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5,906 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: unicystic ameloblastoma ( uca ) was first described by robinson and martinez , to delineate its less aggressive course compared to solid ameloblastoma . with the exception of age of onset and biologic outcome ,
the purpose of this report is to present a case of uca showing a pericoronal radiolucency in the primary lesion and multilocular radiolucency in the recurrent lesion .
an 8-year old girl presented in march 2005 , with a painless swelling on the left side of the mandible of 1 month duration .
extra orally , slight asymmetry was noted and intra orally , the swelling was seen extending from mandibular left permanent first molar to the retro molar region .
panoramic radiograph showed a unilocular radiolucency between mandibular left first permanent molar and anterior margin of the ramus , enclosing the crown of permanent second molar [ figure 1 ] .
panoramic radiographic examination of the initial lesion showing a unilocular radiolucency between mandibular left first permanent molar and anterior margin of the ramus , enclosing the crown of the permanent second molar histologically , the incisional specimen was characterized by a cystic lining with ameloblast - like basal cells and stellate reticulum - like overlying cells .
the fibrous wall was devoid of odontogenic islands and slightly myxoid in character [ figure 2 ] . in april 2005 ,
the post surgical specimen showed same features as incisional biopsy specimen but the fibrous wall showed inactive odontogenic islands [ figure 2-inset ] .
histopathological examination of the incisional specimen characterized by a cystic lining ameloblast - like basal cells and stellate reticulum - like overlying cells .
fibrous wall showing inactive odontogenic rests ( h and e stain , 60 ; 240 ) the patient returned with the complaints of pain and swelling in 2009 .
intra orally , the swelling was found in the edentulous region in relation to missing second permanent molar .
radiographically ( panoramic and lateral oblique view radiographs ) , a multiculocular , soap... | unicystic ameloblastoma ( uca ) is a clinical subtype of ameloblastoma that is considered prognostically different .
the purpose of this report is to present a case of uca showing dual radiographic pattern in a child .
a detailed study of the lesion was carried out in an 8 year old female child who presented to our department of oral and maxillofacial pathology .
clinical , radiological and histopathological findings were recorded . in march 2005 , a painless swelling in the left side of the mandible was noted , which on radiographic examination showed a unilocular radioluceny enclosing the crown of mandibular left permanent second molar , extending between the left first permanent molar and anterior margin of the ramus .
histopathologic diagnosis was uca .
the lesion was treated by enucleation .
the patient returned with recurrence in 2009 , at this time the lesion radiographically presented as a multilocular radiolucency with a soap bubble appearance , extending between the anterior border of the ramus and second premolar .
histopathologic diagnosis was uca .
the lesion was treated by segmental resection with immediate reconstruction .
although a number of treatment modalities are available to treat uca , many factors need to be taken into consideration in the treatment of uca in children . |
5,907 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: nurse turnover is a costly problem that will continue as healthcare faces the impending nursing shortage ; a new generation of nurses enters the workforce , and incentives provided to nurses to work for institutions increase .
a variety of factors influence the retention of nurses in adult care settings , including work satisfaction , group cohesion , job stress , and work schedule .
again , recruitment , retention , turnover , and development of quality care in nursing are global issues within the health care setting .
although the definition of turnover varies according to different literature , employee turnover is defined as the ratio of the number of workers that had to be replaced in a given time period to the average number of workers , and generally viewed as the movement of staff out of an organization .
employee job satisfaction is the fulfillment , gratification , and enjoyment that comes from work .
it is not just the money or the fringe benefits , but the feelings employees receive from the work itself .
the most used research definition of job satisfaction is by locke who defined it as a pleasurable or positive emotional state resulting from the appraisal of one 's job or job experiences .
implicit in locke 's definition is the importance of both effect , or feeling , and cognition , or thinking .
, it is defined simply as how people feel about their jobs and different aspects of their jobs .
it is the extent to which people like ( satisfaction ) or dislike ( dissatisfaction ) their jobs .
wikipedia also defines job satisfaction as a pleasurable emotional state resulting from the appraisal of one 's job , an affective reaction to one 's job , and an attitude towards one 's job .
the ability to produce , the quality of the work , the opportunity to learn and express creativity , the sense of pride in their profession , the recognition for a job well done , the ability to work well in a team , the social satisfaction derived from relationships at work , the opportunity to experience personal... | background .
workplace turnover is destructive to nursing and patient outcomes as it leads to losing competent and qualified nurses .
however , developments of coping strategies demand a clear understanding of workplace variables that either motivate nurses to remain employed or lead them to leave their current jobs . objective .
this study was designed toassess factors influencing job satisfaction and intention to turnover among nurses in sidama zone public health facilities , in southern ethiopia
. method .
cross - sectional study design was carried out on 278 nurses using both qualitative and quantitative data collection methods from may 12 to june 05 , 2010 .
result .
a total of 242 nurses were interviewed giving a response rate of 87% . nearly two - third ( 68.6% ) of the participants were female , and the mean age was 28 ( 6.27 ) years for both sexes .
all job satisfaction subscale except benefit and salary subscale were significant predictors of overall job satisfaction .
satisfactions with work environment and group cohesion ( aor : 0.25 [ 95% ci : 0.12 , 0.51 ] ) , single cohesion ( aor : 2.56 [ 95% ci : 1.27 , 5.13 ] ) , and working in hospital ( aor : 2.19 [ 95% ci : 1.12 , 4.30 ] ) were the final significant predictors of anticipated turnover of sidama zone nurses .
conclusions .
more than any factors managers should consider the modification of working environment and group cohesions rather than trying to modify nurses to retain and maintain more experienced nurses for the organizations . |
5,908 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: development into adulthood has , at its origins , strands of dna inherited from two parents combined with endogenous or external environmental influences .
yet it is well known now that siblings or twins adopted away at birth share very similar physical , personality and mental traits with their close biological relatives . on the other hand
, it is also known that changing the prenatal and perinatal environment of a fetus and infant can have a long - lasting effect on the developed adult and even their offspring .
it is in this context that we try to unravel the genetic mechanism that leads to high risk for schizophrenia , particularly given the last decade of progress that has led us into a new era of human genome research .
early genetic studies (; reviewed in ) led to several false starts and inconsistent chance findings of gene variants associated with schizophrenia and linkages to specific chromosomal regions .
these studies culminated in the presence of over 2,000 reports in the current literature examining allelic associations to schizophrenia and well over 50 genes that are claimed to have positive associations .
in fact , almost every chromosome arm has a reported linkage to schizophrenia ( reviewed in [ 4 - 6 ] ) .
schizophrenia is a lifetime brain disorder detectable in late adolescence to early adulthood that particularly affects the higher cortical centers for complex learning , memory and communication with others .
people with this illness frequently hear disturbing voices that are not there and have multiple delusionary perceptions that prevent them from functioning in society on a daily basis .
it has long been established through epidemiological studies of families , twins and adoptees to be highly heritable .
however , its inheritance does not follow any mendelian pattern . once schizophrenia had been accepted as one of the so - called ' complex ' genetic disorders and
it had become clear that simple methods that were useful for studying the inheritance of mendelian disorders were not... | the search for a genetic basis for schizophrenia has taken a new turn recently with the publication of three reports of various rare copy - number variations that are associated with schizophrenia .
while some of the findings may simply disappear as spurious reports , others remain interesting : that is , deletions in the velocardiofacial syndrome region of chromosome 22 , and regions of chromosome 1q21.1 and 15q13.3 .
these results will gain greater significance if future validation in family studies shows their segregation with illness within families , and when it is understood how the genes containing these variants affect the underlying neurochemistry and neuropathology characteristic of schizophrenia . |
5,909 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: | formylglycine generating enzyme ( fge ) performs a critical posttranslational modification of type i sulfatases , converting cysteine within the motif cxpxr to the aldehyde - bearing residue formylglycine ( fgly ) .
this concise motif can be installed within heterologous proteins as a genetically encoded
aldehyde tag for site - specific labeling with aminooxy- or hydrazide - functionalized probes . in this report , we screened fges from m. tuberculosis and s. coelicolor against synthetic peptide libraries and identified new substrate sequences that diverge from the canonical motif .
we found that e. coli s fge - like activity is similarly promiscuous , enabling the use of novel aldehyde tag sequences for in vivo modification of recombinant proteins . |
5,910 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: at the most basic level , the brain may be viewed as a vast network of nerve cells ( neurons ) with specialized projections ( dendrites and axons ) connected to each other at junctions known as synapses , through which signals are passed from one neuron to the next . as early as the 19 century , well before the exact nature of signals conveyed by neurons and synapses was understood , changes in the ability of one neuron to drive another were hypothesized to underlie the formation of new associations and the learning of new tasks .
years later , donald hebb rephrased these ideas in his influential monograph organization of behavior , suggesting that when one neuron repeatedly takes part in driving a second neuron some growth process or metabolic change takes place at synapses that increases the efficiency of the first neuron in driving the second .
inspired by hebb 's writings , countless attempts have been made to uncover the nature of these
much of this work has focused on dendritic spines ; the tiny door - knob shaped protrusions that extend from the dendrites shafts , mainly because these are the postsynaptic components of most excitatory synapses in the mammalian central nervous system ( cns ) . as it is commonly assumed that persistent changes in synaptic connectivity ultimately require structural changes ,
many studies have focused on the structural remodeling of dendritic spines , or more specifically , on changes in spine numbers , densities , sizes , and shapes . only during the last decade , however , with the development of tools for long - term imaging of individual spines in intact brains , have these ideas been directly addressed .
this commentary will focus on a subset of studies published over the last two years . for more comprehensive reviews , see [ 4 - 6 ] .
imaging of dendritic spines over many days and weeks in adult animals ( mainly mice ) has revealed that the majority of dendritic spines are quite persistent ( reviewed in [ 4 - 6 ] ) .
yet , these studies also reported that new... | the notion that synaptic remodeling underlies certain forms of learning is one of the main tenets of hebb 's inspiring theories dating from the 1940s . until recently
, however , direct evidence for tight relationships between synaptic remodeling and behavior has been scarce .
fascinating data from recent studies on the remodeling of postsynaptic structures known as dendritic spines indicates that such relationships might be more complex than initially expected . |
5,911 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: preeclampsia , a unique human pregnancy disorder , is characterized by the development of new hypertension and proteinuria after 20 weeks of gestation in patients free from any clinical disease .
but it is not only hypertension and proteinuria ; preeclampsia is a multiorgan disease in which the target organs are the endothelium , brain , liver , kidneys ( glomerular endotheliosis ) and the coagulation system .
delivery still remains the only curative treatment in cases of severe preeclampsia , but is not always advantageous for the fetus .
management decisions concerning patients with preeclampsia must be individualized and should balance the maternal risks of continued pregnancy against the fetal risks associated with induced preterm delivery .
preeclampsia is a major cause of maternal and fetal mortality and morbidity , and remains amongst the biggest challenges in obstetrics , but its precise etiopathogenesis is still unclear .
the placenta , as the interface between the mother and fetus , regulates fetal growth and development .
its functions are determined by vascular development and blood flow , which depend on proper trophoblast growth and differentiation . according to the most recent hypothesis , preeclampsia results from impaired placentation early in the beginning of the pregnancy , leading to placental hypoxia and dysfunction .
there are differences between the placental findings in early and late onset preeclampsia , but it is difficult to determine whether these are qualitative , indicating different diseases , or simply quantitative differences within the same disease . it has been suggested that the onset , clinical manifestations , severity , and progression of preeclampsia are affected by the maternal response to placentally derived antiangiogenic factors that lead to the imbalance between angiogenic and antiangiogenic factors .
nitric oxide ( no ) regulates the placental blood flow and actively participates in trophoblast invasion and placental development .
one theory ( of many ) suggests... | backgroundthe aim of this study was to determine the maternal serum concentrations of enos , adma , and homocysteine in preeclamptic pregnancies.material/methodsthe study was carried out on 62 patients with pregnancy complicated by early onset and 53 patients with late onset preeclampsia .
the control group consisted of 65 healthy normotensive pregnant patients .
the serum enos , adma and homocysteine concentrations were determined using elisa assays.resultsour study revealed elevated levels of homocysteine and adma in the serum of women with preeclampsia .
the highest levels were observed in patients with early onset preeclampsia , but the differences between both groups of preeclamptic patients with early and late onset of preeclampsia were not statistically significant .
both groups of preeclamptic women had slightly lower levels of maternal serum endothelial nitric oxide synthase than in normotensive pregnant women , but these differences were not statistically significant.conclusionsthe higher levels of homocysteine and adma observed in patients with early onset preeclampsia may suggest that higher levels of maternal serum homocysteine and adma correlate with the severity , and may determine the earlier clinical onset of the disease .
the elevated levels of adma and the unchanged levels of enos in preeclamptic pregnancies suggest that no deficiency in this pregnancy disorder results not from a reduced level or activity of enos , but from elevated levels of adma , an endogenous enos inhibitor .
the lowering of increased levels of homocysteine and adma may be helpful in therapy of vascular disturbances occurring in preeclampsia . |
5,912 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: glomus tumor is a rare benign tumor arising from neuroarterial plexus concentrated beneath the nailbed usually in women of age group 20 - 40 yrs .
the plexus is an arteriovenous anastomosis functioning without intermediary capillary bed , we report a case of glomus tumor affecting the nailbed of left little finger with characteristic periodic , spontaneous excruciating pain and temperature related algesia for the last 6 months .
patient was operated for excision of the tumor making her completely pain free after resection oftumor .
opd with complaints of pain , cold algesia , and point tenderness on the radial side of base of the nailbed of left little finger for the last 6 months .
diagnosis was delayed despite the patient having sought the advice from different clinicians a number of times before coming to us .
pain used to occur on accidental touching of tender spot , cold water immersion ; excruciating at times , making the patient faint . on physical examination clinical diagnosis of glomus tumor was made , which was confirmed on mri as the plain x - ray was non - contributory .
most of the glomus tumors are benign , which are amenable to cure with complete surgical excision . rarely , if the lesion exceeds 2 cm malignant transformation of the tumor must be suspected unless proven otherwise .
delay in clinical diagnosis due to dithering on the part of the clinician unnecessarily prolong the suffering in the patient which can be greatly helped by m.r.i in clinching the diagnosis early .
the glomus tumor is a rare benign neoplasm that arises from the neuroarterial structure called a glomus body .
theglomus body is a specialized neuroarterial receptor composed of efferent arteriole , an anastmotic sucquethoyer canal , afferent venule .
this accounts for 1 % to 4.5 % of all tumors encountered in the hand .
the normal glomus body is located in the stratum reticulare of the skin throughout the body , but is more concentrated in the digits .
the glomus tumor usually affect a person of age between 30 to 50 years... | introduction : glomus tumor is a rare benign tumor arising from neuroarterial plexus concentrated beneath the nailbed usually in women of age group 20 - 40 yrs . the plexus is an arteriovenous anastomosis functioning without intermediary capillary bed , we report a case of glomus tumor affecting the nailbed of left little finger with characteristic periodic , spontaneous excruciating pain and temperature related algesia for the last 6 months .
mri helped in clinching the diagnosis at an early stage .
patient was operated for excision of the tumor making her completely pain free after resection oftumor.case presentation : a 40-year - old female patient came in ortho .
opd with complaints of pain , cold algesia , and point tenderness on the radial side of base of the nailbed of left little finger for the last 6 months .
diagnosis was delayed despite the patient having sought the advice from different clinicians a number of times before coming to us .
pain used to occur on accidental touching of tender spot , cold water immersion ; excruciating at times , making the patient faint . on physical examination clinical diagnosis of glomus tumor was made , which was confirmed on mri as the plain x - ray was non-contributory.conclusion:most of the glomus tumors are benign , which are amenable to cure with complete surgical excision . rarely , if the lesion exceeds 2 cm malignant transformation of the tumor must be suspected unless proven otherwise .
delay in clinical diagnosis due to dithering on the part of the clinician unnecessarily prolong the suffering in the patient which can be greatly helped by m.r.i in clinching the diagnosis early . |
5,913 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: preventing postoperative complications will not only improve quality of patient care , but is now fiscally incentivized by the provisions of the affordable care act , which sanctions penalties toward hospitals that fail to achieve standards for hospital readmissions .
risks for postoperative complications after spine surgery include older patient age , congestive heart failure and/or history of heart attack , preoperative neurological problems , history of spinal wound infection , corticosteroid use , history of sepsis , classification of 3 or higher according to the american society of anesthesiologists ( asa ) physical status classification , and lengthened surgery times .
anterior lumbar interbody fusion ( alif ) carries a unique and complication profile compared to other lumbar fixation techniques .
the unique morbidity profile reflects risks inherent to anterior retroperitoneal access that involves greater exposure of vasculature , visceral organs , the genitourinary system , and soft tissue .
alif can be utilized to treat a wide variety of indications for degenerative pathologies of the lumbar spine .
these pathologies may include spondylolisthesis , degenerative disc disease , degenerative lumbar scoliosis , pseudoarthrosis , adjacent segment disease , and other indications that may result in instability of the lumbar spine and chronic lower back pain .
the literature cites numerous advantages to an anterior approach over a posterior approach in interbody fusion surgery including improved access to the anterior column , which allows for complete discectomy and increased ability to place a large interbody fusion device . taken together
, these benefits have been shown to contribute to higher fusion rates and improved clinical outcomes .
there have been very few significant multicenter studies evaluating short - term postoperative complications following alif procedures .
the american college of surgeons national surgical quality improvement program ( acs - nsqip ) is a continuing effort to produce a... | study design : retrospective cohort study.objective:the objective of the study was to determine rates of medical and surgical postoperative complications following anterior lumbar interbody fusion ( alif ) along with their associated predictors.methods:using the american college of surgeons national surgical quality improvement database , patients who underwent single - level alif surgery from 2006 to 2013 were identified .
the 30-day rate of postoperative medical and surgical complications along with associated risk factors were evaluated by multivariable logistic regression.results:in total , 1474 patients were included in the analysis .
the overall rate of complications was 14.5% .
the medical complication rate was 12.7% , while the surgical complication rate was 2.8% .
predictors of surgical complications were diabetes ( odds ratio [ or ] = 2.79 , 95% ci = 1.20 - 6.01 , p = .009 ) , corticosteroid dependence ( or = 4.94 , 95% ci = 1.73 - 14.08 , p = .003 ) , and preoperative transfusion of > 4 units ( or = 7.12 , 95% ci = 1.43 - 35.37 , p = .016 ) .
predictors of medical complications were longer operative times ( or = 4.25 , 95% ci = 2.90 - 6.24 , p < .001 ) , preoperative anemia ( or = 2.29 , 95% ci = 1.50 - 3.50 , p <
.001 ) , > 10% weight loss prior to surgery ( or = 6.79 , 95% ci = 1.01 - 45.93 , p = .049 ) , and more severe american society of anesthesiologists classification ( or = 2.18 , 95% ci = 1.54 - 3.11 , p
< .001).conclusions : the present study determines postoperative medical and surgical complications among patients undergoing alif .
the risk factors elucidated in this study indicate that clinical practices to curtail complications should be targeted toward patients with preoperative anemia , weight loss , corticosteroid dependence , and toward those at risk for perioperative transfusions . |
5,914 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the diffuse sclerosing variant of papillary thyroid carcinoma ( dsv - ptc ) , first described by vickery et al . in 1985 , is a histological variant of ptc .
it is characterized by diffuse involvement of one or both thyroid lobules with prominent squamous metaplasia , numerous psammoma bodies , and dense sclerosis in intratumoral areas together with a background of lymphocytic infiltration .
extensive lymphovascular invasion indicates frequent metastasis . because of the early spread of dsv - ptc
dsv - ptc is a major subtype of ptc in young patients , with a higher female predominance ( male : female ratio , 1:7.5 ) .
however , the frequency of dsv - ptc is 0.35.5% among ptc [ 4 , 5 , 6 ] .
we herein report a 15-year - old female patient with estrogen receptor ( er)- and progesterone receptor ( pgr)-positive dsv - ptc with paratracheal lymph node metastasis in whom recurrence in the right cervical lymph nodes was diagnosed 7 years after the first operation .
a 15-year - old female patient with no medical or family history of thyroid tumors consulted an otolaryngological clinic for evaluation of an anterior neck swelling .
a thyroid neoplasm was suspected , and she was referred to kansai medical university takii hospital .
diffuse enlargement of the right thyroid gland with many small calcifications was detected by ultrasonography ( fig .
however , lymph node swelling of the right neck was detected 7 years after the operation and reexcision was performed .
during the treatment course , her serum t3 , t4 , and tsh levels were within the reference ranges and autoantibodies were not detected .
on macroscopic examination , the tumor , which had been located in the right lobe , was 22 mm along its major axis without formation of a dominant mass .
the tumor showed a papillary growth pattern with distinct fibrosis , severe lymphocyte infiltration ( fig .
3c ) ; all characteristics of dsv - ptc were frequently seen . in high - power fields ,
many of the tumor cell nuclei exhibited a ground - glass appearance ,... | the diffuse sclerosing variant of papillary thyroid carcinoma ( dsv - ptc ) is a relatively rare tumor .
we herein report the case of young woman with dsv - ptc who developed cervical lymph node recurrence 7 years after the initial surgery . a 15-year - old female patient with no medical or family history of thyroid tumors developed a thyroid neoplasm in the right lobe .
right thyroidectomy and regional lymphadenectomy were performed , and the tumor was diagnosed as dsv - ptc . she was followed up as an outpatient .
seven years after the surgery , cervical lymph node recurrence developed .
on microscopic examination , the thyroid tumor showed a papillary growth pattern with numerous psammoma bodies and distinct fibrosis .
immunohistochemically , the tumor cells were estrogen receptor and progesterone receptor positive with reduced membranous expression of e - cadherin and were intermingled with s-100-positive dendritic / langerhans cells .
dsv - ptc is characterized by a strong tendency for invasion and metastasis .
thus , accurate diagnosis is clinically important , and a morphological and immunohistochemical understanding of dsv - ptc is necessary . |
5,915 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: brainstem vascular malformations can be classified as arteriovenous malformations , venous malformations , cavernous malformations , or capillary telangiectasias . on pathological examination ,
capillary telangiectasias are a distinct type of vascular malformation , characterized by multiple thin - walled vascular channels , interposed between normal brain parenchyma .
it has been postulated that telangiectasias are acquired lesions , caused by other underlying venous anomalies .
, numerous case reports of presumed brainstem capillary telangiectasias have appeared ; usually pathological confirmation is absent .
the fact that most capillary telangiectasias are found incidentally on mr imaging confirms the suggested clinically benign course in general , although a histopathologically proven , clinically aggressive case in an infant has been described .
we performed a pubmed search of the literature and found 26 cases to date [ 58 ] .
all but one of these cases were thought to be symptomatic , including symptoms of vertigo , tinnitus , hearing loss , ataxia , limb paresthesias , and monocular ptosis .
basilar - type migraine , previously called basilar migraine or bickerstaff migraine , is a migraine variant first described by bickerstaff in 1961 .
being a very rare migraine variant , the exact incidence and prevalence are unknown . although various criteria for the diagnosis have been applied over the years , fully reversible symptoms resulting from brainstem dysfunction are essential for the diagnosis .
a recent study found the median age of onset to be 17 years and a female - to - male ratio of 3.8:1 .
an 18-year - old woman presented to the outpatient clinic with a history of unilateral headaches , accompanied by phonophobia , but no photophobia , nausea , or vomiting .
these headaches had increased in frequency over the last 6 months from once per year to about three times per week , typically lasted several hours , and were alleviated by sleep .
the headache was frequently preceded by visual symptoms ,... | a case of presumed pontine capillary telangiectasia in an 18-year - old woman with a clinical diagnosis of basilar - type migraine is reported .
since both are very rare diagnoses , this case provides some evidence to suggest that pontine capillary telangiectasia might cause a clinical picture resembling basilar - type migraine . |
5,916 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: renal cell carcinoma ( rcc ) can metastasize to any location in the body , and distant metastases are common , being present in 30% to 40% of patients with metastatic disease .
the most common sites affected are the lungs ( 76% ) , regional lymph nodes ( ln ) ( 66% ) , bone ( 42% ) , and liver ( 41% ) .
however , only 1.5 to 3.5% of rcc patients show solitary metastasis , and only 1% have metastasis confined to the head and neck .
moreover , cases of metastatic rcc with a non - identifiable kidney mass are extremely rare . here
, we report a case of metastatic rcc in only a supraclavicular ln with no evidence of a primary kidney lesion .
a 69-year - old man presented with a 2-week history of a progressively enlarging supraclavicular mass in april 2009 .
written consent was obtained from the patient for publication of the study . upon physical examination ,
his body temperature was 37.3 , blood pressure 130/90 mmhg , and pulse rate 75/min . a head and neck examination revealed a palpable firm , fixed , non - tender , 8 cm - sized mass in the right supraclavicular area with no other evident lymphadenopathy , and an abdominal examination revealed no palpable mass . his complete blood cell count , chemistry findings , and renal functionwere normal .
urine dipstick and microscopy tests revealed no hematuria or abnormal cells . computed tomography ( ct ) of
hematoxylin and eosin staining revealed that tumor cells were polygonal with clear cytoplasm and vesicular nuclei with prominent nucleoli ( fig .
immunohistochemical staining showed that tumor cells were positive for pancytokeratin ( 1 : 300 , leica , newcastle upon tyne , uk ) , vimentin ( 1 : 200 , dako , glostrup , demark ) , and cd10 ( 1 : 100 , leica ) ( fig .
2b ) , but negative for thyroid transcription factor 1 ( 1 : 300 , leica ) , cytokeratin 7 ( 1 : 600 , neomarkers , fremont , ca ) , cytokeratin 20 ( 1 : 150 , dako ) and hepatocyte specific antigen ( 1 : 50 , leica ) . based on these findings ,
a diagnosis of metastatic clear cell rcc was made ,... | although metastasis is relatively frequent in cases of renal cell carcinoma ( rcc ) , metastasis in the cervical or supraclavicular lymph node ( ln ) is relatively rare .
moreover , cases of metastatic rcc with a non - identifiable kidney mass are extremely rare . here
, the authors report a case of metastatic rcc in a supraclavicular ln without a primary kidney lesion . a 69-year - old man presented with a progressively enlarging right supraclavicular mass .
incisional biopsy of the affected supraclavicular ln was performed , and histological examination revealed metastatic rcc .
however , no tumor was found in either kidney , despite various examinations .
the patient was treated with radiotherapy followed by sunitinib .
after three months on sunitinib , a follow - up computed tomography scan revealed that the supraclavicular ln had markedly decreased , and after 20 months , the disease had not progressed .
this case suggests that , even when there is no primary kidney lesion , clinicians must consider the possibility of metastatic rcc when evaluating patients with clear cell carcinoma with an unknown primary site . |
5,917 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in the last 30 years , there have been pronounced increases in the use of antidepressants,13 which are now the third most commonly prescribed medication class in the usa.4 although newer antidepressants ( beginning with the selective serotonin reuptake inhibitors ) are effective and generally well - tolerated for treating a number of psychiatric disorders,510 the explosive growth in the use of antidepressants continues to raise questions related to their effectiveness , side effects , and cost.1113 clinical trials have been adequate to establish antidepressant efficacy and to quantify the incidence of common treatment - emergent adverse effects ; however , these data are limited by poor external validity.14 large , randomized , comparative effectiveness studies may partially overcome this limitation,15 but they are unlikely to have sufficient power or duration of follow - up needed to detect outcomes that are infrequent or require a long time to develop.16 furthermore , such trials typically exclude vulnerable but clinically important populations in which antidepressant use may be substantial ( such as pregnant women and medically ill persons ) , and can not address questions about antidepressant prescribing and use at the population level . thus , many important questions related to antidepressant use , safety , and effectiveness must be evaluated outside of clinical trials using rigorously designed observational studies.17 the medical records linkage system maintained by the rochester epidemiology project ( rep ) contains data on essentially all sources of medical care available to and utilized by the olmsted county , minnesota , population,18 and is therefore a potentially valuable resource for studying the use and effects of medications in a well - defined population .
rep records of inpatient and outpatient medical care encounters allow identification of a phenotypically well - defined cohort , longitudinal follow - up of cohort members , and ascertainment of exposures , endpoints , and confounding... | objectivewe validated an algorithm designed to identify new or prevalent users of antidepressant medications via population - based drug prescription records.patients and methodswe obtained population - based drug prescription records for the entire olmsted county , minnesota , population from 2011 to 2012 ( n=149 629 ) using the existing electronic medical records linkage infrastructure of the rochester epidemiology project ( rep ) .
we selected electronically a random sample of 200 new antidepressant users stratified by age and sex .
the algorithm required the exclusion of antidepressant use in the 6 months preceding the date of the first qualifying antidepressant prescription ( index date ) .
medical records were manually reviewed and adjudicated to calculate the positive predictive value ( ppv ) .
we also manually reviewed the records of a random sample of 200 antihistamine users who did not meet the case definition of new antidepressant user to estimate the negative predictive value ( npv).results161 of the 198 subjects electronically identified as new antidepressant users were confirmed by manual record review ( ppv 81.3% ) . restricting the definition of new users to subjects who were prescribed typical starting doses of each agent for treating major depression in non - geriatric adults resulted in an increase in the ppv ( 90.9% ) . extending the time windows with no antidepressant use preceding the index date resulted in only modest increases in ppv .
the manual abstraction of medical records of 200 antihistamine users yielded an npv of 98.5%.conclusionsour study confirms that rep prescription records can be used to identify prevalent and incident users of antidepressants in the olmsted county , minnesota , population . |
5,918 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: infantile tremor syndrome ( its ) is a clinical syndrome of acute or gradual onset of mental and psychomotor changes , pigmentary disturbances of hair and skin , pallor , and coarse tremors in malnourished children aged between 5 months and 3 years .
it has been primarily reported from india and south east asia and has also been reported from other developing countries in asia and africa .
various nutrient deficiencies ( e.g. vitamin b12 , magnesium [ mg ] , zinc [ zn ] , vitamin c , etc .
clinically the presence of tremor has been attributed to structural and functional alterations of extrapyramidal system , but routine neuroimaging studies with computed tomography ( ct ) scan and magnetic resonance imaging in past revealed non - specific structural changes in its . here , we report a classical case of its with a rare association of thin corpus callosum . to the best of our knowledge ,
a 5.5-month - old female infant presented with pallor for 1-month , tremors of hands and feet for 2 days and delayed development .
there was no history suggestive of fever , bleeding , rash , lymphadenopathy , hepatosplenomegaly , jaundice , or seizures .
the child was born at term gestation with no antenatal , natal , or postnatal complications .
the child weighed 5.5 kg , had a length of 66 cm and head circumference of 41.5 cm . on physical examination , the child had sparse hair , pallor , and hyperpigmented knuckles [ figure 1 ] .
there were coarse tremors in all four limbs , the perioral and periorbital region in awake as well as sleep state [ video 1 ] .
there was increased tone in all 4 limbs , but no paresis of limbs or cranial nerve palsies .
investigations revealed anemia ( hemoglobin = 6.6 g% ) , mean corpuscular volume ( mcv ) ( 103.7 fl ) , mean corpuscular hemoglobin ( mch ) ( 38 pg ) , mch concentration ( 37.4% ) , with normal leucocyte count ( 11,400/mm ) , and platelets ( 4 lakh / mm ) .
serum b12 level was 202 pg / ml ( 200900 pg / ml ) and serum folic acid was 6.3 ng / ml ( 521 ng / ml ) .
cerebrospinal... | infantile tremor syndrome ( its ) is a clinical disorder characterized by coarse tremors , anemia and regression of motor and mental milestones , presenting in malnourished children aged between 5 months and 3 years .
few reports of neuroimaging abnormalities in children with its are present .
the most common finding of neuroimaging in its is cerebral atrophy with ex - vacuo enlargement of ventricles and subarachnoid space , some recent reports also showed pontine myelinolysis and cerebral hyperintensities . we did not find any report of thin corpus callosum associated with its in the literature
. |
5,919 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: systemic lupus erythematosus ( sle ) is a chronic multisystem autoimmune disease and is considered to be caused by complex interactions between genetic risk , environmental , and hormonal factors that result in an immune dysregulation , and autoantibody production ensued [ 13 ] .
epidemiological studies reported that sle is more common in asians ( 46.7/100 000 ) than in caucasians ( 20.7/100 000 ) , and ethnicity also influences the age of onset and severity of its manifestations [ 4 , 5 ] .
the precise aetiopathogenesis of sle is still unclear ; however , the search for genes and molecular interactions that influence disease has promoted our understanding of pathogenesis and genetic contributions to autoimmunity in sle .
genetic association studies and recent advances in the field of single nucleotide polymorphisms ( snps ) have been highly successful in identifying several loci associated with disease susceptibility [ 7 , 8 ] .
the ctla-4 molecule has a suppressive effect on t - cell activation and might contribute to maintain immune tolerance by blocking cd28-dependent t cell activation through interactions with its ligand cd80/86 on antigen presenting cells .
the ctla-4/b7 complex can compete with the cd28/b7 complex and convey an inhibitory influence to the t cell affecting t cell development , cytokine production , and immune reactions .
ctla-4 would , therefore , be an important negative regulator of t - cell responses , and its dysregulation has the potential to affect the pathogenesis of sle by altered activation of t cells to self - antigens [ 9 , 10 ] .
the ctla-4 gene is located within the risk region on chromosome 2q33 , and several polymorphisms have been reported in this gene .
however , only few of them have been studied for association with sle susceptibility , of which , two are located within the promoter region : a t / c change at position 1722 and an a / g transition at position 1661 [ 1113 ] .
the former could alter transcription factor binding sites whereas the latter may alter the... | several variants of ctla-4 have been reported to be associated with susceptibility systemic lupus erythematosus ( sle ) ; however , findings have been inconsistent across different populations . using a case - control study design ,
we have investigated the role of ctla-4 polymorphism at positions 1661 and 1722 on sle susceptibility in our chinese sle population in central china 's hubei province .
samples were collected from 148 sle patients and 170 healthy controls .
polymerase chain reaction restriction fragments length polymorphism ( pcr - rflp ) was used to analyze the genotypes of the two sites .
statistically significant difference was observed in genotypes for 1722 , but not for 1661 .
the frequency of the t allele on the 1722 snp was significantly increased in sle patients : 57.8% versus 40.6% in controls ( p < 0.001 , or = 2.002 ) . while the detected c allele frequency in the controls was significantly elevated in comparison to that in the sle patients ( 59.4% versus 42.2% ) . on the contrary
, no association was found between sle and ctla-4 polymorphism at position 1661 . |
5,920 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the genus campylobacter contains fifteen species , of which campylobacter jejuni is the most commonly clinically isolated , in association with invasive diarrheal colitis .
fetus ( c. fetus ) is an opportunistic organism that causes nonintestinal infections with vascular tropism .
it has been implicated in various systemic infections , including endocarditis , mycotic aneurysms , septic thrombophlebitis , pneumonia , and neonatal sepsis.1,2 lower respiratory infection caused by c. fetus has been described as febrile lobar pneumonia , occurring in the absence of gastrointestinal disease , that tends to occur in splenectomized patients.3 patients with underlying chronic debilitating illness , eg , diabetes , thalassemias , malignancy , cardiac conditions , or cirrhosis , are at increased risk for c. fetus bloodstream infections.3,4 the virulence of c. fetus is thought to be mainly related to its production of a high - molecular - weight surface protein , which acts as a microcapsule with high affinity to the vascular endothelium;2 blaser et al reported that c. fetus strains were serum resistant , which explains the high affinity of the organism to endothelial tissues.2 we present a case of pneumonia accompanied by bacteremia caused by c. fetus , in an infant who was suspected to have another undiagnosed comorbidity .
a 5-month - old baby was admitted to the hospital with a 2-day history of a high fever , influenza - like symptoms , and a dry cough but no gastrointestinal or neurological symptoms .
the vital signs were : temperature 39.1c , respiratory rate 40 per minute , blood pressure 80/50 , and oxygen saturation 98% .
bronchopneumonia was clinically diagnosed based on radiological findings , and intravenous cefuroxime was empirically initiated .
the fever did not resolve , while respiratory specimens and stool did not grow any significant isolate on the corresponding bacteriological media .
the patient was previously noted as a case of undiagnosed failure to thrive and scheduled for cardiology assessment... | bacteremia due to campylobacter spp .
is rarely reported , and campylobacter fetus is the species most commonly exhibiting vascular tropism , as occurred in this case report describing the diagnosis of c. fetus bacteremia in an infant presenting with respiratory tract infection . a 5-month - old baby , with undiagnosed failure to thrive , presented to the acute care service with a high fever and respiratory symptoms of 2 days duration .
the initial clinical and laboratory diagnosis suggested bacteremia , but there was difficulty with recovery and identification of the organism from blood .
subsequent laboratory testing confirmed c. fetus as the etiological agent .
campylobacter isolated from blood culture bottles may give atypical laboratory features , rendering its identification challenging .
thus , such an infrequent species might be underestimated in frequency , and it should be considered in diagnostic laboratories , when a gram - negative organism with atypical findings is encountered in respiratory samples or blood culture bottles . |
5,921 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: adoptive immunotherapy , particularly adoptive transfer of antigen - specific cytotoxic t lymphocytes , has shown some success in clinical trials for treating both cancer and viral infections [ 15 ] . however , due to resident tolerance within the tumor environment the most robust ctl must be stimulated for highest efficacy .
delivery of antigen genes into dendritic cells ( dcs ) or precursor monocytes ( mo ) allows for the stimulation of robust antigen - specific ctl . however , there are a variety of improvements that might be made to further enhance ctl stimulation .
one obvious course is the delivery of th1-response interferons / cytokine genes into immune cells for their continuous expression .
interferon gamma ( ifn- ) is an important th1 response interferon / cytokine involved in ctl generation and function and might be used to enhance ctl stimulation .
in addition , ifn- may have other non - t cell - associated attributes as it is believed to stimulate expression of hla class i and ii molecules . however , overall ifn- is strongly linked to the induction of th1 response , the generation of ctl .
of all the th1 response interferons / cytokines ifn- correlates most strongly with the th1 response [ 911 ] as , in fact , many laboratories study t cell expression of ifn- as a substitute for carrying out ctl killing / chromium release assays [ 12 , 13 ] .
moreover , ifn- plus il-12 appears to act cooperatively in the generation of a very strong th1 response [ 14 , 15 ] .
ifn- may also partially overcome low activation and expansion rates of low - avidity ctl [ 16 , 17 ] . as with most of the th1-response - associated chemokines ,
thus , gene delivery of ifn- will likely be very useful in generating a robust th1 ctl response .
while ifn- gene delivery would seem to be beneficial for generating robust ctl , it is unclear which cells should specifically express this cytokine for maximum ctl stimulation .
while activated t cells naturally express ifn- , it has been shown that ifn- is able to... | the adoptive transfer of antigen - specific cytotoxic t lymphocytes ( ctl ) shows promise in the treatment of cancer and infectious diseases .
we utilize adeno - associated virus-(aav- ) based antigen gene - loaded dendritic cells ( dcs ) to stimulate such antigen - specific ctl .
yet further improvements in ctl stimulation and killing may result by gene delivery of various th1-response interferons / cytokines , such as interferon ( ifn- ) , as the delivered gene can continuously produce that interferon .
however which immune cell type should optimally express ifn- is unclear as the phenotypes of both dc and t cells are enhanced by it . here , we used aav to compare and contrast ifn- gene delivery into dc or t cells , and versus the addition of exogenous ifn- , for stimulating carcinoembryonic antigen-(cea- ) specific ctl .
it was found that aav / ifn- delivery into t cells ( autocrine ) resulted in t cell populations with the highest cd8(+)/cd4(+ ) ratio , highest ifn-(+)/il-4(+ ) ratio , highest cd69(+),cd8(+ ) levels , and lowest cd4(+)/cd25(+ ) levels , all consistent with the strongest th1 response .
most importantly , aav / ifn- transduction of t cells resulted in antigen - specific t cell populations with the highest killing capabilities , 49% above other treatments .
these data strongly suggest that aav / ifn- autocrine gene delivery into t cells is worthy of further study towards maximizing the generation of antigen - specific anticancer ctl killers . |
5,922 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: dermatophytosis is a group of skin fungal infections caused by dermatophytes ( or ring worms ) , which invade and attack keratinized tissues .
typical symptoms of these infections include inflammation or redness of the infected part , brittleness and fissures of the nails , and loss of hair from the affected parts . a large number of antifungal agents such as griseofulvin , azole derivatives , allylamines and morpholines are used in the treatment of dermatophyte infections .
however , they have been shown to exhibit adverse side effects such as gastrointestinal disturbances , cutaneous reactions , hepatotoxicity and leucopoenia .
in addition to such adverse effects , the acquired resistance to certain antifungals , and the high cost of synthetic drugs limit the treatment of dermatophytosis . because of their biodegradable nature , the demand for natural drugs has been increasing , and therefore , the development of antifungal agents from local raw material is still a necessity .
this is particularly true in the cases developing countries , which have high levels of their populations .
coula edulis bail ( olacaceae ) , locally known as african walnut , is a commonly occurring medicinal plant in africa .
it can be found in the top canopy of forests as well as the lower story , and has no special soil requirements .
ethnobotanical studies indicate that the stem and fruits of c. edulis are commonly used in west africa for the treatment of stomach ache and skin diseases .
the bark of the plant is used to produce rinses or enemas for loin pains or kidney problems . moreover ,
antibacterial and anti - yeasts activities of c. edulis extracts have been shown in previous studies . to the best of our knowledge
this study , therefore , was undertaken to first evaluate the antidermatophytic activity of the ch2cl2-meoh ( 1:1 v / v ) extract , fractions and compound isolated from the stem bark of c. edulis , and then to assess the toxicological risk of its extract upon consumption .
general experimental procedures for... | background :
coula edulis bail ( olacaceae ) , is an evergreen tree growing to a height of 25 .
this study aimed at evaluating the antidermatophytic and toxicological properties of the stem bark of c. edulis extract as well as fractions and compounds isolated from it .
methods : the plant extract was prepared by maceration in ch2cl2-meoh ( 1:1 v / v ) .
the fractionation of this extract was done by silica gel column chromatography .
antidermatophytic activities were assayed using agar dilution method .
the acute and sub - acute toxicities of oral administrations of the extract were studied in rodents .
results : the crude extract of c. edulis displayed antidermatophytic activity against the tested microorganisms with highest activity against microsporum audouinii and trichophyton mentagrophytes .
the fractionation enhanced the antidermatophytic activity in fraction f3 ( mic=0.62 - 1.25 mg / ml ) compared to the crude extract ( mic=1.25 - 5 mg / ml ) .
further fractionation and purification of the fractions f2 and f3 gave respectively 3-o--d - glucopyranoside of sitosterol ( mic=0.20 - 0.40 mg / ml ) and a mixture of -sitosterol , stigmasterol and n - hexadecanoid acid ( mic=0.80 mg / ml ) .
the median lethal doses ( ld50 ) of the crude extract were 16.8 and 19.6 g / kg body weight ( bw ) in male and female mice , respectively . at 200 mg / kg bw , there was a decrease in body weight gain , food and water consumptions .
gross anatomical analysis revealed white vesicles on the liver of the rats treated with the extract at 200 mg / kg bw .
this dose also induced significant ( p<0.05 ) changes on hematological and biochemical parameters in rats after 28 days of treatment .
conclusion : these data suggest that the ch2cl2-meoh ( 1:1 v / v ) extract of c. edulis stem bark possesses antidermatophytic properties .
they also show that at high doses ( 200 mg / kg bw ) , the extract has significant hepatotoxic and nephrotoxic activities . |
5,923 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: swabs were taken from the anterior nares of dogs , horses , and staff ; nasal surface of cats ; perineum of dogs , cats , and horses ; and the neck skin surface of horses .
swab specimens were directly inoculated onto mannitol salt agar ( labm , bury , uk ) with aztreonam ( 2 mg / l ) and oxacillin resistance
screening agar ( oxoid , basingstoke , uk ) and incubated at 37c for < 48 h. staphylococci were identified by colony shape , gram stain , staphylase test ( oxoid ) , and api staph kit ( mr - cns only ) ( biomrieux , basingstoke , uk ) . the disk - diffusion method ( mast , liverpool , uk )
was used to determine the susceptibility of all isolates to oxacillin , methicillin , gentamicin , vancomycin , rifampicin , ciprofloxacin , co - trimoxazole , fusidic acid , and tetracycline , according to the british society for antimicrobial chemotherapy guidelines , by using s. aureus atcc 26923 , emrsa-15 , and emrsa-16 as controls ( 9 ) .
cell lysates of all methicillin - resistant staphylococci were prepared as described previously ( 10 ) .
cell lysates were also prepared from 3 control strains , emrsa-15 , emrsa-16 , and the canadian epidemic strain , cmrsa-5 , previously found in horses and humans ( 8) .
the presence of the meca gene was determined with polymerase chain reaction ( pcr ) by using a modified method adapted from vanuffel et al . ( 11 ) , with a conventional thermocycler .
pcr to detect the s. aureus fema gene was used to confirm isolates as mrsa ( 12 ) . for all mrsa and equine mr - cns isolates , the sccmec cassette and the agr operon
all mrsa isolates were screened for the gene encoding panton - valentine leukocidin by using the method of lina et al .
( 14 ) ; a positive control for this reaction was provided by the scottish mrsa reference laboratory .
macrorestriction of the genome and pfge were conducted on all mrsa isolates according to the protocol described by murchan et al .
swabs taken from cats ( n = 50 ) and dogs ( n = 55 ) treated at the sah and cats within the community ( february ... | we determined the molecular characteristics of methicillin - resistant staphylococci from animals and staff at a small animal and equine hospital .
methicillin - resistant staphylococcus aureus ( mrsa ) identical to human emrsa-15 was found in dogs and hospital staff .
in contrast , 5 distinct mrsa strains were isolated from horses but not from hospital staff . |
5,924 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the concept of stability in vitiligo is multifaceted , and no consensus has yet been reached on defining the criteria for this so far .
it includes not only clinical aspects of stability but also many recently identified biochemical and ultrastructural correlates of the same .
the exact definition of stability in vitiligo is still elusive , and a number of difficulties arise when examining individual patients to decide on the stability of this disease .
this concept gains utmost importance when selecting appropriate patients of refractory vitiligo for surgical interventions .
apart from clinical features that help in deciding stability of the disease , a number of studies have focussed on evaluating ultrastructural , serological and biochemical parameters to distinguish between stable and active disease .
most of these parameters have evolved as a result of understanding the pathogenesis of the disease and the various hypotheses for the same : autoimmune hypothesis ( serum levels of autoantibodies , t cell subset dysregulation and histological changes ) , neural hypothesis ( serum catecholamines and their metabolites and neuropeptide y ) , oxidative stress ( oxidant - antioxidant levels ) and melanocytorrhagy ( ultrastructural studies ) .
although no universal consensus exists on the optimum duration of non - progression for the disease to be labelled as stable clinically , recently , the indian association of dermatologists and venereologists ( iadvl ) taskforce for standard guidelines of care for dermatosurgical procedures in their consensus recommendations defined stability as a patient reporting no new lesions , no progression of existing lesions , and absence of koebner phenomenon during the past 1 year. the stark difference in the minimum required period of stability in different studies is depicted in table 1 .
however , in a recent study comparing the results of suction blister grafting in patients with varying periods of stability , successful repigmentation ( > 75% ) was seen in 0% of patients with... | stability is a hard - to - define concept in the setting of vitiligo , but is nonetheless extremely crucial to the planning of treatment regimens and also in prognosticating for the patient .
there are several ways to judge stability in vitiligo , which include clinical features and , recently , many biochemical , cytological and ultrastructural correlates of the same .
these recent advances help in not only in prognosticating individual patients but also in elucidating some of the mechanisms for the pathogenesis of vitiligo , including melanocytorrhagy and oxidative damage to melanocytes . |
5,925 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: dpp - iii ( ec 3.4.14.4 ) of the goat brain is a dipeptidylaminopeptidase which removes n - terminal dipeptide from arg - arg-4mna at ph 8.5 .
the enzyme was recently purified and characterized and found to be affected by thiol compounds and metal ions .
it hydrolysed leu - enkephalin and other bioactive peptides and displayed micromolar affinity for enkephalins thereby suggesting its involvement in regulating enkephalin disposition [ 2 , 4 ] .
all the studied analgesic and antihypertensive drugs inhibited the enzyme . in the present study , it has been demonstrated that the enzyme activity is retained in davis gel electrophoresis at ph 8.3 .
understanding of catalytic mechanisms , structural features of protease , and their inhibitors are very important to explore their applications in medicinal field .
ethylene diamine tetraacetic acid ( edta ) , tris - hcl , dialysis bags , polyacrylamide , n , n-methylene bisacrylamide , ammonium persulphate , and temed were procured from himedia .
louis , mo , usa . the routine pipetting was done with micropipettes from tarson and very small volumes were pipetted out using hamilton syringes . the digital spectrophotometer from systronics was used to record the absorbance at 520 nm .
dpp was purified and assayed with arg - arg-4mna as substrate at ph 8.5 ( tris - hcl , 50 mm , containing 100 mm nacl and 1 mm -mercaptoethanol ( -me ) .
one unit of enzyme activity was defined as the amount of enzyme that liberated 1 nanomole of 4 mna from the substrate per minute under assay conditions .
the enzyme was incubated with tris - hcl buffer ( 50 mm , ph 8.5 containing 1 mm -me ) with different concentrations of nacl ( 0 to 1000 mm ) at 37c for 10 min .
, the 10% davis gel was prepared . before loading the protein samples , the polymerized gel was pre - electrophoresed for 2 h at a current of 4 ma by using resolving gel buffer .
purified protein ( 25 g ) was loaded on gel and run at a constant current of 4 ma at 4c .
one half was stained with coomassie... | dipeptidylpeptidase - iii
( dpp - iii ) from goat brain was purified and
characterized using
arginyl - arginyl-4-methoxy--naphthylamide
( arg - arg-4mna ) substrate .
this enzyme retained
its activity in native 10% polyacrylamide
gel when stained using arg - arg-4mna .
the activity was significantly increased by
100 mm chloride .
studies for its
inhibition with some peptides and chemical
inhibitors revealed that leu - trp - met - arg - phe - ala
was most potent inhibitor followed by
arg - phe - ala and gly - phe - leu . all the studied
chemical inhibitors caused 4050%
inhibition at 1 mm .
metal ions helped to
regain activity of edta pretreated enzyme .
zncl2 at 50 m almost completely restored the enzyme activity .
further zncl2 and cocl2 exerted protective effects on edta pretreated enzyme for its susceptibility to dtnb inhibition .
therefore , dpp - iii is a metalloprotease with the involvement of cysteine residues either located at the catalytic site or involved in regulation . |
5,926 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: one of the major questions in the nkt cell field is the identity of the glycolipid ligands responsible for the positive selection of nkt cells .
cd1d molecules most likely bind their ligands as they recirculate through the endosomal / lysosomal pathway of the dp cells before returning to the cell membrane to present the ligands to developing nkt cells ( 68 ) .
the prototypic nkt cell antigen is -galacytosylceramide ( -galcer ) ( 9 , 10 ) , which is recognized by most , if not all , nkt cells in mice and humans .
-galcer , a glycosphingolipid derived from marine sponges , is a potent agonist ligand that can initiate nkt cell dependent immune responses , leading to enhanced immunity to tumors and infectious organisms and suppression of certain autoimmune diseases ( 3 ) .
several other nonmammalian agonist glycolipid ligands for nkt cells have recently been identified ( 9 , 11 ) .
although these ligands provide important insight into targets for nkt cell dependent immune responses , they can not serve as endogenous ligands for nkt cell selection . a word about -hexosaminidase nomenclature.lysosomal -hexosaminidase enzymes are dimers .
-hexosaminidase a is a heterodimer consisting of and subunits , -hexosaminidase b is a subunit homodimer , and -hexosaminidase s is an subunit homodimer .
thus , a mutation in the subunit ( hexa ; tay - sachs disease ) affects -hexosaminidase a and s but not -hexosaminidase b , whereas a mutation in the subunit ( hexb ; sandhoff disease ) affects both -hexosaminidase a and b enzymes . both -hexosaminidase a and b enzymes degrade igb4 to igb3 in lysosomes , meaning that this particular pathway is disrupted in sandhoff disease but not in tay - sachs disease ( 18 ) . a word about -hexosaminidase nomenclature .
-hexosaminidase a is a heterodimer consisting of and subunits , -hexosaminidase b is a subunit homodimer , and -hexosaminidase s is an subunit homodimer .
thus , a mutation in the subunit ( hexa ; tay - sachs disease ) affects -hexosaminidase a and s but not... | natural killer t cells ( nkt cells ) are selected in the thymus by self - glycolipid antigens presented by cd1d molecules .
it is currently thought that one specific component of the lysosomal processing pathway , which leads to the production of isoglobotrihexosylceramide ( igb3 ) , is essential for normal nkt cell development .
new evidence now shows that nkt cell development can be disrupted by a diverse range of mutations that interfere with different elements of the lysosomal processing and degradation of glycolipids .
this suggests that lysosomal storage diseases ( lsds ) in general , rather than one specific defect , can disrupt cd1d antigen presentation , leading to impaired development of nkt cells . |
5,927 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: hcv infection is among life threatening public health problems worldwide , with over 170200 million infected people including about 17 million from pakistan .
it has been estimated to cause approximately 27% of cirrhosis and 25% of hepatocellular carcinoma cases worldwide .
hcv is a small enveloped , positive sense single stranded rna virus and has been classified as a separate genus hepacivirus in the flaviviridae family .
the hcv genome is approximately 9.6 kb , encoding a polyprotein of about 3010 amino acids and is flanked by short untranslated regions ( utrs ) regions at the 5 and 3 terminus .
this polyprotein is posttranslationally processed by viral and cellular proteins to generate the structural proteins ( c , e1 , e2 , and p7 ) and nonstructural proteins ( ns2 , ns3 , ns4a , ns4b , ns5a , and ns5b ) , .
hcv shows high degree of genetic heterogeneity ; consequently six major genotypes and multiple subtypes of hcv have been identified so far in world .
the common subtypes found in north and south america , europe , russia , china , japan , australia , and new zealand are 1a , 1b , 2a , 2c , and 3a .
genotype 4 is predominant in egypt , north africa , central africa , and middle east .
genotype 5 in south africa and genotype 6 in southeast asia have been identified .
genotype 3 is the most prevalent genotype in india , bangladesh , pakistan , and nepal [ 1215 ] .
subtypes of genotypes 1 , 2 , 3 , and 6 have been found prevalent in thailand , vietnam , indonesia , and burma respectively .
genotype 1b is the most prevalent genotype in china ; however genotype 2 has also been reported from some regions of china . in pakistan ,
the prevalence of hcv infection has been estimated to be 8% and is increasing gradually due to deficiency in basic health care recourses and lack of the general public awareness about safety measures .
some studies have been conducted on prevalence of hcv genotypes in khyber pukhtunkhwa region of pakistan [ 1720 ] .
however , little has been reported on prevalence of hcv... | determination of an individual 's hepatitis c virus ( hcv ) genotypes prior to antiviral therapy has become increasingly important for the clinical management and prognosis of hcv infection .
therefore , this study was conducted to investigate the prevalence of hcv genotypes in hcv infected patients of district bannu in khyber pakhtunkhwa region of pakistan .
serum samples of 117 seropositive patients were screened for hcv - rna by using reverse transcriptase - nested polymerase chain reaction ( rt - nested pcr ) and then pcr positive samples were subjected to hcv genotyping . out of 117 seropositive samples ,
110 samples were found positive by pcr analysis .
genotype 3a was the most prevalent one detected in 38% of patients , followed by genotype 3b in 21% of patients , and then genotype 2a in 12% of patients .
however 21% of hcv - pcr positive samples could not be genotyped by method used in this study .
genotype 3a was the most prevalent genotype in patients of all age groups and its prevalence was found high among patients with increasing age ( > 34 years ) .
moreover , genotypes 3a and 3b were found to be the most prevalent genotypes in patients with history of shaving by barbers , receiving multiple injections , and dental procedures . in conclusion
there is need of further investigation of genotypes of hcv by using more sensitive assays and considering large sample size in district bannu . |
5,928 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: smoking tobacco not only predisposes to the development of disease , it increases disease severity and treatment failure rates . for these reasons ,
smoking cessation particularly benefits those patients who have smoking - related cancers such as head and neck or lung cancer and those who are diagnosed with curable disease .
cigarette smoking and alcohol consumption are well - established risk factors for developing squamous cell carcinoma of the head and neck .
furthermore , a number of studies have revealed an association between tobacco carcinogens and the molecular progression of squamous cell carcinoma of the head and neck . in countries with a high prevalence of smoking ,
furthermore , the increased incidence of lung cancer from smoking is proportional to the length and intensity of smoking history .
smoking cessation before diagnosis reduces the risk of developing a primary tumour of all major histological types of lung carcinoma .
prolonged tobacco smoking in cancer patients has many adverse effects during the oncology treatment plan as well .
studies with head and neck and lung cancer patients demonstrate that tobacco smoking reduces survival time and increases the risk of a recurrence or a second primary tumor [ 4 , 5 ] .
smoking also reduces the efficacy of radiotherapy in head and neck cancer patients , as smokers have a lower rate of complete response and poorer 2-year survival rate than nonsmokers and those who quit prior to treatment . tobacco smoking also exacerbates and prolongs radiotherapy induced complications such as mucositis , dry mouth , loss of taste , voice , impaired pulmonary function , wound healing , as well as tissue and bone necrosis [ 4 , 7 ] . despite these adverse health effects , 23% to 35% of head and neck cancer patients [ 5 , 810 ] and 13% to 20% of lung cancer patients who smoked prior to diagnosis continue to do so after diagnosis .
comorbid conditions such as depression , disease - related anxiety , and alcohol abuse often make cessation challenging .
the... | background .
tobacco smoking cessation interventions in the oncology population are an important part of comprehensive treatment plan . objectives . to evaluate through a systematic review smoking cessation interventions and cessation rates in cancer patients .
search strategy .
the literature was searched using medline , embase , and the cochrane library ( inception to november 2010 ) by three independent review authors .
selection criteria .
studies were included if tobacco smoking cessation interventions were evaluated and patients were randomized to usual care or an intervention .
the primary outcome measure was cessation rates .
data collection and analysis .
two authors extracted data independently for each paper , with disagreements resolved by consensus .
main results . the systematic review found eight rcts investigating smoking cessation interventions in the oncology patient population .
pooled relative risks were calculated from two groups of rcts of smoking cessation interventions based on followup duration . in both groups , the pooled relative risk did not suggest a statistically significant improvement in tobacco cessation compared to usual care .
conclusions .
our review demonstrates that recent interventions in the last decade which are a combination of non - pharmacological and pharmacological approaches yield a statistically significant improvement in smoking cessation rates compared to usual care . |
5,929 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: most scientists view estradiol as women 's sole bone - active gonadal steroid . in reality
estrogen plays positive roles in bone biology and osteoporosis prevention and treatment primarily through decreasing bone resorption [ 35 ] .
there is also compelling evidence that powerful bone - destructive cytokines such as il-1 , il-6 , and tnf are released and increase rapidly with dropping estradiol levels , as occurs with surgical menopause .
estradiol achieves its positive bone effects largely through two key actions : facilitation of vitamin d - related intestinal calcium absorption [ 4 , 7 ] and suppression of bone resorption through the osteoprotegerin / rank / rankl system .
it is also clinically obvious that premenopausal women with amenorrhea have lower estradiol levels and lower bone mineral density ( bmd ) and/or lose bone rapidly .
not until recently did randomized , placebo - controlled trial data from the whi studies show that treatment with conjugated equine estrogen ( cee ) plus medroxyprogesterone ( mpa ) or with cee alone ( in women with hysterectomy ) prevented osteoporotic fractures in asymptomatic postmenopausal women ages 5079 [ 5 , 9 ] .
however , progesterone is usually a present , but an unrecognized partner in bone . with amenorrhea and surgical or natural menopause , not only are estradiol levels low or dropping , progesterone levels are also low .
while , in these conditions , estrogen and progesterone deficiency are nearly indistinguishable , progesterone deficiency precedes low estradiol levels in perimenopause , for example , and with ovulatory disturbances , occurs silently in regular cycles with normal estrogen levels .
the purpose of this paper and meta - analyses is to study recent clinical evidence that endogenous progesterone plays a role in bone health .
so far , three in vitro publications document progesterone 's ability to increase osteoblast numbers [ 1214 ] as well as its effects to promote osteoblast maturation and differentiation .
progesterone appears to play a... | estradiol ( e2 ) and progesterone ( p4 ) collaborate within bone remodelling on resorption ( e2 ) and formation ( p4 ) .
we integrate evidence that p4 may prevent and , with antiresorptives , treat women 's osteoporosis .
p4 stimulates osteoblast differentiation in vitro .
menarche ( e2 ) and onset of ovulation ( p4 ) both contribute to peak bmd .
meta - analysis of 5 studies confirms that regularly cycling premenopausal women lose bone mineral density ( bmd ) related to subclinical ovulatory disturbances ( sods ) .
cyclic progestin prevents bone loss in healthy premenopausal women with amenorrhea or sod .
bmd loss is more rapid in perimenopause than postmenopause
decreased bone formation due to p4 deficiency contributes . in 4 placebo - controlled rcts ,
bmd loss is not prevented by p4 in postmenopausal women with increased bone turnover .
however , 5 studies of e2-mpa co - therapy show greater bmd increases versus e2 alone .
p4 fracture data are lacking .
p4 prevents bone loss in pre- and possibly perimenopausal women ; progesterone co - therapy with antiresorptives may increase bone formation and bmd . |
5,930 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: over last three decades , the role of hematopoietic stem cell transplant ( hsct ) in chronic myeloid leukemia ( cml ) has seen several phases and continues to be defined . in 1980 's ,
hsct came as a revolutionary concept that offered cure from cml . in 1990 's ,
transplant methodologies were refined , which resulted in increased cure rates and decreased transplant - related mortality .
survival outcomes improved significantly in chronic phase patients with 3 years survival rate of more than 80% .
thirty years later , it is still the only treatment that offers cure in cml .
the ability of allogeneic hsct to cure cml is related to the antileukemic effects of both the conditioning regimen and the graft versus leukemia ( gvl ) effect of the donor lymphocytes . however , with the advent of imatinib in early 2000 's the natural history of cml was changed and so did the way we treated cml . with the excellent response rates and minimal toxicity imatinib soon became the treatment of choice for chronic phase cml , and it was thought that hsct was no longer needed at least in chronic phase . however , as our experience with imatinib increased , issues of resistance / intolerance in chronic phase emerged . at 18 months of treatment , imatinib resistance
also , the treatment of advanced phase disease ( accelerated and blast phases ) with imatinib proved to be inadequate .
second - generation tyrosine kinase inhibitors ( tkis ) including dasatinib and nilotinib were able to achieve < 50% complete cytogenetic response ( ccyr ) in imatinib resistant / intolerant cases .
thus , transplantation still has a definite , though more limited , role in the treatment of cml .
in advanced phase disease , treatment with tkis can achieve initial good response ( second chronic phase ) .
however , such responses are usually short lived and do not appear to be associated with long - term survival . in one study ,
the rate of major cyr and ccyr in accelerated phase patients treated with imatinib at 600 mg / day was only 24% and 17% ,... | indications for hematopoietic stem cell transplant ( hsct ) in chronic myeloid leukemia ( cml ) have changed over time .
this change has largely been influenced by the advent of tyrosine kinase inhibitors , increased understanding of the mechanisms underlying disease phase progression as well as drug resistance , refinement of transplant techniques and exploitation of graft versus leukemia effect in this disease . here , we have discussed the status of hsct in cml in the present era with regards to the current indications , factors determining outcome and management strategies for posttransplant relapse . |
5,931 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: chorioangiomas are the most common benign tumors of the placenta originating from primitive angioblastic tissues .
the newborn are rare and usually associated with tumors greater than 5 cm in diameter and consist of polyhydramnios , fetal anemia , massive edema with pleural effusion , ascites and intrauterine growth retardation .
we present a case with large chorioangioma as the cause of non - immunologic hydrops fetalis with a successful outcome .
the patient was a female newborn with history of polyhydramnios , symptoms of congestive heart failure and associated anemia , thrombocytopenia and coagulopathy .
chorioangioma of the placenta has potentially serious perinatal risks and so the pregnancy needs to have regular surveillance .
the term non - immunologic hydrops fetalis ( nihf ) defins an edematous fetus with fluid collections in some or all serous cavities that does not have erythroblastosis fetalis from isoimmunization . in 1943
dr edith potter published the first description of nihf ; now over 80 conditions are known to be associated with hydrops with very high perinatal mortality ranging from structural heart disease , fetal arrhythmias , chromosomal anomalies , intrauterine infections and larger chorioangiomas of the placenta[25 ] . in most countries with low rhesus - negative rates in the population ,
nonimmune causes are more prevalent ; the incidence depends on the region and also varies seasonally in relation to parvovirus b19 epidemics .
we describe a newborn in whom cardiac enlargement and congestive heart failure were caused by a vascular shunt through a large placental chorioangioma , emphasizing the importance of the anatomical study of the placenta for the correct diagnosis , managing the neonatal care and evolution of the newborn .
a 2.120 g preterm female newborn , product of a non consanguineous marriage was born from a primigravida by emergency cesarean section at 32 weeks of gestation because ultrasound examination revealed cardiomegaly with abnormal umbilical flow and signs of... | backgroundchorioangiomas are the most common benign tumors of the placenta originating from primitive angioblastic tissues .
it comprises near 1 percent of placental tumors . clinical manifestations in
the newborn are rare and usually associated with tumors greater than 5 cm in diameter and consist of polyhydramnios , fetal anemia , massive edema with pleural effusion , ascites and intrauterine growth retardation .
we present a case with large chorioangioma as the cause of non - immunologic hydrops fetalis with a successful outcome.case presentationthe patient was a female newborn with history of polyhydramnios , symptoms of congestive heart failure and associated anemia , thrombocytopenia and coagulopathy .
the pathophysiology and management of the complications of hydrops fetalis with chorioangioma are discussedconclusionchorioangioma of the placenta has potentially serious perinatal risks and so the pregnancy needs to have regular surveillance .
the chance of developing complications is directly related with the tumor size . |
5,932 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 46-year - old female presented with vague gastrointestinal symptoms , chronic right upper quadrant abdominal pain and intolerance to fatty food and diarrhea for the last two years .
she was given the diagnosis of irritable bowel syndrome and had been followed by her internist .
she had undergone an abdominal hysterectomy with bilateral salpingo - oophorectomy for menometrorrhagia and fibroids 15 years ago but was otherwise healthy . during the work - up , an ultrasound ( u / s ) of the abdomen revealed several small stones in the fundus of the gallbladder and a common bile duct of normal diameter .
laparoscopic visualization of the abdominal cavity revealed a small brownish mass at the tip of the appendix resembling a lymph node .
the camera was then moved from the supraumbilical port to the subxyphoid one . using the same instruments , ie , two endo grasps plus a multifire endo gia 30 stapler , the appendix
pathologic examination demonstrated a carcinoid tumor in the tip of the appendix , which measured 0.3 0.2 cm ( figure 1 , 2 ) .
the margins of the specimen were clear , no lymph nodes were seen , and there was no mesoappendix invasion .
. longitudinal section of the appendix tip demonstrating nests of uniform , polygonal cells with round , centrally placed nuclei , characteristic of carcinoid tumors , 200x .
merling , in 1838 , described the gross pathology of carcinoid tumor of the appendix , and in 1907 oberndorfer coined the term karzinoide .
carcinoid tumors of the midgut arise from the distal duodenum , jejunum , ileum , appendix , and ascending and right transverse colon , with the appendix and terminal ileum being the most common locations .
carcinoids share common histochemical characteristics with other gut cells ; they originate as solid nests of small monotonous neuroendocrine cells with high rare mitoses and occasional acinar or rosette formation .
they have a high amine content in the cytoplasm , are capable of amine precursor uptake , and are able to decarboxylase these products to... | carcinoid tumors of the midgut arise from the distal duodenum , jejunum , ileum , appendix , ascending and right transverse colon .
the appendix and terminal ileum are the most common location .
the majority of carcinoid tumors originate from neuroendocrine cells along the gastrointestinal tract , but they are also found in the lung , ovary , and biliary tracts .
we report the first case of elective laparoscopic cholecystectomy in which we found a suspicious lesion at the tip of the appendix and proceeded to perform a laparoscopic appendectomy .
the lesion revealed a carcinoid tumor of the appendix . |
5,933 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in this article , we take a historical perspective to describe how individual diseases caused by cmv were first recognised .
we focus on congenital cmv , infections in solid organ transplants , bone marrow transplants and advanced hiv using data from developed countries , because other articles in this issue will consider africa , hiv - infected or exposed neonates with cmv and the prospects for developing cmv vaccines .
this was first recognised about 100 years ago when intranuclear inclusion bodies were seen in histopathological sections from cases of stillbirth .
the availability of cell culture diagnosed infection in cases who survived intrauterine infection to be born with features of cytomegalic inclusion disease ( table 1 ) .
prospective natural history studies also showed that apparently normal neonates could have congenital cmv infection .
importantly , those with symptoms at birth had higher levels of cmv in the urine than those without symptoms ( figure 1 ) in what was the first demonstration in humans of the phenomenon now termed viral load .
the implications of this observation from 1975 were profound ( table 2 ) and have all turned out to be correct .
this includes the threshold concept , that disease occurs once viral load exceeds a critical value , so that benefit against disease may be greater than predicted from the activity of a drug against infection .
cytomegalic inclusion disease blueberry muffin rash intrauterine growth retardation sensorineural hearing loss conjugated hyperbilirubinaemia raised liver transaminases periventricular calcifications association between quantity of cmv found in the urine and the severity of disease in neonates .
j infect dis 1975 ; 132 : 568577 implications of results shown in figure 2 cmv is a systemic infection sampling urine provides information about clinically inaccessible sites e.g. inner ear cmv is a chronic infection in neonates so there may be a cmv - specific immune defect cmv may cause disease once a threshold value of viral load is exceeded... | abstractcytomegalovirus ( cmv ) is well - known for the end organ diseases ( eods ) it causes following viraemic dissemination in immunocompromised hosts .
these are termed the direct effects of cmv , where a diagnosis can be made in an individual patient .
in addition , cmv is associated with indirect effects where populations can be seen to be disadvantaged compared to those without cmv .
these indirect effects have been described in solid organ transplants , bone marrow transplants , advanced hiv , people admitted to intensive care units , the elderly and the general population.we summarise the evidence that associates cmv with its direct effects following congenital infection , solid organ transplantation , bone marrow transplantation and advanced hiv as well as its indirect effects in all patient populations .
we propose that the greatest worldwide burden of cmv comes from its indirect effects .
control of this infection at the population level is being sought through the development of vaccines to control eods where cost effectiveness is expected .
we propose that the financial case for universal immunisation will be enhanced even further by the potential benefits vaccines may produce against the indirect effects of cmv . |
5,934 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: interest in the redox properties of natural products has stimulated many studies focusing on natural products that prevent the destructive effects caused by reactive oxygen species ( ros ) on many biomolecules ( 1 ) .
ros are also involved in controlling the pathogenesis of many degenerative diseases ( 2,3 ) and may activate redox sensitive transcription factors ( 4 ) . as a result , the maintenance of redox homeostasis is a crucial asset for survival of stress scenarios , in the tissues of both plants ( 5 ) and animals ( 2).the maintenance of physiological redox homeostasis is as essential for a cell as that of osmosis or ph . during evolution
, cells have developed complex interacting regulatory mechanisms that include enzymes and reducing metabolites that help to maintain the redox homeostasis ( 6 ) .
consequently , natural products have been and are screened for their antioxidant activity and , in this context , especially for their ros - scavenging properties .
this broad interest has led to the development of various assays to determine antioxidant activity ( 710 ) .
the hydroxyl radical ( oh ) occupies an exceptional position among ros because of its extreme reactivity and oxidative potential ; it attacks even inert compound such as alkanes ( 11 ) which are normally considered to be stable under physiological conditions .
one route to hydroxyl radicals is outlined by the fenton reaction ( reaction 1 ) which is catalyzed by transition metals ( e.g. , fe , cr , cu , or mn ) .
gutteridge and co - workers introduced an assay that allowed the detection of interactions of the test compounds with the formation of hydroxyl radicals by the fenton reaction ( 1214 ) .
this assay uses 2-deoxy - d - ribose as detection molecule , and it is utilized in phytochemistry and food chemistry to assess antioxidant properties of various compounds or extracts ( 10,1517 ) .
2-deoxy - d - ribose is degraded by hydroxyl radicals that are generated in the reaction mixture by the fenton reaction .
the amount of the degradation... | interest in the redox properties of natural products has led to the development of various assays for the detection of antioxidant activities and ros - scavenging properties . here , additional modifications of the 2-deoxy - d - ribose degradation assay are introduced that specifically allow the determination of interactions of the test compound with the autoxidation of ascorbic acid and the autoxidation of the test compound itself . to illustrate this ,
juglone and quercetin were used as examples .
the modified assay systems provide insights into their specific antioxidative and pro - oxidative properties . in additional ,
an extensive characterization of the redox properties of their complex with iron is possible , if iron ions are added in the free form or complexed with edta .
the jugloneiron complex proved to be pro - oxidative in a wider range of milieus than the quercetiniron complex . |
5,935 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: arrhythmogenic right ventricular cardiomyopathy/ dysplasia ( arvc / d ) is a myocardial disease in which myocardium of the right ventricular free wall is partially or almost entirely replaced by fatty or fibro - fatty tissue ( 13 ) .
the anterior right ventricular outflow tract , the apex , and the inferior - posterior wall the so - called triangle of dysplasia are primarily involved ( 4 )
. the degenerative process may be segmental or diffuse ; on post mortem examination degeneration results to affect the left ventricle in about 50% of cases and to involve the septum only in 20% ( 3 ) .
clinical manifestations of the disease mostly occur between the second and fourth decade of life ; they include structural and functional abnormalities of the right ventricle , electrocardiographic depolarization / repolarization changes and arrhythmias of right ventricular origin ( 5 ) .
ventricular tachycardias are thought to be due to re - entry between the abnormal and normal areas of the right ventricular myocardium .
arvc is a progressive heart muscle disease with different clinico - pathological patterns : a ) silent cardiomyopathic abnormalities localized to the right ventricle in asymptomatic victims of sudden death ; b ) overt disease characterized by segmental or global right ventricular structural changes , often associated with histological evidence of left ventricular involvement and underlying symptomatic ventricular arrhythmias ; c ) end - stage
biventricular cardiomyopathy mimicking dilated cardiomyopathy , which leads to progressive heart failure and may require heart transplantation ( 6 ) .
a scoring system to establish diagnosis of arvc has been developed on the basis of the presence of major and minor criteria encompassing structural , histological , electrocardiographic , arrhythmic and genetic features of the disease ( 7 ) .
drug treatment is warranted in patients with palpitations , syncope or documented sustained ventricular arrhythmias .
clinical investigation aims at identifying subjects at... | arrhythmogenic right ventricular cardiomyopathy ( arvc ) is a heart muscle disease in which the pathological substrate is a fibro - fatty replacement of the right ventricular myocardium .
the major clinical features are different types of arrhythmias with a left branch block pattern .
arvc shows autosomal dominant inheritance with incomplete penetrance .
recessive forms were also described , although in association with skin disorders.ten genetic loci have been discovered so far and mutations were reported in five different genes .
arvd1 was associated with regulatory mutations of transforming growth factor beta-3 ( tgf3 ) , whereas arvd2 , characterized by effort - induced polymorphic arrhythmias , was associated with mutations in cardiac ryanodine receptor-2 ( ryr2 ) .
all other mutations identified to date have been detected in genes encoding desmosomal proteins : plakoglobin ( jup ) which causes naxos disease ( a recessive form of arvc associated with palmoplantar keratosis and woolly hair ) ; desmoplakin ( dsp ) which causes the autosomal dominant arvd8 and plakophilin-2 ( pkp2 ) involved in arvd9 .
desmosomes are important cell - to - cell adhesion junctions predominantly found in epidermis and heart ; they are believed to couple cytoskeletal elements to plasma membrane in cell - to - cell or cell - to - substrate adhesions . |
5,936 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: double free - flaps are technically challenging due to the complex nature of the defect , harvest of two flaps and use of two pairs of recipient 's vessels . in such limb defects more
further the risk of distal limb ischaemia is imminent when collateral circulation is not adequate .
double fasciocutanous flaps either perfused independently or as chimeric flaps fulfil the requirements provided suitable recipient vessels are available .
the risk of distal limb ischaemia is minimal when a single vascular axial limb vessel is used as the recipient .
harvest of such flaps from a common donor site avoids the morbidity of distant second donor site .
we report successful resurfacing of large bimalleolar defects in a 14-year - old boy using the anterolateral and anteromedial fasciocutanous perforator flaps harvested independently and anastomosed to the proximal and distal cut ends of the anterior tibial vessels .
a 14-year - old boy presented to us with a 2 weeks old infected bimalleolar defect with dimensions of 12 cm 7 cm medially and 8 cm 4 cm laterally [ figure 1 ] at the ankle .
the patient was treated with cast application elsewhere for swelling of the ankle following a fall and had no bony injury .
he developed severe pain in the ankle soon after and fever a week later , .
on removal of the cast , necrosis of the skin was noted over the both malleoli which was debrided at the referral hospital and then he was referred to our institute for further management .
malleoli and the adjacent lower ends of tibia and fibula were exposed with open ankle joint - draining frank pus .
the foot was sensate and well vascularised with good dorsalis pedis and posterior tibial pulsations .
considering the dimensions and proximity of the two defects , a chimeric fasciocutanous anteromedial thigh ( amt ) and anterolateral thigh ( alt ) flap [ figure 2 ] based on the lateral circumflex , femoral vessels was planned and their perforators marked with hand held doppler .
the flaps were raised based on these perforators and the... | double free - flaps are necessary when tissue cover can not be sufficed with a single flap . the other factors to be considered when using two free flaps for resurfacing of distal limb defects are the availability of more than one recipient vessel , the risk of distal limb ischaemia and the donor site morbidity of double flap harvest .
if these factors are adequately addressed , double free - flaps can be safely executed for resurfacing distal limb defects with minimal morbidity .
we report the simultaneous harvest and transfer of the anterolateral and anteromedial thigh flaps inset and vascularised as double free - flaps to resurface a large bimalleolar defect in a 14-year - old boy with no additional morbidity as compared to that of a single free tissue transfer . |
5,937 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: chronic obstructive pulmonary disease ( copd ) is characterized by persistent and progressive airflow limitation resulting from abnormal inflammatory response of the airways and lungs to noxious particles inhalation.1 apart from inducing lung damage , copd is recognized as a multisystemic inflammatory disease associated with extrapulmonary comorbidities that can substantially affect the disease prognosis.1,2 the prevalence of comorbidities in copd patients ranges between 65% and 81%,2 and they represent the primary causes of death in more than 60% of copd patients.3 specifically , the prevalence of cardiovascular disorders in copd patients is ~40%;2 such disorders are directly associated with cardiac autonomic regulation.4,5 the integration of the cardiovascular , respiratory , and muscular systems constitutes a complex and sophisticated mechanism of energy generation6 in which the cardiovascular system activity , aiming at organic homeostasis preservation , is controlled by the autonomous nervous system ( ans).7 however , cardiorespiratory disorders , such as copd , can induce changes in the sympathovagal balance , which can result in detrimental alterations in the ans functioning of these patients.5 the heart rate variability ( hrv ) analysis is an important tool for the assessment of the ans behavior,8 used to determine pathological conditions and investigate physiological modifications , which can be associated with physical exercise performance.6,8 reduced hrv is associated with increased morbidity and mortality in copd patients,4,5 and this has led various researchers to investigate the ans behavior during respiratory maneuvers , position changes , and pharmacological blockade.9 it is widely known that in copd patients the hrv is reduced , and postural adjustments , which induce a predominantly sympathetic stimulation , are also impaired .
however , the number of studies that evaluated the parasympathetic component is scarce.10 the heart rate ( hr ) follows an oscillatory pattern synchronized with the... | introductionchronic obstructive pulmonary disease ( copd ) is recognized as a multisystemic inflammatory disease associated with extrapulmonary comorbidities , including respiratory muscle weakness and cardiovascular and cardiac autonomic regulation disorders .
we investigated whether alterations in respiratory muscle strength ( rms ) would affect cardiac autonomic modulation in copd patients.methodsthis study was a cross - sectional study done in ten copd patients affected by moderate to very severe disease . the heart rate variability ( hrv )
signal was recorded using a polar cardiofrequencimeter at rest in the sitting position ( 10 minutes ) and during a respiratory sinus arrhythmia maneuver ( rsa - m ; 4 minutes ) .
linear analysis in the time and frequency domains and nonlinear analysis were performed on the recorded signals .
rms was assessed using a digital manometer , which provided the maximum inspiratory pressure ( pimax ) and the maximum expiratory pressure ( pemax).resultsduring the rsa - m , patients presented an hrv power increase in the low - frequency band ( lfnu ) ( 46.923.7 vs 75.827.2 ; p=0.01 ) and a decrease in the high - frequency band ( hfnu ) ( 52.823.5 vs 24.027.0 ; p=0.01 ) when compared to the resting condition .
significant associations were found between rms and hrv spectral indices : pimax and lfnu ( r=0.74 ; p=0.01 ) ; pimax and hfnu ( r=0.74 ; p=0.01 ) ; pemax and lfnu ( r=0.66 ; p=0.01 ) ; pemax and hfnu ( r=0.66 ; p=0.03 ) ; between pemax and sample entropy ( r=0.83 ; p<0.01 ) and between pemax and approximate entropy ( r=0.74 ; p=0.01 ) . using a linear regression model , we found that pimax explained 44% of lfnu behavior during the rsa-m.conclusioncopd patients with impaired rms presented altered cardiac autonomic control , characterized by marked sympathetic modulation and a reduced parasympathetic response ; reduced hrv complexity was observed during the rsa - m . |
5,938 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a retrospective case review was performed to identify patients who developed tao in temporal association with periocular surgery .
patients were examined for proptosis , lid retraction and lid lag , extraocular motility abnormalities , and periocular swelling .
radiological investigations ( mri or ct ) were used to confirm clinical impressions and define extraocular muscle and orbital fat involvement .
university institutional review board ( irb ) / ethics committee approval was obtained by authors .
nine patients were identified , all of which female , ranging in age from 45 - 75 years ( average : 59.3 years ) .
group 1 was comprised of four patients who had previously been diagnosed with graves ' hyperthyroidism .
they ranged in age from 48 - 75 years ( average : 58.8 yrs ) .
the diagnosis of graves ' hyperthyroidism had been made 12 to 96 months ( average : 50.5 months ) prior to presenting with orbitopathy .
group 2 was comprised of five patients who were not documented to have had any previous or concurrent thyroid abnormality .
they ranged in age from 45 - 74 years ( average : 60.2 years ) .
none of the patients had previously been diagnosed with tao in relation to their graves ' disease the periocular procedures performed are summarized in table 1 .
all of these patients had been stable with no signs of tao for an average of over four years before periocular surgery .
this 48-year - old patient developed graves ' disease in june of 1994 at age 38 .
she was treated with iodine 131 and rendered euthyroid upon replacement thyroxine treatment . in november 1999
she underwent bilateral lasik surgery to correct her myopia . immediately after surgery she noted swelling in the left eye . in december 1999 it was noted that she had proptosis in both eyes and left upper lid retraction .
she was observed until she was stable and , in june of 2003 , underwent a bilateral fat decompression for cosmesis , followed by left upper lid retraction repair .
this 59-year - old patient was diagnosed with grave 's... | purposeto descirbe a series of patients in which thyroid associated orbitopathy ( tao ) occurred after periocular surgery.methodsa retrospective case review of patients who developed tao in close temporal association with periocular surgical interventions and presented at the orbital clinic from 1997 to 2004 .
history of previous thyroid abnormality and the lack of tao signs and symptoms before surgery were reviewed and analyzed.resultsnine patients that developed tao in association with periocular surgery were identified .
all were women with an average age of 59.3years .
( range : 45 - 75 years ) .
the patients divided into two groups .
group 1 consisted of four patients who had previously been diagnosed with graves ' hyperthyroidism ( gh ) .
they ranged in age from 48 to 75 years ( average : 58.8 years ) .
the diagnosis of gh had been made an average of 50.5 months ( range : 12 - 96 months ) before presentation with tao .
group 2 consisted of five patients who had no previous history of thyroid abnormality .
they ranged in age from 45 to 74 years ( average : 60.2 years ) .
no patients had any signs or symptoms of tao before their recent presentation.conclusionsperiocular surgery may lead to local inflammatory events that may contribute to the instigation of tao in predisposed individuals . |
5,939 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: blood samples and tumour tissues were obtained from 117 operated lung cancer patients admitted to oslo university hospitalrikshospitalet in the period 20062011 . the collected tumor samples consisted of 93 adenocarcinomas , 2 large cell carcinomas and 22 squamous cell carcinomas .
one patient was diagnosed with metastases based on pathology report , and was omitted from survival analyses .
tumour tissue was snap frozen in liquid nitrogen and stored at 80c until dna isolation .
dna was extracted using maxwell16 dna purification kits and a maxwell16 instrument according to technical manual ( literature # tm284)(http://www.promega.com ) .
dna from blood was isolated using the master pure dna purification kit for blood according to the dna purification protocol ( http://www.epicentre.com ) .
targeted resequencing was performed using the sureselect human kinome kit ( agilent technologies ) , with capture probes targeting 3.2 mb of the human genome , including exons and untranslated regions ( utrs ) of all known kinases and selected cancerrelated genes ( 612 ) .
library construction and in solution capturing was performed following agilent 's sureselectxt library construction kit and sureselect target enrichment protocol , respectively .
sequencing was performed on an illumina genome analyzer using truseq sbs kit v5 generating pairedend reads of 75 bp in length .
base calling , demultiplexing and quality filtering was performed using illumina 's software packages scs2.8/rta1.8 and offline basecallerv1.8 .
the raw sequencing reads derived from tumour and control samples were subsequently processed in a computational pipeline to identify and functionally annotate somatic dna changes .
a variant calling pipeline was established to identify somatic mutations in each tumour / control sample pair .
this included several steps : ( i ) alignment of sequence reads toward the reference genome ( grch37 including unlocalised / unplaced contigs and decoy sequences ) using bwamem,9 ( ii ) marking of potential pcrderived... | lung cancer is the leading cause of cancer related death , and the past years improved insight into underlying molecular events has significantly improved outcome for specific subsets of patients . in particular , several new therapies that target protein kinases have been implemented , and many more are becoming available .
we have investigated lung cancer specimens for somatic mutations in a targeted panel of 612 human genes , the majority being protein kinases .
the somatic mutation profiles were correlated to profiles of immune cell infiltration as well as relapsefree survival . targeted deep sequencing
was performed on 117 tumour / normal pairs using the sureselect human kinome kit ( agilent technologies ) , with capture probes targeting 3.2 mb of the human genome , including exons and untranslated regions of all known kinases , kinase receptors and selected cancerrelated genes ( 612 genes in total ) .
cd8 staining was determined using ventana benchmark .
survival analyses were performed using spss .
the number of mutations per sample ranged from 0 to 50 ( within the 612 genes tested ) , with a median of nine .
the prognosis was worse for patients with more than the median number of mutations .
a significant correlation was found between mutations in one of selected dnarepair genes and the total number of mutations in that tumour ( p < 0.001 ) . there was a significant inverse correlation between the number of infiltrating stromal cd8 + lymphocytes and the presence of egfr mutations . |
5,940 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: natural variability in climate is a function of : ( i ) the relative position of the sun ( and its activity such as sunspots , radiation , magnetism , eruption ) and the earth ; ( ii ) the milankovitch cycles ( 1 ) ; and ( iii ) the interactions between the components of the climate system , i.e. the atmosphere , the hydrosphere , the cryosphere , the biosphere and the lithosphere . for centuries
a panoply of climate signals have been noted , ranging from the diurnal , to multi - decadal effects including seasonal , quasi - biennial ( qb ) , el - nio / southern oscillation ( enso ) , quasi - decadal ( qd ) and inter - decadal ( i d ) oscillations ( 2 ) .
adding to these natural cycles and oscillations is the anthropogenic component from population increase , energy needs and associated pollution .
natural climate oscillations interact with the anthropogenic climate change component , and directly impact ecosystems , public health and socio - economic conditions .
the natural variability of the global climate during the 20th century is reproduced in fig . 1
[ see also ( 3 ) ] . during the 20th century a global statistical analysis in the frequency - domain of both sea - surface temperature and sea - level pressure , allows identification of natural climate signals .
coloured bands highlight those signals with their percentage of variance displayed on the ordinates , i.e. secular signal or penta - decadal ( blue band , signal # 1 ) , el - nio / southern oscillation or enso ( orange bands , signals # 4 , 5 and 6 ) , the quasi - biennial signal ( green bands , signals # 7 and 8) .
signal # 2 i d or inter - decadal , and signal # 3 qd or quasi - decadal , are more locals and found over the pacific and atlantic oceans , respectively ( 2 ) . the anthropogenic climate change is interacting and modulates the above climate signals .
climate change alters regional and local social and economic dynamics with the potential of bringing additional inequalities all around the world ( 4 ) .
climate change had impacts in... | backgroundclimate and environment vary across many spatio - temporal scales , including the concept of climate change , which impact on ecosystems , vector - borne diseases and public health worldwide.objectivesto develop a conceptual approach by mapping climatic and environmental conditions from space and studying their linkages with rift valley fever ( rvf ) epidemics in senegal.designponds in which mosquitoes could thrive were identified from remote sensing using high - resolution spot-5 satellite images .
additional data on pond dynamics and rainfall events ( obtained from the tropical rainfall measuring mission ) were combined with hydrological in - situ data .
localisation of vulnerable hosts such as penned cattle ( from quickbird satellite ) were also used.resultsdynamic spatio - temporal distribution of aedes vexans density ( one of the main rvf vectors ) is based on the total rainfall amount and ponds dynamics . while zones potentially occupied by mosquitoes are mapped , detailed risk areas , i.e. zones where hazards and vulnerability occur , are expressed in percentages of areas where cattle are potentially exposed to mosquitoes bites.conclusionsthis new conceptual approach , using precise remote - sensing techniques , simply relies upon rainfall distribution also evaluated from space .
it is meant to contribute to the implementation of operational early warning systems for rvf based on both natural and anthropogenic climatic and environmental changes . in a climate change context , this approach could also be applied to other vector - borne diseases and places worldwide . |
5,941 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: patellar dislocation and patellofemoral instability may occur in a young population with varying activity levels .
the overall recurrence rate of patellar dislocation after an initial event is close to 40 % .
in fact , patients who have a primary patellar dislocation have a 17 % recurrence rate , and patients who sustain repeat patellofemoral joint dislocation have a 49 % recurrence rate .
it is obvious that athletic patients have as a goal resumption of their sports activities at the same high level as prior to the episode of dislocation . for less active patients ,
an increase in their level of activity could be an attractive goal , as strength and stability of the lower limb can prevent re - injury .
information about the functional capacity that allows for a safe return to sports after either primary dislocation or surgical stabilization is sparse .
it is known that medial patellofemoral ligament ( mpfl ) reconstruction and rehabilitation improves the ability to perform routine activities of daily living [ 8 , 13 ] , but it is less evident as regards the ability to resume sports participation safely .
testing protocols are requested after patellar dislocation to assure a safe return to sport ( rts ) , but information on this issue is currently limited in the literature . thus far
, quantitative assessment was recommended , but as it will be shown in this article , qualitative measurement with a systematic video analysis has to be considered to better evaluate the dynamic stability of the knee .
this article focuses on objective patellofemoral instability and return to sport , addressing only those situations where one or more episodes of dislocation have occurred or in cases where surgery for instability has been performed .
it was attempted to answer the following two questions : ( 1 ) how and when can patients safely return to sport after primary or recurrent patellar dislocation , or after patellofemoral stabilization ? ( 2 ) what validated evaluations can be utilized to determine readiness to... | patellofemoral instability may occur in a young population as a result of injury during sporting activities .
this review focuses on return to sport after one episode of dislocation treated no operatively and as well after surgery for chronic patellofemoral instability . with or without surgery ,
only two - thirds of patients return to sports at the same level as prior to injury .
a high - quality rehabilitation programme using specific exercises is the key for a safe return to sporting activities . to achieve this goal ,
recovery of muscle strength and dynamic stability of the lower limbs is crucial .
the focus should be directed to strengthen the quadriceps muscle and pelvic stabilizers , as well as lateral trunk muscle training .
patient education and regularly performed home exercises are other key factors that can lead to a successful return to sports .
the criteria for a safe return to sports include the absence of pain , no effusion , a complete range of motion , almost symmetrical strength , and excellent dynamic stability.level of evidence iv . |
5,942 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the prospective , parallel - design , randomized cluster trial was conducted in three highly populated office buildings for employees in a midwestern mutual health insurance company ( medical mutual of ohio , cleveland ) over a more than 13-month period from february 2014 through march 2015 .
the chesapeake research review institutional review board ( irb ) assessed the study protocol and documentation , approved the study , and provided appropriate oversight throughout the process . in an effort to start the study during typical cold and flu season , baseline surveys were administered in january 2014 .
the building with the most ( 782 ) employees was randomly assigned ( as a cluster ) to the control group .
the 604 employees in the other two buildings ( the second cluster ) were consequently assigned to the intervention group . because the study was low risk in nature , no consent forms were required .
all employees at the three facilities who were 18 years of age or older , were enrolled in the company health insurance coverage , did not transfer between sites and worked onsite full time ( 32 hours ) were eligible for the study .
the three buildings used in the trial had a similar open floor plan with the majority of employees sitting in cubicles . a small percentage
( < 15% ) of traditional - style offices with doors lined the outer perimeter of each floor .
the average amount of work space per worker in the intervention site was 309 square feet , similar to the control site at 323 square feet per worker .
the intervention sites had a total space of 276,000 square feet , and the control site had a total space of 381,000 square feet .
the primary endpoints were ( 1 ) the number of health care insurance claims , for a defined set of preventable illnesses , per subject per year , and ( 2 ) absenteeism , defined as the number of sick episodes per subject per year .
sick episodes were calculated for each employee based on unscheduled paid time off ( pto ) events lasting at least 4 hours .
an unscheduled pto... | objective : the aim of this study was to determine the efficacy of a multimodal hand hygiene intervention program in reducing health care insurance claims for hygiene preventable infections ( eg , cold and influenza ) , absenteeism , and subjective impact on employees.methods:a 13.5-month prospective , randomized cluster controlled trial was executed with alcohol - based hand sanitizer in strategic workplace locations and personal use ( intervention group ) and brief hand hygiene education ( both groups ) .
four years of retrospective data were collected for all participants.results:hygiene-preventable health care claims were significantly reduced in the intervention group by over 20% ( p < 0.05 ) .
absenteeism was positively impacted overall for the intervention group .
employee survey data showed significant improvements in hand hygiene behavior and perception of company concern for employee well-being.conclusion:providing a comprehensive , targeted , yet simple to execute hand hygiene program significantly reduced the incidence of health care claims and increased employee workplace satisfaction . |
5,943 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: almost all newborn infants develop some degree of hyperbilirubinemia as a normal transition in physiology .
high levels of unbound unconjugated bilirubin can cross the blood brain barrier and cause neurological symptoms .
the association between hyperbilirubinemia and encephalopathy was first described in 1847 by hervieux ; the term kernicterus was first used by schmorl in 1903 to describe yellow staining of the basal ganglia .
the terms bilirubin induced neurological dysfunction ( bind ) and kernicterus are often used interchangeably , although some authors consider bind to refer to the clinical presentation and kernicterus to be an anatomical diagnosis . in this paper , the term kernicterus will be used to describe both the neuropathology of bilirubin induced brain injury and the associated clinical presentation .
kernicterus is a preventable condition ; the unconjugated bilirubin levels can be decreased to safe levels by the use of phototherapy or exchange transfusion .
phototherapy is an effective way of decreasing the bilirubin level in neonates , by converting unconjugated bilirubin into isomers such as lumirubin that are water soluble and can be excreted in the urine .
exchange transfusion ( et ) , however , is considered to be the most effective and quickest method to lower the bilirubin level in infants at high risk of kernicterus .
an et is indicated when hyperbilirubinemia remains at dangerous levels despite intensive phototherapy and is particularly useful when there is excessive haemolysis .
the actual bilirubin level at which to implement phototherapy or et has been a subject of controversy for many years . in south africa
, consensus was reached in 2006 on a nationally accepted nomogram for the management of hyperbilirubinemia .
kernicterus is a preventable condition ; however cases still occur , even in high - income countries like the usa .
reasons include early discharge of neonates without predischarge screening , lack of knowledge regarding neonatal hyperbilirubinemia among both health... | background . severe
hyperbilirubinaemia requiring exchange transfusion has become less common in recent years ; however , kernicterus still occurs .
the aim of this study was to review babies undergoing exchange transfusion for severe hyperbilirubinaemia in a johannesburg hospital . methodology .
this was a retrospective review of babies who required exchange transfusion in both the neonatal and the paediatric wards from june 1 , 2006 , to december 31 , 2011 .
results .
there were 64 patients who underwent 67 exchange transfusions .
isoimmune haemolysis ( both rh and abo incompatibility ) was the cause of jaundice in 9/64 ( 14% ) .
most babies who underwent exchange transfusion were sick or preterm and were admitted in hospital after birth ( 38/64 ; 59.5% ) ; three of these babies died , but not during the exchange transfusion ( 3/38 ; 7.9% ) ; all three had signs suggestive of neonatal sepsis . the remaining 26 babies ( 40.6% ) were readmitted to the paediatric wards for exchange transfusion .
six of these babies ( 6/26 ; 23.0% ) had signs of kernicterus .
the most significant complication of exchange transfusion was apnoea requiring mechanical ventilation in three patients ( 3/64 ; 4.6% ) . conclusion . despite a relatively low number of babies undergoing exchange transfusion
, kernicterus still occurs and must be prevented .
proper protocols for screening and management of severe hyperbilirubinaemia need to be enforced . |
5,944 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: recent studies have shown that the classic circulation model of cerebrospinal fluid ( csf ) is incomplete.1 production of csf is not only dependent on choroid plexus but also on water flux in the pericapillary ( virchow robin ) space.2 , 3 historically , csf flow through the pericapillary space is known as interstitial flow , and is considered to play a role equivalent to the systemic lymphatic system.4 , 5 , 6 , 7 , 8 , 9 , 10 advancements in modern magnetic resonance imaging ( mri ) technologies have allowed for the noninvasive investigation of water flow in vivo .
these studies revealed that water dynamics of the pericapillary space , ie , interstitial flow , is controlled by aquaporin4 ( aqp4 ) , the main subset of the aquaporin water channel family in the brain.11 , 12 , 13 it has also been demonstrated that inhibition of aqp4 is strongly coupled with an increase in regional cerebral blood flow ( rcbf).14 these observations have led to a better understanding of the architectural significance and functionality of the cerebrovascular system.15 , 16 this article is a concise review of the modern concept of neural flow coupling ( nfc ) and its relationship to water dynamics in the pericapillary space.5 , 6 , 7 , 8 , 9 , 10 , 16
cerebral autoregulation signifies an intrinsic ability of the cerebral vasculature to maintain cerebral blood flow at a relatively constant rate of approximately 50 ml per 100 g brain tissue per minute in the face of blood pressure changes.17 , 18 , 19 , 20 , 21 , 22 autoregulation generally functions between mean blood pressures of 60 to 150 mmhg .
it is maintained in parasympathetically and/or sympathetically denervated animals,21 and the system is independent from extrinsic neural control . instead
, intrinsic neural nitric oxide ( no ) control22 and release of vasoactive substrates by the brain are believed to play essential roles in maintaining constant cerebral perfusion.19 , 20 perfusion is held constant by means of the cerebral vasculature smooth muscle that constricts and... | abstractthe phenomenon known as neural flow coupling ( nfc ) occurs at the capillary level where there are no known pressure controlling structures .
recent developments in advanced magnetic resonance imaging technologies have made possible in vivo direct investigations of water physiology that have shed new insight on the water dynamics of the cortical pericapillary space and their complex functionality in relation to nfc .
neural activities initiate a chain of events that ultimately affect nfc .
first , neural activities generate extracellular acidification .
extracellular acidosis in turn produces inhibition of aquaporin4 ( aqp4 ) located at the end feet of pericapillary astrocytes , the water channel which regulates water influx into the pericapillary space and , hence , interstitial flow .
reduction of pericapillary water pressure results in a negative balance between pericapillary and intraluminal capillary pressure , allowing for capillary caliber expansion .
proton permeability through the tight junctions of the blood brain barrier is significantly high owing to the grotthuss proton
tunneling mechanism and , therefore , carbonic anhydrase ( ca ) type iv ( caiv ) anchored to the luminal surface of brain capillaries functions as scavenger of extracellular protons .
caiv inhibition by acetazolamide or carbon dioxide results in the accumulation of extracellular protons , causing aqp4 inhibition and a secondary increase in rcbf . |
5,945 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is the leading cause of acquired disability in adults and has a tremendous socioeconomic impact on patients , their relatives and health systems . in switzerland
, the incidence of stroke has been estimated to be 150/100,000 ( year 2000 ) . in 2004 ,
the overall stroke event rate was 296.3/100,000 ( 287.7/100,000 in women , and 305.6/100,000 in men ) .
the age - standardized event rate was 146/100,000 overall . during the same year , the age - standardized mortality rate was significantly higher for men ( 31.4/100,000 ) than for women ( 25.6/100,000 ) .
acute stroke care provided by stroke units ( su ) has been found to be more costly but also more cost - effective than conventional care .
, reported a mean cost of $ 3,200 ( usd ) for ischemic stroke patients . in comparison with care provided in regular neurological wards , this amount corresponds to a 7% increase of the mean cost per admission .
however , the modified rankin scale was improved and post - acute inpatient costs were decreased . the scope of this article is to illustrate the guidelines for establishing su as these have been recently ( 2012 ) proposed by the swiss stroke society .
these guidelines could be applicable not only in developed but also in developing countries worldwide , given sufficient resources .
according to the swiss stroke society , a distinction is to be made between su and stroke centers ( sc ) .
a su is effective for all grades and all age groups of patients with stroke .
it is equipped with monitored and non - monitored treatment beds . on the other hand ,
a sc comprises a su and extends the concept of su to specific structural , neuroradiological and neurosurgical services .
personnel : medical:10-hour presence of a neurologist in the hospital during the day . at night and on weekends call service available ( a consultant neurologist present within 35
minutes).the medical director is a neurologist with proven expertise in stroke treatment and at least 2 years of experience in cerebrovascular diseases.neurologist with... | stroke represents the leading cause of acquired disability in adults and poses a tremendous socioeconomic burden both on patients and the society . in this sense ,
prompt diagnosis and urgent treatment are needed in order to radically reduce the devastating consequences of this disease .
herein the authors present the new guidelines recently adopted by the swiss stroke society concerning the establishment of stroke units .
standardized treatment and allocation protocols along with an acute rehabilitation concept seem to be the core of the swiss stroke management system .
coordinated multidisciplinary care provided by specialized medical , nursing and therapy staff is of utmost importance for achieving a significant dependency and death reduction .
it is believed that the implementation of these guidelines in the stroke care system would be beneficial not only for the stroke patients , but also for the health system . |
5,946 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cell - to - cell adhesion in epithelial cell sheets is maintained mainly through two types of junctions : adherens junction and tight junction .
a number of studies have focused their attention on the transmembrane protein of the adherens junction.1,2 only in recent years has the importance of tight junction proteins in epithelial cell proliferation , survival , apoptosis , and differentiation been recognized .
tight junctions are involved in cell - to - cell adhesion and serve two major functions in epithelial cell layers : the barrier ( or gate ) function and the fence function .
the barrier function of tight junctions regulates the passage of ions , water , and various macromolecules , even cancer cells , through paracellular spaces .
thus , the barrier function is relevant to edema , jaundice , diarrhea , and blood - borne metastasis . on the other hand ,
in other words , tight junctions work as a fence to prevent the intermixing of molecules in the apical membrane with those in the lateral membrane .
this fence function is highly involved in cancer cell biology because loss of cell polarity occurs in many types of cancer cells .
the fence and barrier functions of the tight junction have a common feature of compartmentalization : the fence function is performed at the subcellular level and the barrier function is performed at the organ level . finally ,
because of the ability of tight junction proteins to recruit signaling proteins , tight junctions have also been hypothesized to be involved in the regulation of cell proliferation , differentiation , and many other cellular functions.3,4
claudins were first cloned and named in 1998 by mikio et al.5 the name claudin comes from the latin word claudere
claudins are a multigene family and encode tetraspan membrane proteins that are crucial structural and functional components of tight junctions .
claudins have important roles in regulating paracellular permeability and maintaining cell polarity in epithelial and endothelial cell sheets.6,7 there are... | tight junctions , or zonula occludens , are the most apical component of the junctional complex and provide one form of cell cell adhesion in epithelial and endothelial cells .
nearly 90% of malignant tumors are derived from the epithelium .
loss of cell cell adhesion is one of the steps in the progression of cancer to metastasis .
at least three main tight junction family proteins have been discovered : occludin , claudin , and junctional adhesion molecule ( jam ) .
claudins are the most important structural and functional components of tight junction integral membrane proteins , with at least 24 members in mammals .
they are crucial for the paracellular flux of ions and small molecules .
overexpression or downregulation of claudins is frequently observed in epithelial - derived cancers .
however , molecular mechanisms by which claudins affect tumorigenesis remain largely unknown . as the pivotal proteins in epithelial cells , altered expression and distribution of different claudins
have been reported in a wide variety of human malignancies , including pancreatic , colonic , lung , ovarian , thyroid , prostate , esophageal , and breast cancers . in this review
, we will give the readers an overall picture of the changes in claudin expression observed in various cancers and their mechanisms of regulation .
downregulation of claudins contributes to epithelial transformation by increasing the paracellular permeability of nutrients and growth factors to cancerous cells . in the cases of upregulation of claudin expression , the barrier function of the cancerous epithelia changes , as they often display a disorganized arrangement of tight junction strands with increased permeability to paracellular markers .
finally , we will summarize the literature suggesting that claudins may become useful biomarkers for cancer detection and diagnosis as well as possible therapeutic targets for cancer treatment . |
5,947 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: statins are a very widely used class of medication and controlled studies have demonstrated clear benefits with respect to cardiac disorders and also stroke and cognitive function . because of this there are moves toward their use in primary prevention of atherosclerosis ( 1 ) .
the literature includes numerous reports of cognitive dysfunction ( 2 ) even though their occurrence was not borne out as a general effect in the controlled trials ( e.g.3 ) .
however the previously published reports have not mentioned aphasia or dysphasia as a specific side effect except as part of a much wider and more serious problem ( 4 ) . despite this a general search of the internet
however as at the 30th march 2011 the australian register of drug adverse reactions records six cases of aphasic disturbance with atorvastatin , one with rosuvastatin and two with simvastatin ( goodwin , personal communication ) .
this case is presented as a reasonably well documented occurrence of dysphasia associated with the use of atorvastatin and rosuvastatin and a consideration of some of the factors that might be involved in both the genesis of the syndrome and the absence of documented reports .
mrs . x. y. a 58-yr - old caucasian woman , presented for medicolegal examination on the 14th of april 2010 with regard to a compensation claim involving allegations of harassment at work producing anxiety and depression . at the time of her initial presentation for treatment
her general practitioner had noted that her blood pressure was higher than usual and had prescribed the statin lipitor ( atorvastatin ) 10 mg per day together with indapamide 2.5 mg per day .
x. y. reported that she had developed problems in " word finding " in that her speech would be interrupted because she would be unable to find a word to describe an object .
x. y. had ceased the lipitor after a few days and said that her symptoms had resolved quite quickly .
she had seen her doctor four weeks later and the doctor had noted " had symptoms of haziness and confusion with the... | this paper presents a case of reversible dysphasia occurring in a patient prescribed atorvastatin in combination with indapamide .
a milder dysphasia recurred with the prescription of rosuvastatin and was documented on clinical examination .
this resolved following cessation of rosuvastatin .
the case highlights both a need for a wider understanding of potential drug interactions through the cyp 450 system and for an increased awareness , questioning and reporting of drug side - effects . |
5,948 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: mobility limitations are defined by impairment or dependence in movement and affect between one third and one half of adults aged 65 or older .
lack of physical activity in older individuals can lead to loss of muscle mass ( sarcopenia ) , loss of bone density ( osteoporosis ) , and an increase in fat mass ( obesity ) [ 2 , 3 ] .
isolation and loss of social ties resulting from reduced mobility can lead to depression and other adverse mental health outcomes .
a lack of access to resources such as fresh foods and medical care which can result from limited mobility can also have negative impacts on health .
individuals with mobility limitations are also at higher risk of health service utilization [ 68 ] and institutionalization [ 6 , 9 , 10 ] .
ultimately , further frailty and disability and an increased risk of premature mortality can result from restricted mobility [ 1 , 11 ] . methods of assessing mobility limitations vary . in assessment of mobility , it is important to distinguish between capacity to function what an individual could do and enacted function what an individual does do . in this way
, assessments of an individual 's walking behavior represent an enacted form of mobility while questions that assess an individual 's perception of their ability represent functional capacity .
mobility restrictions are not typically the result of a single cause , but arise from an interaction of risk factors in various domains , both individual and environmental .
traditionally , disability research had been based on the medical model in which the focus is on the individual and pathology .
more recently , following on the work of lawton [ 14 , 15 ] , verbrugge and jette , and the world health organization 's international classification of functioning , disability , and health ( icf ) , disability models have focused on the interaction of the individual with their environment .
lawton stressed the importance of the environment in determining the well - being of older adults where an... | mobility restrictions in older adults are common and increase the likelihood of negative health outcomes and premature mortality .
the effect of built environment on mobility in older populations , among whom environmental effects may be strongest , is the focus of a growing body of the literature .
we reviewed recent research ( 19902010 ) that examined associations of objective measures of the built environment with mobility and disability in adults aged 60 years or older .
seventeen empirical articles were identified .
the existing literature suggests that mobility is associated with higher street connectivity leading to shorter pedestrian distances , street and traffic conditions such as safety measures , and proximity to destinations such as retail establishments , parks , and green spaces .
existing research is limited by differences in exposure and outcome assessments and use of cross - sectional study designs .
this research could lead to policy interventions that allow older adults to live more healthy and active lives in their communities . |
5,949 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: coronary artery fistula ( caf ) is an abnormality in the termination of coronary artery and it was first described in 1865 by krause ( 1 ) .
it is a communication between one or more coronary arteries and a cardiac chamber or great vessel resulting in a left to right shunt .
caf is rare with an estimated prevalence of 0.002% in the general population and 0.05 - 0.25% among patients who undergo coronary angiography ( 2 ) .
the majority of the caf originate from the right coronary artery and drain into the right ventricle ( 3 ) .
herein , we report a rare case of caf from the left circumflex artery to the coronary sinus .
a 35-year - old woman with no co - morbidity was referred to the cardiology unit for palpitations that she had been experiencing since childhood .
the episode occurred at rest , lasting for less than 10 minutes and happened 2 - 3 times a week .
she denied having any chest pain or symptoms of heart failure . on examination , her hemodynamic status was stable .
there was a soft pan - systolic murmur at the precordial area and grade-1 continuous murmur at the left sternal border .
transthoracic 2-dimensional echocardiography demonstrated dilation of both the atrium and left circumflex artery with a maximum diameter of 15 mm color doppler echocardiography showed the course of the left circumflex artery emptying into the coronary sinus ( figure 1 a ) .
continuous turbulence flow on color doppler at the level of coronary artery - coronary sinus connection as well as in the coronary sinus indicated left - to - right shunt flow ( figure 1 b ) for further delineation of the fistulous communication , ecg - gated contrast - enhanced coronary ct angiography was performed .
the patient subsequently underwent an ecg - gated contrast - enhanced coronary ct angiography study using a dual - tube 64-slice multi - detector ct ( siemens , erlangen germany ) .
as per standard protocol in our institution , to achieve a resting heart rate of not more than 70 beats / minute , she was given oral metoprolol 50 mg ,... | coronary artery fistula ( caf ) is a rare anomaly of the coronary artery .
patients with this condition are usually asymptomatic
. however , cardiac failure may occur later in life due to progressive enlargement of the fistula .
diagnosis is traditionally made by echocardiogram and conventional angiogram .
however with the advantage of new technologies such as computed tomography ( ct ) coronary angiography , the course and communications of these fistulae can be delineated non - invasively and with greater accuracy .
we report a case of a left circumflex artery fistula to the coronary sinus which was suspected on echocardiogram and the diagnosis was clinched on ecg - gated ct . |
5,950 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: all subjects gave written informed consent , and the study was approved by the local ethics committee .
monocytes were separated using superparamagnetic polystyrene beads coated with a primary monoclonal antibody specific for the cd14 membrane antigen expressed on human monocytes ( invitrogen , groningen , germany ) and resuspended in hanks balanced solution containing ( in mmol / l ) nacl 136 , kcl 5.40 , cacl2 1 , kh2po4 0.44 , na2hpo4 0.34 , hepes 10 , ph 7.4 .
monocytes were counted in neubauer chamber and adjusted in each experiment . to evaluate the effects of high glucose and oxidative stress on trp channel expression , monocytes were exposed to 5.6 mmol / l d - glucose ( control ) ,
30 mmol / l d - glucose , or 100 mol / l peroxynitrite ( onoo ) for 4 h. additional experiments were performed using 30 mmol / l l - glucose or 30 mmol / l d - glucose in the presence of the superoxide dismutase mimetic tempol ( tmp , 100 mol / l ) .
we also evaluated the effects of lipopolysaccharide - induced oxidative stress , tumor necrosis factor- ( tnf-)-induced activation of nadph oxidase , and production of superoxide radicals as well as reduction of superoxide radicals using diphenylene iodonium .
next , the effects of selective inhibition of phosphatidylcholine - specific phospholipase c by tricyclodecan-9-yl xanthogenate ( d609 ) or the inhibition of phospholipase c activation by 1-[6-[((17)-3-methoxyestra-1,3,5 -trien-17-yl)amino[hexyl]-1h - pyrrole-2,5-dione ( u73122 ) on trp expression in monocytes .
total rna was isolated from monocytes using the rneasy mini kit including rnase - free dnase set ( qiagen , hilden , germany ) . using the transcriptor first - strand cdna synthesis kit ( roche diagnostics , mannheim , germany ) , cdna was synthesized from 2 g of total rna using oligo dt ( 1218 ) and 5 units avian myeloblastosis virus reverse transcriptase at 50c for 60 min , followed by heating to 85c for 5 min .
quantitative ( q ) real - time rt - pcrs for trpc1 , trpc3 , trpc5 , trpc6 , trp melastatin type 6 (... | objectivetransient receptor potential ( trp ) channel induced cation influx activates human monocytes , which play an important role in the pathogenesis of atherosclerosis . in the present study ,
we investigated the effects of high glucose induced oxidative stress on trp channel expression in human monocytes.research design and methodshuman monocytes were exposed to control conditions ( 5.6 mmol / l d - glucose ) , high glucose ( 30 mmol / l d - glucose or l - glucose ) , 100 mol / l peroxynitrite , or high glucose in the presence of the superoxide dismutase mimetic tempol ( 100 mol / l ) .
trp mrna and trp protein expression was measured using quantitative real - time rt - pcr and quantitative in - cell western assay , respectively .
calcium influx and intracellular reactive oxygen species were measured using fluorescent dyes.resultsadministration of high d - glucose significantly increased reactive oxygen species .
high d - glucose or peroxynitrite significantly increased the expression of trp canonical type 1 ( trpc1 ) , trpc3 , trpc5 , trpc6 , trp melastatin type 6 ( trpm6 ) , and trpm7 mrna and trpc3 and trpc6 proteins .
high d - glucose plus tempol or high l - glucose did not affect trp expression . increased oxidative stress by lipopolysaccharide or tumor necrosis factor- increased trp mrna expression , whereas the reduction of superoxide radicals using diphenylene iodonium significantly reduced trp mrna expression . increased trpc3 and trpc6 protein expression
was accompanied by increased 1-oleoyl-2-acetyl - sn - glycerol induced calcium influx , which was blocked by the trpc inhibitor 2-aminoethoxydiphenylborane .
trpc6 mrna was significantly higher in monocytes from 18 patients with type 2 diabetes compared with 28 control subjects ( p < 0.05).conclusionshigh d - glucose induced oxidative stress increases trp expression and calcium influx in human monocytes , pointing to a novel pathway for increased activation of monocytes and hence atherosclerosis in patients with diabetes . |
5,951 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: mucocutaneous leishmaniasis often occurs in new world mostly due to leishmania(l ) braziliensis and less commonly l. panamensis and l. amazonensis(1 ) .
there are also several reports of mucocutaneous leishmaniasis in old world ( 24 ) . recently a case of mucocutaneous leishmaniasis due to l. major has been reported from iran ( 1 ) . in leishmaniasis
, laryngeal involvement often occurs in active cigarette smokers and in patients with chronic respiratory diseases ( 5 ) . a case of visceral leishmaniasis caused by l. major with skin and oral mucosal lesions in a man who was suffering from hoarseness and weight loss
a 28-year - old otherwise healthy , non - smoking man with the chief complaint of hoarseness from southeastern part of iran was referred to our dermatology center in may 2014 .
he had a few indurated , erythematous plaques on his face ( chin and upper lip ) and legs , a violaceous plaque on his hard palate , and complained of hoarseness for the past 7 years ( fig . 1 and 2 ) .
he also complained of dysphagia to solid diet , and about 20 kilograms weight loss in the last year .
hoarseness was the presenting symptom and lasted for about 5 years during the time that the cutaneous lesions were present .
skin lesions : erythematous plaque on chin and upper lip oral mucosal lesion : an erythematous plaque on the palate near the opening of the pharynx the study was approved by the local ethics committee and an informed consent was taken from the patient .
routine laboratory tests were normal except for a mild normocytic normochromic anemia , which was justified with chronic disease anemia .
erythrocyte sedimentation rate , complement levels ( c3 c4 ch50 ) , antinuclear antibody ( ana ) , and angiotensin converting enzyme ( ace ) tests were all within normal limits .
wright , 2-mercaptoethanol ( 2me ) , and widal tests were done for his constitutional symptoms and low back pain , which all came back negative .
vdrl and viral markers ( hivab hbsag hcvab ) were negative , and a ppd skin test was negative... | herein , a 28-year - old man with hoarseness , skin and oral lesions is presented . at the time of admission , the patient had an erythematous plaque on his chin near his lower lip and an erythematous - violaceous plaque on his palate near the opening of the pharynx and 20 kg weight lost in last one year .
the biopsy of his skin lesions by hematoxylin and eosin staining revealed an infiltration of the dermis by lymphoplasma and histiocytic cells with a loose granuloma formation suggestive of leishmaniasis .
biopsy of mucosal lesions revealed leishman bodies in dermis .
pcr was performed on the specimens of skin , bone marrow , mucosa , and saliva , the results were positive .
the pathogenic agent was identified as leishmania major by the nested pcr .
serologic tests including direct agglutination test ( dat ) and indirect immunofluorescence test ( ifat ) were positive with high titers of anti - l .
infantum antibodies ( 1:102400 versus 1:800 , respectively ) , indicative of visceral involvement .
the patient responded to a combination of miltefosine and meglumine antimoniate ( glucantime ) .
visceral involvement due to l. major is rarely reported . to the best of our knowledge ,
probably hoarseness due to l. major has not been previously reported from iran . |
5,952 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: male sprague - dawley rats ( charles river , wilmington , ma ) weighing 275350 g were individually housed in the yale animal resource center in temperature - controlled ( 2223c ) and humidity - controlled rooms .
the animals were fed rat chow ( agway prolab 3000 , syracuse , ny ) , given water ad libitum , and acclimatized to a 12-h light / dark cycle .
seven to 10 days before each study , all animals were anesthetized with an injection ( 1 ml / kg i.p . ) of a mixture of xylazine ( 20 mg / ml anased ; lloyd laboratories , shenandoah , ia ) and ketamine ( 100 mg / ml ketaset ; aveco , fort dodge , ia ) , in a ratio of 1:2 ( vol / vol ) , before undergoing vascular surgery for the implantation of vascular catheters in a carotid artery and jugular vein .
microinjection guide cannulae were then bilaterally inserted into the vmh , targeting the ventromedial nucleus ( coordinates from bregma : anteroposterior 2.6 mm , mediolateral 0.8 mm , and dorsoventral 8.0 ) . on the morning of the study , after an overnight fast and 60 min after opening the catheters , 22-gauge microinjection needles , designed to extend 1 mm beyond the tip of the guide cannula ( plastics one , roanoke , va ) , were inserted through the guide cannula bilaterally into each vmh . the rat was then microinjected over 2 min ( 0.5 l / min ) using a cma-102 infusion pump ( cma microdialysis , north chelmsford , ma ) .
the animals were microinjected immediately before the initiation of a hyperinsulinemic - hypoglycemic clamp with 1 l of one the following pharmacologic agents : artificial extracellular fluid as a control ( n = 12 ) ; 1 mol / l concentration of the b2ar antagonist ici-118,551 ( n = 12 ) ; or 1 mol / l concentration of the b2ar agonist formoterol ( n = 10 ) .
the doses of b2ar agonists and antagonists selected were based on preliminary dose - ranging studies using a 1 nmol / l to 200 mol / l concentration of the agonist and antagonist . in another set of studies , we microinjected 1 mol / l cgp 20712 dihydrochloride , a potent ,... | objectivenorepinephrine is locally released into the ventromedial hypothalamus ( vmh ) , a key brain glucose - sensing region in the response to hypoglycemia . as a result ,
this neurotransmitter may play a role in modulating counterregulatory responses .
this study examines whether norepinephrine acts to promote glucose counterregulation via specific vmh -adrenergic receptors ( bar).research design and methodsawake male sprague - dawley rats received , via implanted guide cannulae , bilateral vmh microinjections of 1 ) artificial extracellular fluid , 2 ) b2ar agonist , or 3 ) b2ar antagonist .
subsequently , a hyperinsulinemic - hypoglycemic clamp study was performed .
the same protocol was also used to assess the effect of vmh delivery of a selective b1ar or b3ar antagonist.resultsdespite similar insulin and glucose concentrations during the clamp , activation of b2ar in the vmh significantly lowered by 32% ( p < 0.01 ) , whereas vmh b2ar blockade raised by 27% exogenous glucose requirements during hypoglycemia ( p < 0.05 ) compared with the control study .
these changes were associated with alternations in counterregulatory hormone release .
epinephrine responses throughout hypoglycemia were significantly increased by 50% when the b2ar agonist was delivered to the vmh ( p < 0.01 ) and suppressed by 32% with the b2ar antagonist ( p < 0.05 ) .
the glucagon response was also increased by b2ar activation by 63% ( p < 0.01 ) .
neither blockade of vmh b1ar nor b3ar suppressed counterregulatory responses to hypoglycemia .
indeed , the b1ar antagonist increased rather than decreased epinephrine release ( p < 0.05).conclusionslocal catecholamine release into the vmh enhances counterregulatory responses to hypoglycemia via stimulation of b2ar .
these observations suggest that b2ar agonists might have therapeutic benefit in diabetic patients with defective glucose counterregulation . |
5,953 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a 47-year - old postmenopausal woman presented with slowly increasing abdominal girth with a palpable abdominal mass and vaginal bleeding . at the age of 15
, she underwent abdominal surgery due to intussusception of the small bowel of unknown cause . during the preoperative evaluation
, colonoscopy identified eight hamartomatous polyps , nine hyperplastic polyps , and two tubulovillous adenomas in her large intestine .
she had abundant mucocutaneous melanin pigmentation around the lips . based on her clinical features and the histopathological diagnosis of hamartomatous polyps and mucocutaneous pigmentation ,
no other family members had clinical signs of pjs . on pelvic and abdominal ultrasonography and computed tomography ,
she was found to have huge bilateral ovarian cystic masses with ascites in the pelvic cavity . on exploratory laparotomy ,
the left ovarian mass was ruptured , and approximately 1,500 ml of ascitic fluid was identified .
the patient underwent hysterectomy , bilateral salpingo - oophorectomy , and small bowel polypectomy via small bowel enterostomy .
grossly , the left ovarian tumor was a multilocular cyst measuring 22206 cm ( fig .
1a ) , whereas the right ovarian tumor was an oligolocular cyst measuring 875 cm ( fig .
microscopically , both ovarian tumors showed cysts of varying sizes lined by a single layer of columnar epithelium , and the architecture of the glandular arrangement was characterized by clusters of small glands budding from surrounding a centrally located large duct - like structures , forming a lobular arrangement at lower magnification ( fig .
the uterine cervix , endometrium , and fallopian tubes were meticulously examined , but no histologic evidence of mucinous epithelial lesions or metaplasia was identified .
polyps of the small intestine showed a branching polypoid structure with crypts and villi of variable lengths and cystically dilated glands , which were divided by muscularis mucosa branching in various directions ( fig .
on combined alcian blue ( ph 2.5 ) and... | we describe an ovarian mucinous neoplasm that histologically resembles lobular endocervical glandular hyperplasia ( legh ) containing pyloric gland type mucin in a patient with peutz - jeghers syndrome ( pjs ) . although ovarian mucinous tumors rarely occur in pjs patients , their pyloric gland phenotype has not been clearly determined .
the histopathologic features of the ovarian mucinous tumor were reminiscent of legh .
the cytoplasmic mucin was stained with periodic acid - schiff reaction after diastase treatment but was negative for alcian blue ph 2.5 , suggesting the presence of neutral mucin .
immunohistochemically , the epithelium expressed various gastric markers , including muc6 , hik1083 , and carbonic anhydrase - ix .
multiple ligation - dependent probe amplification detected a germline heterozygous deletion mutation at exons 17 of the stk11 gene ( c.1-?_920+?del ) in peripheral blood leukocytes and mosaic loss of heterozygosity in ovarian tumor tissue . considering that legh and/or gastric - type cervical adenocarcinoma can be found in patients with pjs carrying germline and/or somatic stk11 mutations , our case indicates that stk11 mutations have an important role in the proliferation of pyloric - phenotype mucinous epithelium at various anatomical locations . |
5,954 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: facial tissue loss or defects can be acquired , congenital , tumoral lesions or accidental . facial deformity can cause functional and serious psychological problems that can affect an individual 's social behavour.1,2 the field of maxillofacial prosthetics is concerned with the prosthetic reconstruction of missing / disfigured head and neck tissue .
a prosthetic replacement of an exterior part is termed as epithesis , which is described as early as seventh century.3 auricular reconstruction is challenging task in which a wide array of reconstructive options must be considered.4 prosthetic replacement of missing facial tissues has several advantages over surgical reconstruction .
the process is relatively inexpensive , allows for periodic evaluation and cleaning of the site .
it is a short process and the maxillofacial clinician has complete control of color , shape and position of the prosthesis .
disadvantages include possible irritation of the tissue site , need for periodic remake and depending on adhesives or some other form of retention.5 the first well documented account of facial prosthetics is provided by ambroise pare who made varied contribution to standardize the indications for and materials used in facial prosthetics . amongst the large number of materials that have been tried out in the history of anaplastology as for example porcelain , natural rubber , gelatin and latex , two have established themselves : methacrylates and silicones.6 long term success of a facial prosthesis
depends mainly on retention.7 these prostheses are retained with different methods of retention such as medical adhesives , anatomical undercuts , and mechanical devices like spectacles , hair bands , magnets and implants.8 since the introduction of percutaneous endosseous implants for use with bone conduction hearing aids in 1977 , implants have acquired important role in the prosthetic rehabilitation of patients with craniofacial defects.9 implants can vastly improve the retention and stability of a facial prosthesis... | maxillofacial prosthodontics is an art and science which provides life like appearance to the person with facial deformity .
maxillofacial prosthetic rehabilitation for acquired defects has become more complex and sophisticated with advancement in techniques and materials .
this case report describes the clinical and laboratory procedure for fabricating an auricular prosthesis for a patient with trauma related bilateral auricular deformity .
ear prosthesis was fabricated in two parts taking retention from external auditory canal . |
5,955 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study:
staphylococcus aureus is a well - adapted human / zoonotic colonizer which can also cause a wide range of diseases and its treatment is becoming more difficult because of increasing rates of drug resistance both in hospital and community settings .
community - acquired methicillin - resistant s. aureus ( ca - mrsa ) has been a subject of interest in the last decade . traditionally , the risk factors for ca - mrsa are chronic illness , history of recurrent use of antibiotics and intravenous drug abuse . moreover , new risk factors such as attendance in military service and day care centers , homosexuality , tattooing , contact sports , sharing soaps and towels , having pets and age 2 years have been proposed , yet several patients with ca - mrsa infections do not have any recognized risk factor for methicillin resistance ( 1 - 6 ) .
in addition to epidemiological differences , ca - mrsa and hospital - acquired methicillin - resistant s. aureus ( ha - mrsa ) differ in antibiotic resistance pattern .
ca - mrsa clones are usually resistant only to -lactams and erythromycin and are usually susceptible to co - trimoxazole , clindamycin and fluoroquinolones ( 1 , 2 , 5 , 7 ) . from a molecular perspective
, ha - mrsa strains usually carry staphylococcal cassette chromosome mec ( sccmec ) types i - iii while ca - mrsa strains carry sccmec types iv or v ( 1 , 4 , 5 , 8) . the aim of this study was to determine the frequency of invasive ca - mrsa in children admitted to the pediatric wards of imam reza and ghaem teaching hospitals .
in this retrospective observational study , data of s. aureus - positive cultures from sterile body sites ( i.e. blood , bone puncture , joint fluid and lymph node aspiration ) was gathered from microbiology laboratory files from march 20 2006 to march 19 2012 .
the community or hospital origin of s. aureus infection was determined by hospital files and telephone communication with the patients parents according to the cdc criteria ( 1 , 6 ) .
during this 6-year period , 23 invasive... | background and objectivecommunity - acquired methicillin - resistant staphylococcus aureus ( ca - mrsa ) is increasingly reported worldwide .
we aimed to determine the frequency of invasive ca - mrsa in children admitted to the pediatric wards of imam reza and ghaem hospitals of mashhad , iran.materials and methodsin this retrospective study , data regarding s. aureus isolates from pediatric patients sterile body sites ( i.e. blood joint , bone and lymph node aspiration ) were retrieved in a time period from march 2006 to march 2012 .
disc diffusion data was analyzed to determine the resistance pattern of the isolates , and differentiation between community - acquired and nosocomial s. aureus was done according to cdc guidelines.resultstwenty three invasive community - acquired s. aureus isolates from sterile body sites were identified , of which seventeen ( 74% ) were ca - mrsa .
the ca - mrsa isolates showed high frequency of resistance to non--lactam antibiotics ( 71% to erythromycin
53% to co - trimoxazole , 44% to gentamicin and 36% to ciprofloxacin).conclusionin this study , the majority of invasive community - acquired s. aureus isolates were found to be ca - mrsa .
therefore , we recommend that primary treatment should be with antibiotics such as clindamycin , vancomycin , linezolid or daptomycin for any invasive infection suspected to be caused by s. aureus in these two hospitals . |
5,956 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: for some , brachytherapy ( bt ) is something on the brink of extinction and their arguments are not scarce .
brachytherapy might not sound too appealing for the average radiation oncologist because it implies transition from behind the screen to the or .
blood appears as a real scenario and most of them chose from the beginning to avoid it willingly .
it is not only about the lack of surgical skills , but also that most junior radiation oncologists do not actually have the chance to see or practice the technique in their centers .
moreover , bt is by itself a niche domain , as there are rather few indications for it , as compared to external beam radiotherapy ( ebrt ) .
therefore , for most of them , bt is something more like see not touch .
last but not least , in a domain driven by ebrt , investing in bt might not seem too appealing for developers . fortunately , some of these issues can be corrected . with proper indications and good technique
thus , in their effort to keep the domain alive , doctors that advocate for it tried to replace the human hand for the bloody part while keeping the radiation therapy spirit friendly to radiation oncologists . as a result of this struggle for accessibility , safety , precision , and accuracy , bt robotic systems appeared .
the aim of this paper is to evaluate the current situation in the field of robotic brachytherapy , briefly outline the existing systems , their technical aspects , and limitations , and to present a custom - made solution to the problem , a universal brachytherapy robotic system , para - brachyrob .
the purpose of bt is to achieve , by interstitial radioactive seed implantation ( low - dose - rate
hdr , or pulse - dose - rate pdr brachytherapy ) , a high conformal dose distribution to cover the target volume . at the same time
it is thus an efficient treatment for virtual any small to medium sized well defined tumor , which can be reached by visual / palpable guidance , provided that correct indications and accurate technique are met .
while... | in a field dominated by external beam radiation therapy ( ebrt ) , both the therapeutic and technical possibilities of brachytherapy ( bt ) are underrated , shadowed by protons and intensity modulated radiotherapy . decreasing expertise and indications , as well as increasing lack of specific bt training for radiation therapy ( rt ) residents led to the real need of shortening its learning curve and making it more popular . developing robotic bt devices can be a way to mitigate the above issues .
there are many teams working at custom - made robotic bt platforms to perfect and overcome the limitations of the existing systems .
this paper provides a picture of the current state - of - the - art in robotic assisted bt , as it also conveys the author 's solution to the problem , a parallel robot that uses ct - guidance . |
5,957 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: epidural ( cse ) technique is a very commonly used method for central neuraxial blockade .
it combines the advantages of spinal as well as epidural blocks and avoids their disadvantages .
several cse techniques are described , but needle - through - needle is the most widely reported technique in the literature and is likely to be the most frequently used .
needle - through - needle cse requires that subarachnoid blockade is initiated before placing and securing the epidural catheter .
this results in an inevitable delay in attending to the developing neural blockade and in cases of significant delay , the final characteristics of the block may be altered .
while injecting hyperbaric local anaesthetic solutions in the sitting position , any delay in positioning can lead to settling down of spinal anaesthetic and unacceptably low level of block .
when the patient is made supine after this , the cephalad spread of local anaesthetics is limited by the lumbar lordosis .
this problem can be overcome and adequate level of block can be achieved in cases of delayed patient positioning if lumbar lordosis can be flattened by using some manoeuvre .
it was also used along with the trendelenburg position as a rescue strategy to increase the spinal anaesthetic level after the spinal block . however , in trauma patients with lower limb fractures , flexion of only uninjured limb is possible .
the literature does not mention the effect of unilateral hip flexion on extent of lordosis obliteration and level of spinal block .
this study was conducted to find out if unilateral hip flexion could extend the level of spinal anaesthesia following a prolonged cse technique .
following approval from institutional ethics committee , 50 american society of anesthesiologists ( asa ) i and ii male patients , aged 1860 years , with unilateral femur fractures , scheduled for elective fracture fixation under cse were included .
patients having bilateral fractures were excluded . those with height less than 150 cm or more than 180 cm were also... | needle - through - needle combined spinal epidural ( cse ) may cause significant delay in patient positioning resulting in settling down of spinal anaesthetic and unacceptably low block level .
bilateral hip flexion has been shown to extend the spinal block by flattening lumbar lordosis .
however , patients with lower limb fractures can not flex their injured limb .
this study was conducted to find out if unilateral hip flexion could extend the level of spinal anaesthesia following a prolonged cse technique
. fifty american society of anesthesiologists ( asa ) i / ii males with unilateral femur fracture were randomly allocated to control or flexion groups .
needle - through - needle cse was performed in the sitting position at l2 - 3 interspace and 2.6 ml 0.5% hyperbaric bupivacaine injected intrathecally .
patients were made supine 4 min after the spinal injection or later if epidural placement took longer .
the control group patients ( n=25 ) lay supine with legs straight , whereas the flexion group patients ( n=25 ) had their uninjured hip and knee flexed for 5 min .
levels of sensory and motor blocks and time to epidural drug requirement were recorded .
there was no significant difference in sensory levels at different time - points ; maximum sensory and motor blocks ; times to achieve maximum blocks ; and time to epidural drug requirement in two groups . however , four patients in the control group in contrast to none in the flexion group required epidural drug before start of surgery
.
moreover , in the control group four patients took longer than 30 min to achieve maximum sensory block . to conclude , unilateral hip flexion did not extend the spinal anaesthetic level ; however , further studies are required to explore the potential benefits of this technique . |
5,958 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: a statistically significant increase ( 19762009 ) has been reported in the age - standardized incidence rate ( asir ) for distant stage breast cancer diagnosed in women at age 2539 years in the population covered by population - based cancer registries of the national cancer institute 's surveillance , epidemiology , and end results ( seer ) program .
the report raised concerns regarding increasing rates of aggressive breast cancer in young women [ 2 , 3 ] , especially because the increases were largest for age 2539 years in the most recent time period examined ( i.e. , 200009 ) with a slight increase also at age 4054 years .
support for stage migration as an explanation for the long - term trends was regarded as limited , and the increase in distant stage incidence in young women is unexplained . the present report focused on recent trends ( 20002011 ) in stage - specific asirs at age < 50 years in relation to the hypothesis of stage migration , which could result from improvements in the detection of distant metastases , as shown for lung cancer .
if the prognosis of cases migrating to distant ( metastatic ) stage tends to be worse than most other patients classified as regional stage but better than most classified as distant , then spurious improvements may occur in survival rates for both stages .
the present report included examination of recent trends in stage - specific survival rates for younger breast cancer cases in seer registries .
seerstat version 8.1.5 software was used with the november 2013 seer submission database that included cancers diagnosed in 20002011 for 18 seer registries , which together cover about 28% of the us population [ 5 , 8 ] .
invasive breast cancer was defined by international classification of diseases for oncology version 3 ( icd - o-3 ) site codes c500c509 , excluding icd - o-3 morphology ( m ) codes m9140 ( kaposi sarcoma ) and m9590 - 9992 ( mainly lymphomas ) .
the focus was on women diagnosed at ages 2539 , an age group used in the previous report , and 4049 years... | background .
unexplained increases have been reported in incidence rates for breast cancer diagnosed at distant stage in younger u.s .
women , using data from the surveillance , epidemiology and end results ( seer ) program . methods .
this report focused on recent seer trends ( 20002011 ) in age - standardized incidence rates of invasive breast cancer at ages 2539 and 4049 years and the hypothesis that stage migration may have resulted from advances in detecting distant metastases at diagnosis .
results .
increases in the rates for distant stage were roughly equal to decreases in the rates for the most advanced stage subgroups within regional stage ; this was evident for estrogen receptor ( er ) negative cancers , associated with poorer prognosis , but not for er positive cancers .
the 3-year relative survival rate increased over time for distant stage ( especially in the er positive subgroup ) and regional stage but not for localized stage ; these trends do not contradict the stage - migration hypothesis .
conclusions .
findings provide some support for stage migration as one explanation for the recent increase in incidence of distant stage breast cancer , but additional studies are needed using other databases . |
5,959 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: lymphedema , an incurable health condition , occurs when an impairment of the lymphatic system results in a lymphatic load that is greater than lymphatic transport capacity .
the consequence is accumulation of protein - rich fluid in the interstitial space [ 1 , 2 ] . over time
, this high concentration of protein stimulates an inflammatory response leading to fibrotic changes in subcutaneous tissue and hypertrophy of adipose tissue .
protein - rich lymph provides a fertile medium for bacterial growth . if untreated , lymphedema can progress , causing continued proliferation of fibrotic tissue , an increase in size of the affected limb , an increased risk for wounds [ 4 , 5 ] , life - threatening infections , loss of functional ability , and decreased quality of life [ 7 , 8 ] .
causes of secondary lymphedema include surgery for carcinoma that involves damage or dissection of lymph nodes , radiation therapy , trauma to lymph nodes or vessels , chronic infection , chronic venous insufficiency , tumors that obstruct the lymphatic flow , and/or a combination of the these conditions [ 6 , 10 , 11 ] .
the return of fluids via the venous and lymphatic system is facilitated by muscle contractions of the legs .
sitting for long periods of time applies pressure to capillaries and lymphatic vessels that also impedes flow .
poor body trunk alignment negatively affects the normal respiratory pump for the lymphatic system and further reduces lymphatic flow .
complete decongestive therapy ( cdt ) is the gold standard treatment for management of chronic lymphedema [ 1316 ] .
the goal of cdt is to reduce swelling and tissue fibrosis , improve functional ability , prevent infections [ 13 , 16 ] , and stop the progression of the disease .
it consists of manual lymphatic drainage ( specialized massage ) to facilitate central lymph flow and promote movement of the lymph out of the effective limb , multilayer short stretch compression bandaging of the extremity , diaphragmatic breathing and exercise to further enhance lymph... | this paper describes design and development of a self - management program , delivered by telerehabilitation ( tr ) , to address the problem of chronic lower limb swelling in persons with limited mobility .
the 18.6 million persons with limited mobility in the usa are at increased risk for chronic lower limb swelling and related secondary complications , including cellulitis and skin ulcers . over time
, chronic swelling often progresses to lymphedema , an incurable condition requiring lifelong care . without successful self - management , lymphedema and
its related complications inevitably worsen .
access and adherence to appropriate treatment are challenging for persons with limited mobility .
program development involved a structured process to establish content validity ( videos and manuals ) , readability , suitability , and selection of a tr platform to deliver the educational program .
our goal was to develop a program that would engage patients in self - management skills . the tr software platform chosen , versatile and integrated system for telerehabilitation ( visyter )
was designed to facilitate face - to - face delivery of an interactive home - based self - management program via the internet in real time .
results demonstrated validity of the educational program and ease of use with tr .
future plans are to evaluate ability of this approach to promote self - management skills , home monitoring , and improved management of persons with lymphedema and limited mobility . |
5,960 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: high - throughput genomics technology has made possible the era of precision medicine , an approach to healthcare that involves integrating a patient 's genetic , lifestyle , and environmental data and then comparing these data to similar data collected for thousands of other individuals to predict illness and determine the best treatments .
precision medicine aims to tailor healthcare to patients by using clinically actionable genomic mutations to guide preventive interventions and clinical decision making . in the past 25 years
in addition , more than 80 million genetic variants have been uncovered in the human genome [ 3 , 4 ] .
clinical pharmacology research using electronic health record ( ehr ) systems has recently become feasible as ehrs have been implemented more widely .
also , studies such as the electronic medical records and genomics - pharmacogenomics ( emerge - pgx ) project , gani_med project , scan - b initiative , and cancer 2015 study have been designed to assess the value of next - generation sequencing ( ngs ) in healthcare . combining the functional characterization of identified genomic mutations with comprehensive clinical data available in ehrs has the potential to provide compelling evidence to implicate novel disease- and/or drug - associated mutations in phenotypically well - characterized patients .
ngs technological advances in clinical genome sequencing and adoption of ehrs will pave the way to create patient - centered precision medicine in clinical practice .
ngs technology is an essential component supporting genomic medicine but the volume and complexity of the data pose challenges for its use in clinical practice . sequencing a single human genome generates megabytes of data ; therefore , investment in a bioinformatics infrastructure is required to implement ngs in clinical practice .
gartner defines big data as high - volume , high - velocity , and/or high - variety information assets that demand cost - effective , innovative forms of information processing that enable... | advances in genomic medicine have the potential to change the way we treat human disease , but translating these advances into reality for improving healthcare outcomes depends essentially on our ability to discover disease- and/or drug - associated clinically actionable genetic mutations .
integration and manipulation of diverse genomic data and comprehensive electronic health records ( ehrs ) on a big data infrastructure can provide an efficient and effective way to identify clinically actionable genetic variants for personalized treatments and reduce healthcare costs .
we review bioinformatics processing of next - generation sequencing ( ngs ) data , bioinformatics infrastructures for implementing precision medicine , and bioinformatics approaches for identifying clinically actionable genetic variants using high - throughput ngs data and ehrs . |
5,961 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: nutritional support is essential for patients undergoing major surgery , and nutritional therapies such as total parenteral nutrition or enteral nutrition are integral to the management of these patients .
however , surgery causes a state of insulin resistance , and changes in glucose metabolism occur after surgery , and overfeeding with high loads of carbohydrates has been associated with clinical complications .
therefore , knowledge of the optimal energy requirements is very important in the nutritional management of the patients undergoing surgery .
an evaluation of the energy requirements of patients undergoing surgery is critical in planning optimal nutritional therapy .
typically , the total energy of the parenteral or enteral nutrition is determined by using the predicted resting expenditure ( pree ) calculated by the harris - benedict equation , and the total energy requirement is calculated by the pree activity factor stress factor . on the other hand ,
there have been several studies reporting that the energy expenditure of patients undergoing surgery changes to a hyper - metabolic status .
however , there have not been any reports on the energy metabolism of patients undergoing a pancreatoduodenectomy .
currently , the pylorus - preserving pancreatoduodenectomy ( pppd ) is generally accepted as the preferred procedure for pancreatic head cancer or bile duct tumors . in this study , we evaluated the change in the energy metabolism of patients undergoing pppd , and determined the optimal energy requirements for their nutritional management .
twelve patients with bile duct cancer or pancreatic tumors ( 5 women and 7 men , median age 70.1 years old ) were enrolled in this study .
the patients were admitted to the gastrointestinal surgery unit of shiga university of medical science hospital .
four patients had pancreatic cancers , 6 patients had bile duct carcinomas , and 2 patients had intraductal papillary mucinous neoplasms ( ipmn ) .
parenteral nutrition was started before surgery in three... | we measured the energy expenditure weekly in patients undergoing a pylorus preserving pancreatoduodenectomy for bile duct cancer or pancreatic tumors .
twelve patients ( 5 women and 7 men ; mean age 70.1 years ) were enrolled in this study , and their resting energy expenditure levels were determined by indirect calorimetry . in these patients , a significant correlation was observed between the measured resting energy expenditures and the predicted resting energy expenditures calculated by the harris - benedict equation .
the resting energy expenditures measured before surgery were almost the same as the predicted resting energy expenditures ( measured resting energy expenditure : 22.4 3.9 kcal / kg / day vs predicted resting energy expenditure : 21.7 2.0 kcal / kg / day ) .
the measured resting energy expenditure / predicted resting energy expenditure ratio , which reflects the stress factor , was 1.02 0.10 .
after the pylorus preserving pancreatoduodenectomy , a significant increase in energy expenditure was observed , and the measured resting energy expenditure was 25.7 3.5 kcal / kg / day on postoperative day 7 and 25.4 4.9 kcal / kg / day on postoperative day 14 .
the measured resting energy expenditure / predicted resting energy expenditure ratio was 1.16 0.14 on postoperative day 7 , and 1.16 0.18 on postoperative day 14 respectively . in conclusion , patients undergoing a pylorus preserving pancreatoduodenectomy showed a hyper - metabolic status as evaluated by their measured resting energy expenditure / predicted resting energy expenditure ratio . from our observations , we recommend that nutritional management based on 30 kcal / body weight / day ( calculated by the measured resting energy expenditureactivity factor 1.21.3 ) may be optimal for patients undergoing a pylorus preserving pancreatoduodenectomy . |
5,962 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: globally , preterm birth ( defined as birth at < 37 weeks of gestation ) affects around 11% of deliveries ( blencowe et al . , 2013 ) and it is closely associated with cerebral palsy , cognitive impairment and neuropsychiatric disease in later life ( kerr - wilson et al . , 2012 ; moore et al . , 2012 ) .
individuals born preterm are more likely to experience behavioral and emotional disturbance ( clark et al . , 2008 ; elgen et al . ,
2012 ) , autistic spectrum disorder ( johnson et al . , 2010 ) , attention deficit hyperactivity disorder ( bhutta et al . , 2002 ) and psychiatric disease , and these problems persist into adulthood ( crump et al . , 2010 ; halmoy et al . , 2012 ; moster et al . , 2008 ; nosarti et al . ,
white matter disease is a core feature of the encephalopathy of prematurity and it is associated with reduced connectivity of neural circuitry ( ball et al . , 2013 ;
boardman et al . , 2006 ; fischi - gomez et al . , 2014 ; pandit et al . , 2014 ; woodward et al
antenatal magnesium sulfate ( mgso4 ) is often given to women expected to deliver preterm because it is associated with reduced rates of cerebral palsy ( doyle et al .
. however , there are uncertainties about its long - term effects , and studies have not been designed or powered to investigate its influence on non - motor functions ( chollat et al . , 2014 ; doyle et al . , 2014 )
biomarkers of tissue integrity in the tracts of neural systems that sub - serve a range of functions are required to evaluate more pervasive neuroprotective effects .
diffusion mri ( dmri ) and tractography enable measures of white matter tract integrity to be determined in specific tracts - of - interest ( tois ) ( basser et al . , 2000 ) .
, 1999 ) or probabilistic ( behrens et al . , 2007 ) approaches to identify the major pathways , with tracts initiated at seed points and typically constrained by operator - defined waypoints
segmented pathways can then be analyzed as 3-dimensional regions - of - interest and water molecule diffusion parameters... | preterm birth is associated with altered connectivity of neural circuits .
we developed a tract segmentation method that provides measures of tract shape and integrity ( probabilistic neighborhood tractography , pnt ) from diffusion mri ( dmri ) data to test the hypotheses : 1 ) preterm birth is associated with alterations in tract topology ( r ) , and tract - averaged mean diffusivity ( d ) and fractional anisotropy ( fa ) ; 2 ) neural systems are separable based on tract - averaged dmri parameters ; and 3 ) pnt can detect neuroprotective treatment effects.dmri data were collected from 87 preterm infants ( mean gestational age 29 + 1 weeks , range 23 + 2 34 + 6 ) at term equivalent age and 24 controls ( mean gestational age 39 + 6 weeks ) .
pnt was used to segment eight major fasciculi , characterize topology , and extract tract - averaged d and fa.tract topology was altered by preterm birth in all tracts except the splenium ( p < 0.05 , false discovery rate [ fdr ] corrected ) . after adjustment for age at scan , tract - averaged d was increased in the genu and splenium , right corticospinal tract ( cst ) and the left and right inferior longitudinal fasciculi ( ilf ) in preterm infants compared with controls ( p < 0.05 , fdr ) , while tract - averaged fa was decreased in the splenium and left ilf ( p < 0.05 , fdr ) .
specific fasciculi were separable based on tract - averaged d and fa values .
there was a modest decrease in tract - averaged d in the splenium of preterm infants who had been exposed to antenatal mgso4 for neuroprotection ( p = 0.002).tract topology is a biomarker of preterm brain injury .
the data provide proof of concept that tract - averaged dmri parameters have utility for evaluating tissue effects of perinatal neuroprotective strategies . |
5,963 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: acute myocardial infarction ( ami ) is a leading cause of morbidity and mortality worldwide with approximately one - half of deaths occurring in the prehospital setting . in
the united arab emirates , mortality statistics from 2008 to 2010 showed that cardiovascular disease was the leading cause of death among both the united arab emirates nationals and expatriates . in the emirate of abu dhabi , early diagnosis and care by emergency medical services ( ems )
can play a crucial role in improving the management and ultimate outcome of patients with ami .
use of ems may result in the faster initiation of reperfusion therapies , and facilitate quicker and more efficient treatment decisions .
of particular importance is the role of ems in caring for patients with st - segment elevation myocardial infarction ( stemi ) , the most serious and time - sensitive type of ami .
stemi is potentially reversible provided that revascularization is initiated rapidly , as evidence has shown increased mortality associated longer culprit vessel occlusion times .
while several international studies have emphasized the need for early activation of ems in patients with ami , ems use is generally low in patients with stemi .
these low ems use rates were also found in the first gulf registry of acute coronary events ( gulf race ) and again in the second gulf race-2 , which reported ems use rates of 17% and 25% , respectively , as well as in other studies of middle eastern countries .
several studies have examined the issue of ems transport to the hospital versus self - transport and found that patient characteristics , american community survey ( acs ) characteristics , and patient 's knowledge of acs symptoms , influence the use of ems as well .
patient perception and knowledge of ems care is critical to proper utilization of such services .
the purpose of this study was to estimate the utilization , knowledge , and perceptions of prehospital ems among patients with stemi in the emirate of abu dhabi to determine if demographic and... | background : data on the use of emergency medical services ( ems ) by patients with cardiac conditions in the gulf region are scarce , and prior studies have suggested underutilization .
patient perception and knowledge of ems care is critical to proper utilization of such services.objectives:to estimate utilization , knowledge , and perceptions of ems among patients with st - elevation myocardial infarction ( stemi ) in the emirate of abu dhabi.methods:we conducted a multicenter prospective study of consecutive patients admitted with stemi in four government - operated hospitals in abu dhabi .
semi - structured interviews were conducted with patients to assess the rationale for choosing their prehospital mode of transport and their knowledge of ems services.results:of 587 patients with stemi ( age 51 11 years , male 95% ) , only 15% presented through ems , and the remainder came via private transport . over half of the participants ( 55% ) stated that they did not know the telephone number for ems .
the most common reasons stated for not using ems were that private transport was quicker ( 40% ) or easier ( 11% ) .
a small percentage of participants ( 7% ) did not use ems because they did not think their symptoms were cardiac - related or warranted an ems call .
stated reasons for not using ems did not significantly differ by age , gender , or primary language of the patients.conclusions:ems care for stemi is grossly underutilized in abu dhabi .
patient knowledge and perceptions may contribute to underutilization , and public education efforts are needed to raise their perception and knowledge of ems . |
5,964 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: sympathetic innervation of the eye is a third - order neuron pathway which emerges from the hypothalamus and runs along a well - known route before reaching the eye [ 1 , 2 , 3 ] .
the third - order neuron is located in the superior cervical ganglion dividing itself into two branches which innervate the mller 's muscle of the eyelids , lacrimal gland , iris dilator muscle , facial sweat glands and the small skin vessels [ 1 , 2 , 3 ] .
horner 's syndrome , also called oculosympathetic paresis , results from any lesion that interrupts the sympathetic neuronal pathway from the hypothalamus to the eye .
it manifests ipsilaterally to the lesion , consisting mainly of miosis , slight ptosis and enophthalmos , but can present other findings [ 1 , 2 , 3 ] .
horner 's syndrome can be caused by many benign and malignant conditions [ 1 , 2 , 3 , 4 ] .
neoplasia is the most common cause and accounts for 3560% of all cases [ 2 , 3 , 4 ] .
the purpose of this paper is to present the case of a woman with a left cervical mass corresponding to a t - cell - rich b - cell non - hodgkin lymphoma that manifested horner 's syndrome due to a sympathetic third - order neuron lesion at diagnosis . to our knowledge
, this is the first case of horner 's syndrome secondary to a lesion in the post - ganglionic level of the sympathetic pathway in a non - hodgkin lymphoma .
a 35-year - old woman was admitted with a cervical lymphadenopathy which had progressively grown over the last 3 months .
it consisted of a coalescent group of hard lymph nodes that infiltrated adjacent tissues and skin , posteriorly located on the left side of the neck ( fig .
simultaneously she presented ipsilateral miosis , slight superior eyelid ptosis , and enophthalmos typical for horner 's syndrome ( fig .
the ocular phenylephrine 1%-test revealed minimal dilatation in the normal right pupil and pronounced dilatation in the left affected pupil ( fig .
ct scan of the neck confirmed a lymphadenopathy that occupied the carotid and paravertebral spaces .
thoracic ct... | in this paper , we present the rare case of a patient with cervical lymphadenopathy diagnosed as a t - cell - rich b - cell non - hodgkin lymphoma that manifested horner 's syndrome due to a post - ganglionic sympathetic neuron lesion caused by the tumor . |
5,965 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: from october to november 2002 , a cluster of skin and soft tissue infections due to mrsa involving pediatric and maternity patients occurred at a new york city hospital .
the hospital has a labor and delivery unit and 2 units that house both healthy newborns and maternity patients .
after the outbreak was recognized , the following interventions were implemented : 1 ) nursing and medical personnel from the involved areas were informed of the outbreak and potential modes of transmission of staphylococci , 2 ) contact precautions were emphasized for all patients with suspected or proven skin infections , 3 ) alcohol - based hand sanitizers were placed in involved areas , 4 ) healthcare workers from involved units were screened for nasal mrsa colonization , and 5 ) environmental surfaces ( including cord clamps , antitheft transponders , and temperature sensors of baby warmers ) were tested for mrsa contamination .
healthcare workers colonized with mrsa were treated with intranasal mupirocin and furloughed until repeat cultures were negative . to identify any other potential case - patients , letters concerning the outbreak
were sent to pediatricians who cared for newborns discharged from the affected units during the outbreak period .
cases were defined as mrsa infections in patients who stayed on the labor and delivery , nursery , or maternity units at any time from october 2002 to december 2002 .
the medical records of the patients were reviewed for information regarding prior healthcare exposures , receipt of antimicrobial agents , underlying medical conditions , treatment , and clinical outcome .
cultures related to the outbreak were grown on tryptic soy agar plates supplemented with 3% sheep blood ; colonies consistent with s. aureus were identified according to standard techniques .
all isolates underwent susceptibility testing with the etest method ( ab biodisk , solna , sweden ) .
ribotyping was performed with the riboprinter microbial characterization system ( qualicon , wilmington , de , usa ) , as... | community - associated methicillin - resistant staphylococcus aureus ( ca - mrsa ) has rarely been reported in the hospital setting .
we report an outbreak of 7 cases of skin and soft tissue infections due to a strain of ca - mrsa .
all patients were admitted to the labor and delivery , nursery , or maternity units during a 3-week period .
genetic fingerprinting showed that the outbreak strain was closely related to the usa 400 strain that includes the midwestern strain mw2 .
all isolates contained the staphylococcal chromosome cassette mec type iv .
genes for panton - valentine leukocidin and staphylococcal enterotoxin k were detected in all isolates , and most contained other enterotoxin genes .
testing of nearly 2,000 mrsa isolates collected during citywide surveillance studies from 1999 to 2003 showed that 1% were genetically related to mw2 .
ca - mrsa strain mw2 has been present in this region at least since 1999 .
this study documents the spread of this strain among healthy newborns at 1 hospital . |
5,966 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it has been claimed that tertian malaria had been completely eradicated in the latter part of 1970 in korea .
but since 1993 , this tertian malaria has reemerged to infect soldiers and civilians living near the armistice line , resulting in 1,724 cases in 1997 . also , imported malaria from an overseas trip has become a medical problem to the extent of calling attention .
reports have appeared calling attention to what has been termed primaquine resistance in plasmodium vivax in korea .
we present a case of primaquine resistant tertian malaria which was thought to be relapsed because of loss of radical cure at initial treatment .
a 50-year - old man presented on november , 1997 with high fever , chills and splenomegaly .
three weeks before admission , he had traveled to ethiopia where he had remained for 10 days without prophylactic chemotherapy against malaria .
the temperature was 39c , the pulse was 100/min and the respiration rates were 22/min .
a physical examination was normal , except for a nontender , firm splenomegaly exceeding 5 cm below the costal margin .
laboratory examinations showed hemoglobin 16.1 gm / dl , white blood cell count 7,510/mm , platelet count 49,100/mm , alkaline phosphatase 248 iu / l , alanine aminotransferase 165 iu / l , aspartate aminotransferase 89 iu / l . at that time , microscopic examination of a blood smear was said to show malaria ( p.vivax ) and a diagnosis of malaria was made .
after treatment with chloroquine ( 750 mg as a loading dose and then 350 mg each 6 , 24 , 48 hours later ) , he felt well but subsequently did not receive primaquine because of the physician s mistake .
laboratory examinations showed hemoglobin 16.5 gm / dl , white blood cell count 4,150/mm , platelet count 26,300/mm .
microscopic examination of a stained blood smear for malarial organism ( 38,180/l ) was positive .
the patient was given a conventional three - day course of chloroquine with relapsed malaria .
on the following day , he became afebrile and reevaluation of blood smears showed... | in plasmodium vivax and plasmodium ovale malaria , some of the liver stage parasites remain dormant .
the activation of these dormant forms ( called hypnozoite ) can give rise to relapse weeks , months or years after the initial infection.to prevent relapses , a course of primaquine may be given as terminal prophylaxis to patients .
different strains of plasmodium vivax vary in their sensitivity to primaquine and , recently , cases of relapse of plasmodium vivax after this standard primaquine therapy were reported from various countries.we reported a case of primaquine resistant malaria which initially was thought to be relapsed caused by loss of terminal prophylaxis . |
5,967 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in general , the gastric tube is used for reconstruction after an esophagectomy , and the reconstruction may be performed via the posterior mediastinum , retrosternal , or presternal route . as the posterior mediastinum route is the shortest and most natural , this route is most often chosen . however , in cases of locally advanced esophageal cancer where there are concerns about local recurrence , the retrosternal route may be chosen in order to minimize the risk of tumor invasion or irradiation of the gastric tube . in which route
, we adopted a cervical anastomosis , so that the anastomosis was located behind the sternum . in gastric tube reconstructions ,
slow peripheral circulation of the gastric tube , tension , and anastomotic complications , such as leakage or stricture , occasionally occur .
leakage induces local inflammation around the anastomosis , with scarring occurring as a result of the inflammation ; ultimately an anastomotic stricture is formed .
when we perform gastric tube reconstructions , we always carefully perform end - to - side esophagogastric anastomoses , using a circular stapler to avoid bending the anastomosis , but regardless of this , strictures occasionally occur
. for anastomotic strictures , bougie dilations or endoscopic balloon dilation techniques are often performed , but in some cases , frequent dilation is required and the resultant expansion may still be insufficient .
additionally , new or recurrent cancer may occur in the esophageal remnant or at the anastomotic site .
however , in the case of cervical anastomoses , approaching the anastomosis is difficult because it is located on the dorsal side of the sternum , and advanced adhesions to the surrounding tissues are often encountered .
for such cases , we have adopted a procedure to approach the anastomosis via the sternum ; the procedure involves resection of the proximal left clavicle and manubrium .
first , an incision is made in the left half of the neck wound that resulted from the previous operation , followed... | in gastric tube reconstruction , anastomotic leakage and stricture occasionally occur .
additionally , new or recurrent cancer may occur in the esophageal remnant or at the anastomotic site .
such complications , after cervical anastomoses , led to our adoption of a procedure to approach the anastomosis by manubrium and proximal left clavicle resection .
this procedure was applied to seven patients between april 2000 and march 2011 .
the mean age of the patients was 69.9 years ( range , 6576 years ) ; all were men .
the mean operative time was 506 min ( range , 374845 min ) , with an average blood loss of 297 ml ( range , 180606 ml ) .
esophagogastric anastomoses were performed in two cases , and free jejunal graft transplantations were performed in the remaining five cases ; oral intake became possible for all patients .
limited range of motion or other movement disorders of the neck and upper limbs , due to the upper sternum and clavicle resection , were not observed .
this invasive surgical procedure can be acceptable for patients who are facing life - threatening consequences or significant decreases in quality of life and are resistant to conservative treatment . |
5,968 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: experimental birds : white leghorn chicks ( n=12 , male ) at one day of age
were commercially obtained from komatsu shukeijyo ( matsumoto , japan ) and reared in our
laboratory given a commercial diet and water ad libitum and under
controlled light condition ( 12 hr light : 12 hr darkness ) up to one week of age .
chicks were
treated in accordance with the guideline for regulation of animal experimentation ( 1997 )
of faculty of agriculture , shinshu university .
tissue samples : chicks were perfused with a mixture of 4% paraformaldehyde
and 0.01% glutaraldehyde in phosphate buffer ( ph7.6 ) following 0.75% nacl solution under
anesthesia with diethyl ether . proximal and distal portions of ileum were immediately
dissected out as the tissue samples and then immersed in the same perfusate for 5 hr at 4c .
tissue samples were cut into small blocks and pieces and embedded in paraffin wax and epoxy
resin , quetol 812 , respectively according to each standard procedure .
immunofluorescent technique : paraffin sections cut at 5
m thickness were treated with 2.5% normal donkey serum ( ihr-8135 ,
immunobioscience , mukilteo , wa , u.s.a . ) for 20 min and incubated with the mouse monoclonal
antibody against synthetic human glp-1 ( aa 736 amide ) ( diluted to 1:2,000 , a6104.1 ,
immunodiagnostik , bensheim , germany ) for 24 hr .
after several washing with phosphate
buffered saline ( pbs ) , paraffin sections were subsequently incubated with rabbit anti - human
( arg)-glp-2 serum ( 1:500 , h-028 - 14 , phenix pharmaceuticals , burlingame , ca ,
u.s.a . ) for 24 hr .
incubation of sections with the cocktail of fitc - labeled donkey
anti - mouse ig g ( 1:100 , gtx85337 , genetex , irvine , ca , u.s.a . ) and rhodamine - labeled donkey
anti - rabbit ig g
( 1:100 , 611 - 700 - 127 , rockland immunochemicals , gillbertsville , pa , u.s.a . )
thermo fisher scientific , fremont , ca , u.s.a . ) , observed and photomicrographed
under a fluorescent microscope ( axioimager , zeiss ,... | abstractcolocalization of glucagon - like peptide ( glp)-1 with glp-2 in l - cells was investigated in
the chicken ileum by using double immunofluorescent and immunocytochemical techniques .
ultrastructural features of l - cells were also clarified in this study .
l - cells showing
immunoreactivity for both glp-1 and glp-2 were distributed in the whole ileum .
they showed
comma - like or flask - like shape and were located in epithelium of crypts and lower part of
intestinal villi .
l - cells showing glp-1-immunoreactivity only were found in epithelium of
lower and middle parts of intestinal villi .
transmission electron microscopy indicated
that l - cells identified by colloidal gold - labeled immunocytochemistry were covered
apically with microvilli , open - type and contained many secretory granules in their
perikarya .
these secretory granules without halo were round to oval in shape and showed
moderate electron density .
the longest and shortest diameters of secretory granules were
355 62 nm ( mean sd ) and 287 48 nm , respectively .
double labeling immunocytochemistry
using two different sizes of particles ( 6 and 12 nm in diameter ) of colloidal gold
revealed that glp-1 colocalized with glp-2 in the same secretory granules .
this study
advances new morphological data about the endocrine system of the chicken small
intestine . |
5,969 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: insulin resistance ( ir ) plays a crucial role in the pathophysiology of metabolic syndrome ( mets ) , which is associated with an increased risk of cardiovascular disease and type 2 diabetes . from the standpoint of primary prevention , it is important to identify the patients at risk of mets , especially at an early stage when ir contributes to the clustering of borderline metabolic risk factors .
homeostasis model assessment of ir ( homair ) is a useful model for assessing ir in largescale clinical research , and it has been validated by the gold standard method the hyperinsulinemiceuglycemic clamp technique .
healthassociated reference interval of homair , which covers the central 95% of 2153 healthy japanese subjects , by applying the stringent c28a3 document from the clinical and laboratory standards institute .
we have established the reference interval for homair as between 0.4 and 2.4 , and proposed that homair 2.5 be considered a reasonable indicator of ir in a japanese population as recommended by the japan diabetes society .
healthassociated reference interval and is defined for use by clinicians to diagnose or manage patients .
the present study focused on ir as a marker of earlystage mets and aimed to establish a
an optimal cutoff point for homair to discriminate mets in nondiabetic japanese subjects was determined by receiver
of the 7305 healthcheck examinees ( 4042 men and 3263 women ) who first visited the health evaluation and promotion center at tokai university hachioji hospital between april 2007 and march 2011 , 6868 examinees ( 3727 men and 3141 women ) were included in the present study after exclusion of those with fasting plasma glucose ( fpg ) 126 mg / dl and those on medication for diabetes .
the present study was crosssectional in design , and was approved by the ethics committee of tokai university school of medicine ( 11r096 ) and complied with the helsinki declaration .
waist circumference ( wc ) was assessed at the end of expiration , measuring the minimum... | abstractwe have recently established a healthassociated reference interval of homeostasis model assessment of insulin resistance ( homair ) between 0.4 and 2.4 . in the present study ,
the aim was to establish a
decisionbased limit of homair for the discrimination of metabolic syndrome ( mets ) in nondiabetic japanese subjects .
the receiver
operating characteristic curve of homair for detecting mets was developed using data from 6868 nondiabetic subjects ( 3727 men , 3141 women ) .
the optimal cutoff point was determined based on the point that yielded the minimum value of the square root of [ ( 1
sensitivity)2 + ( 1 specificity)2 ] .
homair
= 1.7 was determined as the optimal cutoff value , with a sensitivity and specificity of 73.4% and 70.5% for men , and 81.5% and 77.0% for women , respectively . in conclusion
, the optimal cutoff value for homair to discriminate mets in nondiabetic japanese subjects appears to be 1.7 .
( j diabetes invest , doi : 10.1111/j.20401124.2012.00194.x , 2012 ) |
5,970 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: composite pheochromocytoma ( pc ) is a rare neoplasm that typically arises in the adrenal medulla as a mixture of pc and other tumors of neural origin , including peripheral neuroblastic tumors , malignant peripheral nerve sheath tumors , and neuroendocrine carcinomas ( 1 , 2 ) . the frequency of composite pcs in the adrenal gland has been estimated to be < 10% of the total number of adrenal pcs ( 3 , 4 ) . to the best of our knowledge ,
approximately 75 adrenal ( 1 , 2 , 5 - 15 ) and 12 extra - adrenal ( 16 - 24 ) cases have been reported in the medical literature to date .
peripheral neuroblastic tumors encompass a wide spectrum of differentiation and malignancy potentials from the most primitive and malignant neuroblastomas ( nbls ) to the most mature and benign ganglioneuromas ( gns ) .
ganglioneuroblastomas ( gnbls ) are an intermediate stage of neuroblastic tumors ( 25 , 26 ) .
gns coexist most frequently in 72.6% and 92.9% of adrenal ( 1 , 2 , 5 - 15 ) and extra - adrenal ( 16 - 24 ) composite pcs , respectively .
however , other types of composite pcs are extremely rare , with only a few cases having been reported for adrenal pc - gnbls ( 2 , 25 , 27 - 37 ) . very recently , we revealed for the first time that extracellular signal - regulated kinase 5 ( erk5 ) together with ankyrin repeat domain 1 ( ankrd1 ) induced by erk5 regulates tyrosine hydroxylase ( th ) activity and catecholamine biosynthesis during neural differentiation , with erk5 expression levels correlated with th levels in the normal adrenal medulla ( 38 ) . however , erk5 was down - regulated , and the erk5-mediated regulation of the cellular function was disrupted in human adrenal pc ( 38 ) .
following our review of the previous literature , we herein report on a rare case of adrenal incidentaloma in a normotensive patient who was diagnosed post - operatively with a composite pc , occurring together with a gnbl component from the right adrenal medulla on microscopic findings .
in addition , we also immunohistochemically... | composite pheochromocytoma ( cpc ) is extremely rare , arising in the adrenal medulla as a mixture of pc and other tumors of neural origin .
we herein report on a case of adrenal incidentaloma post - operatively diagnosed as cpc with ganglioneuroblastoma ( gnbl ) .
the pc component had 7 points on the pass , a ki-67 index of 5.1% , a focal absence of sustentacular cells , and no genetic aberrations in succinate dehydrogenase subunit b. the gnbl component exhibited no n - myc amplification .
tumor cells of both components were stained positively for extracellular signal - regulated kinase 5 and ankyrin repeat domain 1 .
the aberrant activation of growth signaling may play a role in the marginal malignancy of cpc . |
5,971 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: sarcoidosis is a systemic disease of unknown etiology with systemic inflammation leading to formation of granulomas .
macrophages and activated lymphocytes , an immunological hallmark of sarcoidosis , are also involved in the process of thrombin activation and fibrin formation [ 2 , 3 ] .
the association between sarcoidosis and venous thromboembolism ( vte ) has been reported recently [ 4 , 5 ] , nevertheless it is still not clear if sarcoidosis is a risk factor for vte .
thus , the aim of the present study was to describe possible mechanisms that could be responsible for the increased occurrence of vte in sarcoidosis .
a higher risk of pulmonary embolism ( pe ) in sarcoidosis patients has been reported recently , according to data from the uk , with a risk ratio of 2.0 ( 95% ci : 1.1 - 3.4 ) , in patients under 65 years of age , comparing to a reference cohort .
swigris et al . found pe in 2.5% of us decedents with sarcoidosis , regardless of gender , race or age . in the retrospective analysis of clinical outcome and comorbidities among 798 sarcoidosis patients who have been hospitalized in the 2 pulmonary department of our institution between 2004 and 2014
the mechanisms that could predispose sarcoidosis patients to the development of vte may be related to several factors : activity of inflammation , clinical picture of sarcoidosis or comorbidities .
a close anatomic relation between the site of active sarcoidosis and thrombus formation was described in the literature : mural thrombus in myocardial sarcoidosis , cerebral vein thrombosis in neurosarcoidosis [ 79 ] , thoracic vein thrombosis in mediastinal sarcoidosis [ 1012 ] , portal vein hypertension in hepatic sarcoidosis , suggesting the local hypercoagulability status as the cause of thrombosis .
local hypercoagulability might have been the consequence of active granulomatous inflammation with an increased concentration of inflammatory markers [ 1419 ] .
we have found recently features of disease activity : elevated crp , esr , and ace , monocytosis... | the association between venous thromboembolism ( vte ) and sarcoidosis has been reported recently , nevertheless the true incidence of co - incident sarcoidosis and vte is unknown .
sarcoidosis as a chronic disease of immune dysregulation might be associated with an increased risk of vte .
the mechanisms responsible for vte development are not clear and may be influenced by several factors : activity of inflammation , clinical characteristics of sarcoidosis and comorbidities .
pulmonary embolism ( pe ) as a potentially fatal condition should be considered in all of the patients with sarcoidosis in whom worsening of the respiratory status is diagnosed .
a high plasma d - dimers ( dd ) level may be suggestive of vte , nevertheless elevated plasma dd should be interpreted with caution , in the context of the active inflammatory process .
if sarcoidosis appears to be one of risk factors for vte development , further investigations are needed to define the pro - thrombotic phenotype of this disease . |
5,972 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: infectious bronchitis ( ib ) , caused by the infectious bronchitis virus ( ibv ) , is a highly contagious viral disease of chickens with a worldwide distribution .
it is characterized by respiratory symptoms , nephritis , poor performance and reduced egg reproduction . despite extensive vaccination
, ib has been a perpetual problem in the korean poultry industry since the disease was first reported in 1986 [ 7,9 - 11,16,17 ] .
recently , phylogenetic analysis revealed that korean field isolates of ibv constitute at least three distinct phylogenetic types : k - i , k - ii and k - iii .
k - i type strains are native viruses associated with localized incidence in korea , k - ii type strains are closely related to nephropathogenic ibv strains isolated in china , and k - iii type strains are closely related to enteric ibv variants of chinese strains . in particular , the k - ii type nephropathogenic ibv is associated with a high mortality rate , and has been the source of great economic losses in the poultry industry in korea , despite the availability of a vaccine based on the km91 strain of korean nephropathogenic ibv [ 7,9 - 11,17 ] . molecular epidemiological evidence suggests that k - ii type qx - like viruses ( k - iib type ) isolated since 2003 form a different cluster than those ( k - iia type ) isolated prior to 2003 ( e.g. , strain km91 ) .
nevertheless , antigenic differences between k - iia and k - iib type viruses have yet to be fully investigated .
the purpose of this study was to investigate the pathogenic and antigenic characteristics of k - iib type ibv strains currently circulating in korea to determine whether available ibv vaccines based on k - iia type strains will confer cross - protection against field ibv strains .
two korean ibv strains , km91 and kr / q43/06 ( national veterinary research and quarantine service , korea ) , were analyzed .
strain km91 is a nephropathogenic k - iia type virus that was isolated in early 1990s , and strain kr / q43/06 is a k - iib type virus isolated in 2006... | despite the existence of an active vaccination program , recently emerged strains of nephropathogenic infectious bronchitis virus ( ibv ) in korea have caused significant economic losses in the poultry industry . in this study , we assessed the pathogenic and antigenic characteristics of a k - iib type field strain of ibv that emerged in korea since 2003 , such as kr / q43/06 .
specific pathogen free 1-week - old chickens exhibited severe respiratory symptoms ( dyspnea ) and nephropathogenic lesions ( swollen kidneys with nephritis and urate deposits ) following challenge with the recent ibv field strain . the antigenic relatedness ( r value ) , based on a calculated virus neutralization index , of the k - iib type field strain and k - iia type strain km91 ( isolated in 1991 ) was 30% , which indicated that the recent strain , kr / q43/06 , is a new variant that is antigenically distinct from strain km91 .
this report is the first to document the emergence of a new antigenic variant of nephropathogenic ibv in chicken from korea . |
5,973 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: renal hyperparathyroidism ( rhpt ) is a serious complication of long - term dialysis treatment .
the european dialysis and transplant association ( edta ) report published in 1991 showed that up to 40% of patients undergo surgical treatment for rhpt after 15 years of dialysis .
rhpt is a form of renal osteodystrophy that causes increased bone fragility , and in addition , it has also been reported that hypercalcaemia and hyperphosphataemia associated with rhpt induce ectopic calcification in the vascular walls and heart valves , thereby significantly affecting the patient 's survival prognosis [ 49 ] . in patients with severe rhpt refractory to medical treatment
there are two types of such methods , percutaneous ethanol injection therapy ( peit ) and a parathyroidectomy ( ptx ) . determining which of these methods is the most appropriate intervention for individual cases is therefore a major issue for clinicians .
peit is easy to perform on an outpatient basis ; however , it has been associated with a significant adverse event , namely adhesion formation .
an indistinct margin of the parathyroid gland is often found during surgery following peit due to the firm fibrous membrane .
ptx is considered to be the last treatment option in patients with severe rhpt resistant to medical treatment and peit .
this study was conducted to determine whether similar results can be expected when ptx is performed in patients who underwent peit by investigating the effect of peit on subsequent ptx .
the patients had a diagnosis of rhpt , for which surgery was indicated , from january 2004 to december 2005 .
the subjects were divided according to whether they underwent peit ( peit group ) or not ( non - peit group ) .
an analysis was performed to compare the pre- and postoperative biochemistry results as well as intact pth levels ( preoperative , postoperative and year 1 postoperatively ) , number of the parathyroid glands detected by ultrasonography , operation time , the amount of bleeding , the number of parathyroid glands... | background .
renal hyperparathyroidism ( rhpt ) is a serious complication of long - term dialysis treatment .
two intervention methods can be administered to treat rhpt , namely percutaneous ethanol injection therapy ( peit ) and a parathyroidectomy ( ptx ) .
peit is associated with a significant adverse event , adhesion formation .
this study was performed to investigate the effect of peit on subsequent ptx.methods .
a total of 80 subjects were included in the study .
the patients had a diagnosis of rhpt for which surgery was indicated .
they were divided according to whether they underwent peit ( peit group ) or not ( non - peit group ) .
the outcomes of ptx following peit were evaluated.results .
there were 19 patients in the peit group and 61 in the non - peit group .
the operation time was significantly longer in the peit group but no significant differences in the amount of bleeding or frequency of recurrent nerve paralysis were observed .
the intact pth levels immediately following surgery were slightly higher in the peit group .
the postoperative intact pth levels were found to be significantly higher in those who received two or more courses of peit .
the number of patients with an intact pth level > 60 pg / ml on postoperative day 1 was significantly higher in the peit group.conclusions .
these findings suggested that peit prior to ptx can affect the subsequent surgical outcome due to associated adhesions and dissemination . for patients with a possibility of either a decreased efficacy or a lack of efficacy for peit
, it is therefore important to consider ptx from the very beginning of the treatment . |
5,974 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: mountainous ecosystems are highly sensitive to any disturbances in natural balance , what makes them especially interesting for observations of chemical and radiochemical contamination .
the area of the babia gra national park ( bpn ) , being located along the main ridge of the flysch carpathian mountains , is just the proper place in this respect .
the terrain belongs to the young folded mountains , built mainly of flysch and some other lithology .
the highest summit of the babia gra mountain s massif ( west part of the beskid ywiecki chain of mountains ) is diablak reaching 1,725 m asl . to protect this unique area
the area of the bpn , like other regions of poland , was exposed to substantial contamination with radionuclides due to the chernobyl accident in 1986 and nuclear weapon tests since the fifties of the twentieth century [ 16 ] .
researches on radionuclides distribution in the environment are important not only because these are perfect markers of the environment pollution but also because radioactive isotopes are not immobilized in soil but are constantly interchanged between inorganic matter and living organisms .
the aim of the work was to establish the spatial distribution of -radionuclides i.e. anthropogenic cs ( t1/2 = 30.07 years ) and natural k ( t1/2 10 years ) in the soil samples collected in the described above area .
10 cm thick soil core samples were collected with the use of a cylindrical corer ( 10 cm in diameter ) .
13 sampling points were selected in the studied area , most of them localized along the mountains main ridge .
each of the sampling points was described by its geographical coordinates and height above the sea level . in case of few points
it was impossible to determine their precise coordinates ( the lack of gps signal ) , so the closest available coordinates were interpolated . in the laboratory , the cores were divided into three sub - samples each to enable radioisotopes determination in various depths .
the samples were then dried at 105 c and the total... | the aim of this work was to determine 137cs and 40k radioactivities in soil samples taken from the babia gra national park ( bpn ) in south poland .
the cluster analysis ( ca ) and principal component analysis ( pca ) were used to discuss the obtained data .
10 cm thick soil cores were collected from the bpn area .
each sample was divided into three sub - samples .
the samples were dried , homogenized and packed in polyethylene containers .
the radioactivities of 137cs and 40k were measured by means of gamma spectrometry .
it was found that 137cs radioactivity in the whole 10 cm soil cores was in the range from 1,916 to 28,551 bq m2 .
the radioactivity of 40k varied from 1,642 to 25,654 bq m2 . using ca it was possible to diverse the soils taking into account soil types . by use of the pca method ,
it was chosen three factors which are appropriate to characterize researched parameters . |
5,975 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the prevalence of human immunodeficiency virus ( hiv ) infection in india is 0.34%.(1 ) even though the survival of people living with hiv ( plwh ) has improved with the advent of anti - retroviral therapy ( art ) , their life is affected by social factors like stigma / discrimination . hence , quality of life ( qol ) which gives a holistic picture of their health status has gained importance.(2 ) further , knowing the factors affecting the qol of plwh would be helpful in making important policy decisions and health care interventions .
literature on the factors influencing qol was not consistent as qol depends on the socio - cultural milieu in which the individual lives.(3 ) one such variation observed in hiv was with relation to gender .
in chennai , it was found that females experienced poor qol in the sociological domain , and men in the psychological domain,(4 ) whereas , the multicentric preliminary study of whoqol with two centers in india found that women experienced less qol across all domains.(5 ) on the contrary , in africa , it was found that gender does not influence qol.(6 ) since india accounts for nearly half of the asia 's hiv prevalence,(7 ) there is a definite need to study qol and the factors influencing it in the indian setting .
measuring qol would help to identify the most affected domain , and knowledge on factors influencing it will aid in taking appropriate intervention .
it would also provide regional and objective data for planning interventions for the betterment of plwh .
to assess the quality of life of plwh.to study the socio - cultural and demographic determinants of quality of life in plwh .
to assess the quality of life of plwh . to study the socio - cultural and demographic determinants of quality of life in plwh .
to assess the quality of life of plwh.to study the socio - cultural and demographic determinants of quality of life in plwh .
to assess the quality of life of plwh . to study the socio - cultural and demographic determinants of quality of life in plwh... | context : with anti - retroviral therapy ( art ) for human immunodeficiency virus infection ( hiv ) coming into picture , quality of life ( qol ) has gained importance .
knowledge on the factors affecting qol would be helpful in making important policy decisions and health care interventions.aims:the aim of this study is to assess the quality of life of people living with hiv ( plwh ) and to identify the factors influencing their qol.materials and methods : the study was done among 200 plwh attending a tertiary care hospital , and three non governmental organizations at puducherry , india , from november 2005 to may 2007 .
qol was assessed using hiv specific world health organization quality of life scale ( whoqol - hiv ) bref questionnaire which has six domains ( physical , psychological , level of independence , social relationships , environment and spirituality / religiousness / personal belief ) .
social support and stigma were measured using multidimensional scale of perceived social support and
hiv stigma scale , respectively , using likert scale .
factors influencing qol were identified using backward stepwise multiple linear regression with the six domain scores as the dependent variables.results:male : female ratio was 1:1 and 58% were in early stage of the disease ( stage i / ii ) .
psychological and srpb ( spirituality religiousness and personal beliefs ) domains were the most affected domains .
all the regression models were statistically significant ( p<0.05 ) .
the determination coefficient was highest for the social relationship domain ( 57% ) followed by the psychological domain ( 51% ) .
disease stage and perceived social support significantly influenced all the domains of whoqol .
younger age , female gender , rural background , shorter duration of hiv , non - intake of art and greater hiv related stigma were the high risk factors of poor qol.conclusion:interventions such as art , family , vocational and peer counseling would address these modifiable factors... |
5,976 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: equilibrium gated radionuclide ventriculography ( ernv ) is a non - invasive , reproducible and minimally operator - dependent study .
ernv has been used widely for the assessment of wall motion abnormalities and left ventricular ejection fraction ( lvef ) . fourier phase analysis on ernv in addition
this loss of synchronous contraction is called lv dyssynchrony.[35 ] since fourier phase analysis is an effective tool for detecting dyssynchrony , ernv can differentiate synchronous and dyssynchronous contraction of heart . hence , we aim to establish the range of phase parameters in normal individuals and derive cut - off limits for parameters to detect cardiac dyssynchrony .
the study group included 30 individuals ( age 5323 years , 25 males and 5 females ) with no history of cardiovascular disease .
they all had normal lvef and wall motion ( lvef 5570% on echocardiography ) , were in sinus rhythm , with normal qrs duration ( 120 msec ) and either normal myocardial perfusion scintigraphy or normal coronary angiography .
the electrodes used for cardiac gating were secured on the skin in order to ensure an optimal ecg signal .
the cardiac rhythm was noted to rule out marked heart rate variability that could interfere with the procedure and interpretation of ernv results .
after 20 minutes , 25 mci of tc 99 m pertechnate solution was injected intravenously .
ernv was performed using dual head ge infinia hawkeye 4 gamma camera with low - energy , high - resolution , parallel hole collimator interfaced to a dedicated computer .
the simultaneity of r wave triggered by the gating device and the qrs complex were verified before initiation of the study .
a 15% r - r interval beat acceptance window was selected to include acceptable cardiac cycles .
thirty - two frames per r - r interval were obtained for assessment of ventricular wall motion , assessment of ejection fraction and phase analysis .
images were acquired so that the heart occupied ~50% of the usable field of view .
supine imaging was performed in a minimum... | aim : to define the range of phase spread on equilibrium gated radionuclide ventriculography ( ernv ) in normal individuals and derive the cut - off limit for the parameters to detect cardiac dyssynchrony.materials and methods : ernv was carried out in 30 individuals ( age 5323 years , 25 males and 5 females ) who had no history of cardiovascular disease .
they all had normal left ventricular ejection fraction ( lvef 5570% ) as determined by echocardiography , were in sinus rhythm , with normal qrs duration ( 120 msec ) and normal coronary angiography .
first harmonic phase analysis was performed on scintigraphic data acquired in best septal view .
left and right ventricular standard deviation ( lvsd and rvsd , respectively ) and interventricular mechanical delay ( ivmd ) , the absolute difference of mean phase angles of right and left ventricle , were computed and expressed in milliseconds .
mean + 3 standard deviation ( sd ) was used to derive the cut - off limits.results:average lvef and duration of cardiac cycle in the study group were 62.5%5.44% and 868.9114.5 msec , respectively .
the observations of lvsd , rvsd and right and left ventricular mean phase angles were shown to be normally distributed by shapiro wilk test .
cut - off limits for lvsd , rvsd and ivmd were calculated to be 80 msec , 85 msec and 75 msec , respectively.conclusion:fourier phase analysis on ernv is an effective tool for the evaluation of synchronicity of cardiac contraction .
the cut - off limits of parameters of dyssynchrony can be used to separate heart failure patients with cardiac dyssynchrony from those without .
ernv can be used to select patients for cardiac resynchronization therapy . |
5,977 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: hepatitis b virus is one of the most important factors for infected diseases in the world .
it was estimated that 350 million people infected with hepatitis b virus and almost 75% patients are living in asia ( 1 ) .
nearly one million people die annually from chronic liver diseases such as , chronic hepatitis b , cirrhosis and hepatocellular carcinoma ( 2 ) .
the prevalence of hepatitis b is reported various in different parts of the world , so this virus existed as hyper endemic in most asian countries . throughout the world , carrier variability rate for hepatitis b infection is estimated to be 0.1% to 20% which is different in various areas and is classified into three regions : the first group with areas as having low ( < 2% ) , the second group with intermediate prevalence ( 2 - 7% ) and with high prevalence ( > 8% ) ( 3 ) .
the prevalence of hepatitis b infection is high in africa , southeast asia , the middle east , southern and western pacific island , ( they are of endemic regions ) intermediate areas consist of south central and southwest asia , israel , japan , eastern , southern europe and russia and prevalence of hepatitis b infection is low in northern and western europe , north america , australia , new zealand , mexico and southern america ( 4 ) . in iran , a study showed that 35% of population were infected with hepatitis b and the percentage of chronic carriers is about 3% ; although after implementing control programs and public vaccination , the prevalence of hbv infection has reduced to less than 2 % ( 5 ) .
the hbv has ten genotypes ( a - j ) , multiple subtypes and serotypes ( adr , adw , ayr , ayw ) , showing genotypes vary in different geographic areas worldwide . there is a relation between serotype and genotype in the world ( 6 ) .
it seems that infected persons with different genotypes show various responses to therapy ( 7 ) . also different in genotypes
have shown influences in sever course of disease , infection and vaccination ( 8) . some studies suggested that genotype d could... | hepatitis b virus ( hbv ) infection is a public health problem as a cause of liver diseases including hepatocellular carcinoma and cirrhosis .
it is estimated that 350 million people live with chronic infection and about one million people die every year from complication of this chronic disease in the world .
so far , ten hbv genotypes ( a - j ) has been identified which show a geographical distribution . throughout the world , carrier variability rate for hepatitis b infection is estimated to be 0.1% to 20% , with regions classified as having low endemicity ( < 2% ) , intermediate endemicity ( 2 - 7% ) and high endemicity ( > 8% ) .
the prevalence of hepatitis b infection is estimated at 2 to 7 percent in iran .
after hbv vaccination program the prevalence of hepatitis b infection has been reported less than 2% , so iran can be considered one of the countries with low hbv infection endemicity . in iran several studies
were shown that the only genotype of hbv(100%)was found genotype d as the prominent type in some provinces , but some studies reported genotype b(5%)as well as genotype d(95%).the distribution of hbv genotypes may guide us in determining disease burden , prognosis and antiviral responses .
so , it is important to know the epidemiologically of hbv genotyping as well . |
5,978 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is a benign locally aggressive tumor usually involving the distal end of the femur , proximal tibia and distal radius in young adults .
the main variables to be considered for planning treatment include the site of involvement and campanacci stage of the tumor .
different treatment options are available which include intralesional curettage , extended curettage , wide resection and reconstruction
. functional and oncological outcome of these treatment options varies widely , the predominant detrimental factor being tumor recurrence rate .
reconstruction of endoprosthesis after wide excision of the tumor offers good short - term and mid - term functional and oncological outcomes as established by previous studies .
this study was conducted to evaluate the long - term outcome of 11 patients with gct who underwent wide excision and customized endoprosthetic replacement .
this study included 11 patients ( eight men and three women ) aged 2448 ( mean 32 ) years with primary gct of proximal femur campanacci stage - iii who were available for mean follow - up duration of 10.6 ( range 10.214 ) years .
the definite diagnosis was established on histopathological confirmation with incisional biopsy . computed tomography scan of chest and bone scan
none of the patients had pulmonary metastasis , and all the 11 patients had a solitary lesion in the proximal femur .
these patients underwent wide resection of the tumor using postero - lateral approach to the proximal femur .
the proximal femur was reconstructed using a customized , titanium , cemented endoprosthesis [ figure 1 ] .
hip abductors , short external rotators and iliopsoas tendon were secured onto the prosthesis and hip capsule repair was performed .
postoperative rehabilitation protocol included nonweight bearing and abduction splinting of the limb for 6 weeks followed by nonweight bearing crutch walking for another 6 weeks . once the hip abductors and quadriceps strength was regained weight bearing was allowed .
long - term functional outcome was evaluated... | introduction : giant cell tumor ( gct ) of bone is locally aggressive benign tumor involving the epiphysis of long bones in young adults . various treatment options include intralesional curettage , extended curettage , wide resection , resection and reconstruction and amputation .
the main variables to be considered for planning treatment include the site of involvement and campanacci stage of the tumor .
functional and oncological outcomes of these treatment options vary widely , the predominant detrimental factor being tumor recurrence rate.aim:a study was conducted to evaluate the long - term oncological and functional outcome of patients with gct of the proximal femur that underwent tumor resection and endoprosthetic replacement.materials and methods : eleven patients with campanacci stage - iii gct of proximal femur who underwent wide excision of tumor and endoprosthesis replacement with a mean follow - up the duration of 10.6 years were assessed using standard proforma .
the treatment outcome was evaluated using the revised musculoskeletal tumor society rating scale for the lower extremity.results:at mean follow - up the duration of 10.6 years , none of the cases had tumor recurrence , infection , prosthesis loosening or dislocation .
all the patients were community ambulators among whom eight patients were walking without support while three patients were using a cane for support .
the mean total musculoskeletal tumor society score was 26.8 out of 30 indicating the good outcome.conclusions:the authors recommend that wide resection and endoprosthetic replacement should be considered as a preferred treatment option for proximal femur gct as the functional , and oncological outcome is satisfactory with this modality of treatment . |
5,979 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: iridodialysis is not an uncommon complication during phacoemulsification procedures or any intraoperative maneuver , since the iris root is the thinnest and weakest portion of the stroma .
when the eye is contused or the iris is accidentally engaged during an operation , separation occurs most frequently at this site.1 superior defects covered by the upper eyelid may be less symptomatic ; however , an iridodialysis in any other quadrant can result in potentially debilitating visual sequelae , including monocular diplopia , glare , and photophobia . in the pseudophakic state
, corectopic pupils can potentially expose the edge of an intraocular lens , with the attendant undesired optical phenomena.2 iridodialysis may also cause cosmetic problems .
for all these reasons , such conditions must be treated properly.3 several previously described techniques have addressed ways for management of such a problem ; however , complications of inappropriate management can be disastrous , making skilled repair a must and the search for novel techniques an ongoing project .
complications vary widely ; for example , inadvertent engagement of the ciliary body causing hemorrhage or increased cyclitis , pulling the iris tissue more peripherally than its initial origin causing corectopia , and if the suture is tightened and the iridodialysis is reduced to the scleral wall , the iris within the suture bite , not the actual iris root , is reapproximated near the iris base , leaving less stroma between the pupil margin and the scleral wall .
corectopia can be further exaggerated by the fibrotic response that commonly occurs in the band of disinserted iris stroma .
furthermore , the disinserted sector of sphincter muscle is deprived of its radial innervation and blood supply and thus has reduced tone that acts to counteract the curling up of this delicate iris tissue.2 techniques described to repair iridodialysis can be classified into two groups : open chamber and closed chamber techniques.4 open chamber techniques access the... | managing large iridodialysis that may occur during phacoemulsification is challenging .
i describe how a procedure to reposit a prolapsed iris while the anterior chamber is markedly inflated by a current of infusion fluid may inadvertently lead to large iridodialysis , and discuss how to avoid such a complication .
i describe a fast and efficient technique for managing large iridodialysis both immediately , once it occurs , or as a secondary maneuver .
my technique involved fixing the iris periphery back to its root at the anterior chamber angle using 10 - 0 polypropylene suture with two straight needles introduced directly through the cornea at distant points , and an insulin syringe as a guide track to a point 1.5 mm from the limbus at the base of a triangular scleral flap that was designed to be centered on the area of iridodialysis .
i confirmed the simplicity , efficacy , and safety of my technique through a 1-year follow - up period . |
5,980 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: in patients with obstructive colorectal cancer , where conventional colonoscopy can not traverse obstruction , clearance of the proximal colon remains a problem .
a 58-year - old woman presented to her physician with rectal bleeding and intermittent diarrhea . conventional colonoscopy revealed a bulky tumor which was diagnosed as rectal cancer .
slim optical colonoscopy ( pcf - p240al / i , olympus , tokyo , japan ) showed obstructive cancer in the rectosigmoid junction ( fig . 1 , arrow a ) and no information of the proximal side of the obstruction .
the patient then underwent multidetector - row computed tomographic ( ct ) colonography ( virtual colonoscopy ) for further evaluation of the proximal colon .
three - dimensional endoluminal fly - through images revealed another protruded lesion ( fig .
diagnosis of synchronous double cancer was made by ct air - contrast enema image ( fig .
this ct data was not only used to create three - dimensional images but also to decide on a preoperative clinical staging .
laparoscopy - assisted high anterior resection was performed and t3 rectal cancer and t1 sigmoid colon cancer were confirmed in the resected specimen ( fig .
between 4.6 and 11% of patients with colorectal cancer have a second synchronous cancer [ 1 , 2 , 3 ] .
preoperative evaluation of the whole colon and rectum in patients with colorectal cancer is widely recommended .
optical colonoscopy is the current gold standard method as it examines the whole colon and rectum .
however , preoperative examination by optical colonoscopy may be hampered by occlusive colorectal cancer , and failure to find the presence of a synchronous cancer will change the surgical approach from circumscribed resection to resection of the involved segments .
ct colonography might be offered in preference to barium enema for incomplete colonoscopy [ 5 , 6 ] .
ct colonography has recently become a popular preoperative examination tool with significant improvement in quality of image due to a rapid progress in computer technology [... | a 58-year - old woman presented to her physician with rectal bleeding and intermittent diarrhea . optical colonoscopy revealed a bulky tumor which was diagnosed as rectal cancer .
she was referred to our institution for further evaluation and treatment .
slim optical colonoscopy showed an obstructive cancer in the rectosigmoid junction and no information of the proximal side of the obstruction .
the patient then underwent computed tomographic ( ct ) colonography for further evaluation of the proximal side .
three - dimensional endoluminal fly - through images revealed another protruded lesion in the proximal side of the obstruction .
diagnosis of synchronous double cancer was made by ct colonography .
this ct data was not only used to create three - dimensional images but also to decide on a preoperative clinical staging .
laparoscopy - assisted high anterior resection was performed and t3 rectal cancer and t1 sigmoid colon cancer were confirmed in the resected specimen .
follow - up optical colonoscopy revealed no other tumors .
ct colonography has recently become a popular preoperative examination tool with significant improvement in quality of image due to a rapid progress in computer technology .
ct colonography correctly showed synchronous double cancer in our case and provided crucial information for planning surgery .
we recommend that ct colonography should be used for evaluating the proximal side of obstructive colorectal cancer . |
5,981 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: venous thromboembolic ( vte ) disease encompasses deep venous thrombosis ( dvt ) and pulmonary embolus ( pe ) .
it is an important source of morbidity and mortality in hospitalized patients . with an increasing focus on patient safety and quality of care ,
vte has become a target measure of quality by multiple quality improvement organizations and also consumer watch groups . despite the implementation of screening protocols and guidelines for dvt prophylaxis ,
there are no uniformly accepted dvt surveillance programs in the united states , and as a result , the reported incidence of dvt varies greatly depending on which studies are evaluated .
it has been reported that trauma centers that aggressively screen for dvt have a tendency to report a higher incidence of these events .
most vte screening programs are focused solely on the evaluation of the lower extremity deep venous system .
we hypothesize that for trauma patients in the intensive care unit ( icu ) the incidence of upper extremity dvt ( uedvt ) is higher than the incidence of lower extremity dvt ( ledvt ) , and as a result , trauma centers that aggressively screen for dvt should include the upper extremities in their surveillance protocols .
after approval by the institutional review board , a retrospective trauma registry and chart review of icu trauma patients with upper and ledvts detected on surveillance duplex ultrasound from january 2010 to december 2014 was carried out at our institution .
all patients 18 years of age or older who were admitted to the icu and received an upper and lower extremity surveillance duplex study that demonstrated a dvt were included in this study .
patients with a known preexisting dvt and dvts identified outside of the icu setting were excluded .
all patients received prophylaxis with low molecular weight heparin unless there was an existing contraindication to anticoagulation .
variables reviewed were patient age , injury severity score ( iss ) , icu length of stay , total length of stay , gender , mechanism of... | background : due to the high incidence of thromboembolic events ( deep venous thrombosis [ dvt ] and pulmonary embolus [ pe ] ) after injury , many trauma centers perform lower extremity surveillance duplex ultrasounds . we hypothesize that trauma patients are at a higher risk of upper extremity dvts ( uedvts ) than lower extremity dvts ( ledvts ) , and therefore , all extremities should be evaluated.materials and methods : a retrospective chart and trauma registry review of intensive care unit trauma patients with upper and ledvts detected on surveillance duplex ultrasound from january 2010 to december 2014 was carried out .
variables reviewed were age , gender , injury severity score , injury mechanism , clot location , day of clot detection , presence of central venous pressure catheter , presence of inferior vena cava filter , mechanical ventilation , and fracture.results : a total of 136 patients had a dvt in a 5-year period : upper - 71 ( 52.2% ) , lower - 61 ( 44.9% ) , both upper and lower - 4 ( 2.9% ) .
overall , 75 ( 55.2% ) patients had a uedvt .
upper dvt vein : brachial ( 62 ) , axillary ( 26 ) , subclavian ( 11 ) , and internal jugular ( 10 ) .
lower dvt vein : femoral ( 58 ) , popliteal ( 14 ) , below knee ( 4 ) , and iliac ( 2 ) .
10.3% had a pe : uedvt - 5 ( 6.7% ) and ledvt - 9 ( 14.8% ) p = 0.159.conclusions:the majority of the dvts in the study were in the upper extremities .
for trauma centers that aggressively screen the lower extremities with venous duplex ultrasound , surveillance to include the upper extremities is warranted . |
5,982 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cancer is a prothrombotic condition that predisposes patients to various thromboses such as lower extremities thromboses and pulmonary embolism [ 1 , 2 ] .
obstruction of blood flow from external compression , frequently from lymph node masses , is also common , especially malignancy of the lower abdomen and pelvis which can cause lower extremity edema and in the mediastinum which can cause superior vena cava syndrome from mediastinal lymphadenopathy . in contrast , compression of pulmonary vessels from mediastinal lymphadenopathy is less common but is important to correctly diagnose because the treatment and prognosis are different from those of pulmonary embolism .
we report the case of a man with metastatic bladder carcinoma who had massive mediastinal lymphadenopathy causing external pulmonary artery compression leading to a rapidly fatal outcome .
a 59-year - old man was admitted to the hospital with severe fatigue and dyspnea at rest . he had undergone a radical cystectomy with neobladder construction for transitional cell carcinoma of the urinary bladder seven months previously and had received five cycles of adjuvant dose - dense mvac ( methotrexate , vinblastine , adriamycin , and cisplatin ) chemotherapy after the operation . a few days before admission , restaging cts showed multiple liver metastases , two right kidney lesions , a lytic lesion in the thoracic spine , massive right hilar lymphadenopathy , right pelvic lymphadenopathy , and a right pleural effusion . on admission ,
the patient was pale , with dyspnea at rest , tachypnea , and tachycardia , but he had no chest pain , cough or hemoptysis .
his blood pressure was 110/70 mmhg and the o2 saturation was 97% when the patient was on room air .
laboratory evaluation showed a leukocytosis at 45,000 /l with neutrophilia at 43,700 /l and lymphopenia at 500 /l as well as a hemoglobin of 9.5 gm / dl and platelets at 66,000 /l .
other abnormal values from the biochemical evaluation included the alkaline phosphatase at 218 iu / l ( normal... | transitional cell carcinoma of the urinary bladder is a malignancy that metastasizes frequently to lymph nodes including the mediastinal lymph nodes .
this occurrence may produce symptoms due to compression of adjacent structures such as the superior vena cava syndrome or dysphagia from esophageal compression .
we report the case of a 59-year - old man with metastatic transitional cell carcinoma for whom mediastinal lymphadenopathy led to pulmonary artery compression and a rapidly fatal outcome .
this rare occurrence has to be distinguished from pulmonary embolism , a much more frequent event in cancer patients , in order that proper and prompt treatment be initiated . |
5,983 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: over the past years , the design and synthesis of nanostructured materials with desired size , shape , and morphology have attracted considerable attention for achieving novel morphology - dependent chemical physical properties.[1 - 8 ] particularly , porous nanostructure materials have received significant interest owing to the pore structure features and the large specific surface area , which make them suitable for applications in catalysis , sensing , energy storage , etc.[9 - 16 ] glucose monitoring is vital in clinical diagnostics , biotechnology , and the food industry .
specifically , there has been great interest in the development of electrochemical glucose sensors . compared with other detection approaches ,
the use of an electrochemical technique is one of the most promising in the construction of simple and low - cost glucose sensors because of its high sensitivity , good selectivity , and ease of operation .
the conventional glucose biosensors based on glucose oxidase ( god ) exhibit high sensitivity and selectivity .
however , due to the intrinsic features of enzymes , these god - based biosensor approaches suffer greatly from the influences of various environmental factors such as temperature , humidity , ph value , organic reagents , and toxic chemicals.[18 - 21 ] to solve these problems , nonenzymatic glucose biosensors based on the direct detection of glucose have been developed for practical applications .
recent research has shown that nanomaterials can be applied as sensors for glucose detection because of their unique physical and chemical properties .
for example , noble metals , metal alloys , and metal oxides have been successfully used in the construction of nonenzymatic glucose sensors,[22 - 28 ] suggesting that nanostructured materials are potential candidates for application as nonenzymatic glucose sensors . as an important ii vi semiconductor material ,
zns has been extensively studied due to its luminescent , photochemical , and electrochemical properties .
, nis has also... | mesoporous zns
nis composites are prepared via ion- exchange reactions using zns as the precursor . the prepared mesoporous zns
nis composite materials have large surface areas ( 137.9 m2 g1 ) compared with the zns precursor .
more importantly , the application of these mesoporous zns nis composites as nonenzymatic glucose sensors was successfully explored .
electrochemical sensors based on mesoporous zns nis composites exhibit a high selectivity and a low detection limit ( 0.125 m ) toward the oxidation of glucose , which can mainly be attributed to the morphological characteristics of the mesoporous structure with high specific surface area and a rational composition of the two constituents . in addition , the mesoporous zns
nis composites coated on the surface of electrodes can be used to modify the mass transport regime , and this alteration can , in favorable circumstances , facilitate the amperometric discrimination between species .
these results suggest that such mesoporous zns
nis composites are promising materials for nonenzymatic glucose sensors . |
5,984 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: patients aged between 10 and 65 years with type 1 diabetes diagnosed for more than 1 year , with reasonable metabolic control assessing carbohydrate intake and self - adjusting insulin , and an hba1c level < 7.5% , using intensive insulin treatment with either an insulin pump or multiple daily injections , and not using a real - time continuous glucose monitoring device for at least 4 weeks were eligible for the study .
all eligible patients identified from the local diabetes registries were invited to participate and screened consecutively based on the order of their positive reply .
the study protocol was designed by the researchers and approved by the institutional or national medical ethics committees from all three centers , and the conduct of the study was consistent with the good clinical practice provisions of the declaration of helsinki with all amendments and local regulatory requirements .
a written informed consent was obtained from all participants and parents of minors ( under 18 years of age , who signed an assent ) before enrollment . at screening patients provided a blood sample for measurement of hba1c and entered a 4-week run - in period during which self - monitoring of blood glucose ( smbg ) was conducted according to patients standard glycemic management regimen . a freestyle blood glucose meter ( abbott diabetes care , alameda
, ca ) was provided to familiarize patients with freestyle test strips and collect baseline smbg frequency and glucose levels .
diaries were distributed for recording events of hypoglycemia and associated food intake , insulin doses , and exercise .
all patients meeting the eligibility criteria , including hba1c result from the screening visit , were invited to attend the randomization visit . following the 1-month run - in period , patients were randomized to participate in a 6-month intervention period .
patients were assigned to home monitoring with a freestyle blood glucose meter and a masked continuous glucose monitor to be worn for 5 days every second week (... | objectiveto assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes.research design and methodsin this randomized , controlled , multicenter study , 120 children and adults on intensive therapy for type 1 diabetes and a screening level of glycated hemoglobin a1c ( hba1c ) < 7.5% were randomly assigned to a control group performing conventional home monitoring with a blood glucose meter and wearing a masked continuous glucose monitor every second week for five days or to a group with real - time continuous glucose monitoring .
the primary outcome was the time spent in hypoglycemia ( interstitial glucose concentration < 63 mg / dl ) over a period of 26 weeks .
analysis was by intention to treat for all randomized patients.resultsthe time per day spent in hypoglycemia was significantly shorter in the continuous monitoring group than in the control group ( mean sd 0.48 0.57 and 0.97 1.55 h / day , respectively ; ratio of means 0.49 ; 95% ci 0.260.76 ; p = 0.03 ) .
hba1c at 26 weeks was lower in the continuous monitoring group than in the control group ( difference 0.27% ; 95% ci 0.47 to 0.07 ; p = 0.008 ) .
time spent in 70 to 180 mg / dl normoglycemia was significantly longer in the continuous glucose monitoring group compared with the control group ( mean hours per day , 17.6 vs. 16.0 , p = 0.009).conclusionscontinuous glucose monitoring was associated with reduced time spent in hypoglycemia and a concomitant decrease in hba1c in children and adults with type 1 diabetes . |
5,985 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: traumatic brain injury ( tbi ) is a clinical condition which can have substantial and long - lasting effects not only upon brain structure , but also upon motor ability , attention , memory , higher cognition , personality , and affect . due to the wide range of mechanisms
whereby brain injury can be inflicted , the etiology of this condition is varied and often complex , as is the host of potential effects that tbi can have upon life quality and expectancy .
monitoring primary tbi evolution and optimizing clinical care in response to secondary injury are often challenging due to the structural heterogeneity of brain insults across patients , as well as the multifaceted nature of metabolic , neurochemical , and electrophysiological responses prompted by neural injury .
currently , a wide range of experimental techniques are used to probe brain function changes which occur after tbi .
because of the intimate relationship between brain structure and function , a complementary relationship exists between structural and functional neuroimaging , and a large proportion of functional neuroimaging studies of tbi involve the use of structural neuroimaging as well . in a previous review,1 we highlighted the importance of structural neuroimaging in identifying neuroimaging biomarkers with predictive clinical value , and discussed the role of magnetic resonance imaging ( mri ) and diffusion tensor imaging ( dti ) in formulating next - generation approaches for the treatment of tbi .
combining imaging modalities can lead to substantial insights into brain structure and function , which can not be obtained using only one technique by itself .
this is the case to such an extent2 that multimodal neuroimaging using an ever - increasing number of imaging methods has been a pervasive trend since at least the mid-1990s .
for example , a thorough review by the pediatric tbi neuroimaging workgroup3 identified no fewer than 15 structural or functional macroscopic neuroimaging modalities which have been approved for use in human... | functional deficits due to traumatic brain injury ( tbi ) can have significant and enduring consequences upon patients life quality and expectancy .
although functional neuroimaging is essential for understanding tbi pathophysiology , an insufficient amount of effort has been dedicated to the task of translating functional neuroimaging findings into information with clinical utility .
the purpose of this review is to summarize the use of functional neuroimaging techniques especially functional magnetic resonance imaging , diffusion tensor imaging , positron emission tomography , magnetic resonance spectroscopy , and electroencephalography for advancing current knowledge of tbi - related brain dysfunction and for improving the rehabilitation of tbi patients .
we focus on seven core areas of functional deficits , namely consciousness , motor function , attention , memory , higher cognition , personality , and affect , and , for each of these , we summarize recent findings from neuroimaging studies which have provided substantial insight into brain function changes due to tbi .
recommendations are also provided to aid in setting the direction of future neuroimaging research and for understanding brain function changes after tbi . |
5,986 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: scheme 1 outlines
the synthesis of novel
thioacetamide ( compounds 4a4z ) and
sulfinylacetamide ( compounds 5a5 g ) analogues of ( )-1 . the thioacetamide analogues 4a4z were generated via three different
synthetic routes .
the first route ( procedure a ) affords the
thioacetamides in one
step and was employed in the synthesis of compound 4a and the n - methylthioacetamides 4g4i . as opposed to the previously reported two - step synthesis
, thioacetamide 4a was synthesized
in one step by coupling 2-mercaptoacetamide with diphenylmethanol
in trifluoroacetic acid ( tfa ) at room temperature .
similarly , n - methylthioacetamides 4g4i were synthesized via the coupling reaction between 2-mercapto - n - methylacetamide and diphenylmethanol ( for 4 g ) or the corresponding bis(halophenyl)methanol ( for 4h and 4i ) in tfa . to improve product yields , the reactions
for compounds 4h and 4i required heating
to 60 c .
reagents and conditions :
( a )
2-mercaptoacetamide or 2-mercapto - n - methylacetamide ,
tfa , room temperature ( 60 c for substituted phenyl analogues ) ,
20 h ( procedure a ) ; ( b ) ( i ) thioglycolic acid , tfa , room temperature
( 5560 c for substituted phenyl analogues ) , overnight ;
( ii ) ch3i , k2co3 , acetone , reflux ,
overnight ; ( iii ) nh4oh , nh4cl , meoh , 50 c ,
72 h ( procedure b ) ; ( c ) ( i ) thioglycolic acid , tfa , room temperature
( 5560 c for substituted phenyl analogues ) , overnight ;
( ii ) cdi , thf , room temperature , 2 h ; ( iii ) rnh2 , thf ,
0 c to room temperature , overnight ( procedure c ) ; ( d ) h2o2 ( 30% ) , acoh meoh ( 1:3 ) , 40 c , overnight . the second synthetic route ( procedure b ) , used
for the synthesis
of thioacetamides 4b4f , required
three steps , similar to previously described methods .
mono- or disubstituted diphenylmethanol was coupled with
thioglycolic acid in tfa , followed by esterification with iodomethane
in acetone under reflux conditions .
the resulting methyl esters were
converted... | 2-[(diphenylmethyl)sulfinyl]acetamide
( modafinil , ( )-1 ) is a unique dopamine uptake inhibitor
that binds the dopamine
transporter ( dat ) differently than cocaine and may have potential
for the treatment of psychostimulant abuse . to further investigate
structural requirements for this divergent binding mode , novel thio-
and sulfinylacetamide and ethanamine analogues of ( )-1 were synthesized wherein ( 1 ) the diphenyl rings were substituted
with methyl , trifluoromethyl , and halogen substituents and ( 2 ) substituents
were added to the terminal amide / amine nitrogen . halogen substitution
of the diphenyl rings of ( )-1 gave several amide
analogues with improved binding affinity for dat and robust selectivity
over the serotonin transporter ( sert ) , whereas affinity improved at
sert over dat for the p - halo - substituted amine analogues .
molecular docking studies , using a subset of analogues with dat and
sert homology models , and functional data obtained with dat ( a480 t )
and sert ( t497a ) mutants defined a role for tm10 in the substrate / inhibitor
s1 binding sites of dat and sert . |
5,987 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: reversible left ventricular ( lv ) dysfunction and takotsubo 's cardiomyopathy has been described in endocrine conditions such as addison 's disease , isolated adrenocorticotropic hormone deficiency , primary adrenal insufficiency in adrenal crisis , pheochromocytoma , thyrotoxicosis , and multiple endocrine neoplasia . it has also been described in various neurological conditions such as stroke , guillian barre syndrome , seizures , subarachnoid bleed empty sella syndrome , and reversible posterior leukoencephalopathy syndrome . the most common cause of secondary adrenal insufficiency is a tumor of the hypothalamic - pituitary region , usually associated with panhypopituitarism caused by tumor growth or treatment with surgery or irradiation .
however , takotsubo 's cardiomyopathy in a case of the pituitary tumor with secondary adrenal insufficiency has not been described to the best of our knowledge .
a 48-year - old man with no known comorbid illness , presented to the emergency department with a progressive decrease in vision and headache for 2 months , vomiting for 1 day , and acute onset altered sensorium for 4 h. at admission , the patient was unresponsive with glasgow coma scale score of 6/15 ( e1m4v1 ) .
he was resuscitated with intravenous ( iv ) fluids ( 2.0 l of crystalloid and 1.0 l of colloid within 1 h ) and vasopressors ( noradrenaline infusion at 0.2 mcg / kg / h ) .
laboratory evaluation revealed hyponatremia ( 108 meq / l ) and hyperkalemia ( 5.5 meq / l ) .
the temperature was 36c . in view of the progressive loss of vision and altered sensorium , contrast
it revealed a dense sellar - suprasellar mass lesion extending into the hypothalamus , right cavernous sinus , and anteriorly under the frontal lobe of size 40 mm 23 mm .
hormonal profile revealed hypocortisolism [ table 1 ] . a provisional diagnosis of hypopituitarism with secondary adrenal insufficiency in adrenal crisis was considered .
hormonal profile of the patient resuscitation was continued , and central venous pressure ( cvp )... | we describe a case of takotsubo cardiomyopathy in a case of pituitary macroadenoma in acute adrenal crisis . a 48-year - old man presented with acute onset altered sensorium , vomiting , and gasping . on admission
, he was unresponsive and hemodynamically unstable .
he was intubated and ventilated and resuscitated with fluids and inotropes .
the biochemical evaluation revealed hyponatremia , hyperkalemia , and hypocortisolism .
hyponatremia was corrected with 3% hypertonic saline .
contrast enhanced computed tomography ( ct ) scan of the brain revealed a sellar - suprasellar mass with hypothalamic extension with no evidence of pituitary apoplexy . a diagnosis of invasive pituitary adenoma with the addisonian crisis was made and steroid replacement was initiated . despite volume resuscitation , he had persistent refractory hypotension , recurrent ventricular tachycardia , and metabolic acidosis .
electrocardiogram ( ecg ) showed st elevation and t - wave inversion in lateral leads ; cardiac - enzymes were increased suggestive of acute coronary syndrome .
transthoracic echocardiography showed severe regional wall motion abnormalities ( rwmas ) involving left anterior descending territory and low ejection fraction ( ef ) . coronary angiogram
revealed normal coronaries , apical ballooning , and severe left ventricular dysfunction , consistent with a diagnosis of takotsubo 's cardiomyopathy .
patient was managed with angiotensin - converting enzyme inhibitors and b - blockers .
he improved over few days and recovered completely . at discharge , ecg changes and rwma resolved and ef normalized to 56% . in patients with addisonian crisis with persistent hypotension refractory to optimal resuscitation , possibility of takotsubo 's cardiomyopathy should be considered .
early recognition of association of takotsubos cardiomyopathy in neurological conditions , prompt resuscitation , and supportive care are essential to ensure favorable outcomes in this potentially lethal condition . |
5,988 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: munchausen syndrome is characterized by feigning physical symptoms to seek attention ; it was first reported by asher in 1951 .
we report a case of cutaneous munchausen syndrome in a patient who self - inflicted trauma to a postoperative wound .
a 50-year - old japanese woman consulted the emergency department of our hospital in august 2015 for bleeding due to an intractable postoperative wound on the lower abdomen ; the postoperative wound was owing to a laparoscopic cholecystectomy performed 1 year previously for acute cholecystitis .
the wound was sutured and the patient consulted with the dermatology department 3 days later ( fig .
, she presented with a painful ulcer ( diameter 6 cm ) on her right lower abdomen , and its suture had disappeared ( fig .
she also presented with multiple scars , skin grafts on the extremities , and a missing left lower leg , the causes for all of which were unexplained ( fig .
2 ) . her white blood cell count , neutrophil number , platelet count , renal and liver functions , c - reactive protein level , and ch50 level were normal , except for the hemoglobin level ( 9.2 g / dl ; normal range 12.015.0 g / dl ) .
negative results were obtained for cytoplasmic antineutrophil cytoplasmic antibodies , myeloperoxidase antineutrophil cytoplasmic antibodies , and anti - ss - a antibodies .
a histology of the skin biopsy specimen from the margin of the abdominal ulcer did not show any specific findings such as pyoderma gangrenosum or vasculitis , although we had considered these as differential diagnoses .
she had been presenting with repeated intractable wounds since she was a child , which resulted in the amputation of her left lower leg .
although we asked her about the scar and amputation , she did not reveal any details .
the previous surgeon who had performed the laparoscopic cholecystectomy 1 year before revealed that surgical wound dehiscence had occurred during her admission . after
her medical records indicated that she had been admitted to the department of plastic surgery... | a 50-year - old japanese woman consulted the emergency department of our hospital for bleeding due to an intractable postoperative wound on the lower abdomen ; the postoperative wound was owing to a laparoscopic cholecystectomy performed 1 year previously for acute cholecystitis .
she presented with a painful ulcer on her right lower abdomen .
she also presented with multiple scars , skin grafts on the extremities , and a missing left lower leg , the causes for all of which were unexplained .
the results of her blood test were normal , except for the hemoglobin level .
histology of the skin biopsy specimen from the ulcer did not show any specific findings .
the previous surgeon who had performed the laparoscopic cholecystectomy revealed that surgical wound dehiscence had occurred during her admission .
after a body restraint had been applied , the ulcer improved .
medical records indicated that she had been admitted to the department of plastic surgery at our hospital for skin grafting of a leg ulcer . during that admission
, she refused to consult with the department of psychiatry , al - though the staff suspected mental disorders .
therefore , we diagnosed her with cutaneous munchausen syndrome .
after vacuum - assisted closure ( vac ) therapy had been performed to prevent her from traumatizing the ulcer again , it rapidly became granulated and reepithelialized . munchausen syndrome is characterized by feigning physical symptoms to seek attention .
patients self - inflict numerous lesions , keep getting admitted to different hospitals , and feign acute illness , usually spectacular diseases .
vac therapy may be effective for preventing patients with cutaneous munchausen syndrome from traumatizing their wounds . |
5,989 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: gastrointestinal stromal tumors ( gists ) are the most common mesenchymal neoplasms of the alimentary tract .
it represents approximately 1% to 2% of all the alimentary malignancies . based on their phenotypic similarities ,
gists are considered to arise from muscularis propria of gastrointestinal tract , and derived from the interstitial cells of cajal ( icc ) .
histologically , the majority of gists display spindle cell morphology ( 70% ) , followed by epithelioid morphology ( 20% ) , and mixed morphology ( 10% ) .
gain - of - function mutations in the c - kit proto - oncogene protein ( kit ) protooncogene in gists were demonstrated by hirota et al .
gastrointestinal stromal tumors can occur anywhere throughout the gastrointestinal tract and are seen most commonly in the stomach ( 40%70% ) , small intestine ( 20%40% ) , and colon and rectum ( 5%15% ) .
the reporting of esophageal gists has been limited to individual case reports and case series of small numbers .
studies involving large numbers of esophageal gists are lacking , many questions remain unanswered regarding the clinicopathologic profiles and clinical outcomes .
therefore , the aim of the current study was to explore the clinicopathologic characteristics and clinical outcome of esophageal gists , and to investigate the potential factors that may predict postoperative outcomes .
gastrointestinal stromal tumor cases of the esophagus were from our center and in addition from the literature . from may 2010 to march 2015 , 7 patients of esophageal gists were diagnosed and received treatment in our center .
literature search of medline was performed for all articles in english published from 2000 through 2015 .
medline search resulted in 46 case reports , including 52 patients and 8 case series , including 76 cases . to this end , a total of 135 esophageal gists patients were identified ( figure 1 ) .
in addition , the clinicopathologic characteristics and prognosis of 297 patients of gastric gists were analyzed and compared with esophageal gists... | abstractclinicopathologic features and clinical outcomes of gastrointestinal stromal tumors ( gists ) in esophagus are limited , because of the relatively rare incidence of esophageal gists . therefore , the aim of the current study was to investigate the clinicopathologic features and clinical outcomes of esophageal gists , and to investigate the potential factors that may predict prognosis.esophageal gist cases were obtained from our center and from case reports and clinical studies extracted from medline .
clinicopathologic features and survivals were analyzed and compared with gastric gists from our center.the most common location was lower esophagus ( 86.84% ) , followed by middle and upper esophagus ( 11.40% and 1.76% ) .
the majority of esophageal gists were classified as high - risk category ( 70.83% ) .
mitotic index was correlated with histologic type , mutational status , and tumor size .
the 5-year disease - free survival and disease - specific survival were 65.1% and 65.9% , respectively .
tumor size , mitotic index , and national institutes of health risk classification were associated with prognosis of esophageal gists . only tumor size , however , was the independent risk factor for the prognosis of esophageal gists . in comparison to gastric gists ,
the distribution of tumor size , histologic type , and national institutes of health risk classification were significantly different between esophageal gists and gastric gists .
the disease - free survival and disease - specific survival of esophageal gists were significantly lower than that of gastric gists.the most common location for esophageal gists was lower esophagus , and most of the esophageal gists are high - risk category .
tumor size was the independent risk factor for the prognosis of esophageal gists .
esophageal gists differ significantly from gastric gists in respect to clinicopathologic features .
the prognosis of esophageal gists was worse than that of gastric gists . |
5,990 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: the recurrent laryngeal nerve ( rln ) injury is one of the most important complications during thyroid surgery , leading to dysfunction , and palsy of the vocal cords . for years , surgeons have attempted to prevent this complication by improving surgical techniques and optimizing surgical strategies .
the identification and preservation of the anatomical integrity of the rln during thyroid surgery is commonly accepted as a gold standard .
however , even in the most experienced hands , rln injury occasionally occurs . in the last decade , intraoperative neuromonitoring ( ionm ) has been widely applied during thyroid surgery to aid in the localization and identification of the rln .
one of the most important roles of ionm is assistance in intraoperative navigation and rapid identification of rln distribution .
repetitive tissue stimulation in the vicinity of the nerve allows the nerve to be localized using a stimulation probe before visual identification . the reported stimulation intensity for mapping the path of the nerve ranges from 2 to 3 ma . this range is higher than that used for direct nerve stimulation , as the use of stronger stimulation current would depolarize a greater sphere of tissue around the probe tip
however , failure to obtain signal deflection at 3 ma during nerve localization might occasionally occur , in which case a surgeon might consider increasing the stimulation intensity . however , electrical stimulation is also a potential risk factor for rln injury , and the nerve can become damaged in the case of over - stimulation .
therefore , in this study , we developed an experimental canine model to determine whether supramaximal stimulation during ionm could induce nerve damage and investigated the safe range of stimulation current intensity .
twenty adult , male beagle dogs weighing 1520 kg were obtained from the animal center of peking university health science center ( institutional protocol no .
the dogs were randomly divided into four groups of five each and maintained under... | background : intraoperative neuromonitoring ( ionm ) of the recurrent laryngeal nerve ( rln ) has been widely applied during thyroid surgery .
however , the safe range of stimulation intensity for ionm remains undetermined.methods:total thyroidectomies were performed on twenty dogs , and their rlns were stimulated with a current of 520 ma ( step - wise in 5 ma increments ) for 1 min .
the evoked electromyography ( emg ) of vocal muscles before and after supramaximal stimulation were recorded and compared .
acute microstructural morphological changes in the rlns were observed immediately postoperatively under an electron microscope.results:the average stimulating threshold for rlns stimulated with 15 ma and 20 ma showed no significant changes compared to the unstimulated rlns ( 15 ma group : 0.320 0.123 ma vs. 0.315 0.097 ma , p = 0.847 ; 20 ma group : 0.305 0.101 ma vs. 0.300 0.103 ma , p = 0.758 ) .
similar outcomes were shown in average evoked emg amplitude ( 15 ma group : 1,026 268 v vs. 1,021 273 v , p = 0.834 ; 20 ma group : 1,162 275 v vs. 1,200 258 v , p = 0.148 ) .
however , obvious acute microstructural morphological changes were observed in the nerves that were stimulated with 20 ma.conclusions:a stimulation intensity less than 15 ma might be safe for ionm of the rln . |
5,991 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: conventional venoplasty of post - liver transplant inferior vena cava ( ivc ) stenoses is limited by a high primary treatment failure rate and problematic durability . while ivc
stenting may deliver a successful outcome after failed angioplasty , this approach , however , is not always suitable .
hepatic vein ostial coverage may not be desired , device migration may be a concern , and excessive risk for intra - stent stenosis may be perceived in specific cases , rendering definitive balloon dilation therapy as the lone possible minimally invasive treatment option . recognizing that single - session balloon venoplasty may not successfully and consistently address ivc stenoses , the percutaneous management approach of fibrotic , benign biliary strictures , namely , scheduled sequential balloon dilation sessions , may be adapted for the treatment of analogously scarred vascular lesions .
herein , we describe the case of a young patient with an initially angioplasty - resistant post - transplant ivc stenosis who was successfully treated with programmed successive balloon dilation , and highlight the utility of this approach in managing cases where stent insertion is undesirable .
institutional review board approval is not required for single retrospective case study at our institution . a 36-year - old woman with a history of autoimmune hepatitis and two prior orthotopic liver transplants in 1998 and 2008 (
the second transplant was performed due to rejection of the first graft ) presented 5 years after her most recent transplant with a chief complaint of progressive bilateral lower extremity edema and weight gain over the preceding 8 weeks . on physical examination ,
duplex ultrasonography and computed tomography ( ct ) imaging revealed a focal thrombus within the hepatic level ivc .
compression stockings and diuretic therapy provided minimal symptomatic relief , and the patient 's condition continued to worsen in terms of leg swelling despite initiation of therapeutic anticoagulation .
the patient was... | obstruction of the inferior vena cava ( ivc ) is a rare complication of liver transplantation with significant consequences including intractable ascites and hepatic dysfunction .
although venoplasty and stenting are effective in many cases , patients who fail first - line treatment may require surgical intervention or re - transplantation .
scheduled sequential balloon dilation , an approach frequently used to treat fibrotic , benign biliary strictures , but less commonly vascular lesions , may avert the need for such high - risk alternatives while achieving favorable clinical and angiographic response .
herein , we report the case of a 36-year - old woman with transplant - related , initially angioplasty - resistant ivc stenosis that was successfully treated with sequential balloon dilation . |
5,992 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: cough , sputum , and shortness of breath are cardinal features of chronic obstructive pulmonary disease ( copd ) . the natural history of copd is characterized by a progressive reduction in exercise tolerance and health - related quality of life ( hrqol).1,2 the rate of decline in lung function , which is a strong predictor of morbidity and mortality in copd,3 as well as health care utilization,4 is higher in patients with mucus hypersecretion and recurrent exacerbations.57 there is currently a variety of methods to improve mucociliary clearance ( mcc ) that have been shown to be effective in chronic lung conditions associated with excess mucus production , such as cystic fibrosis ( cf ) and non - cf bronchiectasis .
these include physical therapy techniques such as autogenic drainage , the active cycle of breathing technique,8 and adjuvant mechanical devices such as the flutter device9 and positive end - expiratory pressure .
high - frequency chest wall oscillation ( hfcwo ) is a technique utilizing automated pneumatic chest wall percussion delivered through a vest and transmitted to the airways that allows patients to manage their condition independently in their own homes , thus reducing health care costs .
hfcwo delivers pressurized air pulses to the external chest wall via the vest , which results in transient cephalad bias airflow spikes in the airways to loosen bronchial mucus so that the patient can more easily expel secretions by coughing .
although hfcwo is well tolerated in children with cf1012 and has shown demonstrable improvement in mcc,13 as well as in some institutionally managed adults with amyotrophic lateral sclerosis , there is currently very little evidence of usage or benefit in adults with copd.14 the in vivo benefit of hfcwo in improving mcc is based on the hypothesis that cyclical mechanical stress on the airway mucosa may improve hydration of the airway surface layer by activation of the p2y2 receptors.15 intuitively , improved mcc may reduce airflow obstruction,16,17 subsequent... | introductionchronic obstructive pulmonary disease ( copd ) patients with mucus hypersecretion tend to demonstrate increased frequency of infective exacerbations and a steeper slope of decline in lung function .
enhanced mucociliary clearance with high - frequency chest wall oscillation ( hfcwo ) devices previously used in cystic fibrosis and bronchiectasis patients may offer the opportunity for community - based , self - managed therapy to improve quality of life and lung function.study design and methodsa randomized controlled crossover pilot study of hfcwo compared with conventional treatment was conducted in 22 patients with moderate to severe copd and mucus hypersecretion .
patients spent 4 weeks using an hfcwo ( smartvest ) device and 4 weeks in a conventional phase with a 2-week washout .
eleven patients started with hfcwo and changed to conventional treatment , whereas the other eleven patients started conventional treatment and crossed over to hfcwo.resultsthe patients were elderly with a mean age of 71 ( standard deviation [ sd ] 10 ) years and were at the upper end of the normal range of body mass index ( 25 [ sd 4.2 ] kg / m2 ) .
the majority of patients had moderate to severe copd with a mean percentage predicted forced expiratory volume in 1 second of 41 ( sd 15.6 ) and percentage predicted forced vital capacity of 73 ( sd 17.7 ) .
baseline sputum production was negatively correlated to lung function and positively to st george s respiratory questionnaire .
symptom scores and st george s respiratory questionnaire symptom dimension improved significantly ( 8 , p < 0.05 ) .
sputum production showed a declining trend in the hfcwo phase , although not reaching statistical significance .
the hfcwo device was well tolerated with good reported compliance.conclusionthis pilot study demonstrated that patients with advanced copd and mucus hypersecretion at increased risk of declining lung function tolerated the hfcwo treatment well , leading to improvement in quality of life and reduced symptoms . |
5,993 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: codam participants were selected from a large cohort in the general population , as described in detail elsewhere ( 1820 ) .
briefly , subjects were selected if they were of caucasian ethnicity , aged > 40 years , and had at least one of the following inclusion criteria : positive family history of t2 dm ( first - degree relatives ) , history of gestational diabetes , bmi 25 kg / m , use of antihypertensive drugs , postprandial glucose 6.0 mmol / l , or glycosuria . in total , 574 individuals were included , and their lifestyle and cardiovascular and metabolic profile was extensively characterized during two visits to the university s metabolic research unit .
we performed the current cross - sectional analyses in the baseline evaluation of this cohort and excluded 13 participants with insulin therapy and 7 with a self - reported history of liver disease . to exclude possible hereditary hemochromatosis , we excluded 21 subjects with elevated serum ferritin ( > 150 g / l for premenopausal women , > 400 g / l for men and postmenopausal women ) and elevated transferrin saturation ( > 45% ) , according to dutch guidelines ( 21 ) .
subjects with missing data on iron markers ( n = 9 ) , glucose or insulin ( n = 6 ) , adiponectin ( n = 7 ) , or important covariates ( n = 19 ) were also excluded .
the study protocol was approved by the medical ethical committee of the maastricht university medical centre , and all subjects gave written informed consent .
participants were asked to stop their lipid - lowering drugs 14 days before the visit and to stop all other medication the day before the visit .
after an overnight fast , venous blood samples were collected for assessment of several biomarkers , and an oral glucose tolerance test ( ogtt ) was performed .
after centrifugation at 3,000 rpm for 15 min , serum aliquots were stored at 20c , and plasma ( edta ) aliquots were stored at 80c until use .
ferritin , transferrin , total iron , and unsaturated iron - binding capacity ( uibc ) were determined in serum on a... | objectiveadipocyte insulin resistance ( ir ) is a key feature early in the pathogenesis of type 2 diabetes mellitus ( t2 dm ) , and although scarce , data in the literature suggest a direct role for iron and iron metabolism related factors in adipose tissue function and metabolism .
serum ferritin and transferrin were shown to be associated with muscle insulin resistance ( ir ) and t2 dm , but little is known about the role of iron metabolism on adipose tissue .
we therefore investigated whether markers of iron metabolism were associated with adipocyte ir and plasma adiponectin.research design and methodsserum ferritin , transferrin , total iron , non transferrin - bound iron ( ntbi ) , transferrin saturation , and plasma adiponectin were determined in 492 individuals .
adipocyte ir was defined by the product of fasting insulin and nonesterified fatty acids ( nefas ) . using linear regression analyses
, we investigated the difference in adipocyte ir or adiponectin ( in % ) according to differences in iron metabolism markers.resultsserum ferritin ( = 1.00% increase in adipocyte ir per 10
g / l [ 95% ci 0.661.34 ] ) , transferrin ( 4.18% per 0.1 g / l [ 2.885.50 ] ) , total iron ( 1.36% per mol
/ l [ 0.612.12 ] ) , and ntbi ( 5.14% per mol / l [ 1.888.52 ] ) were associated with adipocyte ir after adjustment for several covariates , including inflammatory markers .
all markers of iron metabolism were also associated with nefas ( all p < 0.01 ) .
in addition , ferritin and transferrin were inversely associated with adiponectin ( both p < 0.01).conclusionsthe observed associations of several markers of iron metabolism with adipocyte ir and adiponectin suggest that factors related to iron and iron metabolism may contribute to adipocyte ir early in the pathogenesis of t2 dm . |
5,994 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: structural studies were carried out using an engineered hkor construct ( see methods and supplementary fig . 1 ) and crystallized in cholesterol - doped monoolein lipidic cubic mesophase ( see methods ) .
the construct used displayed pharmacological behavior similar to that of a native receptor expressed in hek 293-t cells ( supplementary tables 2 and 3 ) . data collection and refinement statistics are shown in supplementary table 1 .
the structure of hkor - jdtic was determined at 2.9 in the p 212121 space group .
the asymmetric unit ( asu ) consists of a two receptors forming a parallel dimer ( fig .
the dimer interface with ~1100 buried surface area is formed through contacts between helices i , ii and viii ( fig .
parallel receptor dimers have been identified in crystal structures of activated rhodopsin ( involving helices i , ii and viii ) , 2 adrenergic receptor ( 2ar ; cholesterol mediated ) and cxcr4 ( involving helices iv , v and vi ) .
consistent with these crystallographic data , recent biochemical studies have suggested the existence of two dimerization interfaces : along helices iv and v - sensitive to receptor activation , and along helix i insensitive to the state of activation .
while the orientations of the two t4-lysozyme ( t4l ) copies in the receptor monomers in one asu differ by ~ 60 rotation , both copies of the receptor are highly similar ( fig .
the remaining residues of the n- and c - termini in the hkor / jdtic structure are disordered as in other class a gpcrs .
the main fold of the hkor consists of a canonical 7tm bundle of helices followed by an intracellular helix viii that runs parallel to the membrane .
structural comparison with other gpcrs suggests that hkor has striking similarities in the ecl region with cxcr4 , another peptide binding receptor in the subfamily . in the 7tm region , however , the hkor structure is closer to aminergic receptors belonging to the subfamily ( rmsdc ~2.3 for 2ar , ~1.9 for dopamine d3 receptor ( d3r ) , and ~2.7 for cxcr4 ) .
the... | opioid receptors ( ors ) mediate the actions of endogenous and exogenous opioids for many essential physiological processes including regulation of pain , respiratory drive , mood , and , in the case of -opioid receptors ( kor ) , dysphoria and psychotomimesis . here
we report the crystal structure of the human kor ( hkor ) in complex with the selective antagonist jdtic , arranged in parallel - dimers , at 2.9 angstrom resolution .
the structure reveals important features of the ligand binding pocket that contribute to jdtic s high affinity and subtype - selectivity for hkor .
modeling of other important kor - selective ligands , including the morphinan - derived antagonists nor - bni and gnti , and the diterpene agonist salvinorin a analog rb-64 , reveals both common and distinct features for binding these diverse chemotypes .
analysis of site - directed mutagenesis and ligand structure - activity relationships confirms the interactions observed in the crystal structure , thereby providing a molecular explanation for hkor subtype - selectivity along with insight essential for the design of hkor compounds with new pharmacological properties . |
5,995 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: procyanidins are the second most abundant natural phenolic after lignin , and they are widely distributed in fruits , berries , beans , nuts , cocoa , and wine .
they participate in glucose homeostasis and modulate insulin synthesis , secretion , and degradation .
moreover , changes in -cell insulin production may also be due to variations in the number of insulin - producing cells .
-cell mass adapts to increased metabolic demands caused , for example , by obesity , pregnancy , or insulin resistance .
however , when -cells are unable to compensate for increased insulin demand , there is a decrease in -cell mass characteristic of the onset of type 2 diabetes mellitus ( t2 dm ) .
moreover , they protect cells from diverse drug- or chemical - induced toxic assaults by decreasing apoptosis and inducing cell growth . however , there is little information available regarding their effects on -cells
. other studies by our research group have reported that procyanidins modulate proliferation and apoptosis of the pancreatic -cell line ins-1e under altered conditions .
procyanidins also alter the protein and/or gene expression of factors involved in apoptosis in zucker fatty rats .
obesity has become a worldwide problem , leading to an explosion of obesity - related health issues .
obese individuals develop resistance to the cellular actions of insulin , a key etiological factor for t2 dm , which is also becoming an epidemic .
t2 dm is characterised by peripheral insulin resistance as well as pancreatic -cell dysfunction and decreased -cell mass .
these lifestyle changes , involving high - energy diets and reduced physical activity , are linked to the pandemics of obesity and t2 dm . given the high prevalence of the disease , obtaining knowledge about natural compounds with potential beneficial effects on glucose homeostasis is of great interest .
several animal models have been used to study obesity , including both genetic and diet - induced obesity models . however , the cafeteria diet is a more robust model to... | in a previous study , the administration of a grape seed procyanidin extract ( gspe ) in female wistar rats improved insulin resistance , reduced insulin production , and modulated apoptosis biomarkers in the pancreas . considering that pharmacokinetic and pharmacodynamic parameters in females are different from these parameters in males , the aim of the present study was to evaluate the effects of gspe on male wistar cafeteria - induced obese rats .
the results have confirmed that the cafeteria model is a robust model mimicking a prediabetic state , as these rats display insulin resistance , increased insulin synthesis and secretion , and increased apoptosis in the pancreas .
in addition , gspe treatment ( 25 mg / kg of gspe for 21 days ) in male rats improves insulin resistance and counteracts the cafeteria - induced effects on insulin synthesis .
however , the administration of the extract enhances the cafeteria - induced increase in bax protein levels , suggesting increased apoptosis .
this result contradicts previous results from cafeteria - fed female rats , in which gspe seemed to counteract the increased apoptosis induced by the cafeteria diet . |
5,996 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: primary nasopharyngeal adenocarcinomas ( npacs ) are extremely rare malignant tumors accounting for 0.38% to 0.48% of all malignant nasopharyngeal neoplasms and 0.70% of all nasopharyngeal carcinomas .
these properties mean that the treatment of choice for these tumours is total surgical resection of the primary tumor , and this has an excellent prognosis .
traditionally , because of the anatomic complexity of the nasopharynx , resection of nasopharyngeal tumors has used an external approach . however , here we suggest that an alternative exclusively endoscopic surgical strategy should be considered .
this is because this tumor type is pedunculated , histologically relatively non - aggressive and , further , we have now refined our existing published endoscopic technique and successfully used it to resect different types of tumour [ 2 - 9 ] .
here we describe our exclusively endoscopic approach for the resection of primary nasopharyngeal adenocarcinoma . to the best of our knowledge ,
this is the first time to excise the nasopharyngeal adenocarcinoma via the strictly endoscopic approach .
the first case is a 28-year - old female with the symptoms of nasal bleeding for about 3 weeks .
was noted by nasopharyngoscopic exam and biopsy with magnetic resonance imaging ( mri ) was performed .
mri showed an approximate 1.5 cm pedunculated nodule attaching on the left lateral wall ( fig .
1 ) . the second case is a 58-year - old male with the symptoms of blood tinged sputum for about 1 month .
mri showed an approximate 2.2 cm pedunculated nodule occupying the nasopharyngeal airway , from the nasopharyngeal roof .
the pathologic biopsy report of both patients showed low - grade papillary adenocarcinoma composed of papillary fronds lined by pseudostratified columnar cells with bland unclei . according to the preoperative pathologic biopsy
the operations were performed under general anesthesia with our patient placed in a semi - sitting position .
prior to surgery , the nasal turbinates were decongested using cotton... | we reported two patients with nasopharyngeal adenocarcinoma resected by using the exclusively endoscopic approach .
case reports and a review of the world literature concerning nasopharyngeal adenocarcinoma .
the tumors were resected successfully via the exclusively endoscopic approach and no conversions to the conventional approach were necessary .
the two patients were followed up for 26 and 18 months respectively , and no recurrence was noted without postoperative chemotherapy or radiotherapy . to the best of our knowledge ,
this is the first report of endoscopic resection of nasopharyngeal adenocarcinoma .
our experience revealed that not only for the early recurrent nasopharyngeal carcinoma , the exclusively endoscopic nasopharyngectomy can be expanded for the resection of selected nasopharyngeal adenocarcinoma . |
5,997 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it has long been accepted that bipolar disorder has its peak onset in late adolescence to young adulthood .
however , biederman and colleagues ( wozniak et al . , 1995 ) proposed that most cases of bipolar disorder have a preschool age onset and that irritability , not elevated mood , is the core feature .
affective storms or prolonged and aggressive temper outbursts and with chronic and continuous rather than episodic and acute clinical course ( biederman et al . , 1996 ,
in the same year , geller and colleagues ( 1995 ) , in another departure from traditional concepts of manic depressive illness , proposed that most cases of bipolar disorder in children still exhibited elevated mood but also featured ultradian mood cycles several cycles of mania and depression per day .
geller and luby ( 1997 ) , in a review article in the journal of the american academy of child and adolescent psychiatry ( jaacap ) , stated , pre - pubertal onset manic depressive disorder may present with continuous , mixed manic , rapid - cycling of multiple brief episodes .
thus , children may be having a laughing fit and happily doing arts and craft when , without any environmental prompt , they suddenly become miserable and acutely suicidal
( p. 1172 ) over the next decade these pediatric bipolar disorder ( pbd ) constructs gained acceptance in the united states .
another review article in jaacap ( pavuluri , birmaher , & naylor , 2005 ) noted that the national institute for mental health roundtable on pre - pubertal pbd , convened in april 2000 , had termed the chronic irritable mood group broad phenotype pbd and the elevated mood group narrow phenotype pbd . when jaacap published
( kowatch et al . , 2005 ) , a commentary ( mcclellan , 2005 ) raised doubts about the diagnostic validity of pbd , but skeptical articles in the literature were few .
biederman ( 2006 ) , although acknowledging the debate over the validity of pbd , asserted that the literature supported the diagnosis and that up to 20% of psychiatrically referred... | objectivepediatric bipolar disorder ( pbd ) reflects shifts in conceptualizing bipolar disorder among children and adolescents since the mid-1990s .
since then , pbd diagnoses , predominantly in the united states , have increased dramatically , and the diagnosis has attracted significant controversy . during the same period ,
psychiatric theory and practice has become increasingly biological .
the aim of this paper is to examine the rise of pbd in terms of wider systemic influences.methodin the context of literature referring to paradigm shifts in psychiatry , we reviewed the psychiatric literature , media cases , and information made available by investigative committees and journalists.resultssocial historians and prominent psychiatrists describe a paradigm shift in psychiatry over recent decades : from an era of brainless psychiatry , when an emphasis on psychodynamic and family factors predominated to the exclusion of biological factors , to a current era of mindless psychiatry that emphasizes neurobiological explanations for emotional and behavioral problems with limited regard for contextual meaning .
associated with this has been a tendency within psychiatry and society to neglect trauma and attachment insecurity as etiological factors ; the atheoretical ( but by default biomedical ) premise of the diagnostic and statistical manual of mental disorders ( 3rd and 4th eds . )
; the influence of the pharmaceutical industry in research , continuing medical education , and direct - to - consumer advertising ; and inequality in the u.s . health system that favors diagnostic upcoding .
harm from overmedicating children is now a cause of public concern.conclusionit can be argued that pbd as a widespread diagnosis , particularly in the united states , reflects multiple factors associated with a paradigm shift within psychiatry rather than recognition of a previously overlooked common disorder . |
5,998 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: both prospective and retrospective studies have shown that hemiplegic stroke patients are
at a high risk of fall throughout their post - stroke lifespan1 .
although previous studies have reported varying fall rates among
hemiplegic stroke patients , there is a general consensus regarding the higher fall rate in
stroke patients compared to the general population of the same age2 , 3 .
falls are a common
and serious complication after stroke4 ,
and approximately one - third of hospital - related falls lead to potentially serious injuries ,
such as a fracture5 . given that falls in
stroke patients
are associated with lower rehabilitation potential and functional
recovery6 , prevention of falls is a
major rehabilitation goal . although the physical consequences of a fall receive the most attention , the psychosocial
effects are also important .
one of these psychosocial effects is the fear of falling .
falling and fear of falling form a vicious circle . the experience of falling increases the
fear of falling , and the fear of falling decreases physical activity , resulting in
deconditioning .
deconditioning leads to decreased physical activity , resulting in lower
functioning that increases the incidence of falls in stroke patients7,8,9 .
the negative effect that the fear of falling has on rehabilitation
emphasizes the need for physical therapists to be aware of this fear in hemiplegic stroke
patients .
assessment is the first step in developing a targeted rehabilitation intervention . choosing
an appropriate tool that measures the fear of falling is the foundation for planning an
appropriate course of therapy for post - stroke intervention and assessing the effects of an
intervention10 . despite a shift that
places emphasis on task - oriented evaluation and self - efficacy in rehabilitation assessment
and management of chronic disease11 , use
of a self - reported scale is insufficient in most environmental contexts .
the falls efficacy
scale ( fes ) developed by... | [ purpose ] the purpose of this study was to investigate the psychometric properties of the
falls efficacy scale using rasch analysis in patients with hemiplegic stroke .
[ subjects ]
fifty - five community - dwelling hemiplegic stroke patients were selected as participants .
[ methods ] data were analyzed using the winsteps program ( version 3.62 ) with the rasch
model to confirm the unidimensionality through item fit , reliability , and appropriateness
of the rating scale .
[ results ] there were no misfit persons or items .
furthermore , infit
and outfit statistics appeared adjacent .
the person separation value was 3.07 , and the
reliability coefficient was 0.90 .
the reliability of all items was at an acceptable level
for patients with hemiplegic stroke .
[ conclusion ] this was the first study to investigate
the psychometric properties of the falls efficacy scale using rasch analysis .
the results
of this study suggest that the 6-point falls efficacy scale is an appropriate tool for
measuring the self - perceived fear of falling in patients with hemiplegic stroke . |
5,999 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: although the vocalizations of most animal
species constitute their innate behavior , some animal groups , such as mammals ( humans ,
cetaceans , bats , elephants , and pinnipeds ) and birds ( oscine songbirds , parrots , and
hummingbirds ) develop a complex vocal pattern through vocal learning [ 23 , 24 ] . the songbird is an
attractive animal model for understanding the mechanisms underlying vocal learning because
non - human primates and rodents have a limited ability to modify their vocalization .
there are approximately 3,500 songbird species all
over the world , and their birdsong shows a readily quantifiable species - specific variation ,
ideal to investigate the developmental changes of acoustic and sequential song structure
( fig .
the zebra finch is known as a closed - ended learner ,
meaning that once a stable species - specific song pattern motif is developed , the
song structure remains unchanged throughout life [ 8 , 22 , 74 ] .
this stereotypy of crystallized song enables precise
quantification of the similarities and differences in vocal development and song
patterns between experiments , allowing for examination of genetic and epigenetic
factors that contribute to the acquisition and maintenance of complex vocal patterns .
( b , c ) examples of adult song patterns of two bengalese finches ( b ) and two java
sparrows ( c ) . )
. some species of birds such as the zebra finch and canary are easily bred under
laboratory conditions .
these features mean that
studies of songbirds can provide excellent insights into the evolution , function ,
development , and mechanisms of vocal learning .
here we review vocal learning in songbirds ,
with particular focus on auditory input as a developmental epigenetic factor of vocal
development .
first , we highlight the parallels between human speech and birdsong and
introduce the neural mechanisms involved in vocal production and learning .
we then provide
an overview of the contribution of auditory input during... | like humans , songbirds are one of the few animal groups that learn vocalization .
vocal
learning requires coordination of auditory input and vocal output using auditory feedback
to guide one s own vocalizations during a specific developmental stage known as the
critical period .
songbirds are good animal models for understand the neural basis of vocal
learning , a complex form of imitation , because they have many parallels to humans with
regard to the features of vocal behavior and neural circuits dedicated to vocal learning .
in this review
, we will summarize the behavioral , neural , and genetic traits of birdsong .
we will also discuss how studies of birdsong can help us understand how the development of
neural circuits for vocal learning and production is driven by sensory input ( auditory
information ) and motor output ( vocalization ) . |
6,000 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: activation of the sympathetic nervous system exerts a number of physiological responses either directly through stimulation of postganglionic sympathetic nerves localised in target organs or indirectly through the activation of powerful humoral systems .
while the importance of sympathetic tone is readily acknowledged for cardiovascular and blood pressure regulation it is less well appreciated that activation of the sympathetic nervous system forms an integral part of energy homeostasis and can exert profound metabolic effects .
insufficient physical activity and excess energy intake , coupled with genetic programming , have been attributed to the rising incidence of obesity , hypertension , dyslipidemia , insulin resistance , and hyperglycemia in western societies .
more importantly , the clustering of these metabolic conditions , referred to as the metabolic syndrome ( mets ) , has become increasingly more common with one - quarter of all adults predicted to have mets . given the augmented risk for type 2 diabetes , cardiovascular disease , and premature mortality associated with the mets [ 24 ] there is growing interest in understanding the complex pathways underlying the metabolic derangements seen in the condition . accumulating data from animal and human studies suggest that central sympathetic activity plays a pivotal role in the aetiology and complications of mets and its associated conditions .
this is evidenced by a distinct preponderance for patients with the mets to exhibit clinical signs of chronic sympathoexcitation such as elevated urinary noradrenaline levels , increased efferent muscle sympathetic nerve activity , and elevated rates of plasma noradrenaline spillover , even in the absence of hypertension [ 59 ] .
interestingly , recent evidence indicates that the benefits derived from diet and exercise induced weight loss are in part mediated by a reduction in sympathetic nerve activity .
latest findings from clinical studies suggest pharmacological and device - based therapies ( i.e. ,... | sympathetic tone is
well recognised as being implicit in
cardiovascular control .
it is less readily
acknowledged that activation of the sympathetic
nervous system is integral in energy homeostasis
and can exert profound metabolic effects .
accumulating data from animal and human studies
suggest that central sympathetic overactivity
plays a pivotal role in the aetiology and
complications of several metabolic conditions
that can cluster to form the metabolic syndrome
( mets ) . given the known augmented risk for type
2 diabetes , cardiovascular disease , and premature
mortality associated with the mets understanding
the complex pathways underlying the metabolic
derangements involved has become a priority .
many factors have been proposed to contribute to
increased sympathetic nerve activity in
metabolic abnormalities including obesity ,
impaired baroreflex sensitivity ,
hyperinsulinemia , and elevated adipokine levels .
furthermore there is mounting evidence to
suggest that chronic sympathetic overactivity can
potentiate two of the key metabolic alterations
of the mets , central obesity and insulin
resistance .
this review will discuss the
regulatory role of the sympathetic nervous
system in metabolic control and the proposed
pathophysiology linking sympathetic overactivity
to metabolic abnormalities .
pharmacological and
device - based approaches that target central
sympathetic drive will also be discussed as
possible therapeutic options to improve
metabolic control in at - risk patient
cohorts . |
6,001 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: it is well known that free radicals , including reactive oxygen species ( ros ) such as superoxide ( o2 ) or hydroxyl radical ( ho ) , contribute to the development of several diseases by causing oxidative stress .
oxidative stress induced by ros occurs when the production of ros exceeds the capacity of the cell to detoxify these potentially injurious oxidants using endogenous antioxidant defense systems ; however , where an excessive amount of ros is produced or defense mechanisms are impaired , oxidative stress leading to events such as lipid peroxidation may occur .
one well - accepted example for the mechanism of ros - induced vascular disease , such as hypertension , is that oxidative stress caused by excess o2 scavenging endothelial nitric oxide ( no ; a vascular smooth muscle relaxant ) could contribute to increased vascular smooth muscle contraction and hence elevated total peripheral resistance .
these phenomena would also appear to be important in contributing to several pathological conditions in the central nervous system ( cns ) , including stroke .
therefore , ros - induced oxidative stress has been implicated as a potential contributor to the pathogenesis of the ischemia - reperfusion cns injury characteristic of hypertension and stroke .
electron spin resonance ( esr ) has been recognized as one of the most powerful techniques for the detection of ros in the form of free radicals , in biological tissues and cells .
it has been developed an esr - based technique to determine the effects of reactions induced by ros in biological systems in vitro and in vivo with an emphasis on a rodent disease model .
regarding in vitro esr applications , spin trapping technique is well known as esr spin adduct to detect ros , quantifying spin concentration in experimental systems .
otherwise , for in vivo esr applications , nitroxyl radicals are very useful as exogenous spin probes to measure free radical distribution , oxygen concentration , and redox metabolism in biological systems .
it has been suggested... | the pathophysiology of hypertension or stroke is associated with an excess of ros generation in the vascular system , and results in induction of various pathological cascades of cerebrovascular damage .
we have demonstrated that electron spin resonance methods using a spin trap or spin probe will be useful for understanding redox status under conditions of oxidative stress in the spontaneously hypertensive rat or stroke - prone spontaneously hypertensive rat brain .
we have used electron spin resonance imaging and noninvasive l - band electron spin resonance to characterize the higher degree of brain oxidative stress in the stroke - prone spontaneously hypertensive rat and spontaneously hypertensive rat than in the wistar - kyoto rat brain , and the lower extent of oxidative stress in the spontaneously hypertensive rat than in the stroke - prone spontaneously hypertensive rat brain .
indeed , we may be able to confirm propofol medium - chain triglyceride / long - chain triglyceride ( mct / lct ) as neuroprotective anesthesia and crocetin as antioxidant food factor against human stroke after screening for antioxidant properties in stroke models such as stroke - prone spontaneously hypertensive rat .
thus , our electron spin resonance biomedical application suggests that it could be used to assess antioxidant effects on oxidative stress in the brain using spontaneously hypertensive rat and stroke - prone spontaneously hypertensive rat .
we hope that further advances in the instrumentation used for electron spin resonance imaging and the development of optimized nontoxic spin probes will make this technology even more promising for novel clinical prediction or noninvasive diagnosis of human stroke . after screening drugs or foods for antioxidant property using in vitro or in vivo electron spin resonance assessment
, it will be possible to find and develop novel drugs or food factors with such properties for the prevention of stroke in the near future . |
6,002 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: percutaneous cardiopulmonary support ( pcps ) provides hemodynamic support via the femoral artery and vein , using a closed artificial heart - lung system which is usually composed of a centrifugal pump and a membranous artificial lung.1)2 ) in terms of cardiac failure , the most common indications for pcps are post - cardiotomy ( in which cardiopulmonary bypass can not be taken off the patient following cardiac surgery ) , post - heart transplant ( usually due to primary graft failure ) and severe cardiac failure due to almost any other cause ( eg . , decompensated cardiomyopathy , myocarditis , acute coronary syndrome with cardiogenic shock , profound cardiac depression due to drug overdose or sepsis ) . in terms of respiratory failure ,
the most common indications include adult respiratory distress syndrome , pneumonia , trauma , and primary graft failure following lung transplantation.2 - 4 ) in particular , pcps has proven to be a technique of value in high - risk coronary patients who undergo percutaneous coronary intervention ( pci).5 - 9 ) however , there have been few studies on pcps - supported pci in korea .
we combined the use of pcps and coronary stent revascularization in 19 patients between august 2005 and june 2009 , at the yonsei cardiovascular center .
pcps was used as an elective procedure in 10 patients who satisfied at least two of the selection criteria : left ventricular ejection fraction ( lvef ) < 35% , target vessel(s ) supplying more than 50% of the viable myocardium , high risk surgical patients { old age , impending end stage of renal disease , chronic obstructive pulmonary disease , a history of coronary artery bypass graft surgery ( cabg ) } , and patients who refused cabg surgery . in the remaining 9 patients ,
pcps was used as an emergency procedure to stabilize and even resuscitate patients with acute myocardial infarction ( ami ) and cardiogenic shock , in order to attempt urgent pci .
we compared the clinical characteristics , pcps and angiographic findings , and clinical... | background and objectivespercutaneous cardiopulmonary support ( pcps ) has proven to be a valuable technique in high - risk coronary patients undergoing percutaneous coronary intervention ( pci ) . however , there have been few studies on pci associated with pcps in korea .
we summarized our experience with pcps - supported pci.subjects and methodswe retrospectively reviewed 19 patients with pcps - supported pci between august 2005 and june 2009 .
pcps was used as an elective procedure for 10 patients with at least two of the following conditions : left - ventricular ejection fraction < 35% , target vessel(s ) supplying more than 50% of the viable myocardium , high risk surgical patients , and patients who refused coronary bypass surgery . in the remaining 9 patients pcps
was used as an emergency procedure , to stabilize and even resuscitate patients with acute myocardial infarction and cardiogenic shock , in order to attempt urgent pci.resultsamong the 19 patients who were treated with pcps - supported pci , 11 ( 57.9% ) survived and 8 ( 42.1% ) patients did not .
st elevation myocardial infarction with cardiogenic shock was more prevalent in the non - survivors than in the survivors ( 75% vs. 27.3% , p=0.04 ) .
the elective pcps - supported pci was practiced more frequently in the survivors than in the non - survivors ( 72.7% vs. 25% , p=0.04 ) . in the analysis of the event - free survival curve between elective and emergency procedures , there was a significant difference in the survival rate ( p=0.025 ) . among the survivors
there were more patients with multi - vessel disease , but a lower thrombolysis in myocardial infarction grade in the culprit lesions was detected in the non - survivors , before pci .
although we studied high - risk patients , there was no procedure - related mortality.conclusionour experience suggests that pcps may be helpful in high risk patients treated with pci , especially in elective cases .
more aggressive and larger scale studies of pcps should follow . |
6,003 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: streptococcus minor was described in 2004 as a new species isolated from the tonsils of dogs , cats and cattle as well as from the intestinal tract of dogs .
although staphylococci and streptococci are commonly involved genera in bite - infected wounds , no cases of human infection by s. minor have been reported in the literature . here
a 51-year - old woman was admitted for a dog bite injury to her right hand .
the patient s medical history revealed a urinary bladder cancer 3 years ago , currently in remission .
she presented with inflammation , redness , heat and pus production at the bite wounds ( fig . 1 ) .
clinically , the patient was afebrile ( temperature 36.6c ) , and no signs of systemic infection were observed .
biologic investigations revealed an inflammatory syndrome with a c - reactive protein value of 46 mg / l ( normal value , < 5 mg / l ) associated with a light leukocytosis of 10.880 cells/l ( normal range , 4 to 10 10 cells/l ) .
urgent surgery was proposed but was refused by the patient despite warnings of the risk of sepsis and necrosis .
the wounds were washed with povidone iodine , and intravenous empiric antibiotic therapy was initiated ( cefazolin 2 g / d ) .
one set of peripheral blood cultures ( including aerobic and anaerobic conditions ) was performed , and no growth was observed after 5 days of incubation .
aerobic culture from pus wounds after 48 hours on columbia agar ( becton dickinson , franklin lakes , nj , usa ) yielded a pure growth of unpigmented , regular , translucent and -hemolytic colonies of gram - positive streptococcus .
identification as streptococcus minor was achieved using matrix - assisted laser desorption / ionization time - of - flight mass spectrometry ( maldi - tof ms ; bruker daltonics , bremen , germany ) , with an excellent score of 2.428 .
sequencing of 16s rrna gene ( 96ga3730 xl ; thermo fisher scientific life sciences , waltham , ma , usa ) confirmed the identification of s. minor with 100% of identity and demonstrated the usefulness of... | we report the first case of human infection caused by streptococcus minor in a 51-year - old immunocompetent woman admitted for dog bite injuries . at present , the role of streptococcus minor in bite wound infections is unknown .
further studies on virulence factors are needed to elucidate its pathogenicity mechanisms . |
6,004 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: overabundant food intake with chronic positive energy balance leads to obesity and type 2 diabetes , whilst reduction in food intake , by increasing insulin sensitivity and improving glucose homeostasis , is currently recommended in the treatment of these metabolic disorders [ 14 ] .
such a caloric restriction may include a relative decrease of food intake [ 57 ] or otherwise either a total short [ 8 , 9 ] or prolonged fasting .
intermittent overnight fasting , inspired by the daily fasting period during the ramadan , was recently reported to prevent the progressive deterioration of glucose tolerance otherwise taking place in sand rats exposed to a hypercaloric diet [ 1113 ] .
the major aim of the present study was to investigate whether a comparable benefit of intermittent fasting may prevail in streptozotocin - induced diabetic rats .
eight to 10 weeks after birth , female wistar rats ( charles river , wilmington , ma , usa ) were injected intraperitoneally , after overnight starvation , with streptozotocin ( stz , 65 mg / kg body wt . ) freshly dissolved in a citrate buffer ( 50 mm , ph 4.5 ) .
these rats were given access during the night after the injection of streptozotocin to a solution of saccharose ( 10 g/100 ml ) to prevent possible hypoglycemia .
five days after the injection of streptozotocin , the glycemia was measured with the help of glucometer ( lifescan benelux , beerse , belgium ) in blood obtained from caudal vein .
only those rats displaying a glycemia in excess of 16.7 mm were kept for further investigations . in order to compare the effects of an intermittent fasting , mimicking the ramadan fasting , to that of a caloric restriction ,
twenty days after the injection of either streptozotocin ( stz rats ) or the citrate buffer vehicle ( control rats ) , the rats were either given free access to food throughout the experimental period ( nf : nonfasting rats ) , deprived of food and water from 5 p.m. to 8 a.m. ( if : intermittently fasting rats ) or given access from 5 p.m. onwards to... | this study investigates the effects of intermittent overnight fasting in streptozotocin - induced diabetic rats ( stz rats ) . over 30 days
, groups of 5 - 6 control or stz rats were allowed free food access , starved overnight , or exposed to a restricted food supply comparable to that ingested by the intermittently fasting animals .
intermittent fasting improved glucose tolerance , increased plasma insulin , and lowered homeostatis model assessment index .
caloric restriction failed to cause such beneficial effects .
the -cell mass , as well as individual -cell and islet area , was higher in intermittently fasting than in nonfasting stz rats , whilst the percentage of apoptotic -cells appeared lower in the former than latter stz rats . in the calorie - restricted stz rats ,
comparable findings were restricted to individual islet area and percentage of apoptotic cells .
hence , it is proposed that intermittent fasting could represent a possible approach to prevent or minimize disturbances of glucose homeostasis in human subjects . |
6,005 | Assuming you're helping a researcher in a hurry, could you summarize the essence of this research for them?
Study: myiasis is a term derived from the greek word myia , meaning invasion of vital tissue of humans or other mammals by fly larvae.[15 ] the term myiasis
hope in 1940 , and since then , it has been used to designate infestation by the larvae.[68 ] myiasis was defined by zumpt as the infestation of live human and vertebrate animals by dipterous larva , which at least for a certain period feed on host 's dead or living tissue , liquid body substances or ingested food .
a condition similar to myiasis was considered by the hindu mythology as god 's punishment to sinners .
a 22-year - old male patient reported to the outpatient department of oral medicine with a primary complaint of worms in the mouth since 4 days .
the medical history revealed that the patient was affected by cerebral palsy since birth [ figure 1 ] .
clinical oral examination revealed an area of ulceration in the anterior palatal aspect of the mouth , accompanied by erythema , redness and bleeding on probing [ figure 2 ] .
external profile of the patient intraoral photograph showing palatal swelling a total of 20 larvae were grasped gently and taken out with the help of tweezers after application of turpentine oil . out of these , only three were viable .
these were then taken to department of parasitology where they were identified as larvae of the common housefly .
histopathological examination of the incisional biopsy specimen revealed dense inflammatory infiltrate comprising chiefly lymphocytes in the connective tissue stroma .
this parasitic infestation frequently occurs in rural areas , infecting livestock and pets such as dogs and cats .
after the fly lays eggs in the dead and decaying tissues , the larvae hatch in about 810 hours , soon after which they burrow into the surrounding tissues ; and in this stage , there will be tissue inflammation ensuing discomfort , which makes the patient consult a doctor .
the opening of the burrow is usually kept patent with induration of the marginal tissues , and is raised forming a dome - shaped ... | myiasis is a relatively rare condition arising from the invasion of body tissues or cavities of living animals or humans by maggots or larvae of certain species of flies .
it is an uncommon clinical condition , being more frequent in underdeveloped countries and hot climate regions , and is associated with poor hygiene , suppurative oral lesions ; alcoholism and senility .
its diagnosis is made basically by the presence of larvae .
the present article reports a case of oral myiasis involving 20 larvae in a patient with neurological deficiency . |
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