: Implications for Forward Masking in the Inferior Colliculus

Abstract

A phenomenological model of the responses of neurons in the superior paraolivary nucleus (SPON) of the rodent is presented in this study. Pure tones at the characteristic frequency (CF) and broadband noise stimuli evoke offset-type responses in these neurons. SPON neurons also phase-lock to the envelope of sinusoidally amplitude-modulated (SAM) stimuli for a range of modulation frequencies. Model SPON neuron received inhibitory input that was relayed by the ipsilateral medial nucleus of the trapezoid body from the contralateral model ventral cochlear nucleus neuron. The SPON model response was simulated by detecting the slope of its inhibitory postsynaptic potential. Responses of the proposed model to pure tones at CF and broadband noise were offset-type independent of the duration of the input stimulus. SPON model responses were also synchronized to the envelope of SAM stimuli with precise timing for a range of modulation frequencies. Modulation transfer functions (MTFs) obtained from the model response to SAM stimuli resemble the physiological MTFs. The output of the proposed SPON model provides an input for models of physiological responses at higher levels of the ascending auditory pathway and can also be utilized to infer possible mechanisms underlying gap detection and duration encoding as well as forward masking at the level of the auditory midbrain.

http://ift.tt/2j7emNu

Strain Elastography as a New Method for Assessing Pelvic Floor Biomechanics

Publication date: Available online 17 January 2017
Source:Ultrasound in Medicine & Biology
Author(s): Jana Marie Kreutzkamp, Sebastian Daniel Schäfer, Susanne Amler, Felix Strube, Ludwig Kiesel, Ralf Schmitz
Strain elastography (SE) is a new technique of parametric imaging that allows quantification of the elasticity of tissue. The aim of our study was to determine if the elasticity of para-urethral tissue correlates with urethral mobility and urinary incontinence (UI). Ninety-nine unselected women were investigated with SE. They were given a standardized interview about UI, and SE raw data for the para-urethral tissue were acquired in a sagittal standard urethra-symphysis view while being stimulated by a coughing fit. We placed one region of interest (ROI A) in the tissue between the urethra and vagina at midlevel of the urethra bordering the urethral wall. The second ROI (ROI B) was set at the level of the os urethra internum in the tissue of the bladder neck in one line to ROI A. We measured elasticity in both ROIs with TDI-Q (Tissue Doppler Imaging-Quantification Software) and calculated the ratio between ROI A and ROI B (A/B). Mobility of the urethra was quantified by measuring the angle between a line parallel to the urethra and a line parallel to the bladder neck during stress and rest. SE analysis was feasible in all cases. A/B was found to be correlated with the incidence of urethral mobility (p < 0.001). The incidence of UI was associated with an increase in urethral mobility (p = 0.04). No correlation between UI and A/B could be shown (p = 0.24). We observed a correlation between urethral mobility and elasticity of the para-urethral tissue. In case of increasing urethral mobility, the para-urethral tissue close to the bladder neck seems to be more elastic, and the patients reported about more symptoms of UI. No noticeable correlation between UI and urethral elasticity was shown. SE may be a useful technique for direct quantification of tissue elasticity and assessment of pelvic floor biomechanics.



http://ift.tt/2jIdn6U

Ecoceramics

Publication date: Available online 17 January 2017
Source:Materials Today
Author(s): Robert C. Pullar, Rui M. Novais




http://ift.tt/2iMVfuq

Diagnostic Accuracy of Transabdominal Ultrasound in Chronic Pancreatitis

Publication date: Available online 17 January 2017
Source:Ultrasound in Medicine & Biology
Author(s): Trond Engjom, Dag A. Sangnes, Roald F. Havre, Friedemann Erchinger, Khanh Do-Cong Pham, Ingfrid S. Haldorsen, Odd H. Gilja, Georg Dimcevski
The performance of transabdominal ultrasound (US) in chronic pancreatitis (CP) following the advances in US technology made during recent decades has not been explored. Our aim in this prospective study was to evaluate the diagnostic accuracy of modern abdominal US compared with the Mayo score in CP. One hundred thirty-four patients referred for suspected CP were included in the study. Fifty-four patients were assigned the diagnosis CP. After inclusion, transabdominal US was performed. Ductal features (calculi, dilations and caliber variations, side-branch dilations and hyper-echoic duct wall margins) and parenchymal features (calcifications, cysts, hyper-echoic foci, stranding, lobulation and honeycombing) were recorded. Features were counted and scored according to a weighting system defined at the international consensus meeting in Rosemont, Illinois (Rosemont score). Diagnostic performance indices (95% confidence interval) of US were calculated: The unweighted count of features had a sensitivity of 0.69 (0.54–0.80) and specificity of 0.97 (0.90–1). The Rosemont score had a sensitivity of 0.81 (0.69–0.91) and specificity of 0.97 (0.90–1). Exocrine pancreatic failure was most pronounced in Rosemont groups I and II (p < 0.001). We conclude that using both unweighted and weighted scores, the diagnostic accuracy of modern transabdominal US is good. The extent of pancreatic changes detected by the method is correlated with exocrine pancreatic function.



http://ift.tt/2k2KgP7

Unit cost analysis of pet-ct at an apex public sector health care institute in India

SH Gajuryal, A Daga, V Siddharth, CS Bal, S Satpathy

Indian Journal of Nuclear Medicine 2017 32(1):1-6

Context: PET/CT scan service is one of the capital intensive and revenue-generating centres of a tertiary care hospital. The cost associated with the provisioning of PET services is dependent upon the unit costs of the resources consumed. Aims: The study aims to determine the cost of providing PET/CT Scan services in a hospital. Methods and Material: This descriptive and observational study was conducted in the Department of Nuclear Medicine at a tertiary apex teaching hospital in New Delhi, India in the year 2014-15. Traditional costing methodology was used for calculating the unit cost of PET/CT scan service. The cost was calculated under two heads that is capital and operating cost. Annualized cost of capital assets was calculated using methodology prescribed by WHO and operating costs was taken on an actual basis. Results: Average number of PET/CT scan performed in a day is 30. The annual cost of providing PET/CT scan services was calculated to be 65,311,719 Indian Rupees (INR) (US$ 1,020,496), while the unit cost of PET scan was calculated to be 9625.92 INR (US$ 150). 3/4th cost was spent on machinery and equipment (75.3%) followed by healthcare personnel (11.37%), electricity (5%), consumables and supplies (4%) engineering maintenance (3.24%), building, furniture and HVAC capital cost (0.76%), and manifold cost (0.05%). Of the total cost, 76% was capital cost while the remaining was operating cost. Conclusions: Total cost for establishing PET/CT scan facility with cyclotron and chemistry module and PET/CT scan without cyclotron and chemistry module was calculated to be INR 610,873,517 (US$9944899) and 226,745,158 (US$3542893), respectively. (US$ 1=INR 64)

http://ift.tt/2jIhBvD

Tc-99m sulfur colloid lymphoscintigraphy with single-photon emission computed tomography/computed tomography in a case of acquired vulval lymphangiomas

Shruti Tulsyan, Madhavi Tripathi, Kalpa Das, Divya Yadav, Shamim Ahmed Shamim, Nishikant Damle, Chandrasekhar Bal

Indian Journal of Nuclear Medicine 2017 32(1):73-74

We describe the lymphoscintigraphy findings of a 25-year-old female patient who was undergoing presurgical workup for lymphangiomas of the vulva. She had a history of treatment for disseminated tuberculosis 6 years back and presented with herpetiform oozing vesicles in the external genitalia. Single-photon emission computed tomography/computed tomography (SPECT/CT) confirmed cutaneous tracer accumulation in the vulval lesions and demonstrated the presence of densely calcified inguinal nodes secondary to healed tuberculosis as the etiology of secondary lymphangioma.

http://ift.tt/2jIfOGF

Radio-adaptive response in myocardial perfusion imaging induced by technetium-99m

Mohammad Mehdi Shirazi, Ali Shabestani-Monfared, Maryam Shahidi, Mehrangiz Amiri, Seyed Mohammad Abedi, Sajad Borzoueisileh, Kourosh Ebrahim Nejad Gorji

Indian Journal of Nuclear Medicine 2017 32(1):7-10

Purpose of the Study: Low dose radiation will induce adaptation and following exposure to an adaptive dose, the cells are more resistance to following challenging doses. This phenomenon is known as radio-adaptive response. The aim of this study was to investigate the percentage of apoptotic cells in the peripheral blood samples of the patients which undergo myocardial perfusion imaging (MPI) with technetium-99m (Tc-99m) before thallium scan to assess the induction of radio-adaptive response. Materials and Methods: In this study, 97 samples from 74 patients, referred to nuclear medicine center of Mazandaran Heart Hospital for MPI, which had no history of diagnostic, therapeutic, occupational, and radioactive exposures during past 2 years, were provided. The participants were classified into four groups including control, patients which were scanned solely with technetium, the patients which examined by thallium and the last group were the patients that examined by technetium followed by thallium. Then 2 ml Peripheral blood samples were obtained, and after 24 h incubating, the samples were studied by neutral comet assay. Statistical analysis was carried out using Student's t-test along with one-way analysis of variance. Results: The mean percentage of apoptotic cells in the exposed groups were higher than the control. Furthermore, among exposed groups, the apoptotic cells in thallium group were more than others and this index was significantly lower in the group which was undergone technetium administration before thallium scan. Conclusions: These findings suggest that exposure to Tc-99m could induce a radio-adaptive response against the exposure of thallium-201.

http://ift.tt/2k2PE51

Somatostatin receptor spect/ct using 99mTc labeled hynic-toc aids in diagnosis of primary optic nerve sheath meningioma

Piyush Chandra, Nilendu Purandare, Sneha Shah, Archi Agrawal, Venkatesh Rangarajan

Indian Journal of Nuclear Medicine 2017 32(1):63-65

Primary optic nerve sheath meningiomas (ONSM) are rare, benign and slow growing tumor involving the intra-orbital/intra-canalicular segment of the optic nerve. Untreated, they can potentially lead to visual deterioration. Magnetic resonance (MR) is the gold standard imaging modality for diagnosing the entity. Often, a clinical dilemma exists to narrow the differential diagnosis of an enhancing intra-orbital mass on MR. Molecular imaging provides a high degree of precision in diagnosing meningioma in view of relatively high levels of somatostatin receptor expression by these tumors. The following case demonstrates the potential clinical utility of somatostatin receptor SPECT using 99mTc- labeled HYNIC-TOC in clinical diagnosis of ONSM.

http://ift.tt/2jIjCI3

Specificity of 68Ga-PSMA PET/CT for prostate cancer - myths and reality

Arun Sasikumar

Indian Journal of Nuclear Medicine 2017 32(1):11-12

68Ga-PSMA ligand PET/CT for imaging prostate cancer is a novel imaging technique, which is rapidly gaining popularity. Sufficient evidence has been accumulated in literature regarding the usefulness of 68Ga-PSMA PET/CT in prostate cancer. Recently literature regarding the localization of 68Ga-PSMA PET/CT imaging in non-prostatic malignancies is also published, thus questioning the specificity of the tracer with regards to prostate cancer. This commentary tries to address the issue of specificity of 68Ga-PSMA PET/CT and its relevance in imaging prostate cancer.

http://ift.tt/2k2GKEC

Subependymal spread of glioblastoma multiforme in positron emission tomography/computed tomography

Agostino Chiaravalloti, Orazio Schillaci, Pasqualina Sannino

Indian Journal of Nuclear Medicine 2017 32(1):81-82



http://ift.tt/2jI1XA6

Rare sites of metastases in prostate cancer detected on ga-68 psma pet/ct scan—a case series

Sugandha Dureja, Parul Thakral, Vineet Pant, Ishita Sen

Indian Journal of Nuclear Medicine 2017 32(1):13-15

Ga-68 labeled prostate-specific membrane antigen (PSMA) whole body PET/CT scan is a novel upcoming modality for the evaluation of prostate cancer. We present three cases of prostate cancer showing rare sites of metastases like brain, penis, and liver detected on Ga-68 PSMA PET/CT scan thus emphasizing its role in lesion detection and staging.

http://ift.tt/2k2zSXF

Ocular granulocytic sarcoma as an initial clinical presentation of acute myeloid leukemia identified on flurodeoxyglucose positron emission tomography/computed tomography

Piyush Chandra, Nilendu Purandare, Sneha Shah, Archi Agrawal, Venkatesh Rangarajan

Indian Journal of Nuclear Medicine 2017 32(1):59-60

Granulocytic sarcoma (GS) or chloroma, rare extramedullary manifestation of acute myeloid leukemia and not infrequently, can be presenting clinical feature. Multiple studies have demonstrated the clinical utility of fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in early detection and follow-up assessment of GS after chemotherapy. Commonly involved areas include bones, lymph nodes, breasts, and skin and not uncommonly, the disease can be multifocal. We present a rare case of ocular GS, where FDG-PET/CT in addition to the identifying the ocular mass, revealed multiple clinically occult extramedullary lesions.

http://ift.tt/2jIfFD3

Intracranial leptomeningeal carcinomatosis in three cases from breast cancer demonstrated on f-18 fluorodeoxyglucose positron emission tomography/computerized tomography

Hulya Ortapamuk, Mustafa Kemal Demir

Indian Journal of Nuclear Medicine 2017 32(1):16-18

Leptomeningeal carcinomatosis (LC) is an uncommon late manifestation of non-central nervous system (CNS) solid tumors. With prolonged survival in solid tumors, an increased frequency of metastases is noted in these tumors too. The detection of tumor cells in the cerebrospinal fluid remains the gold standard. Noninvasively, magnetic resonance imaging is frequently used for the diagnosis of LC. Although its low sensitivity of F-18 fluorodeoxyglucose positron emission tomography/computerized tomography (F-18 FDG PET/CT) on demonstrating CNS lesions, it could be useful in identifying the possibility of LC of breast carcinoma by giving high attention to the meninges. We discuss here three cases all of them having intracranial LC; where 18F-FDG PET/CT study helped us in the diagnosis of LC. To our knowledge, this is the second report about intracranial LC from breast cancer demonstrating on 18F-FDG PET/CT.

http://ift.tt/2k2Mxdi

“Drop” metastases from an operated case of intracranial anaplastic ependymoma identified on fluoro-2-deoxyglucose positron emission tomography/computed tomography

Piyush Chandra, Nilendu Purandare, Sneha Shah, Archi Agrawal, Venkatesh Rangarajan

Indian Journal of Nuclear Medicine 2017 32(1):68-70

The seeding of tumor through cerebrospinal fluid (CSF) from primary intracranial tumors is very rare, often goes undetected, and is usually identified only on autopsy. CSF cytology along with magnetic resonance imaging constitutes the standard approach of diagnosing this grave condition. Use of fluoro-2-deoxyglucose positron emission tomography/computed tomography (PET/CT) in indentifying spinal metastases from primary intracranial malignancies is very limited and has been reported in patients with metastatic glioblastoma multiforme and medulloblastomas. We present a rare case of metastatic anaplastic ependymoma to show the potentially clinically utility of PET/CT in diagnosing leptomeningeal or the so-called "drop" metastases.

http://ift.tt/2jIkuML

Radioactive iodine-131 as a definitive treatment in rare association of down syndrome with hyperthyroidism: A case report and review of literature

Shoukat H Khan, Aditya Mahajan, Tanveer A Rather

Indian Journal of Nuclear Medicine 2017 32(1):19-24

Down syndrome characterized by trisomy of chromosome 21 is frequently associated with thyroid dysfunctions due to underlying autoimmune disorders. Hypothyroidism is the commonest thyroid dysfunction and hyperthyroidism, usually Graves' disease, is far less common. On literature review, we came across approximately 112 cases reported so far with the first such case report in 1946. The published data from India on hyperthyroidism in Down syndrome is of three case reports. We report one such patient, an adult male of 28 years who was administered Iodine-131 as a definitive treatment after 9-10 years of initial diagnosis.

http://ift.tt/2juxyZ2

18F-FDG pet/ct/mri fusion images showing cranial and peripheral nerve involvement in neurolymphomatosis

Ana Carolina Trevisan, Fernanda Borges Ribeiro, Emerson Nobuyuki Itikawa, Leonardo Santos Alexandre, Felipe Arriva Pitella, Antonio Carlos Santos, Belinda Pinto Simões, Lauro Wichert-Ana

Indian Journal of Nuclear Medicine 2017 32(1):77-78

We report a 56-year-old female patient with non-Hodgkin's diffuse large B cell lymphoma (NHL) who, on magnetic resonance imaging (MRI) with a T1 weighted and gadolinium-enhanced imaging, was found to have thickening and infiltration in 75% of peripheral nerves of the patient and enlargements of cranial nerves, possibly related to lymphomatous infiltration. Subsequent positron emission tomography/computed tomography (PET/CT) using 18F-labeled 2-deoxy-2-fluoro-d-glucose (18F-FDG) showed widespread active involvement of the cervical plexus, bilateral peripheral nerves, right femoral nerve, the parasellar region of the skull, and marked hypermetabolism in the left trigeminal ganglia. This case re-emphasizes that while CT and MRI provide anatomical details, 18F-FDG PET/CT images better delineate the metabolic activity of neurolymphomatosis (NL) in the peripheral and central nervous system.

http://ift.tt/2k2JEJj

Hypothyroidism in mccune–albright syndrome and role of bone scan in management of fibrous dysplasia: An unusual case scenario with review of literature

Narvesh Kumar, Subhash Chand Kheruka, Rani Kunti R Singh, Mudalsha Ravina, Deepanksha Dutta, Sanjay Gambhir

Indian Journal of Nuclear Medicine 2017 32(1):25-29

The McCune–Albright syndrome (MAS) is a triad of café-au-lait skin pigmentation, precocious puberty (PP), and polyostotic fibrous dysplasia of bone (FD). In general, FD seems to be the most common component of MAS but very rarely precocious puberty can be found in association with café-au-lait skin pigmentation in the absence of FD (about 1% of the cases). Therefore, a more clinically relevant definition of MAS is fibrous dysplasia of bone (FD) and at least one of the typical hyperfunctioning endocrinopathy and/or café-au-lait spots, with almost any combination possible. Bone scan can be the modality of choice to look for bone disease burden of fibrous dysplasia in most patients of MAS and may change the management accordingly. Most of the cases of MAS reported worldwide are associated with hyperthyroidism, up to best of our knowledge on the basis of literature search in pubmed and Google; no case was reported with hypothyroidism. Herein, we report a 12-year-old girl diagnosed with MAS and associated hypothyroidism.We have also reviewed the MAS related literature.

http://ift.tt/2jIexzh

Successful staging of synchronous gastric cancer and diffuse large b-cell lymphoma (dlbcl) using f-18-fluorodeoxyglucose positron emission tomography/computed tomography (fdg pet/ct) based on distinctive levels of metabolic activity between the two malignancies

Hossein Mehdikhani, Sherif Heiba

Indian Journal of Nuclear Medicine 2017 32(1):85-86



http://ift.tt/2k2JbqH

Hepatitis c virus-related arthritis: Bone scintigraphic appearances

Gul Ege Aktas, Ali Sarikaya, Ozan Kandemir

Indian Journal of Nuclear Medicine 2017 32(1):30-32

A symptomatic joint involvement and arthralgia are frequent in patients with chronic hepatitis C virus (HCV) infection. However, HCV infection-related arthritis (HCVrA) affects up to 4-11% of the subjects suffering from disease. We reported a patient with HCVrA presented with the commonly accepted diagnostic clinical signs and laboratory parameters. The painful joints distinctly demonstrated increased uptake of Tc-99 m methylene diphosphonate in scintigraphy and normal findings in radiography.

http://ift.tt/2jIpykv

Detection of thymoma on 99mtc mibi scintigraphy: Revisiting the past

Girish Kumar Parida, Shambo Guha Roy, Anshul Sharma, Chetan D Patel

Indian Journal of Nuclear Medicine 2017 32(1):57-58

Although thymoma is a rare tumor, it is the most common anterior mediastinal tumor, usually affecting the adults in their fifth and sixth decade. We present a case of 68-year-old man with history of myocardial infarction, who presented to the cardiology OPD with recent onset of exertional dyspnea. On 99mTc MIBI myocardial perfusion SPECT, there was an extra cardiac accumulation of radiotracer in the anterior mediastinum just above the heart, which later was diagnosed as thymoma on histopathology.

http://ift.tt/2k2NdiU

Incidentally detected agenesis of dorsal pancreas on pet/ct: Case report and review of literature

Rasika Kabnurkar, ML Rokade, Kalashree Bandekar, Nikhil Kamat

Indian Journal of Nuclear Medicine 2017 32(1):33-35

Agenesis of Dorsal Pancreas (ADP) is a rare congenital anomaly characterized by the absence of body and tail of pancreas. We report a case of incidentally detected ADP on Contrast Enhanced Computed Tomography (CECT) component of Fluorodeoxyglucose Positron Emission Tomography (FDG PET/CT) in a treated case of carcinoma (Ca) tongue with suspected local recurrence. Dependent Intestine Sign, hallmark of ADP on CECT imaging was noted in our patient.

http://ift.tt/2jIjIPU

Altered Metabolic Homeostasis between Vitamin D and Long Chain Polyunsaturated Fatty Acids in Preeclampsia

Publication date: Available online 17 January 2017
Source:Medical Hypotheses
Author(s): Anindita A. Nandi, Nisha S. Wadhwani, Sadhana R. Joshi
Sub-optimal maternal nutrition may result in pregnancy complications like preeclampsia. Preeclampsia is known to be of placental origin and a major cause of maternal morbidity and mortality worldwide. Our earlier studies suggest that altered metabolism of folic acid, vitamin B12 and long chain polyunsaturated fatty acid (LCPUFAs) in the one carbon cycle increases homocysteine levels in preeclampsia. Recent reports indicate that vitamin D deficiency may also have a role, although the mechanisms are unclear. A disturbed one carbon cycle can influence methylation patterns of various genes involved in placental development. Altered expression of cystathionine beta synthase (CBS) gene can result in hyperhomocystenemia. Higher homocysteine levels are known to increase reactive oxygen species (ROS) production which in turn leads to increased expression of phospholipase A2 (PLA2) and cyclooxygenase-2 (COX-2). Higher expression of PLA2 and COX-2 can influence the release of arachidonic acid (AA) from membrane phospholipid and result in increased conversion to thromboxane. Vitamin D [1,25(OH)2D3] is known to induce the CBS gene expression while it can suppress the oxidative stress-induced COX-2 up-regulation and thromboxane production. Based on this, we propose a novel hypothesis that a disturbed vitamin D and LCPUFA metabolism influence the regulation of the one carbon cycle which will trigger inflammation through oxidative stress in preeclampsia. This may lead to altered feto-placental growth and development in preeclampsia.



http://ift.tt/2iMW7Pw

Update on Aspirin-Exacerbated Respiratory Disease

Abstract

Aspirin-exacerbated respiratory disease (AERD) is an acquired disease characterized by chronic eosinophilic airway inflammation with underlying dysregulation of arachidonic acid metabolism. The purpose of this paper is to review the latest developments in our understanding of the underlying pathophysiology including the role of eosinophils, mast cells, innate lymphoid cells (ILC₂), and platelets. Clinical features such as respiratory reactions induced by alcohol, aggressive nasal polyposis, and anosmia will allow for earlier recognition of these patients in clinical practice. The current state of the art management of AERD will be addressed including the ongoing central role for aspirin desensitization and high-dose aspirin therapy.

http://ift.tt/2j5ukHL

Update on Aspirin-Exacerbated Respiratory Disease

Abstract

Aspirin-exacerbated respiratory disease (AERD) is an acquired disease characterized by chronic eosinophilic airway inflammation with underlying dysregulation of arachidonic acid metabolism. The purpose of this paper is to review the latest developments in our understanding of the underlying pathophysiology including the role of eosinophils, mast cells, innate lymphoid cells (ILC₂), and platelets. Clinical features such as respiratory reactions induced by alcohol, aggressive nasal polyposis, and anosmia will allow for earlier recognition of these patients in clinical practice. The current state of the art management of AERD will be addressed including the ongoing central role for aspirin desensitization and high-dose aspirin therapy.

http://ift.tt/2j5ukHL

Evaluation of the postoperative cognitive dysfunction in elderly patients with general anesthesia

OBJECTIVE: The present study is aimed to study the neuron-specific enolase (NSE) and S100b proteins in the evaluation of postoperative cognitive dysfunction in elderly patients with general anesthesia.

PATIENTS AND METHODS: A total of 142 aged patients, who were treated with transurethral resection of the prostate (TURP) surgery under general anesthesia with propofol from June 2014 to December 2015, were randomly divided into two groups. The experiment group was given scopolamine butylbromide by intramuscular injection before the operation, while the control group had no preoperative intramuscular injection. The propofol was used for maintenance during the operation. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales were adopted for testing the patients on preoperative day 1, postoperative day 2 and postoperative day 9. After the surgery, there were 4 cases of postoperative cognitive dysfunction (POCD) patients in experiment group, while 21 cases of POCD patients in control group. While the 142 healthy adult volunteers, who were admitted to physical examination center of our hospital in the corresponding period, were selected as healthy controls. The expression levels of S100b and NSE of patients, as well as healthy controls, were detected by ELISA.

RESULTS: In POCD patients, serum S100b and NSE levels were evidently higher than those of patients without POCD and healthy control group (p<0.05). S100b and NSE levels of POCD patients in experiment group were significantly lower than those of control group (p<0.05). Serum S100b and NSE levels are higher, the longer duration of POCD is, as the correlation coefficient rs=-0.1342, -1.6644, p<0.05.

CONCLUSIONS: The expression levels of S100b protein and plasma NSE in the serum of POCD patients increased, which indicated the severity of the disease. The preoperative intramuscular injection of scopolamine butylbromide has important clinical significance for the prevention of POCD.

L'articolo Evaluation of the postoperative cognitive dysfunction in elderly patients with general anesthesia sembra essere il primo su European Review.

http://ift.tt/2iHUO4l

Parameters From the Complete Phonatory Range of an Excised Rabbit Larynx

This study aims to collect data throughout the complete phonatory range using rabbit larynges.

http://ift.tt/2jls14c

Vocal Symptoms and Voice Quality in Children With Allergy and Asthma

The background for dysphonia is multifactorial, and health-related factors have been listed among the factors affecting voice. In previous studies with adult participants, allergy and asthma have been indicated to have a connection to vocal symptoms. With the majority of previous research being studies involving adult participants, it is unclear what the effect of allergy and asthma on children's voices is. The aim of this study was to investigate if allergies and asthma are risk factors for having vocal symptoms.

http://ift.tt/2iyFp8g

Cardiovascular and cerebrovascular events among patients receiving omalizumab: Pooled analysis of patient-level data from 25 randomized, double-blind, placebo-controlled clinical trials

Capsule summary: Among patients who participated in randomized clinical trials of omalizumab, no substantial overall increase in the risk of cardiovascular events was observed in the treatment arms compared with placebo. <<29/35 words>>

http://ift.tt/2iyTvGq

Tryptase-catalyzed core histone truncation: a novel epigenetic regulatory mechanism in mast cells

Tryptase is mainly implicated in events downstream of mast cell degranulation. Here we show that tryptase additionally has a role in intranuclear core histone processing, thereby affecting epigenetic regulation and cellular differentiation in mast cells.

http://ift.tt/2jWIOtz

CCSP Serum Level is A Surrogate Marker of Small Airway Involvment in Asthma

Serum CCSP level was independently related to small airway hyperresponsiveness, measured by the slope of air-trapping progression measured using CT. In asthmatic patients, this blood biomarker may identify small airways involvement.

http://ift.tt/2jWDYwq

Minimally-invasive middle fossa craniotomy approach with endoscopic repair of superior canal dehiscence

Publication date: Available online 17 January 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Elliott D. Kozin, Daniel J. Lee
Superior canal dehiscence (SCD) is a bony defect of the superior semicircular canal (SSC). SCD syndrome (SCDS) occurs when vestibular or auditory dysfunction accompanies SCD. While not all SCD patients are symptomatic, surgical repair is an option in patients with incapacitating symptoms and unresponsive to conservative treatment. Traditionally, repair of SCDS when involving the arcuate eminence can be achieved utilizing a middle fossa craniotomy (MFC) approach. However, approximately 30% of SCD cases have a medial arcuate eminence defect along a downsloping tegmen, making the defect difficult to visualize with the binocular microscope without a large craniotomy, extensive temporal lobe retraction and drilling of the skull base. As complete visualization of an arcuate eminence defect is essential for successful repair, we describe an operative approach to visualize the SCD that combines a small MFC and rigid angled endoscopy. The wide-field view and superior transillumination with skull base endoscopy can be achieved with a minimal access skin incision, small bony window, less dural dissection, reduced brain retraction, resulting in unequivocal identification of the entire arcuate eminence defect.



http://ift.tt/2jHZYfa

Posttraumatic stress disorder symptoms and attitudes about social support: Does shame matter?

Publication date: Available online 17 January 2017
Source:Journal of Anxiety Disorders
Author(s): Thomas S. Dodson, J. Gayle Beck
Considerable research has examined the association between posttraumatic stress disorder (PTSD) symptoms and social support. One facet of this relationship that deserves greater attention concerns trauma survivors' negative expectations towards social support, termed negative network orientation. To expand our understanding of negative network orientation, the current study examined shame as a possible mediator in the relationship between PTSD symptoms and negative network orientation, in a sample of 202 female survivors of intimate partner violence (IPV). Additionally, a history of child abuse (CA) was evaluated as a moderator of the association between shame and negative network orientation in this model. Path analyses indicated a significant indirect effect between PTSD symptoms and negative network orientation through shame, indicative of mediation. A history of CA moderated this effect, such that women with a history of CA in addition to IPV showed a significantly stronger relationship between PTSD symptoms and negative network orientation through shame, relative to women who only had a history of IPV. These findings support the relevance of shame in understanding the association between PTSD symptoms and negative beliefs about social support and highlight the role of childhood abuse as a moderator in this process among IPV survivors.



http://ift.tt/2iMpXDW

Keratosis Obturans: A Disease of the Tropics?

Abstract

Keratosis obturans appears to be an obscure and relatively uncommon entity, even in literature search of journals and reference texts, so much so that there is not even any prevalence or incidence statistics available. However, the condition did not appear to be as uncommon based on our clinical observations. We have managed to obtain 64 patients representing 67 ears with keratosis obturans in our study period of about 18 months with a pattern of occurrence during this period. Humid weather seemed to play a role in the frequency of its appearance during certain period in our observation. There also appears to be a correlation between the severity of symptoms (predominantly pain and hearing loss) and the presenting appearance of the condition, i.e., presence or absence of granulation tissue, as well as that the degree of difficulty in exenteration of the keratosis obturans (matrix and content) depending on the expansion of the bony canal. Our figures showed the majority of the patients are females and young individuals, the majority of them occur unilaterally. The condition also appear to stop short of involving the tympanic membrane with only the bony canal being expanded with the surrounding oedema creating an apparent "canal stenosis".

http://ift.tt/2iKfR6m

Outcomes of Newborn Hearing Screening Program: A Hospital Based Study

Abstract

Hearing loss is hidden disability and second most common congenital pathology. Prevention, early identification and early intervention of hearing loss can prevent further disability in development of speech, language, cognition and other developmental domains. The prevalence of congenital hearing loss has been estimated to be 1.2–5.7 per thousand in neonates. In these contexts, the aim of study was to determine outcomes of neonates hearing screening program in Hospital. It is a clinical cross-sectional study which was conducted in tertiary care centre from 8th July, 2015 to 31th May, 2016. Total no of 2254 cases were screened. Details case history including high risk register, Pediatric Audiometry, Otoacoustic Emission tests were performed followed brainstem evoked response audiometry. The Prevalence of hearing loss among high risk babies confirmation by BERA was 8.8% per 1000 babies and 16 cases were recommended for Cochlear Implant. The screening protocol with objective test i.e. Distortion Product Otoacoustic Emission and confirmation by Brainstem Evoked Response Audiometry is very useful tool in early identification of congenital hearing loss in neonates. Hence, the results of this study will be used to initiate universal newborn hearing screening in other hospitals. Moreover, this study highlights the relevance of neonatal hearing screening in other states of India and country where this screening is not performed routinely in all hospitals and creating awareness to identify neonatal risk factors associated with hearing loss and understand the importance of early identification and early intervention and among health care professionals.

http://ift.tt/2jGfTdS

Role of Topical Medication in Prevention of Post-extubation Subglottic Stenosis

Abstract

Iatrogenic laryngotracheal injury is the most serious complication of endotracheal intubation since this method of establishing airway was first described by Eugene Bouchut in 1858. Even today, subglottic stenosis is the most dreaded complication of intubation. This animal study is focused on the host tissue response to intubation induced injury resulting in subglottic stenosis and methods to prevent this complication. To assess the role of topically applied Mitomycin-C and Triamcinolone Acetonide in wound healing process following post-extubation subglottic injury. Prospective Randomized block, single-blinded, experimental study. Forty New-Zealand white rabbits where block randomized and allocated into 4 groups based on the type of topical medication that was applied post-extubation. Further these groups where subdivided into 3 subgroups based on the time of sacrifice (4, 6 and 12 weeks) to study the histopathological changes that occurred in a temporal sequence at the subglottis. It was observed that the rabbits in the control group and those that received Mitomycin-C only had more respiratory distress compared to those treated with Triamcinolone Acetonide. Statistically significant histopathological changes were observed in all the 4 groups. Mitomycin-C applied topically did not alter the wound healing process following post-extubation injury in the subglottis. Triamcinolone Acetonide significantly altered wound healing in the subglottis and prevented occurrence of respiratory distress.

http://ift.tt/2iMiPrg

Keratosis Obturans: A Disease of the Tropics?

Abstract

Keratosis obturans appears to be an obscure and relatively uncommon entity, even in literature search of journals and reference texts, so much so that there is not even any prevalence or incidence statistics available. However, the condition did not appear to be as uncommon based on our clinical observations. We have managed to obtain 64 patients representing 67 ears with keratosis obturans in our study period of about 18 months with a pattern of occurrence during this period. Humid weather seemed to play a role in the frequency of its appearance during certain period in our observation. There also appears to be a correlation between the severity of symptoms (predominantly pain and hearing loss) and the presenting appearance of the condition, i.e., presence or absence of granulation tissue, as well as that the degree of difficulty in exenteration of the keratosis obturans (matrix and content) depending on the expansion of the bony canal. Our figures showed the majority of the patients are females and young individuals, the majority of them occur unilaterally. The condition also appear to stop short of involving the tympanic membrane with only the bony canal being expanded with the surrounding oedema creating an apparent "canal stenosis".

http://ift.tt/2iKfR6m

Outcomes of Newborn Hearing Screening Program: A Hospital Based Study

Abstract

Hearing loss is hidden disability and second most common congenital pathology. Prevention, early identification and early intervention of hearing loss can prevent further disability in development of speech, language, cognition and other developmental domains. The prevalence of congenital hearing loss has been estimated to be 1.2–5.7 per thousand in neonates. In these contexts, the aim of study was to determine outcomes of neonates hearing screening program in Hospital. It is a clinical cross-sectional study which was conducted in tertiary care centre from 8th July, 2015 to 31th May, 2016. Total no of 2254 cases were screened. Details case history including high risk register, Pediatric Audiometry, Otoacoustic Emission tests were performed followed brainstem evoked response audiometry. The Prevalence of hearing loss among high risk babies confirmation by BERA was 8.8% per 1000 babies and 16 cases were recommended for Cochlear Implant. The screening protocol with objective test i.e. Distortion Product Otoacoustic Emission and confirmation by Brainstem Evoked Response Audiometry is very useful tool in early identification of congenital hearing loss in neonates. Hence, the results of this study will be used to initiate universal newborn hearing screening in other hospitals. Moreover, this study highlights the relevance of neonatal hearing screening in other states of India and country where this screening is not performed routinely in all hospitals and creating awareness to identify neonatal risk factors associated with hearing loss and understand the importance of early identification and early intervention and among health care professionals.

http://ift.tt/2jGfTdS

Role of Topical Medication in Prevention of Post-extubation Subglottic Stenosis

Abstract

Iatrogenic laryngotracheal injury is the most serious complication of endotracheal intubation since this method of establishing airway was first described by Eugene Bouchut in 1858. Even today, subglottic stenosis is the most dreaded complication of intubation. This animal study is focused on the host tissue response to intubation induced injury resulting in subglottic stenosis and methods to prevent this complication. To assess the role of topically applied Mitomycin-C and Triamcinolone Acetonide in wound healing process following post-extubation subglottic injury. Prospective Randomized block, single-blinded, experimental study. Forty New-Zealand white rabbits where block randomized and allocated into 4 groups based on the type of topical medication that was applied post-extubation. Further these groups where subdivided into 3 subgroups based on the time of sacrifice (4, 6 and 12 weeks) to study the histopathological changes that occurred in a temporal sequence at the subglottis. It was observed that the rabbits in the control group and those that received Mitomycin-C only had more respiratory distress compared to those treated with Triamcinolone Acetonide. Statistically significant histopathological changes were observed in all the 4 groups. Mitomycin-C applied topically did not alter the wound healing process following post-extubation injury in the subglottis. Triamcinolone Acetonide significantly altered wound healing in the subglottis and prevented occurrence of respiratory distress.

http://ift.tt/2iMiPrg

Aminoleveulinate photodynamic therapy (ALA-PDT) for Bowen’s disease in a SLE patient: Case report and literature review

Publication date: Available online 17 January 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Ting Lv, Jie-Chen Zhang, Fei-Miao, Hong-wei Wang
We reported a rare case of topical 5-aminolevulinic acid (ALA)–photodynamic therapy (PDT) in the treatment of a systemic lupus erythematosus (SLE) patient with lower limb multiple Bowen's disease (BD). At the end of the treatment, an excellent clinical response was observed and no recurrence of rash after 2 months of treatment. The recovery time was prolonged only after the first treatment, however, no photosensitive phenomena were observed during and after the treatment. This is the first report to describe ALA-PDT for patient-confirmed photosensitivity in an Asian patient. Whether PDT is contraindicated for SLE remains to be discussed, although our findings show that PDT can be used as an alternative therapy for SLE patients with BD who cannot tolerate surgery.



http://ift.tt/2iMfybs

Laser and photochemotherapy for the treatment of oral mucositis in young patients: randomized clinical trial

Publication date: Available online 16 January 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): João Batista Medeiros Filho, Etevaldo Matos Maia Filho, Meire Coelho Ferreira
BackgroundThe aim of the present study was to evaluate the effect of low-level laser therapy (LLLT) combined with photochemotherapy (PCT) for the treatment of chemotherapy-induced oral mucositis in young patients.MethodsA randomized, blind, clinical trial with a split-mouth design was conducted involving a sample of 15 cancer patients aged three to 16 years at the Aldenora Bello Hospital in the city of São Luís, Brazil. The treatments (PCT+LLLT and LLLT alone) were randomly determined for each side of the oral cavity. The patients were blinded to the type of therapy performed on each side. The outcome was the area of the lesion measured in cm² over an eight-day evaluation period. Treatment and follow up of the lesions under evaluation as well as other lesions occurred until complete remission. Friedman and Wilcoxon tests were employed. Significance was set at a 95% confidence level (α=0.05) and the effect size was calculated.ResultsA statistically significant difference was found between therapies for lesion area on Days 6 to 8 (p=0.020, 0.011 and 0.005, respectively), which was confirmed by the moderate effect size. Lesions submitted to PCT+LLLT had a smaller area at the end of the evaluation period.ConclusionBased on the present findings, PCT+LLLT had a greater therapeutic effect in comparison to LLLT alone regarding the reduction in the degree of severity of chemotherapy-induced oral mucositis.



http://ift.tt/2jlH6mr

Selenium rescues orbital fibroblasts from cell death induced by hydrogen peroxide: another molecular basis for the effects of selenium in graves’ orbitopathy

http://ift.tt/2jliElq

Re: Minimal invasive treatment using patient-specific template for mandibular fractures in children: “Wing- splint” by CAD/CAM technology

We appreciate Hegab's comments about our recent paper and agree with him in some parts.1 We understand the concern that the orthodontic implants installed in the alveolar bone of children may be loosened when intermaxillary fixation is put in place, because the bone is not rigid in a child's mandible at the time of permanent tooth eruption. The "wing-splint" of our paper was an effort to overcome this.2

http://ift.tt/2iMfV5y

Epstein-Barr-virus-related mucocutaneous ulceration that mimics oral squamous cell carcinoma: the importance of recognising this new condition

We report a case and present a literature search of the relatively newly reported condition of Epstein Barr Virus (EBV)-related mucocutaneous ulceration. EBV-related mucocutaneous ulcers clinically present as oral squamous cell carcinoma (OSCC) in immunocompromised elderly patients but usually resolve by stopping or modifying the medication.As the two conditions can present in a similar way, and the management of each is totally different, this case highlights the importance of recognising this condition at an early stage.

http://ift.tt/2j6Kukl

A Novel Role for Endothelial Tetrahydrobiopterin in Mitochondrial Redox Balance

Publication date: Available online 17 January 2017
Source:Free Radical Biology and Medicine
Author(s): Jade Bailey, Andrew Shaw, Roman Fischer, Brent J. Ryan, Benedikt M. Kessler, James McCullagh, Richard Wade-Martins, Keith M. Channon, Mark J. Crabtree
The redox co-factor tetrahydrobiopterin (BH4) regulates nitric oxide (NO) and reactive oxygen species (ROS) production by endothelial NOS (eNOS) and is an important redox-dependent signalling molecule in the endothelium. Loss of endothelial BH4 is observed in cardiovascular disease (CVD) states and results in decreased NO and increased superoxide (O2^-) generation via eNOS uncoupling. Genetic mouse models of augmented endothelial BH4 synthesis have shown proof of concept that endothelial BH4 can alter CVD pathogenesis. However, clinical trials of BH4 therapy in vascular disease have been limited by systemic oxidation, highlighting the need to explore the wider roles of BH4 to find novel therapeutic targets. In this study, we aimed to elucidate the effects of BH4 deficiency on mitochondrial function and bioenergetics using targeted knockdown of the BH4 synthetic enzyme, GTP Cyclohydrolase I (GTPCH). Knockdown of GTPCH by >90% led to marked loss of cellular BH4 and a striking induction of O2^- generation in the mitochondria of murine endothelial cells. This effect was likewise observed in BH4-depleted fibroblasts devoid of NOS, indicating a novel NOS-independent role for BH4 in mitochondrial redox signalling. Moreover, this BH4-dependent, mitochondria-derived ROS further oxidised mitochondrial BH4, concomitant with changes in the thioredoxin and glutathione antioxidant pathways. These changes were accompanied by a modest increase in mitochondrial size, mildly attenuated basal respiratory function, and marked changes in the mitochondrial proteome and cellular metabolome, including the accumulation of the TCA intermediate succinate. Taken together, these data reveal a novel NOS-independent role for BH4 in the regulation of mitochondrial redox signalling and bioenergetic metabolism.



http://ift.tt/2jwykUN

Comparison of the redox chemistry of sulfur- and selenium-containing analogs of uracil

Publication date: Available online 17 January 2017
Source:Free Radical Biology and Medicine
Author(s): N. Connor Payne, Andrew Geissler, Aileen Button, Alexandru R. Sasuclark, Alayne L. Schroll, Erik L. Ruggles, Vadim N. Gladyshev, Robert J. Hondal
Selenium is present in proteins in the form of selenocysteine, where this amino acid serves catalytic oxidoreductase functions. The use of selenocysteine in nature is strongly associated with redox catalysis. However, selenium is also found in a 2-selenouridine moiety at the wobble position of tRNA^Glu, tRNA^Gln and tRNA^Lys. It is thought that the modifications of the wobble position of the tRNA improves the selectivity of the codon-anticodon pair as a result of the physico-chemical changes that result from substitution of sulfur and selenium for oxygen. Both selenocysteine and 2-selenouridine have widespread analogs, cysteine and thiouridine, where sulfur is used instead. To examine the role of selenium in 2-selenouridine, we comparatively analyzed the oxidation reactions of sulfur-containing 2-thiouracil-5-carboxylic acid (s²c⁵Ura) and its selenium analog 2-selenouracil-5-carboxylic acid (se²c⁵Ura) using ¹H-NMR spectroscopy, ⁷⁷Se-NMR spectroscopy, and liquid chromatography-mass spectrometry. Treatment of s²c⁵Ura with hydrogen peroxide led to oxidized intermediates, followed by irreversible desulfurization to form uracil-5-carboxylic acid (c⁵Ura). In contrast, se²c⁵Ura oxidation resulted in a diselenide intermediate, followed by conversion to the seleninic acid, both of which could be readily reduced by ascorbate and glutathione. Glutathione and ascorbate only minimally prevented desulfurization of s²c⁵Ura, whereas very little deselenization of se²c⁵Ura occurred in the presence of the same antioxidants. In addition, se²c⁵Ura but not s²c⁵Ura showed glutathione peroxidase activity, further suggesting that oxidation of se²c⁵Ura is readily reversible, while oxidation of s²c⁵Ura is not. The results of the study of these model nucleobases suggest that the use of 2-selenouridine is related to resistance to oxidative inactivation that otherwise characterizes 2-thiouridine. As the use of selenocysteine in proteins also confers resistance to oxidation, our findings suggest a common mechanism for the use of selenium in biology.

Graphical abstract

http://ift.tt/2jwxA2f

Obstructive hydrocephalus in pyridoxine dependent epilepsy: An Uncommon complication

Publication date: Available online 17 January 2017
Source:Pediatric Neurology
Author(s): Renu Suthar, Shiv Sajan Saini, Jitendra K. Sahu, Pratibha Singhi




http://ift.tt/2j6AuHU

Cardiovascular autonomic dysfunction in children and adolescents with Rett syndrome

Publication date: Available online 17 January 2017
Source:Pediatric Neurology
Author(s): Ajay Kumar, Ashok Jaryal, Sheffali Gulati, Biswaroop Chakrabarty, Akanksha Singh, K.K. Deepak, R.M. Pandey, Neerja Gupta, Savita Sapra, Madhulika Kabra, Rajni Khajuria
IntroductionAutonomic dysfunctions are common in children with Rett syndrome. They usually manifest with agitation, persistent screaming, constipation, gastroesophageal reflux, aerophagia, hyperventilation and breath holding spells. Cardiovascular autonomic dysfunction are known which at times may result in fatal arrhythmias. Many of these events are mistaken as seizures and treated with antiepileptics.MethodsThe current study was conducted in a tertiary care teaching hospital in north India over a 6 month period. MeCP2 mutation positive, 24 cases with Rett syndrome and 24 healthy age matched girls, were evaluated for cardiovascular autonomic dysfunction { heart rate variability (HRV), head up tilt (HUT) test and cold pressor test (CPT)}.ResultsThe mean age in years was 9.06 (+/- 3.4) and 9.75 (+/- 3.13) for patients and controls respectively. The HRV contributed independently by parasympathetic and sympathetic nervous system was significantly reduced in cases as compared to controls (p=0.033 and p=0.001 respectively). There was significant sympathovagal imbalance with sympathetic overactivity in cases as compared to controls (p=0.001). The mean longest QTc interval was significantly prolonged in cases compared to controls (p=0.001). CPT and HUT could be done in 16 RTT patients (due to poor cooperation) and in all 24 controls. The change in blood pressure during CPT and HUT was not significantly different in cases and controls.ConclusionChildren with Rett syndrome were observed to have significant cardiovascular autonomic dysfunction in the form of sympathetic overactivity, parasympathetic underactivity and sympathovagal imbalance. This has got important therapeutic and outcome related implications.



http://ift.tt/2j6LLYx

Selenium rescues orbital fibroblasts from cell death induced by hydrogen peroxide: another molecular basis for the effects of selenium in graves’ orbitopathy

http://ift.tt/2jliElq

Anatomic Considerations for Sinonasal and Ventral Skull Base Malignancy

Malignancies of the sinonasal region and ventral skull base include a varied group of uncommon tumors that are a challenge to treat. These malignancies, with few exceptions, often present late because of their insidious growth and bland symptomatology. As with malignancies of other sites, the primary goal in surgical management is complete resection with negative margins. This presents a unique surgical challenge in that these lesions lie within a region of densely populated anatomic real estate. This fact reinforces the importance of complete preoperative work-up and a sound anatomic understanding. This article discusses key anatomic regions and their importance from an endonasal perspective.

http://ift.tt/2iBuVQC

The Role of Radiation Therapy in the Management of Sinonasal and Ventral Skull Base Malignancies

Sinonasal and ventral skull base malignancies are rare tumors that arise in a complex anatomic location juxtaposed with critically important normal tissues. The standard treatment paradigm for most histologies has been surgery followed by postoperative radiation therapy. Because of their propensity to present at an advanced stage and the presence of nearby critical structures, patients are at risk for severe radiation-induced long-term toxicity. Recent advances in radiotherapy technique have improved the therapeutic ratio between tumor control and normal tissue toxicity. This article reviews issues pertinent to the use of radiotherapy in the management of these tumors.

http://ift.tt/2iGVI18

Anatomic Considerations for Sinonasal and Ventral Skull Base Malignancy

Malignancies of the sinonasal region and ventral skull base include a varied group of uncommon tumors that are a challenge to treat. These malignancies, with few exceptions, often present late because of their insidious growth and bland symptomatology. As with malignancies of other sites, the primary goal in surgical management is complete resection with negative margins. This presents a unique surgical challenge in that these lesions lie within a region of densely populated anatomic real estate. This fact reinforces the importance of complete preoperative work-up and a sound anatomic understanding. This article discusses key anatomic regions and their importance from an endonasal perspective.

http://ift.tt/2iBuVQC

The Role of Radiation Therapy in the Management of Sinonasal and Ventral Skull Base Malignancies

Sinonasal and ventral skull base malignancies are rare tumors that arise in a complex anatomic location juxtaposed with critically important normal tissues. The standard treatment paradigm for most histologies has been surgery followed by postoperative radiation therapy. Because of their propensity to present at an advanced stage and the presence of nearby critical structures, patients are at risk for severe radiation-induced long-term toxicity. Recent advances in radiotherapy technique have improved the therapeutic ratio between tumor control and normal tissue toxicity. This article reviews issues pertinent to the use of radiotherapy in the management of these tumors.

http://ift.tt/2iGVI18

Update HNO

http://ift.tt/2j6pvy1

Dank an die Gutachter 2016

http://ift.tt/2jtHBO0

Update HNO

http://ift.tt/2j6pvy1

Dank an die Gutachter 2016

http://ift.tt/2jtHBO0

Financial development and sectoral CO 2 emissions in Malaysia

Abstract

The paper examines the impacts of financial development on sectoral carbon emissions (CO₂) for environmental quality in Malaysia. Since the financial sector is considered as one of the sectors that will contribute to Malaysian economy to become a developed country by 2020, we utilize a cointegration method to investigate how financial development affects sectoral CO₂ emissions. The long-run results reveal that financial development increases CO₂ emissions from the transportation and oil and gas sector and reduces CO₂ emissions from manufacturing and construction sectors. However, the elasticity of financial development is not significant in explaining CO₂ emissions from the agricultural sector. The results for short-run elasticities were also consistent with the long-run results. We conclude that generally, financial development increases CO₂ emissions and reduces environmental quality in Malaysia.

http://ift.tt/2iEpPDa

Different physiobiochemical and transcriptomic reactions of rice ( Oryza sativa L.) cultivars differing in terms of salt sensitivity under salinity stress

Abstract

Salinity stress is the most important and common environmental stresses throughout the world, including Iran. The aim of this study was to investigate the expression of several important genes involved in the salinity tolerance of the rice cultivars differing in salt sensitivity. In this research, the expression of four mitochondrial genes, H₂O₂, malondialdehyde (MDA), proline, sodium, potassium and superoxide dismutase (SOD), was measured in Iranian rice cultivars and two well-known international varieties as checks in response to 100 mM salt stress. The results show that the activity of SOD in the tolerant cultivars is much higher than in the susceptible ones under saline conditions (100 mM NaCl). The study of the gene expression in the tolerant and sensitive cultivars also showed that the expression of the genes increased in the early hours of the stress, with the exception of the OsGR1. Moreover, the amount of the expression in the tolerant cultivars was far more than the susceptible ones. The result of this study showed that the function of a set of antioxidant enzymes can lead to detoxification of the reactive oxygen species, so in order to better understand ROS scavengers, a comprehensive study on the antioxidant system should be conducted.

http://ift.tt/2iErGb9

Phytoremediation of fluoride with garden ornamentals Nerium oleander , Portulaca oleracea , and Pogonatherum crinitum

Abstract

Nursery grown plants of Nerium oleander, Pogonatherum crinitum, and Portulaca oleracea were observed to remove fluoride up to 92, 80, and 73%, respectively, from NaF solution at the concentration of 10 mg L⁻¹ within 15 days. Concentration range of 10–50 mg L⁻¹ of fluoride revealed a constant decrease of removal from 92 to 51% within 15 days by N. oleander, while the biomass (one to five plants) showed enhancement in removal from 74 to 98% in 10 days. Translocation and bioaccumulation factors calculated after fluoride contents in roots and leaves of N. oleander, P. crinitum, and P. oleracea were 1.85, 1.19, and 1.43, and 9.8, 3.6, and 2.2, respectively. P . oleracea, P. crinitum, and N. oleander showed reductions in chlorophyll contents by 40, 57 and 25 and 8%, carbohydrates by 50, 44, and 16%, and proteins by 38, 53, and 15%, respectively. Activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX) in the roots of P. oleracea, P. crinitum, and N. oleander were observed to be induced by 400, 383, and 500%; 80, 105, and 424%; and 153, 77, and 71%, respectively, while the leaves showed induction in SOD, CAT, and GPX activities by 550, 315, and 165%; 196, 227, and 243%; and 280, 242, and 184%, respectively. Results endorsed the superiority of N. oleander for fluoride removal over other plant species.

http://ift.tt/2jw9mFh